? Lantus once daily at bedtime?

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ORRY and Halyphill

Member Since 2017
Things havent been going too well for Orry lately. Latest curve left me scratching my head. At supper time, he was at 71... under 100... no insukin but then of course, the food shoots him to 330 at bedtime. In the morning he is around 360s, eats and dosed. He peaks at 3pm and stayed green for 4 hours!

Im still waiting for the vet's interpretation but wondering what thoughts are there about dosing once a day... say at bedtime? (I only sleep maybe 7hrs anyway so low would be at breakfast timw anyway.)

He is currently at 0.5u 2x daily... eats about 7oz of Fancy Feast Roasted or Classic.

Also, are micro-seizures a thing? I had to check that Orry wasn't sitting on my phone. His fur looked like it was vibrating.

https://docs.google.com/spreadsheet...23s2jscbeOA12-k23TTjbm_fkXE/edit?usp=drivesdk

I know it isnt that good of a spreadsheey but it is what I can manage. (Living alone, random job hours). I tend to watch clinical signs more and spot check as necessary.

Thanks for any words of wisdom!
 
It's possible to dose less than 0.5 u by carefully eyeballing half way between marks on the syringe or using callipers. Looks like a smaller dose might be what he needs. Once a day dosing doesn't work well for cats because they metabolize insulin quickly. Let's see what the pros think.
 
Hi there. Are you following TR or SLGS. If it's TR, you could start shooting lower as long as you can monitor. Those of us doing TR are shooting anything over 50 on a human meter. Notice when you get a number like last night's PM and the night before you have skipped , he shoots high and then given the 0.5 dose the next day and it does get him where you need him. If you could get comfortable shooting some lower numbers you might be able to get him to stay in the greens all day and start weening him off the insulin.

Let's see what others say.
 
Closer to SLGS... than TR... I think. pDVM and I have been conversing and we typically change in 0.5 increments.

I don't want to skip doses thatcis for sure but below 100 and he doesn't get any insulin. We shoot for between 100 and 300 the majority of the day. So, those green numbers are cause for mild concern.

He has pancreatits and orignal diagnosis carried ketones. Latest blood and urinalysis showed pancreas was getting worse and no ketones. I'm saving money for a dental cleaning for his birthday.

Insulin is clear, no floaties, and acquited April 23rd... so 4 months. I got the wrong syringes last time so eyeballing the 0.5u. If we go to 0.25u, I will be getting the right syringes.

2pm today... (+7) BG of 284. So... much higher than we want it. Poop. But kooks like he will be getting dosed tonight!

Still waiting to hear from the pDVM. Probably tonight.
 
It looks like what you're seeing is that the 0.5u is too big of a dose if you want to give a shot twice a day -- and a cat's metabolism requires a twice a day dose. If you can measure out 0.25u, I would encourage you to try that as your dose. This is what the dose looks like:

025unit-1.jpg
 
I agree with @Sienne and Gabby (GA) , it looks like the 0.5u BID is too much for him at the moment, however if you went to once a day shot of insulin you would not get good duration, you've seen this when you've skipped a dose and his numbers shoot up a few hours later.
By shooting 0,25u twice a day, hopefully that would allow you to shoot comfortably twice a day, resulting in him spending longer in a healthy BG range.

Most vets don't think you can measure below 0.5u, but it is possible.

You mention he had ketones at diagnosis, I would get into the habit of regularly checking for ketones, especially if his numbers are running high, he get's and infection, is off his food, or seems off in any way. DKA can develop very quickly into an emergency situation.
 
Okay.... so still nothing from pDVM... probably because she wanted a consult with other DVM. I agree that the 0.5u dose was too great.

I get home from work at 8pm, so 13hrs after AMPS. Orry had a PMPS of 254. I a encouraged by this. I dosed him at 0.25u tonight. Man, that looks like NOTHING!

Thanks for your support. I will letcha know how things fair.
 
I'm glad you reduced the dose. However, you do need to try to get a "before bed" test in every night. Some cats have lower numbers during the PM cycle.

 
pDVM approved the doaing change... if I am confident I can pull 0.25u. She also suggested 0.5u once a day or some pill since Orry needs very low dose. Well, Orry doesnt like pills too much so the thought of having that battle was a no brainer! I WILL* get confident in pulling 0.25u. pDVM said this one was the better choice.

Orry has been eating well and chasing his red dot. Today, he played with the yarn balls and we even played hide n seek!

Thanks for your help... always better to have some knowledge going into a convo with vet.
 
or some pill

You don't want to use the oral meds....the way they work is to force the pancreas to work harder to produce it's own insulin.....the key to remission is to let the pancreas rest and heal, so forcing it to work harder just ends up destroying more beta cells and you end up on insulin anyway when the oral meds can no longer "force it"

It's not as important that you get an "exact" .25.....just that you get as consistent as possible. You might play with some used syringes and colored water and figure out where you think .25 is going to be and use that as an example to compare to when you're using the real insulin
 
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