Lantus - 4 units per day
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Chris & China (GA)
Member Since 2013
Yes, we hear that kind of thing all the time.....but it's not what's recommended
The starting dose for a 9.5lb cat would be no more than 1U, AM and PM
My own vet told me I should start China at 4U.....at the time, she weighed less than 8lbs!! In the almost 5 years since then, she's never needed that much and now she's on less than .25
Learning to home test will be the best thing to keep your kitty safe as well as knowing how they're responding to treatment
The starting dose for a 9.5lb cat would be no more than 1U, AM and PM
My own vet told me I should start China at 4U.....at the time, she weighed less than 8lbs!! In the almost 5 years since then, she's never needed that much and now she's on less than .25
Learning to home test will be the best thing to keep your kitty safe as well as knowing how they're responding to treatment
jayla-n-Drevon
Member Since 2015
whoa that is a big dose!
my 20 pound boy gets 1.5 and if I go a smudge over he is in danger of going too low.
This forum and home testing was a God-send
my 20 pound boy gets 1.5 and if I go a smudge over he is in danger of going too low.
This forum and home testing was a God-send
Tricia Cinco(GA) & Harvey
Member Since 2011
Sounds like your vet doesn't have a lot of experience with long-lasting insulins like Lantus. I wouldn't start with more than 1 unit twice a day, either. Especially if you aren't home testing.
Toro & Ovi
Member Since 2017
As far as I know, for high BG numbers (>400) this start dose is part of TR (start with half of the weight in kilograms(9 lbs.= 4 kg) ).
But that works only if you can observe the kitty and check the BG 24 hours out of 24 so you can act quickly if hypo is present - I'd say this start is pretty much for professionals/experienced only.
If you can't do that, you probably shall start lower - more experienced people from this forum can tell you with what dose (1u seems to be the common ground
).
But that works only if you can observe the kitty and check the BG 24 hours out of 24 so you can act quickly if hypo is present - I'd say this start is pretty much for professionals/experienced only.
If you can't do that, you probably shall start lower - more experienced people from this forum can tell you with what dose (1u seems to be the common ground
).
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Gill & George
Member Since 2015
I would not start on any higher than 1u, if you were following TR.
What are you feeding your kitty? is he on an all wet Low Carb Diet?
I am not sure where you are getting this from.
The TR protocol that we follow on this board is the following: Taken from the tight regulation protocol sticky
STARTING DOSE:
The weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
- the formula is 0.25 unit per kg of the cat's ideal weight
- if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actualweight
- if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
FWIW George never got above 3u BID, he's a 8kg cat,and since his numbers were over 400 at diagnosis (red and black) following your calculation that would have seen him start on 4u BID (twice a day), I can't imagine what would have happened had I started with 4uBID(, and I tested a lot. Following the TR protocol on this site it took 4 weeks, but he soon started seeing blue and green numbers, became very well regulated and went OTJ 6 months later and still is OTJ 18months later. I followed the TR protocol here, taking his dose up quickly when he was mired in red (0.5u steps every 6 cycles, then slowed down once his numbers got below 300, holding 6-12 cycles depending how low his nadirs were. This took his dose up safely and quickly, and I remained in control, I think if I had started with 4u BID I would have had a symptomatic hypo on my hands or worse, no matter how much I tested.
Toro & Ovi
Member Since 2017
One of them is here:
https://www.veterinarywebinars.com/...urnal_of_Feline_Medicine_and_Surgery_2015.pdf
This one says 0.25-0.5u/ kg ("The higher dose of 0.5 U/kg may be appropriate if BG is >20 mmol/l (360 mg/dl)")...but there are many sites saying the same.
Not all the TR from internet agree to the small details, it's up to the owners and the vets to take the decisions.
Personally, I believe the TR from this forum is one of the safest and more conservative ones out there, fitting everybody even if not possible to test the BG every single hour - which is good.
Gill & George
Member Since 2015
Thanks for the link, going to have a proper read of it, but on a first scan,. It says Lantus nadirs at +12??? And has a duration of 24hrs???
we know from our experience on this site, that typical nadir is +6 and typical duration is +12. I wonder how accurate their info is?? Going to have a hard time trusting it.
The TR we follow here is based on the Romp Rand peer reviewed study, and I believe it's the only one to have been published for lantus.
Yes there are safeguards built in but it's still a relatively aggressive approach. A regime that pushed a cats BG lower/faster would worry me, even though I was with George pretty much 24/7 and was a self confessed testaholic.
Toro & Ovi
Member Since 2017
I completely agree - that's the reason we choose to follow the TR from here, seems to be the safest out there.
