Insulin dosage and glucose questions

Sarah Way Knight

Sarah Way Knight

Member Since 2019
Need some assistance. My sugar boy George weighs 13.30 lbs. Dx'd on 12/18, Prescribed Lantus 3 units twice a day. Glucose initially 586. Started diabetic diet as well. He used to free feed now I feed before shot and leave food down till noon pick up and put down for PM shot and leave down till bedtime, (he was waking me up all hours to eat lol) I am testing twice a day and his first curve was to be yesterday. Upon his reading it was 161 so no insulin was given and we could not do his curve because no insulin was given. PM reading was 260. He was given his three units and this morning he was 89. I am not sure what is going on with him. He has only had one shot in 36 hours? Is it possible the food is starting to help with the glucose? I have scaled back the dosages at some injections when they are lower but after that his glucose goes up to high 300's and high 400's. This is so stressful! He will be 15 Jan 5th. Any suggestions? Please and thank you and you are the best!
 
Welcome Sarah and George.

I will let others give you the fine details.

First Lantus is a depot insulin and needs to build a reserve. It likes consistency so same amount for both shots. 3 units is high to start with. Lantus is fixed on how low the glucose goes during a 12 hr cycle. Normally the low will happen 5-7 hrs after shot. That is what determines whether to increase or decrease a dosr. Any time you skip a shot interferes with depot, it's the depot that helps keep them level.

Diabetic food is not necessary. Fancy Feast Pate is just fine, most of us use it or Friskies Pate. Any wet food under 10% carbs is best. You won't find it listed on the labels. Will link food chart for you. If giving dry food try to transition off it. Very high in carbs.

You can free feed. Just no food 2 hrs prior to pre insulin shot test. I would drop your dose though maybe to 0.5 units or 1 unit. We change doses in 0.25 increments so having syringes with 1/2 units marks is very handy.

Let me find that food list for you.
 
Welcome to the forum!

Get to play housekeeper!! When you have a moment, could you set up a signature (click on the link the left for instructions) so we know a bit more about George. You may have noticed that we all have spreadsheets linked in our signatures. We are very numbers driven and the good news is that it sounds like you are getting blood glucose readings at home! This link will take you to the information on how to set up a spreadsheet so you can track George's progress and we can also see how he's doing.

As Paula noted, unless you have a huge cat, 3.0u is a whoppingly large starting dose of insulin. The initial dose of Lantus is based on a cat's ideal weight (initial dose = 0.25 x ideal weight in kilograms). For an average sized cat, this calculates out to around 1.0u, give or take. In addition, it sounds like you changed George's diet. What are you feeing him? Some of the prescription diet foods are terribly high in carbohydrates. Some are OK. There are also many other options that cost far less than prescription foods and are way less in carbohydrates.

It is certainly possible that the food is having an effect on George's blood glucose (BG) levels. Lantus also forms a depot - this is the link to the sticky note on the insulin depot. George's depot may be influencing the numbers you're seeing but the longer he's without insulin, the less that effect will be. There's no way to know for sure if it's a matter of the food or the insulin. However, with any insulin, you need to test more often than at your shot/pre-shot times. The BG reading at shot times tell you whether it's safe to give insulin. However, with Lantus, dosing decisions are based on how low numbers go -- the nadir. If your pre-shot number was 89, you should get another reading to make sure George is in safe numbers. I would strongly encourage you to get spot checks.
 
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