Lantus dosing question for Zeus

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knolet

knolet

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Good Morning, for the past three days, Zeus has not gotten any insulin in the morning because his numbers were below 150 - for 2 days they're actually below 100. While I'm really happy about this, I'm also a little concerned because I know Lantus is supposed to be given 2X daily. He hasn't had any dry food since Wednesday - so today will be the 4th day off the dry food. On Thursday last week, the Vet wanted to increase his dosage from 1.5 to 2. I did that Thursday night, but have backed it down to 1.5 since. His numbers yesterday, with no morning insulin were 277 at +6 hours after eating, and then 297 at PMPS.

My question is... what to do now? I don't know if three days is enough time to make the decision, but it kind of seems to me that maybe I should lower his evening dose, so that he'll need a morning dose as well, which would hopefully keep his numbers from getting into the yellow? But I really don't have enough experience to make that decision. Any thoughts?

Thanks so much! Happy Sunday.
Kathie and Zeus
 
Thanks Larry and kitties :smile: I'll see what the numbers are mid day and then tonight. I don't really have much experience with this, but I've seen lots of other posts that say to decrease by .25 or .5 so that's probably what I'll try, with a quick email to the Vet as well. Thanks again.
 
I second Larry's suggestion.

Again - you're aiming for a dose that can be given consistently every 12 hours. 1.5 units doesn't work for that, as you've seen 3 days in a row. Try 0.5 or 1.0 units at the next shot time.

On your other post, I suggest feeding consistently - at pre-test and perhaps 3 or 4 hours afterwards, both day and night. This is to keep the food coming in consistently and predictably, so the insulin will match up with it consistently and predictably ... well, at least as much as it can be predictable - it is a cat, after all! :lol:
 
BJM said:
I suggest feeding consistently - at pre-test and perhaps 3 or 4 hours afterwards, both day and night. This is to keep the food coming in consistently and predictably, so the insulin will match up with it consistently and predictably ... well, at least as much as it can be predictable - it is a cat, after all!
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More frequent and consistent does make sense, thanks. But you're saying +3 or +4 - you wouldn't do so at +6 AMPS and +6 PMPS? I don't have an auto-feeder, went looking for one today, but couldn't find one anywhere. that's why I was going to feed at AMPS, then at +6 ish when I come home for lunch, and PMPS. Then I could put something partially frozen out before bed. Would that be better, or does that interfere with that lowest point test?

Sorry for so many questions!
 
No problem with the questions.

Without a feeder, go ahead and freeze half of his meal to thaw over the cycle. He can nibble on it as it thaws. For feeder recommendations, the Petmate 5 meal has been used successfully by a number of folk here. It may be found on Amazon.

The reason for giving food in the 1st half of the cycle is that is when the insulin is taking effect and the glucose is being lowered. The food will help that be a gradual drop, not a dive.

After the nadir, the insulin effect begins waning and the glucose normally rises. Adding food then fuels the fire, so to speak. Thus the suggestion to provide food in the first half of the cycle, or mini meals so that food is going in gradually along with the insulin. No food 2 hours before the next shot lets you see a glucose level when there isn't a food spike covering the end result. (Obviously, if your cat needs to eat because he's in hypo, you disregard that and feed according to the protocol for handling hypos.)
 
BJM said:
The reason for giving food in the 1st half of the cycle is that is when the insulin is taking effect and the glucose is being lowered. The food will help that be a gradual drop, not a dive.

After the nadir, the insulin effect begins waning and the glucose normally rises. Adding food then fuels the fire, so to speak. Thus the suggestion to provide food in the first half of the cycle, or mini meals so that food is going in gradually along with the insulin. No food 2 hours before the next shot lets you see a glucose level when there isn't a food spike covering the end result. (Obviously, if your cat needs to eat because he's in hypo, you disregard that and feed according to the protocol for handling hypos.)
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Ok, that makes sense now, thank you!

So last night, Zeus' PMPS was 213, I gave 1U. This morning, his AMPS is 155, no shot. I have auditors this week at work, but I still should be able to come home to get a mid day bg.

