dosing help for Oliver

[Melody I.]

Hello, Oliver was diagnosed with diabetes the day before Thanksgiving. He had a BG of 386. The vet told me to give him 3 units of glargine 2x day. I am using Basaglar and when I started home testing him I immediately dropped his dosage as the 3 units was taking him too low. Since then I have been adjusting his insulin for every shot but after discovering this site I see that probably isn't the correct thing to do. I've got about a month's worth of data in Oliver's spreadsheet and I'm not seeing any trends, which is probably due to constantly adjusting his dose. I'm off of work for a couple of days so will do more mid cycle testing. Would the recommendation at this point be to just start over with a lower dose and be consistent with that for a week before changing dosage? My vet doesn't seem to be FD knowledgeable and keeps wanting me to bring him in for all day testing, even though I'd doing the home testing. Any help or advice would be appreciated.

 

[Sienne and Gabby (GA)]

I think you are correct on all counts. The initial dose was way too high. The initial dose of glargine (Lantus or Basaglar) is based on weight (initial dose = 0.25 x ideal weight in kilograms) and usually calculates out to around 1.0u, give or take.

It sounds like you may be found your way over to the Lantus/Basaglar/Levemir forum. There is information on dosing methods there that will be helpful. And again, you are correct, with Lantus you need to hold the dose and base your dosing decision on the lowest number in the cycle, not on the pre-shot numbers. That also means you need to get at least one test, other than the AMPS and PMPS, during each cycle in order to know if Oliver is in safe numbers. It's important to get tests during the PM cycle since many cats experience lower numbers at night. In addition, if you don't test at night, you're missing half of your data.

I'd encourage you to copy your post above and open a thread on the Lantus board. I would not dose more than 1.0u at both AM and PM. Lantus likes consistency both in terms of dose and shot time. If you know Oliver's weight, we can calculate what the starting dose should have been.