Murka has steroid-induced diabetes. Help needed

[Julia MURKA]

Hello everyone!
I really need your help because I'm not sure if my veterinarian and I are doing the right thing with LANTUS dosage.

My cat, Murka (female, 11 years old), was diagnosed with IBD/small cell lymphoma of the stomach on January 13, 2026 (a biopsy was inconclusive). Murka was prescribed prednisolone 5 mg in the morning and 5 mg in the evening (reducing the dose causes vomiting, so she's currently on this dose).

On May 25, 2026, the veterinarian diagnosed elevated blood sugar levels to 14-18 mmol/L and prescribed LANTUS at a dose of 1.5 units twice daily (a few months earlier, he diagnosed elevated blood sugar levels to 8-9 mmol/L, but didn't prescribe LANTUS).

Since then, I've been keeping track of Murka's blood sugar levels.
As prescribed by the veterinarian, I increase the dose every 5 days.
I skip an injection or administer half the dose (1/2) if the pre-injection blood sugar levels are between 5.8 and 11.1 mmol/L.

Murka eats whenever she wants during the day (small snacks of carbohydrate-free wet food). If she doesn't eat for 4-5 hours, she starts vomiting due to hunger, which can be caused by IBD or lymphoma.

By June 18, 2026, I reached a dose of 2.75 units.
On June 20, 2026, Murka's blood sugar levels began to drop significantly, and the vet recommended reducing the dose from 2.75 units to 1 unit.
On June 26, 2026, her blood sugar levels began to increase, and the vet recommended increasing the dose to 1.5 units.

Please tell me if I'm doing the right thing.

P.S.: I've also noticed several times that if Murka's blood sugar isn't high enough for an injection and I feed her to boost it, her blood sugar DROPS an hour after feeding (from about 7-9 mmol/L to 6 mmol/L). Is this normal? The vet said this happens, but didn't explain the cause.

Link to the spreadsheet with measurements:
MURKA

 

[Tim & Pookey]

Hi Julia and welcome. Nice job getting the spreadsheet going and test data in there. It sounds like you're doing a lot of the right stuff, home testing, feeding a low carb wet food, and a good insulin.

For the most part, dose changes here are made in 0.25 unit increments. Have you seen the dosing methods? TR has research behind it.

Her numbers look good. Lantus is a depot insulin so that could explain why you're seeing a drop even without a shot that morning.

 

[sacker1002]

Reactive hypoglycemia (also called postprandial hypoglycemia) happens when blood glucose levels drop too far within 2 to 4 hours of eating.1 It’s not the same as fasting hypoglycemia, which occurs after going long periods without food. Instead, it’s tied directly to how your body responds to a meal.1

Here’s what’s going on: you eat, your pancreas releases insulin to help shuttle glucose into your cells, but in some cases, the system overshoots. Too much insulin hangs around, and instead of returning to baseline, your blood sugar levels sink below where they should be. That dip (sometimes dipping under 70 mg/dl (3.9 mmol/l)) can trigger symptoms that make you feel shaky, weak, or foggy.1

Why does it happen? Common culprits include:

Excessive insulin release: Some people’s systems are hypersensitive to carbs. A bowl of pasta or soda floods the bloodstream with glucose, and the pancreas responds by pumping out excessive insulin.2 The result? Levels crash lower than your body can comfortably handle.

Insulin resistance/prediabetes: In the early stages of type 2 diabetes, insulin isn’t as effective. Your body may release more of it to compensate, but because the response is poorly timed, glucose still drops in an unsteady way.

Understanding Reactive Hypoglycemia: Causes and Solutions

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
Murka’s numbers are pretty good for a newly diagnosed kitty.
What foods are you feeding Murka.?
Could you set up a signature please as this will stop us having to keep asking you the same questions over again. Thanks?

I would suggest you have a look at our two dosing methods for Lantus and choose one of those. This will get Murka into better numbers quicker and take the guesswork out of dosing .
Lantus dosing methods