Lantus dosing ??

[Jeff D / Sketch]

This is a follow up to my last questions regarding dosing. There has been a recent change in Sketchs numbers going much lower than previous for no apparent reason (diet/food consistent) I have included some updated SS info (line 155 down) for Sketch since his numbers started jumping around. As you can see I have been altering his dose based on pre shot#and his previous cycle. The two nights he was in the green/blue he was receiving some high cal food and treats each time I tested him as I was a bit frightened he might crash never seeing #'s that low on him.
I have dropped the dose from the 8.5 where Sketch was previously. I realize he could go lower and hasn't been in danger but without being able to be around constantly and his recent inconsistency I have tried to be conservative. Additionally I have dropped his dose in the evenings since he appears to go lower at night in fear he might crash when I'm sleeping.
So questions to you knowledgeable folks are. 1. do you change dose based on preshot #? 2 do you change dose from am to pm? 3. am I creating a bigger issue with changing dose based on # and am pm? 4. Would I be better off dropping dose way back to a much lower # and shooting the same in am and pm?
Sketch's nadir seems to arrive later in the twelve hr cycle than many cats. As you can see this morning after a reduced dose last night his AMPS was 162 ( actually it was 128 but I waited and retested in a half hour when it came up to 162) lowest pre shot # on him I've ever seen.
All this said and despite being a suspected Acrocat he seems normal going out and patrolling his hood in the early evening (he is in at night) and sleeping in his favorite spots in the yard or house during the day. I had a meeting with his vet the other day to discuss but she didn't really have any suggestions beyond what I've done. Any input is welcome.

 

[Wendy&Neko]

Here is the link to your last post here, included for connectivity: http://www.felinediabetes.com/FDMB/threads/lantus-dosing.203819/

On this forum, we dose by nadirs, or how low the dose takes the cat, not by preshots. With a depot insulin, we find you can get some wonky numbers if you are changing the dose all the time. Our dosing methods call to hold the same dose, unless they either earn a reduction, or need more insulin. If you want him to run a little higher, it would be better to pick a slightly lower dose, maybe 8.0 units and stick to that. The 66 you saw was a perfectly safe number, just hard to keep monitoring cause it was at night.

As for nadir, it's hard to say what it is when your dose is jumping around. Nadirs can change from cycle to cycle. Reduced shots, skipped shots, breaking bounces are some of the situations that can impact the nadir time. Neko's nadirs on Lantus were between +3.5 and +13, though most often between +7 and +9.

 

[Jeff D / Sketch]

Thanks Wendy. I think I will take your advice and drop his dose back maybe to 7.5u (to give a little cushion) and keep it even both in am and pm rather than bouncing around. As we discussed the other night Sketch had never been under 100 @ 8.5u (seldom ever in the 100's) and all of a sudden he was in the 60's and early in his cycle which was my major concern if I had just gone to bed and he had dropped further.