getting started with lantus: dosing for a 200 bg

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beccalecca

beccalecca

Member Since 2011
I'm new here. Hi, all. Star was diagnosed with diabetes a month ago, 459 at the vet's. We switched her to a low carb diet, courtesy of reading on the forums here, immediately, and a week later got readings right around 200 (180-220 at various times of day). Our vet then did not prescribe insulin at all, saying she was close enough to normal, but we got some Lantus from a fellow board member on our own. Then Star stopped eating and we ended up at a new vet, who put Star on some antibiotics for a UTI (untreated for a month! thanks old vet for not telling us even though it was in the test YOU ran). Anyway, that's our story. And now I need dosing advice.

New vet tested Star at 395 yesterday and declared her infection gone. He instructed us to start with 2u twice daily. BUT, after pulling the last of her dry food yesterday and some failed home tests, we got her at 205 tonight. I know this means the vet's 2u twice daily will be too high. But what do you all suggest we try? I am a newbie. Star has not gotten ANY insulin yet. If we follow the typical "no shooting at 200 or lower" advice, she won't get any insulin. But I know that can't be right either. So, what advice do you all have?
 
Welcome to Lantus Land, Becca and Star. Great progress in stopping the dry food and bringing the numbers down some as well as identifying the UTI and treating it. We have some really experienced folks who can make suggestions for your dosing and I am going to give you a bump so one will come along.

Star is a lovely girl!!!! Let us know how we can help.
 
Hi Beccalecca!

What a great name! Welcome! I'm not a dosing expert but I pulled this from one of the stickies above under Tight Regulation Protocol. Stickies have a ton of info but are a great read.

You can calculate how much Lantus to shoot:
Using a weight based formula for determining a starting dose of Lantus or Levemir:
the formula is 0.25 unit per kg of the cat's ideal weight
if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
Click to expand...

Here is the onine calculator to convert kg to lbs

My vet told me 150 to 200 too. As I found out on this board, you can go even lower and my happy place (besides getting Junior off insulin) is between 50-100. But before you shoot that low, look for guidance on this board and read the stickies. And get a hypo kit ready.

Great that you got your SS set up! Once you plug in your SS, just open up one thread a day (what we call condos here) with the date, name of your kitty, AMPS/PMPS and the test result. AMPS is the morning preshot and PMPS is evening.

I hope I haven't overwhelmed you but this should be good to get you started. And ask tons of questions! I know I do!

Welcome to Lantus Land!
Bonnie
 
welcome, Becca and Star!

It looks on your spreadsheet like you only pulled up the dry food yesterday, is that correct? If that is true, then honestly I would probably wait until tomorrow to decide whether to shoot. Try feeding small, frequent meals of wet food tonight and see what happens. Get a couple of tests tonight if you can.

Most likely Star will need insulin, but if she brought herself down from 396 to 205 without insulin and just a diet change, then IMHO it is worth giving her another 12 hours to see what she does next. Then post in the morning for advice.

In the meantime, please read through the stickies in the Lantus group.
 
Welcome Becca!

As others mentioned, reading the starred, sticky notes at the top of the Board will get you started. In particular the New to the Group, Tight Regulation Protocol, and this post on making the most of your Lantus experience will help to get you oriented.

The formula that MauiGuppy (Bonnie) provided you will come up with a dose of approximately 1.0u for an average sized cat. Given that Star has cleared an infection and you have just completely eliminated dry food, you may want to start at a lower dose than 1.0u. (My guess is that the numbers at the vet's office are higher due to stress.) It's fine to start at 0.5 or 0.75u.

Do you have syringes that are in half unit increments? These syringes will make life much easier.
 
Thanks for the links. I'll definitely read those over.

To clarify, Star was diagnosed a month ago. We pulled dry food immediately, and by the time we got a monitoring kit a week later (3 weeks ago) she was hitting between 180-220 consistently. We only pulled dry food back out a week and a half ago hoping that it might entice her to eat again. When she finally did start eating again 4 days ago, it was the dry food she went for. So we didn't want to take it away too quickly, and only pulled it again last night. We will test again, though I kind of expect her to go back to the 180-220 we got before she was sick.

She is a long kitty, a healthy 14 pounds. That would put .25u per kg suggesting a 1.6u dose for Star.

We don't have half unit syringes yet. CVS doesn't carry them. Either DH or I will check around some other pharmacies tomorrow.
 
Most pharmacies don't carry the half unit syringes. Walmart may stock their Relion brand which does come in half units. Otherwise, you will have to order on-line. These are they syringes I use from Hocks. Some people have had some problems with their orders from Hocks. I've not had any problems. These are their house brand syringe. Monoject is also a popular brand that many people here use.
 
Tested her this morning after breakfast and got 204. I can't update my spreadsheet on this computer though, so that will have to wait until this afternoon.

Is the consensus somewhere between 0.5 and 1, then?
 
Welcome to Lantus Land! We wanted to stop by and introduce ourselves and tell you hello. Good luck with the dosing. We have some pretty experience people here who will help out.

Star is a beauty! Have a great day!
 
Welcome Becca and Star. Along with reading the stickies, remember PATIENCE is also necessary for the sugar dance. Lots of support and help available here. Ask questions and post often. Good luck on your sugar journey.
 
Thanks for the welcomes. Finally made it out to Wal-mart to get syringes. I think we will start with 0.5u just to see what it does. Star is still sitting just right around 200 without insulin. Probably start insulin tomorrow morning, so we can monitor during the day. After two nightmares last night for our 3-year old, I don't want to risk having to stay up monitoring Star tonight. I've got some sleep-catching-up if you know what I mean...
 
Hi Becca and Star-

Welcome! Glad you were able to get the syringes...that will make dosing much easier. And it sounds like starting tomorrow with .5U is a good, safe plan. Have a great day!!

Amy
 
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