lantus user, can't get numbers down. help!

[Theresa6]

My cat Stella seems to not be responding much to the lantus. She is 10 years old and weighs around 10 lbs. She's probably a little overweight. She was diagnosed with FD and hyperthyroidism at the same time and started her meds for both at the same time. She was started on 2u of lantus twice a day (first day was Dec 14th) and I started home testing a couple of weeks later when i realized she was still drinking like crazy and flooding the box. My home testing showed that her numbers remained high, between 350 and 450. Our vet recomended upping to 3u, but I started slow at 2.5u. It has been about a week now, and I am testing 3 times a day and finding the same results with the exception of one 24 hour period where she was 250 at night and 176 in the morning.

What could be going on? Why is she just not responding? What numbers are we aiming for in cats? Our vet said 170 is normal. Is that what we are aiming for?

 

[Sienne and Gabby (GA)]

Welcome to Lantus Land.

It's great that you've started home testing. It would be even more helpful if you could put your test information into a spreadsheet and attach that info to your signature so we can have a better idea of what Stella's numbers have been looking like. Also, with Lantus, we encourage you to get at least 4 tests per day -- your two pre-shot tests and one test each cycle. Since dose decisions are based on the nadir, it's important to get at least one spot check per cycle.

It may take a bit longer for Stella to get regulated given the hyper-T. This particular condition can knock a cat that's in remission out of remission so it's not surprising that it may take a bit longer to get Stella's numbers under better control. In part, because in hyper-T metabolism is speeded up, insulin may be metabolized more quickly, as well. As a result, you may not be getting as much duration from Lantus as you will once the hyper-T is under control. This link may be helpful.