Insulin Dosing Question

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Angela and Prince

Angela and Prince

Member Since 2022
Hello and thank you for all the support. I am new to this group. My name is Angela and I live in Ontario, Canada. My cat, Prince was dx w/diabetes a month ago. The vet started him on Lantus 2iu q12hrs. He had a hypo incident within 48hrs and that is when I discovered this group through the FB page. After the hypo incident I dropped Him down to 1iu q12hrs for a week and then increased to 1.5iu which he has been on ever since. I also changed his diet to Fancy Feast pate. He gets a full can at 6am w/ insulin, 1/2 a can at 10am & 2pm, a full can at 6pm w/ insulin and half a can at around 8 or 9pm. He also gets freeze dried or baked chicken treats at bg testing times. I am looking for advice on Lantus dosing at this point? I have attached Prince's spread sheet. I have had a hard time with him getting into food he should not eat(human food). I also have 2 small kids that drop food wherever and whenever they are eating. Prince is always right there to grab whatever they have dropped. With regards to my vet and getting advice from her, after the hypo incident at the beginning I did talk to her. She told me he was bordering on starting at 1iu or 2iu and she chose 2. She told me to drop the dose to 1iu and then increase by 1/4 or 1/5 a dose from there. She didn't really explain when to increase the dose except if his bg is consistently higher than 12. She also told me to only hold the insulin if his bg is lower than 4 or he does not eat. As you can see in his chart, there are times where his bg drops low which is why I am wondering if I should leave the dose as is or increase to 2? Thanks again for the advice and support.

https://docs.google.com/spreadsheet...w8_uy6s2pbyIyeCv7ehaIMlest0/edit?usp=drivesdk
 
Hi and welcome to the site.

For Lantus we have two different dosing protocols Stay Low and Go Slow is one and the other is Tight Regulation which one you chose depends on how often you can test your kitties blood glucose. The protocols guide you on when to increase or decrease a dose.

You can find information on that here.

https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

Also if you go to the Lantus folder, you can see members post daily their kitties' numbers and can get advice from experienced members. Also filling out the spreadsheet allows others to look at your data and advise, that's great that you have already done that.:)

Now, I do not have enough experience to advise others on insulin dosing, but looking at your spreadsheet, when you get a lime-green number (under 2.8) we reduce the dose by 0.25. I see you have a few of those already.

What type of meter are you using?

Also, here is some more information on getting started here.

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
 
Hello and thank you for the response. Should I be posting this question in the Lantus Folder? Sorry, this is my first post here.

I have just read up on the Stay Low and Go Slow Method to insulin dosing in the past couple days, which is what has promoted this pist. Unfortunately, I have been following the advice of my vet for the past month which is not in line with this method so I am wondering where to go from here.

With regards to the lime green numbers. Both occurred because I was not following the Stay Low and Go Slow method for insulin dosing as I was following my vets advice and did not know otherwise.

I am using the Freestyle Lite human meter to test Prince's BGs.

Thanks again!
 
Hopefully, someone will be by to help you with your dosing question. If not soon maybe post again on the Lantus forum. When do you give your next insulin dose.

I personally i would suggest not increasing your dose since you had 5.2 yesterday. But let's see if anyone else responds.
 
Please test in 1 hour, I am concerned dose is too high. Do not increase. When you are new we recommend not shooting anything below 200, rather stall without feeding for 20 minutes and ask for help here. Do you have a hypo kit? What foods do you have on hand (brands and flavors please, I clouding high carb stuff)

When you get a chance can you please complete your signature? https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

It will avoid everyone asking you the same 20 questions ;)

I suspect dose is too high. Tagging @tiffmaxee @Bandit's Mom @Christie & Maverick .
 
Would it be possible to also get the US spreadsheet? Don’t increase. Are you going to follow SLGS OR TR?
 
