How long for Lantus to kick in? Max and Elise

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tiffmaxee

tiffmaxee

Member Since 2013
Max was on Lantus for a month and off for 3 weeks. We started it again Monday. I tested him at home for the first time today and +6 his BG on my Relion Micro was 270. Since he is only getting .25 I wonder if he is really getting it. Maybe it will take more time to kick in and I am doing right. I have practiced with food coloring but it's still questionable in my opinion.
 
Lantus has an onset of around +2.

The insulin depot takes several days, 3-5, to fill before you will start to see the true effects of this dose.

Patience little grasshopper.
 
You may have started at the wrong dose.

How much does he weigh?
How much should he weigh?
Take the lower number.
Convert it to kilograms (pounds divided by 2.2)
Multiply by 0.25.
Round down to the nearest quarter unit (which may need to be eyeballed as syringes don't measure that finely).
 
Max's BG came down too low before and we thought he was in remission. So any formula for figuring how much insulin to give him won't work. We are starting low so we don't take the chance of him going hypo. I think we probably stopped too soon like some of the lantus forum suggested. We just started Monday and today was the first time I tested. As someone else pointed out it can take 3-6 days.
 
I brought up the link spreadsheet and didn't see any numbers . Its ok to continue with the previous spreadsheet.

What was his dose before you stopped earlier? How low was too low?
 
Max started with one unit, then .75, and .5 before going off insulin for a month. When he was on .5 his BG was 70-130 at +6. Someone was kind enough to get my spreadsheet up for me. I need to plug in the few numbers I have when I get home to my computer. I have to go back and get all his numbers.
 
So today at +6 he was 230. He has been getting .25 since Monday BID. Does it sound like he will need more insulin?
 
If you've got 5 days on the dose, and a nadir over 150 mg/dL on a human glucometer, I would increase 0.25 units to 0.5 units BID.
 
I would worry that he might be dropping low at night. Hard to tell without an occasional night test or morning test. You are missing data to really know how well this dose is working.

Minimum its really important to get a test in the morning before the morning shot. You don't want to shoot when low and cause a hypo!!!

I usually recommend 3-4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.
 
Hi Wendy. I tested Max before his shot last night and he was 328. His Nadir after the morning shot was 214 so he is all over the place. I didn't get to test this morning because he decided to eat about an hour before his shot. I thought I wouldn't be home but will be able to test him today around +5. I think it will turn out that the insulin dose is too low based on the numbers I do have, the amount of urine and his pretty good appetite. I read somewhere here that I should pick up the food 2 hours before his shot. I free feed and forgot to do it.
 
I just tested Max 5 1/2 hours after his insulin. He was 175. I think the spreadsheet is working but if anyone looks please let me know. Thanks.

Elise and Max
 
Heres the thing. Not every cat nadirs at +6. They vary. My Tiggy does it at +10 generally. Plus there is a phenomenon called "bouncing" which happens if the cat drops too low or too fast. That means say he drops low at night like many cats do, then his body panics and causes the sugar to shoot up again. So by the time you measure at +6 (midday) you are seeing him high, EVEN THOUGH he was low at night.

Really you need to get more tests done if you can, if only for a few days to check he isn't bouncing. I am really suspicious he may be dropping low at night and then rising.
 
Max likes to eat at night. He generally eats around 7:00, 10:00 and then again during the night. He wakes me between 5:30-6:00 in the morning for food too. Wouldn't that keep his BG up rather than drop? Last night I tested before his shot and he was 328. So I will test before his shot at 8:00 and then in 3-4 hours. Do I need to pick up his food for 2 hours before that last test?

What is an active cycle? If that is happening what should I be doing?

Thanks.
 
You only need to pick the food up for two hours before his shot, not other times. The idea is that you want to know exactly what his number is like before you shoot and food will influence that number. Other times you can feed whenever.

An active cycle means the blood sugar can be expected to drop but not sure how low.

Really it's important to test before every shot to ensure you don't shoot if he is too low... Especially as the preshot number is the highest number of the day. Then it's important to get a test midcycle to see how low the insulin is taking him.


Wendy
 
Thanks, Wendy. I was busy and see that he just ate. He gets his shot in 1 1/2 hours. He is a grazer so it wasn't a lot, maybe 1/4 a can of fancy feast. Will that make much of a difference? The problem is Max usually eats around 7 at night. I'm often not home until 6:30-7. If I test him then and shoot at 8:00 is that close enough to the shot?
 
