Need Help with Insulin Dose. Is Vet Crazy?

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Scdal

Member Since 2020
After 2 weeks my new vet finally emailed me and adjusted Phoenix's insulin from 4 units to 6 units. Phoenix weighs 34 lbs and started on Lantus 2 weeks ago. This was Friday night and the clinic is not open on weekends.

I adjusted my cat's dose to 5 units over the weekend and his glucose still did not go down. The vet only has him taking Lantus once a day.

Yesterday afternoon, Monday, my vet finally looked at the email I had sent him over a week ago with my cat's weekly glucose readings that had risen to the high 300 and 400 levels. He emailed me back and said that since the Lantus only lasts 12 hours, he thinks it would be best to give him insulin twice a day and see how that works. He wants me to lower his morning units back to 4 and twelve hours later, give him 2 units.

Does this make any sense at all? At 5 units yesterday, his preshot reading was 401
Four hours later after giving 5 units his reading was 398. Another reading after 9 hours was still 398.

Can his eating better be keeping his blood glucose high? When he first started on insulin 2 weeks ago, he was barely eating and his insulin dropped dramatically. Now that he is eating better, his glucose is rising or remaining the same after the insulin.

I have been hesitant to go against what my vet tells me to do. But telling me to lower his insulin when his glucose is rising makes no sense to me. Please advise me what I should do. I am ready to listen.
 
Well, the good news is that your vet is now on board with 2X/day insulin shots! The bad news is that he's still not quite on top of how Lantus works. Lantus likes consistency in dosing, so it's much better to have the same dose 2X/day than to have a different morning and evening dose.

The other day Bron suggested splitting the 4U to 2U morning, 2U evening. How do you feel about trying that? We could also try a little higher, 2.5U and 2.5U.

You will have to do some nighttime tests when you do this. Even just one before-bed test, around +3 or +4, is great for this, just to see where he's headed.
 
I agree with everyone here. You need the same dose twice a day. I’ve been through at least 3 vets and still the only person I trust is her nutritionist. I also need to say that he was diagnosed recently and you have some time to figure all of this but you should google the hell out of Lantus and diabetic cats and see how all the experts out there say the same thing these guys here are telling you. I had to tell me vet I wanted Minnie to go on ondansetron when Cerenia didn’t work for her nausea. She had never used in cats and didn’t know much about it but I had done all the research and knew I wanted to try it. Sometimes you have to be the advocate for your pet just like you would with a child. Hell its not just vets a lot of doctors are also clueless why would vets be any different?
 
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