Having issues understanding the depot and dosing.

[Ashley & Harry]

Hi!

So, I've been giving Harry about 1.5u 2x a day. But because of how it's working in his system, I've ended up skipping some shots, so I tried reducing it to 1.25u instead... but it seems to be doing nothing. My understanding is that this is related to the depot, but I'm still having a hard time wrapping my head around it. Only been on Lantus for about two weeks, so bear with my cluelessness

He starts at 346. I give him 1.5. He drops down to 140, if not lower (didn't get his sugar right at nadir). He starts at 266, I give him 1.25, he drops down to 259 after five hours. I worry that if he starts at 266 and I give him 1.5, he'll go too low, but 1.25 seems to be doing nothing. So I'm having a hard time understanding how it works and how I should give him his doses.

So I have a few questions.

What number is safe to shoot 1.5 under? If he's at 266, should I still give him 1.5? What if he's only around 160?
How low can he go before I should start worrying? I've been stressing at about 90, but is he safe down by 50?

edit: do want to add that I'm going to be asking my vet the same questions later today, but I'm still waiting on a call back from him so I figured I'd post here too.

 

[Nan & Amber (GA)]

It's not just you, believe me. It takes a while to wrap your head around the action of the depot, plus there are other things going on (such as bouncing from low numbers). The thing is, bounces can last up to three days, and it can take almost that long for the depot to re-adjust after you change a dose. So, it's really hard to make sense of what is happening if you focus only on a single cycle after a shot-- that cycle may not be reacting to the shot you just gave, it's reacting to the depot from a previous shot, or to a bounce from a low two days ago, or breaking the bounce he's been in for two days, etc. etc.....

We generally recommend holding a particular dose for some number of cycles before changing (the two dosing procedures, TR and SLGS, give the basic rules for changing) in order to be certain you are really seeing what that dose can do. The other big rule to keep in mind is that Lantus is dosed based on the low point of a typical cycle-- not the pre-shot.

Normal cat BG numbers on a human meter range from 50-120, with occasional ventures slightly outside that range (depending on the cat). The "when to take some action" number depends on the situation-- early vs. late in the cycle, speed of the drop, etc.-- although the absolute "should definitely feed some high-carb now" number is 50 on a human meter. So for example, he might be in the 70's at hour 9 after the shot (+9), and we'd all be exchanging high-fives about how well he was doing, whereas if he dropped from 250 to 90 at +2, we'd be advising you to give him some (low-carb) food to try to slow him down a bit.

Hope this helps a little, and that the vet is helpful when you talk to him!

 

[Ashley & Harry]

The other big rule to keep in mind is that Lantus is dosed based on the low point of a typical cycle-- not the pre-shot.

Normal cat BG numbers on a human meter range from 50-120, with occasional ventures slightly outside that range (depending on the cat).

That helps a lot, thank you. I'm still in the Vetsulin mindset of basing it off his pre-shot to make sure it doesn't knock him down too low, cause the depot is kind of hard to go by when I'm not familiar with it. 1.5 seemed to be working best for him so far, so I think I'll keep him at that for now and I'll just check him every few hours for the next week or two to make sure he's in good numbers. Thank you for your help! You've been really supportive these past few days and I really appreciate it.