Spreadsheet setup and read only access is working! Good job on getting that set up and linked into your signature.
 
It depends on the cat, food can have a different impact on each cat and it may not have worn off in an hour. But if you have no choice then go ahead and shoot an hour from feeding. So in this case it's more important you get a +2 test to ensure he isn't dropping..
 
Are you still putting the Stella and Chewy on top of his food? Is that the dry stuff that comes in a purple pouch that you are supposed to add water to?
 
Yes but he just gets one piece of Stella's sprinkled on it. I contacted them and was told it is less than 3% carbs. I saw that the dog food has lots more stuff in it and has to be higher carbs. Why?
 
Dogs are omnivores and supposed to eat a variety of foods; cats are obliigate carnivores who need meat protein.
 
The dog version of the Stella's food has more stuff in it, because dogs need a different diet than cats do.
 
I know but is there any reason not to give the cat type as a topper to diabetic cats? I asked before and was told that it's low carb. I was asked if I'm still using it and wondered if I shouldn't be. Thanks.
 
It is OK to sprinkle some Stella and Chewey' freeze dried on top of the canned food.. (Is that the question you wanted answered?)
 
Oh sorry... I raised the question about the Stella sprinkles. I know that this food purports to be low carb but it made my sugarcat's bg go up. Every cat is different though. You may want to experiment by removing it for a couple of days (if he will still eat) and see if there is any effect on his bg.

I actually like the idea of using it as a topper and may use it to entice my hunger-striking, non-diabetic civvie.
 
Okay what are sprinkles? Do you mean the small purple pouches? If so that is what I am using but u bought a big bag because it was so much more economical. Is that what raised your day's BG? Thanks.
 
I think Robin meant, that she breaks up the pieces of the freeze dried Stella & Chewy's food, and sprinkles the smaller pieces on top of the wet food. This can tempt a cat that does not want to eat much, to eat a bit more.

I take the Halo Liv-a-Little freeze dried chicken treats and twist a piece between my fingers. That breaks it up into tiny, crumb size, "sprinkle" size pieces which I then put on top of the food to make it more tempting to eat. Wink would do just about anything for a taste of those Halo Liv-a-Little freeze dried chicken treats. It's one way I transitioned him from dry food to wet.
 
Okay, so you are doing the same thing that I am doing. That's what I meant by a topper. I can't figure out from the ingredient list what would cause BG to rise though. Pumpkin seeds maybe? Speaking of that is it okay to mix a teaspoon of canned pumpkin to help keep the stool soft? It doesn't have a high glycemic value but I don't want to add anything that will raise BG. I used to put some Gerber's quash in his food but someone said it doesn't have a lot of fiber. I thought it did.Thanks.
 
The teaspoon of plain pumpkin might help to keep the stools softer.

One of my civies, Delta, has chronic constipation. I've been using Miralax, 1/8T twice a day but it's not doing enough right now. So, I'm experimenting with adding a tiny bit of the pumpkin, about 1/2 teaspoon to each of her 4 meals a day.
 
Deb, I've been using Miralax as well. A friend uses it twice a day. I gave a little more than 1/8 today as he didn't go yesterday for the first time in ages. Them he went too soon for it to be from the Miralax. Let us know what the pumpkin does. Before diabetes I used it.
 
Yes, thanks. I'm familiar with it. Miralax is working if I can add pumpkin I might not need the Miralax. First I need to get him dosed properly. Or maybe I should try a little pumpkin while figuring it out?
 
There is no reason you can't give the pumpkin before the BG levels are in better control. I've used both the pumpkin and the Miralax to help with feline constipation in my cats.
 
Yes. I have used the purple pouches of Stella. I don’t know what caused bg to go up but civvies did not like it with water added so I put in a bowl dry and they ate it.

Civvies like the Weruva freeze dried treats but not Alska. I like the idea of using the Stellas as a topper when my civvies get finicky. Luckily, I don't need any enticement for Al Alska to eat but civvies have had waning appetites since getting over the upper respiratory virus that raged through my house in early December.
 
I just sprinkle one piece on top of the canned food and add a little water to that. If he won't eat when I put the food down, I do this and he often cleans the plate. Unlike many cats with diabetes that eat a lot, Max is finicky probably due to the chronic pancreatitis. He eats enough and actually could lose about 8 ounces but if he stops eating he needs help to avoid fatty liver. I've been fortunate in that regard.
 
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