FrostD said:
Please test in 1 hour, I am concerned dose is too high. Do not increase. When you are new we recommend not shooting anything below 200, rather stall without feeding for 20 minutes and ask for help here. Do you have a hypo kit? What foods do you have on hand (brands and flavors please, I clouding high carb stuff)

When you get a chance can you please complete your signature? https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

It will avoid everyone asking you the same 20 questions ;)

I suspect dose is too high. Tagging @tiffmaxee @Bandit's Mom @Christie & Maverick .
Click to expand...

I just updated all that info I to my Profile. I should also add it to my signature?
 
Angela Wolfer said:
I just updated all that info I to my Profile. I should also add it to my signature?
Click to expand...
Yes. We all look at the signature. Include food he eats, meter, date diagnosed. Was he eating dry or higher carb wet food before you switched to fancy feast? That alone can make a big difference in dosing in a positive way.

5.2 is almost a reduction if following SLGS it’s 92 and under 90 is a reduction. Did you shoot 1.5 already?
 
tiffmaxee said:
Yes. We all look at the signature. Include food he eats, meter, date diagnosed. Was he eating dry or higher carb wet food before you switched to fancy feast? That alone can make a big difference in dosing in a positive way.

5.2 is almost a reduction if following SLGS it’s 92 and under 90 is a reduction. Did you shoot 1.5 already?
Click to expand...
Yes already gave insulin.
 
With TR reductions are when under 50. If you did not give insulin, did you feed him? If not, please get another test.
 
Angela Wolfer said:
Yes already gave insulin.
Click to expand...
Please test in an hour and post the result. He should get a food bump. Lantus typically onsets at +2 so if the +2 is lower than the pmps you will have an active cycle and need to test more.

I just checked and saw he came up quite a bit. Post the +2. He just might bounce from being at 5.2 and continue to go up tonight.
 
I am curious how your cat was diagnosed with diabetes. Was he showing symptoms and you brought him in for a vet check? Did the vet run blood work and urinalysis and possibly a fructosamine test to verify the diagnosis? Could you also please confirm you are using U-100 insulin are 3/10 cc capacity, 30 or 31 gauge, with 1/2-unit marks. This pic shows the insulin syringe scales, I'm hoping your 1.5u matches. https://www.felinediabetes.com/FDMB/attachments/49823063143_3437e9e997_o-jpg.59849/

Regardless of the dosing method, it is important to note that we make dose decisions based on nadirs not preshots. The fact that you are getting green preshots makes me wonder how low he was going the cycle before. Most definitely do not increase. If you haven't fed yet, can you stall (don't feed) and retest 20 minutes from your last test?
 
tiffmaxee said:
Please test in an hour and post the result. He should get a food bump. Lantus typically onsets at +2 so if the +2 is lower than the pmps you will have an active cycle and need to test more.

I just checked and saw he came up quite a bit. Post the +2. He just might bounce from being at 5.2 and continue to go up tonight.
Click to expand...
I can check again I'm an hour and update.
 
tiffmaxee said:
Please test in an hour and post the result. He should get a food bump. Lantus typically onsets at +2 so if the +2 is lower than the pmps you will have an active cycle and need to test more.

I just checked and saw he came up quite a bit. Post the +2. He just might bounce from being at 5.2 and continue to go up tonight.
Click to expand...
Next time save the high carb treats until you see the +1. That will have influenced the +1.
 
Christie & Maverick said:
I am curious how your cat was diagnosed with diabetes. Was he showing symptoms and you brought him in for a vet check? Did the vet run blood work and urinalysis and possibly a fructosamine test to verify the diagnosis? Could you also please confirm you are using U-100 insulin are 3/10 cc capacity, 30 or 31 gauge, with 1/2-unit marks. This pic shows the insulin syringe scales, I'm hoping your 1.5u matches. https://www.felinediabetes.com/FDMB/attachments/49823063143_3437e9e997_o-jpg.59849/

Regardless of the dosing method, it is important to note that we make dose decisions based on nadirs not preshots. The fact that you are getting green preshots makes me wonder how low he was going the cycle before. Most definitely do not increase. If you haven't fed yet, can you stall (don't feed) and retest 20 minutes from your last test?
Click to expand...
He was showing symptoms and I took him to the vet. He lost weight, was eating a lot, peeing a lot, hiding, low energy and not himself. Fructosamine test was done along with full labs. I don't have those results but that's how my vet dx. I have u-100 insulin syringes with 1/2 unit markings, 30G.
 
