Lantus help

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AbyResq

AbyResq

Member Since 2016
I picked up a new foster to temporarily help DCIN with an urgent cat. He should be going to medical boarding on Monday. My diabetic cats all use Prozinc so I'm not familiar with Lantus.

This guy was surrendered to animal control on 7/11. Owner gave them her medical records which show that he'd been prescribed Prozinc in May.

He went to a different foster home on 7/14 and transferred to me this morning.

I was handed a box of Lantus pens so I assume ACC did the switch from Prozinc to Lantus on 7/11.

The other foster mom was told to give him 2 units in the AM and 1 in the PM. She continued feeding him high carb food. No testing. She told me he quickly ate everything she offered. Drank a lot and peed a a lot. OK so sounds like his blood sugar was still high.

I immediately tested him and his blood sugar was 447 on my Relion Confirm. This was about +4.5

My question..... would you switch him to low carb food and leave the does alone or would you also increase his PM dose? Yes, I will test before his shot. I'm really not familiar with Lantus but the different doses for AM and PM seems odd to me. Also not sure when Lantus peeks.

My goal right now is to keep him safely out of DKA or a hypo episode. No history of ketones. He's only here for 48 hours but the 447 blood sugar mid cycle was concerning to me.
 
Hey Kristen, usually with Lantus since it is a depot insulin, you would give the same dose AM and PM 12 hours apart. If you are transitioning him from dry food to lower carb food, he could possibly need less insulin. If he were my kitty, I would take him to 1 unit twice a day and see how his numbers do with that amount and lower carb wet food and go forward from there.

What is the new foster's name? And have you set up a SS for him yet? Also, do you know if you are going to follow Tight Regulation Protocol or the Start Low, Go Slow method? There are stickies for each at the top of the Lantus forum.
 
lantus and Levemir should have same doses since those are depot insulins. However, I do have slight differences like 0.1 or o.2 dose difference but 1/2 units dosing is too much in my experience.
Do you have preshot BGs?
 
Lantus usually peaks between 5-7 hours after the shot but some cats can have later nadirs. Like others have said because Lantus is a depot insulin that it works best on consistent dosing on a 12/12 hour schedule. If the doses are different with the AM/PM, the depot could not form fully and you would have two very different cycles in the AM & PM which wouldn't allow much in the way of regulation. However because you're not keeping him long term, is there a way to make sure the changes you implement are followed for certain into the medical boarding in regards to changing to a LC food and being on the same dose AM/PM? If you did switch to LC and his numbers dropped greatly as a result, you'd be able to test this weekend but I'm wondering how often he would be tested in medical boarding?
 
AbyResq said:
He's only here for 48 hours but the 447 blood sugar mid cycle was concerning to me.
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Sometimes too much insulin can look like not enough and he has just had his world rocked and his environment changed with new cats to get used to. With no history of ketones, I would take him to 1 unit twice a day and start tracking his numbers and go from there.

You are a wonderful bean to take on another diabetic foster cat. :bighug::bighug::bighug::bighug::bighug:
 
Bobbie And Bubba said:
You are a wonderful bean to take on another diabetic foster cat.
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Crazy may be more like it!

Thank you everyone! I will get a +7 in a few minutes to see if he lowered at all around the typical nadir time. Sounds like the consensus is to move him to 1 unit AM/PM until he transfers. Someone raised an excellent point about the food being different at the boarding facility. I do have a case of wet DM here that was sent from a vet with a different one of my fosters. I immediately put that cat on something lower carb. I think I will put this guy on the DM - a vet might actually continue that if he ends up being boarded at a vet practice.

I'm not doing a spreadsheet for this one since he's only here a few days. His name is Nimir. It's my understanding that he has an adopter lined up and DCIN is trying to arrange his transport. I'm also going away for a few days next week. That's why he may be going to medical boarding before going onto his new home. He's incredibly sweet. He already groomed me :) If anyone in the greater Philadelphia area wants to help DCIN by fostering him until he can go home, I know DCIN would love the help. Medical boarding is usually really expensive.
 
I was thinking along the same lines as Bobbie. The one test of 447 could be a bounce from some lower numbers he got yesterday or last night, along with the stress of the new environment, and high carb food. I think I would try to transition him to lower carb food, test often (especially pre-shots), and would try 1 unit BID, as the lower carb food can affect his blood sugars by quite a bit.
 
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