Lantus not working

Status
Not open for further replies.
A

Anna12345

Member
Hi, new member. My cat 14 year old cat Dylan has been on Lantus for many months and it always worked at 1.5 every 12 - 18 hours. The last few days his blood is over 400 and won’t go down. I don’t know what to do! Please help
 
Anna12345 said:
Hi, new member. My cat 14 year old cat Dylan has been on Lantus for many months and it always worked at 1.5 every 12 - 18 hours. The last few days his blood is over 400 and won’t go down. I don’t know what to do! Please help
Click to expand...
Hi Anna, what are you feeding Dylan? dry food?, if this is the case that is very likely why his numbers are so HI, dry kibbles have carbs between 25-30% carbs, diabetic cats need a low carb diet of wet foods between 0-10 % carbs, they cannot digest carbs, so it hits the pancreas like a bomb, we need to know a little bit more about D
Dylan in order to help you better below there are two link one to get as much information on you and Dylan and the other is A Drs. Food chart, many brands to choose from, most of un members enjoy Fancy Feast Pates, the third column of the list are the % of carbs for each foods, stay away from gravies they have the highest amount of carbs. I am hoping that the diet could be the problem:bighug::cat::cat:

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
 
Thank you for your reply. I have been feeding him both a renal canned food from the vet (it is high carbs but he has the beginnings of kidney disease) and also fancy feast pate. The high carb canned food hasn’t bothered his numbers at all for months - his blood is usually between 90 - 126 after 12 hours of his 1.5 dose. But for three days now of me testing him every couple of hours his blood just won’t go down from 350 - 420 and is mostly over 400 every time I test. I’ve been just feeding fancy feast only since yesterday just in case it was the carbs but it hasn’t brought the numbers down at all. I don’t think it’s bouncing either since I’ve been testing so much and it’s not lowering but I don’t know enough about bouncing. I’m worried my Lantus is defected even though it’s not expired and looks fine (and I’ve tried two different viles just in case). Could he need a dose increase all of a sudden and has become immune to 1.5? Should I go up to 2 at his next dose? I’m so worried. He’s drinking a lot of water too which he stopped doing for months when he was doing well on Lantus.
 
Your previous post intro post
https://felinediabetes.com/FDMB/thr...ose-level-keeps-climbing.294442/#post-3210134


@Anna12345
Anna you need to set up your signature
Information we need about Dylan and also set up our spreadsheet so members can see what's going on
This is where you can set up what we call your signature, it's at the end of everyone's post in gray letters. Just tap on your name up top then tap on signature and add this information. You will link it to your spreadsheet

  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
 
Last edited:
Anna12345 said:
Thank you for your reply. I have been feeding him both a renal canned food from the vet (it is high carbs but he has the beginnings of kidney disease) and also fancy feast pate. The high carb canned food hasn’t bothered his numbers at all for months - his blood is usually between 90 - 126 after 12 hours of his 1.5 dose. But for three days now of me testing him every couple of hours his blood just won’t go down from 350 - 420 and is mostly over 400 every time I test. I’ve been just feeding fancy feast only since yesterday just in case it was the carbs but it hasn’t brought the numbers down at all. I don’t think it’s bouncing either since I’ve been testing so much and it’s not lowering but I don’t know enough about bouncing. I’m worried my Lantus is defected even though it’s not expired and looks fine (and I’ve tried two different viles just in case). Could he need a dose increase all of a sudden and has become immune to 1.5? Should I go up to 2 at his next dose? I’m so worried. He’s drinking a lot of water too which he stopped doing for months when he was doing well on Lantus.
Click to expand...
the insulin has to be refrigerated at the same temperature always, once the seal of the bottle is open the insulin is only good for 60 days, I will tag an expert member to help you with dosing, don't worry we'll figure it out with you:bighug::bighug::cat::cat:
@ Suzanne & Darcy
@Sienne and Gabby (GA)
 