Thanks for clarifying. You mentioned you changed to FF pate. Was he on dry food previously? I ask because making a change from high carb dry food to exclusive low carb canned food can have a significant impact (reduction) on insulin needs.
 
Christie & Maverick said:
Thanks for clarifying. You mentioned you changed to FF pate. Was he on dry food previously? I ask because making a change from high carb dry food to exclusive low carb canned food can have a significant impact (reduction) on insulin needs.
Click to expand...
Yes, he was eating dry food before and friskies pate. I changed his diet the day he was diagnosed and the vet still started him on 2 units of Lantus. He then hypod and the vet told be to decrease to 1 unit and increase if BGs were consistently over 12. I didn't no that should have gone by nadirs, not preshots until now. So should I bring him back down to 1 unit or how do I give 1.25 units?
 
You are in good hands with Elise and Christie so I won't clog up the thread, but please do put together a hypo kit ASAP. You'll want 5-6 cans medium carb wet food from 10-15%, 3-4 cans high carb wet food from 16-20%, and I always like to have a few very high carb wet foods as well, 23% or so. Plus karo or honey. We try to avoid dry food and treats if possible, but they work in a pinch. And always make sure.you have at least 100 extra test strips at any time.

Here is a food list with carb %: https://catinfo.org/chart/index.php
 
I wouldn't suggest 1u. 1.25u is eyeballed, you'd take up 1.5u and gently squeeze out a couple of drops to get between 1u and 1.5u. I wish I could have seen a test earlier today.

If you hold the dose, are you able to get a test each cycle including the preshots going forward, just to get a sense of his patterns? With SLGS from the numbers you do have over the last 7 days, including the curve data you could keep to 1.5u, and if you see a number under 90 you would reduce to 1.25u.

He's got a little bouncing going on, so it is expected to have some higher numbers, then when the bounce clears he drops again. Many of us find getting a +2 is a good indication of how the cycle will go. If it is much lower than preshot, that indicates you need to pay attention, and follow up with additional tests. When +2 is higher, that often indicates they won't be dropping dramatically.
 
Christie & Maverick said:
I wouldn't suggest 1u. 1.25u is eyeballed, you'd take up 1.5u and gently squeeze out a couple of drops to get between 1u and 1.5u. I wish I could have seen a test earlier today.

If you hold the dose, are you able to get a test each cycle including the preshots going forward, just to get a sense of his patterns? With SLGS from the numbers you do have over the last 7 days, including the curve data you could keep to 1.5u, and if you see a number under 90 you would reduce to 1.25u.

He's got a little bouncing going on, so it is expected to have some higher numbers, then when the bounce clears he drops again. Many of us find getting a +2 is a good indication of how the cycle will go. If it is much lower than preshot, that indicates you need to pay attention, and follow up with additional tests. When +2 is higher, that often indicates they won't be dropping dramatically.
Click to expand...
I just did a +2 test and it dropped again(5.4). I can hold the dose and check at +2 for the next few days before I go to work?
 
Little stinker, like Elise said looks like the HC treats gave him a temporary bump. Are you able to get a +3 or +4 tonight? I suspect he might have plans to show you that reduction.
 
Just in case you haven't seen these, we use the terms often, and part of the reason testing is important is it helps determine how your cat responds to insulin and carbs.
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
 
Christie & Maverick said:
Just in case you haven't seen these, we use the terms often, and part of the reason testing is important is it helps determine how your cat responds to insulin and carbs.
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
Click to expand...
Thanks! I need to do more curves.
 
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