Hi. New member here 12/20/25. Questions about Lantus and dosing

D

DBSG & Lily

Member Since 2025
Hi. As the subject states. I’m new here so not sure how any of this works.
There’s lots of info to share about my kitty so not sure where to start. Please direct me and I will provide all the info. I need help with Lantus and how I’m dosing. Currently we are on 0.75 units the last few days, most times it works fine. This morning didn’t work at all. Last night didn’t work either , but that reason I know why.
I do have some more questions. But again, there’s quite a bit of info to provide.
 
All the Lantus info is here: Lantus / Levemir / Biosimilars

But stay here on Health for now since you're a newbie :) Can you give us more information about your cat? How was the diagnosis made and when? Symptoms? Any ketones? Are you testing blood glucose levels at home or not? What are you feeding your cat? What dose of Lantus did your cat start at and how long was he on that dose?
 
Hi. Thanks . I actually just read about all the threads on Lantus before I joined 😅. Full disclosure.. before I get into all the info. I’ve been a vet tech for abt 17yrs. I currently work in a 24hr ER hospital where I have IM drs I work with. They are only half helpful , which is why I’m here. It’s been abt 12 yrs since I’ve dealt with anything diabetic (and it’s never been my strong suit) I have since been a surgery tech and now I’m a radiation oncology tech that does anesthesia and delivers radiation. I have some knowledge but not much about insulins.

Lily has been diagnosed with steroid induced diabetes on 9/18/25. She gets her steroid EOD And her diabetes is quite mild.
She was started on 0.5u Lantus once a day. After a few days , 1 u once a day.. damn near made her hypo by morning so went to 0.5u BID. She eventually stopped needing insulin in the morning so we went back to SID. Which worked for her. Had some more hypo events went shooting under 300. So the plan was 0.25units <300 and 0.5 >300. I know that none of this is how Lantus works but this is what me and my IM VET worked out. She was extremely sensitive to insulin. Not only that, but her BG was actually dropping after she ate, not going up so she was making some of her own insulin.

FAst forward to couple weeks ago , she stopped responding to insulin. I suspected pancreatitis. I was right , I caught it quick and have been managing at home. She lost whatever insulin she was making and became more insulin dependent. Her insulin got bumped to 1 unit BID by a different IM VET bc her vet was out for a bit . I Feel like , even with pancreatitis , 1 unit is a lot for her and it terrifies me , especially since she’s doing better.
I bumped her down to 0.75units BID. most times it works, sometimes it doesn’t. Last night didn’t work bc it was steroid night. This morning didn’t work and not sure why. But it has been working just fine for her
With her steroid nights , I feel like she could benefit from 1 unit. I spoke with our medical director, who is also an IM vet. And he said it was fine to give her 1 unit on her steroid nights and 0.75 other times.
Can this work? I know this is not how it typically works but I don’t know what else to do otherwise she’s high all night on steroid nights. Not sure why her insulin didn’t even work this AM
I HAve a FSL 3+ on her to watch trends and I check her AM/PMPS with an AlphaTrak
IM SORRY, this is ALOT OF INFO
 
Not sure if you’d be able to see this. But Dec 4 is when she was at work with me and got diagnosed with pancreatitis. AM/PMPS are AlphaTrak numbers , numbers with * are also AT, rest of post shot numbers are FSL
IMG_0666.jpeg
 
Any chance you could link the spreadsheet document in your signature? More information here: New? How You Can Help Us Help You!

With the dosing methods we use here, and since Lily is eating high carb dry food, you would stay with this dose for 7 days before deciding if the dose needs to be change.
 
I’m a little worried about waiting 7 days if her numbers are going to stay high. Before she got diagnosed with pancreatitis , on the dose she was on .. it took only a few days for her to start showing symptoms to the point where I had to start checking her ketones everyday until I had my appointment. Her steroid nights spike her a lot more than her food does.
 
Has Lily shown ketones in the past? If so, that's important to add to the signature.

Lily hasn't been staying high all the time. I think she got down to 114 a few days ago? Sorry, finding that copy of the spreadsheet hard to read. I suspect Lily will not stay high on this dose, but rather is doing something we call bouncing.
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
Click to expand...
You want to try to avoid increasing when she is clearing the bounce. Meaning, time for patience.
 
She has not had a drop in blood sugar in over 24hours. Isn’t a bounce something that happens right away ? A few days ago. She got as low as 90 in her FSL after the 114. But never had a bounce from that
 
Or can a bounce happen either right away or over time?

The most she’s had with ketones is 2 on a meter with blood. Usually it reads low. She didn’t have any when she got diagnosed.
I will link her spreadsheet tomorrow.
 
Most cats will bounce shortly after a large drop or lower number than they are used to. But a few cats, like mine, will sometimes delay the start of a bounce. Bouncing doesn't mean solid high numbers, there can be some wobbling around in numbers.

It's good to show the lowest numbers on the spreadsheet, as we like to know how low the dose can take the cat. With dry food in the picture, you don't want them going any lower than 90 on a dose. You did say that was with the Libre. Have you done side by side comparisons between the Libre and the AT? Often the Libre reads lower in numbers under 100.
 
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