Lantus Dose Increase

[John Ford]

My true feline companion Trixie has been treating for diabetes for going on 4 months, and she is now being injected with Lantus, at 4.5 units/inj, twice daily. She was initially injecting with Novolin N. While she was showing progress with the Novolin, her numbers were short lived, her peak in the high 100's to low 200's and her highs returning to the 400's at end of 12 hours. She was on 5 units Novolin at that time.

She was switched over to Lantus and she is having BG numbers at her peak of 280 - 320, with her highs around 340 at the end of her 12 hour period. Her original numbers were high 400's and low 500's, so she is showing some consistent improvement. We are also giving her B-12 supplement, Vitacoast or Zibaline for her presence of neuropathy. She is mentally alert and vibrant on Lantus, no swings in behavior, like she showed on Novolin.

We currently monitor her BG weekly and I am looking for reinforcement on my quest for increasing dose. Is it advisable to continue incremental increases her doses by .25 to .5 every few days until we get to the measured numbers we need to see, those being in the 100's to low 200's. Her syringe is BD 6mm, 31ga for use in upper shoulder areas. 8mm used in areas more toward the scruff.

At what point would it be said that increased doses of Lantus might be not doing anything. For example, if it turns out she is getting injections twice daily of 8 units per inject but, her numbers are in our desired range, do we just accept that as what is necessary to control her BG numbers?

Her food is Young Again Mature Zero carb food, so we have taken that element away of food with hidden carbs. She is on a 1/3 cup food per day.

Should we also be considering another type of insulin.

I wish some of these other human insulins could be tested and approved for use on cats.

Open for any advice or experiences.

Thanks.
.

 

[rhiannon and shadow (GA)]

We can help you with that.
The first thing we will ask is that you create a spreadsheet ...
click on the blue link to see the instructions.

You will also want to post frequently, if not daily for daily input and support.

Yes, to your question on increasing slowly. There are sticky's at the top of this forum that you will want to read.

Did you get to your current dose slowly or has the vet increased you in larger jumps?

There is another insulin possibility that might become a good choice but I'm not sure that you haven't given this one enough time yet.
Lantus is a good insulin, but it stings a bit at a higher dose, there are some who prefer Levemir. They are much the same but Levemir has a later nadir for most cats.

 

[Marvin's Mom - Nat]

At what point would it be said that increased doses of Lantus might be not doing anything. For example, if it turns out she is getting injections twice daily of 8 units per inject but, her numbers are in our desired range, do we just accept that as what is necessary to control her BG numbers?

Hello John and welcome. If your cat gets to 6U you may want to consider having it tested for insulin resistant conditions such as IAA and Acromegaly. You can have these tests done sooner.

The first thing that we would need as mentioned above is spreadsheet. You mentioned you test BG weekly, you will notice that we test daily, pre=shot, mid cycle when we can, and before going to sleep. This data helps to see any patterns, and determine how the cat is reacting to the insulin, and helps to keep them safe. You always want to make sure that pre-shot BG is safe to give the injection.

 

[Wendy&Neko]

Hello and welcome. Since you are feeding dry food, it means following the Start Low Go Slow Method for dosing, and increasing no sooner than once a week. By the way, the Young Again is actually more like 5% carbs. It's still low carb. Most people here feed foods in the 3-5% range, and anything under 10% is considered low carb. Some cats actually do better with a little bit higher % in the low carb range.

If a cat needs 8 units, that what they need. We have cats here that need more than 20 units, and some that need just a drop of insulin. However, as Nat says, if they get over 6 units, there is probably a secondary condition contributing to the higher insulin needs. Neko got to 8.75 units and had two high dose conditions. One in four diabetic cats has acromegaly, which is one of the conditions.