How fast can I reduce lantus dosage?

[Robyn & Mika]

How fast can you reduce the insulin dosage? I have a 12 year old Siamese that was diagnosed on 7/20/11. My vet started him out at 3 units every 12 hours. Over the past month my vet has increased his dosage from 3 to 5 to 7, and now 8. I feel this is too aggressive and would like to follow the Rand protocol and drop him to a starting dose of 1.5 with home testing to get him regulated. Can I reduce his dosage from 8 to 1.5 overnight, or do I have to do it gradually? He has been on a low carb (fancy feast less than 6 percent) since the day after he was diagnosed. Lowest napir was 275 on 8 unit of Lantis. Thanks for the help.

 

[nancy and payne]

This would be a good question to take over to the Lantus support group, put need help with dosage in the subject line. It is farther down under the ISG. They are the experts in Lantus and are the best ones to guide you.

 

[Robyn & Mika]

Thanks Nancy!

 

[Sienne and Gabby (GA)]

Nancy/Payne posted on the Lantus board and asked that people stop by.

Are you home testing? If so, what kind of blood glucose numbers have you been seeing besides the nadir you noted? Or, what is your vet telling you about your cat's BG levels? Is there any relevant medical history -- like diabetic ketoacidosis?

We've certainly had people start over on their dosing regimen. I don't recall if anyone was on 8.0u BID, though. I've put out a note to a few people who have better/longer institutional memory than I do.

I'd suggest doing some additional reading about Lantus if you are planning on following the Rand protocol (which is what we use on the Lantus board). Below is an overview of the information in the starred sticky notes:

• Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
• New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
• Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
• Lantus depot/shed: This is an important concept for understanding how Lantus works.
• Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.