Happy Monday :smile:
 
You'll need roughly 3 days for the lower dose to stabilize and the shed to drain, all else being stable too (dehydration, constipation, etc)
 
The shed? I've read where others have commented about that too.... but is that a good thing, or a bad thing? Draining the shed? And then when it stabilizes, it fills up again?

It's kind of funny, I keep having to bounce between the posts and the glossary, LOL. It's like learning a new language ;-)

Another question. The Vet said to feed Zeus between a can and a can & 1/2 of food. We're still on the purina DM, with a little FF mixed in for flavor. I didn't want to change everything all at once. Now I'm trying/starting to feed 4 x daily. But Zeus seems still hungry. Do I need to restrict his food at this point? Can I give him a little more? He's at about 10 pounds and the Vet said he should be 11 or 12... I do think he's a bit too thin, but I don't want him to gain too much too quickly either. Maybe he'll be OK after his last feeding tonight.

Oh, and another no shot morning, but tonight we're back in the pink tonight :sad: If he's 200 or above in the morning, I should shoot the 1U, right? What if he's close - like 175? I won't be able to check on him until around + 6.5, but I will leave frozen food out before leaving for work.

Hope everyone is having a good evening!
Kathie
 
The shed is like climbing up an escalator moving down.

It takes some effort to go up and if you stop moving, you head back to where you started (a missed dose).

You can get up to a certain level (new user), then set a pace where you stay at the same height (regular dosing of consistent amount).

You can adjust that level by going a bit faster then stabilizing (a dose increase), or going a bit slower and stabilizing (a dose decrease).
 
knolet said:
...Another question. The Vet said to feed Zeus between a can and a can & 1/2 of food. We're still on the purina DM, with a little FF mixed in for flavor. I didn't want to change everything all at once. Now I'm trying/starting to feed 4 x daily. But Zeus seems still hungry. Do I need to restrict his food at this point? Can I give him a little more? He's at about 10 pounds and the Vet said he should be 11 or 12... I do think he's a bit too thin, but I don't want him to gain too much too quickly either. Maybe he'll be OK after his last feeding tonight.
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Go ahead and up his food intake; until he is well regulated, he can't use everything he eats, so he's going to be hungry. Also, that may help to keep the glucose high enough you can shoot, especially if you give a bit more at night (some cats go lower at night). Do the feedings mainly in the 1st 6 hours of the cycle, as the insulin is wearing off in the last 6 hours. You might feed at preshot and +3, or preshot and +2 and +4, or whatever works best for your schedule. Alternatively, you might freeze half his food and set it out to thaw, so that he can nibble as it thaws.

knolet said:
...Oh, and another no shot morning, but tonight we're back in the pink tonight :sad: If he's 200 or above in the morning, I should shoot the 1U, right? What if he's close - like 175? I won't be able to check on him until around + 6.5, but I will leave frozen food out before leaving for work.
Click to expand...

Either feeding him more at night, feeding him more overall, feeding him a slightly higher carbohydrate level, and/or reducing the dose by 0.25 ... or some combination ... may be needed to get him on a stable 12 hour dosing schedule.

If you are testing for ketones (see secondary monitoring tools in my signature link), you might change 1 thing - his dose - and take it down to 0.5. If the insulin is too high for him, he's going to be very hungry! And his numbers look like he might do well between 0.5 to 1.0 units (my opinion; several others have way more experience than I)
 
Ok thanks... I did give him some extra food. He has retired to the bed for a catnap :-D So darned cute. I'll give him more in a few hours before bed,

BJM said:
the insulin is wearing off in the last 6 hours.
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I bet that's why we're in the pink tonight - I gave him a snack at +6.5. Wow, I hope I get this figured out sometime soon.

Hey BJM, thanks so much for answering all of my questions. I really appreciate it!
 
No problem. Just be sure to get input from others, and read others posts in other forums, so you can glean ideas that may be helpful to you.

I'm not as experienced as a lot of folks ... and mostly it was with an unregulated cat with several complicating comorbidities. I tried some things with Spitzer that really freaked folks out, ie got "don't DO that!" responses, especially towards the end.
 
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