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

This link will also explain how to use the spreadsheet , it's easy. If you can fill in all the tests you have done already.
Once you do all this then members will be able to give you some advice

Also if Dylan is on Lantus you need the U-100 syringes with the half unit markings since we either increase or decrease by 0.25 units at a time


You can order the U-100 syringes with half unit markings from Amazon without a doctors script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO


We just eyeball when we need to increase or decrease by 0.25 units

@Anna12345
 
Last edited:
Anna12345 said:
Hi, new member. My cat 14 year old cat Dylan has been on Lantus for many months and it always worked at 1.5 every 12 - 18 hours. The last few days his blood is over 400 and won’t go down. I don’t know what to do! Please help
Click to expand...
@Bron and Sheba (GA)
@tiffmaxee
I gave her info to set up her signature and spreadsheet and enter the numbers she already has when she tested Dylan which she has in her previous thread ,I posted it above
 
Just one note about Lantus. It does need to be refrigerated but it lasts way longer than 60 days. It should be good until the expiration date and many times even beyond. I got Bobo in remission with a Lantus pen that was past its expiration date. As long as it’s clear and not foggy and you don’t see any particles, it should be fine. It sounds like it’s time for a dose adjustment. Just because 1.5 worked for months, it doesn’t mean it will always work. In fact, most cats need their dose tweaked quite often
 
https://docs.google.com/spreadsheet...9ZIFZ8PJsAI6eUntkoEmD-tRZE0tyAxxtyxhZ/pubhtml

I tried to fill out a spreadsheet. Here it is. I was confused since I don't give Dylan insulin every 12 hours somedays because when I test him his blood is too low so I wait a few hours and then test again and when it's high enough I give him insulin. I always give 1.5. So in the spreadsheet basically anytime it's over 144 - 160 I give his dose. You will see lately that his numbers won't come down like they used to. I will work on the signature next. Thank you
 
Anna12345 said:
https://docs.google.com/spreadsheet...9ZIFZ8PJsAI6eUntkoEmD-tRZE0tyAxxtyxhZ/pubhtml

I tried to fill out a spreadsheet. Here it is. I was confused since I don't give Dylan insulin every 12 hours somedays because when I test him his blood is too low so I wait a few hours and then test again and when it's high enough I give him insulin. I always give 1.5. So in the spreadsheet basically anytime it's over 144 - 160 I give his dose. You will see lately that his numbers won't come down like they used to. I will work on the signature next. Thank you
Click to expand...
@Anna12345

You need to fill out your signature please , I posted how to do it above ,so members won't have to keep asking you the same questions
Link it to your spreadsheet
Also on your spreadsheet we need the year Dylan was diagnosed not. 1 + years
 
Also on your spreadsheet we need the year Dylan was diagnosed not. 1 + years
.and put the year Dylan was diagnosed on your signature have you read the dosing methods for Lantus ?
Here is the link
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

You need to pick one and follow it and add which one you want to follow band add it to you signature and spreadsheet up top where it asks you
Each one will tell you when an increase or decrease is needed

Please read all the yellow stickys for Lantus
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
@Anna12345
 
I just tested him again and now he's 435.6! It's not even 12 hours yet since his last dose with no improvement it just keeps climbing and never became low during these last 10 hours. I just gave him another dose of insulin of just under 2 to see if this will bring his numbers down. I'm really worried
 
Anna12345 said:
I just tested him again and now he's 435.6! It's not even 12 hours yet since his last dose with no improvement it just keeps climbing and never became low during these last 10 hours. I just gave him another dose of insulin of just under 2 to see if this will bring his numbers down. I'm really worried
Click to expand...
You should never give another dose of insulin
Can you please update your spreadsheet for 9-29
Also I see in some days you didn't test during the PMPS cycle and didn't fill in how much insulin you gave
@Anna12345
 