The Aussies in particular are more aggressive with their approach.
Gill & George
Member Since 2015
I have not used caninsulin, but the research I did when George was initially diagnosed suggested that it wasn't the best choice insulin for a cat.
It was developed for use in dogs, cats have faster metabolisms, and as a result they don't get enough duration. So what you tend to find is they drop hard and fast, in the first few hours, but don't spend much time in healthy BG levels.
The research I did at the time suggested that lantus j(which is longer acting 'gentler') gave a cat the best chance at remission. Bear in mind that the best chance of remission is noted in newly diagnosed cats, who achieved good glycaemic control (blood glucose in the normal range for a healthy cat, for most of the day), I just don't feel caninsulins duration alone can help you achieve this.
So even though my vet wanted to initially start George on caninsulin, I asked for lantus, and she was ok with it.
As far as the recommendation on starting dose, on caninsulin,
Have you done a curve at home? My vet encouraged me to do this as a curve in the vets office was likely to be stress influenced, and readings would be higher.
I would learn to test at home before starting, and still go with the lower calculation, which would be 1u for your cat weight (assuming that there are no other health issues aside from the diabetes, and that at 4kg he's not overweight), interestingly, with George who is bigger than your boy, and running at 400 my vet recommended starting on 1u of caninsulin.
If you test at home you can adjust the insulin dose up if it is not getting him into good numbers. I prefer this approach than starting off with a dose that could see kitty blood glucose crash, and have you deal with a hypo. By testing at home you will be able to make more frequent dose adjustments to get numbers in an appropriate range. Often vets assume clients won't want to or be able to test at home, so they start with a dose, have you hold it for anumber of weeks then get cat in for a curve at the office.... I find this a really risky approach, and sadly I've seen it end badly for some kitties, so I would strongly encourage you above all else, to get hold of a glucometer (you can use a human one, they are cheaper to buy and the test strips are also more economical, and will do the job, again my vet recommended me getting a human one.
What are you feeding?
This is a huge part of the equation in getting your cat regulated, a low carb (below 10%) is recommended, much much better if it's a wet diet, please note that the prescription diets vets often recommend are expensive and too high in carbohydrate.
We have food lists of suitable foods for different countries, what part of the world are you in?
It was developed for use in dogs, cats have faster metabolisms, and as a result they don't get enough duration. So what you tend to find is they drop hard and fast, in the first few hours, but don't spend much time in healthy BG levels.
The research I did at the time suggested that lantus j(which is longer acting 'gentler') gave a cat the best chance at remission. Bear in mind that the best chance of remission is noted in newly diagnosed cats, who achieved good glycaemic control (blood glucose in the normal range for a healthy cat, for most of the day), I just don't feel caninsulins duration alone can help you achieve this.
So even though my vet wanted to initially start George on caninsulin, I asked for lantus, and she was ok with it.
As far as the recommendation on starting dose, on caninsulin,
Have you done a curve at home? My vet encouraged me to do this as a curve in the vets office was likely to be stress influenced, and readings would be higher.
I would learn to test at home before starting, and still go with the lower calculation, which would be 1u for your cat weight (assuming that there are no other health issues aside from the diabetes, and that at 4kg he's not overweight), interestingly, with George who is bigger than your boy, and running at 400 my vet recommended starting on 1u of caninsulin.
If you test at home you can adjust the insulin dose up if it is not getting him into good numbers. I prefer this approach than starting off with a dose that could see kitty blood glucose crash, and have you deal with a hypo. By testing at home you will be able to make more frequent dose adjustments to get numbers in an appropriate range. Often vets assume clients won't want to or be able to test at home, so they start with a dose, have you hold it for anumber of weeks then get cat in for a curve at the office.... I find this a really risky approach, and sadly I've seen it end badly for some kitties, so I would strongly encourage you above all else, to get hold of a glucometer (you can use a human one, they are cheaper to buy and the test strips are also more economical, and will do the job, again my vet recommended me getting a human one.
What are you feeding?
This is a huge part of the equation in getting your cat regulated, a low carb (below 10%) is recommended, much much better if it's a wet diet, please note that the prescription diets vets often recommend are expensive and too high in carbohydrate.
We have food lists of suitable foods for different countries, what part of the world are you in?
Neko was started on caninsulin because that is what her vet was most familiar with. But in spite of Neko have a higher BG, and being over 6 kg, we still only started on 1 unit. Caninsulin can hit hard and there is a much greater chance of hypos with it, so I think it was a good idea to start conservatively.
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