Lantus dose?

[Jill & Pansy Panini]

Hi all,

After a hypo event and false 2 day remission, we've started insulin again at a 1 unit dose.

Prior to the hypoglycemia, Pansy was on 3 units of insulin and was on Hills m/d, canned and dry, twice a day. That vet had difficulty getting BG reading from P because she was grumpy. Eventually I heard about the glucose curve and went to a fear free cats only clinic (get #2) and they did the curve, which had high numbers 400+ to 500, I think. Vet #2 referred me to Dr. Lisa's website and advised a low carb canned food, no dry kibble. I started that and didn't reduce the insulin dose and didn't home test (I know better now).Went in 10 days later and BG was 47. Told kitty could hang out in clinic or i could take her home and feed her, which I did. That evening I did a BG - first time I was successful - and it was 44. I called get clinic #2 to ask if i should skip insulin and was told to take her to the ER. She was treated, we came home. Numbers low and no insulin.

Numbers up again after fake out remission so vet #2 prescribed 1 unit insulin. The next morning BG was 113. No insulin. BG at 5 PM was 211 so I gave .5 units. (Nice forum member suggested the .5 dose and it made sense to me). I thought it was reasonable to try .5 for a week, see how kitty does. This morning BG was 189 so I gave .5 units again. This evening BG was 308 and I gave .5 units, thinking it was good to stay the course for a bit. Wondered if I should have given 1 unit. Pansy has been grumpy about shots lately so it is possible that I did a fur shot this morning.

Was this wrong? Should I adjust the dose each time? Or is that harmful? All I was told is "Don't shoot it under 180" . Or stick with .5 for a certain amount of time?

Also, I use U100 3/10 cc syringe with 29 gauge needle. I wanted to try the 31 gauge needle but pharmacist said he'd heard of 31 gauges getting broken off in cats, and that scared me. I'd be willing to try the 30 gauge of anything to make Pansy more comfortable.

Sorry, but get not available on the weekend and I don't think she has the detailed knowledge possessed by the people on this forum.

Thank you!

Jill

 

[Figaro's Liz]

Hello Jill!!

First off, great job getting set up with home testing! Many people here use 28 g lancets for testing and find that 30 or 31 g don't produce enough blood. I haven't heard of needles breaking off in cats but don't worry, the 29 won't hurt Pansy. There are many tips about home testing collected here: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Have you visited the lantus Insulin Support Group sub forum yet? There is a lot of great info about lantus, and many knowledge caregivers who want to help over there. Look for the "sticky" posts at the top of that sub forum, those will be especially useful as you build your knowledge about FD and Lantus. You may want to post there about your lantus-specific questions for a quicker response.

Generally folks on this board recommend giving a consistent dose of lantus, rather than adjusting it each time. There is a sticky post in the lantus forum that describes the lantus "depot" that explains how the insulin is utilized by the body over an extended period of time. I personally am not experienced enough to comment on specific dosing. Hopefully others will chime in, but if not, you may want to post the lantus group instead.

 

[Bron and Sheba (GA)]

Hi Jill and Pansy,
Well done home testing and getting the SS up and running.
When you mentioned the 31 g needle were you referring to the needle on the syringe? If so the 31 g needle is fine. I've never heard of it breaking with a cat.
Pansy's numbers on the SS are looking good. With Lantus it is a depot insulin and it needs 5 to 7 days initially for the depot to fill. So best to stay with the 0.5 units for the first week. The numbers on the SS will fluctuate so don't be alarmed if you see some higher numbers.
What I would suggest is getting some inbetween tests if you can, to see how low the insulin is taking Pansy, as we adjust the dose on the nadir (the lowest point) not the preshot number. If you work during the day try and get a +2 before work or a +10 after work or whatever you can and then get more on the weekends. Then during the PM cycle try and always get a 'before bed test' in because cats often drop lower at night. If the before bed test or a +2 test is lower than the preshot then you will probably have an active cycle and may need to get up later and test.

If Pansy drops low or fast, or drops lower than she has been, this can trigger a bounce and her body will dump glucose and regulatory hormones into the blood stream to 'save herself' and her BG numbers will skyrocket. Bounces can last for up to 6 cycles and there is nothing you can do about them except wait them out.

Are you testing before every shot? Itis really important you do to keep Pansy safe.
With feeding, a lot of us give several smaller meals during the day and night. We feed at preshot then again around +2 or 3 and then again at +4/5or 6 ...whatever suits you and Pansy.

The 308 this evening could have been because she dropped lower during the day and is bouncing a bit from the lower numbers.
Keep asking lots of questions and read the yellow stickies at the top of the Lantus page.
There are 2 dosing methods....the TR (tight regulation) and the SLGS (start low to slow) methods. Have a look at those and see which one would suit you and Pansy.