I thought the right hand side of the spreadsheet (everything after the PM coloumn meant after 12 hours). I give insulin to Dylan sometimes every 15-18 hours since at 12 hours his blood level is too low to give his dose. I always give 1.5 dose once his blood goes above 144 - 160
 
Ale & Bobo & Minnie (GA) said:
Just one note about Lantus. It does need to be refrigerated but it lasts way longer than 60 days. It should be good until the expiration date and many times even beyond. I got Bobo in remission with a Lantus pen that was past its expiration date. As long as it’s clear and not foggy and you don’t see any particles, it should be fine. It sounds like it’s time for a dose adjustment. Just because 1.5 worked for months, it doesn’t mean it will always work. In fact, most cats need their dose tweaked quite often
Click to expand...
got it!!:bighug::bighug::cat::cat:
 
Have you read our methods sticky? You need a dose you can give every 12 hours without skipping. Your spread shows bg like 52.2. How are you coming up with that? Since you are feeding high carb food you would need to follow SLGS. You also need to because you are not getting a minimum of 2 tests every cycle. I would reduce the dose to 1.25 and see if there’s a drop under 90 on that dose. Stick with it unless that happens for 7 days. Start posting daily so we can help.
 
Yes on September 19 Dylan's blood glucose level was 52.2 (2.9 mmol). I had given him his 1.5 dose in the morning when his blood was 309.6 and 12 hours later it was that low (2.9). I'm just so confused because his insulin dose was working pretty well it seemed up until a few days ago. It just won't go down. Since I just gave him almost a dose of 2 insulin right now I will test him every hour to see if it goes down or goes up. I have corn syrup ready in case it drops but it doesn't look like it's going to based on the last few days. I was skipping some doses because when it was 12 hours his blood level was low like under 100 lets say so I didn't know what to do so I would just wait a couple hours so that would be like 14/15 hours from his last dose and then test again and when it was high enough I would give him 1.5. Should I not have been doing that?

I can try to give him 1.25 in 12 hours and then every 12 hours after that.
 
Please do decrease to 1.25 as it’s important not to have to skip so many doses. The newest ckd treatment guidelines say not to feed very low protein diets when in early stages and I’d suggest looking at the food lists above to find some foods to try. Lantus duration is around 12 hours so dosing once and then skipping due to low numbers will cause lots of high bg and bouncing around from high to low. That’s why I would try a lower dose. If you switched to KD that could explain why Lantus appears to not be working as well too.
 
I've updated the spreadsheet from testing him every hour or two since giving him his dose of 2 insulin today at 12pm. The lowest it went was 343.8 and now is climbing again. Why would this be? I can't figure out why it won't go lower than this the last couple of days. Could he be becoming insulin resistant? I called my vet today and she suggests I give him another 2 tonight at midnight (12 hours from when I gave him his last dose). She thinks he needs more insulin not less
 
When you skip shots it ruins the depot. Did you give any 9/29 or 9/30? Where you have nothing written did you skip? Please fill in the amounts and whether 12-18 hours.
 
I just tested him and he's 293.4! That's the lowest it's been in a while! I updated the spreadsheet again as best as I could. The last few days are accurate. I added some notes as well so you can see whether it was 12 hours or longer. I'm just not sure what to give him tonight for a dose. I'll keep testing him though.
 
Lisa and Witn (GA) said:
When was the last time he had a dental or full bloodwork done. If he has an infection that could also affect glucose levels.
Click to expand...

His teeth aren't great but I just worry about dental work at his age since they would need to give him anesthesia. He had bloodwork done 2 months ago (that's when they saw he had early stage kidney disease). My vet said today that if his numbers don't improve at the 2 units then we need to do bloodwork again this week...
 
I second what Elise said, 1.5 unit was too high a dose. You need to lower it to 1.25 units.

The reason you are seeing higher numbers could be from what we call a bounce, which is his body's reaction to lower number. Here is the description of a bounce:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
Yes thanks for asking. It was 446.4 so I gave him 2 units yesterday. Finally it's come down to 81 now but this is 14 hours after I gave him the dose. It slowly came down and was still high at +10. So I will wait another couple of hours and test again before giving him a dose.
 
Anna12345 said:
Finally it's come down to 81 now
Click to expand...
The Lantus is working! But perhaps too much. The 2.0 units dose is too much, given that you are feeding renal food. If you've got the 1/2 unit marked syringes, you can eyeball and give a dose of 1.75 units.
 
I think you're right. I gave 2 units to really get his blood down since it wouldn't go down with other doses but I can see it's too much to be giving twice a day at 12 hours consistently. I'm going to try 1.75 for his next dose once it's high enough. Thank you!
 
Lantus isn't great at "shooting down" higher numbers. Those higher numbers were likely the result of a bounce, which I described in post #31. You just have to wait for the numbers to come down on their own, which they will over time.

Good luck with the new dose.
 
Anna12345 said:
His teeth aren't great but I just worry about dental work at his age since they would need to give him anesthesia. He had bloodwork done 2 months ago (that's when they saw he had early-stage kidney disease). My vet said today that if his numbers don't improve at the 2 units then we need to do bloodwork again this week...
Click to expand...
I think you could skip the bloodwork again, it will be messed up given that something's wrong, and not necessarily reveal what is wrong.
You shouldn't leave teeth to become infected, it's the last thing you want, it will speed up his kidneys' deterioration and mess up with his blood glucose.
If you worry about anesthesia - which you should rightly given that there are some very bad practices out there - you should ask the vet what protocol she's following. Tanya's CKD group has a great guideline for CKD/Senior cat going under anesthesia. I can't copy-paste here for copyright issues, you can however join the group (I highly recommend it) here https://tanyackd.groups.io/g/support
They've been a great support for Feloro and me, and they're the ones who sent me over here for Aida.

Here some info about the importance of dental health: https://www.felinecrf.org/dental_problems.htm
and here some about anesthesia: https://www.felinecrf.org/anaesthesia.htm
 
Dylan's blood glucose level is 504 right now. It's never been this high. I'm sure it was a bounce since when I checked it a few hours ago it was 54. I'm just wondering what do I do during a bounce like this? He's at +12 hours right now but do you give a shot considering it was so low and the only reason it's high right now is because of his body releasing glucose? To get this number down I would need to give him 1.75-2 units but I just want to understand if you do that when the number is high because of his own release of glucose because the number was too low. I have read stickies but I'm looking for answers that I really don't understand yet. Thank you. I will look into dental work and the info you sent and take Dylan to the vet this month.
 
Try to ignore the bounce numbers. With that 54 today, he told you that the 1.75 units dose is still too much, as it took him below 90. Reduce the dose to 1.5 units and practice patience for the next couple days. ;) He will come down when the bounce is over.
 
@Anna12345
Hi Anna I noticed you haven't picked a dosing method for Lantus yet. If you are feeding any dry food you will have to follow the SLGS method.
Here they are so you can read about them and choose one then add it to your signature and spreadsheet up top.
Each one will tell you when to increase or decrease the dose
We base the dose on how low the BG is dropping not what the AMPS or PMPS is

Good luck with the new dose
 
I think I am going to do the SLGS method because I feed RC renal canned food. I've ordered the Weruva wx though so that may be better for him and I'm getting the BFF canned food that is low carb low phosphorus as well. But I think for now the SLGS is best.

Thank you
 
Anna12345 said:
I think I am going to do the SLGS method because I feed RC renal canned food. I've ordered the Weruva wx though so that may be better for him and I'm getting the BFF canned food that is low carb low phosphorus as well. But I think for now the SLGS is best.

Thank you
Click to expand...
@Anna12345
Ok good can you please add SLGS to your signature and spreadsheet up top so members know :cat:
Oh when you start feeding the Weruva change it on your signature also
@Anna12345
 
Last edited:
Status
Not open for further replies.
Back
Top