Need some dosing advice for Lantus

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doombuggy

doombuggy

Member Since 2011
We were diagnosed on 4/22/11 and started on his insulin on 4/23 (1 unit every 12 hrs). I have created a spreadsheet and at this point, the vet increased his units to 2.5 (from 2 units every 12 hrs, see sheet). His numbers were generally in the 200 range, but I think the problem was I was testing him after feeding but before insulin; and I didn't give Cedric his 1/8 cup of dry Thursday night (was planning on cutting back to 1/8 per day) and forgot to give it to him yesterday. :oops:

Last night he tested very low 2x, so he got no insulin. (51 & 61 30 minutes later). Please note that he is acting normal and displaying no symptoms of hypo. I use the Reli-on Micro.

This morning, I read 150 at 6am, then 131 at 6:45. the only thing he had to eat was an Evo treat that is high protein no grain. I then fed him, and gave him 1 unit at 7am.

I don't leave for work until about 9:45a, so I will be watching him until then (I work part time at Walt Disney World on the weekends). If his number stay in the 100 range, I think dropping to 1 unit would be better/safer than 2.5 (every 12 hours for all doses, of course). I did call the vet yesterday because I felt I had been reporting inaccurate testing since I was taking those readings AFTER food. I did send them a link to my spreadsheet. I know my vet wants to get Cedric into remission, and they have been very co-operative with me calling them with questions, etc. They over charged me for his boarding/dental last week by $35.50, but I am starting to feel they deserve the money since I call them a couple times a week (vet called me Thursday night too).

So any advice you can give me would be awesome. I am Cedric's only caregiver, and work in an office during the week. He can/has gone to the office with me, so that can be an option. We are off on Memorial day and I have told the vet I would do another curve that day. Thanks again for your time and advice.
 
Welcome! I know others will be around shortly to give you more thorough advice, but right now the best advice I can give you is in order to succeed in bringing Cedric into remission is to be PATIENT. Lantus takes awhile to settle in with kitties, which means you have to stick with one dose for longer than you'd think and get some numbers before you change the dose. And changing doses is done in very small increments. A one unit increase based on one curve is a huge amount.

There are a lot of stickies posted at the top of the board that are very helpful. Read them, read them again...then a few days from now read them again. Abby has had diabetes for 3 years (most of that time has been in remission, but we're back again) and I can't even count how many times I've read the information. It's an awful lot to absorb but one day it'll all start to make sense!!!
 
My best explanation for the shift in numbers is that you inadvertently eliminated the dry food in Cedric's diet. There are any number of caregivers here who would feed a reasonably good quality, low carb dry and once it was gone from their cat's diet, numbers dropped. The timing of Cedric's lower numbers does seem rather coincidental with the elimination of dry food. Even a small quantity, like you were feeding, can influence BG levels.

Once the dry is gone, it's likely he will require less insulin. I think your instincts are good! I would strongly encourage you to reduce Cedric's dose and 1.0u seems very reasonable. Reducing the dose is particularly important since you can't be around to test during the day and you want to make sure Cedric is safe. I would also encourage you to get as many tests in at night since you do have a challenging schedule during the day. Think about getting tests right before you leave and when you walk in the door from work. Any tests you can get will help you to know what's going on with Cedric's numbers and help to guide your dosing decisions.

FYI - numbers in the 50 - 60 range are normal BG numbers. In fact, it's a great range for Cedric's pancreas to heal. Vet's often get nervous with numbers in that range because the majority of their clients don't test or don't know how to manage lower numbers.
 
I second all of Sienne's observations. Welcome to Lantus Land! Right now it looks like 2.5 units is probably too much, and 2 units might be too. Starting over at 1 unit seems like a good idea. You can work up (or down) from there once you have gathered some data.
 
just saying glad you made it over here to the lantus forum, and glad you got rid of the dry food. looks like cedric is going to do really great!

here's the link from your previous condo: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=43666

if you had more than the one, it's helpful to put them here. that way if someone's wanting to look at history to give better advice, it's easy to find.

have a great day at WDW! do you get to wear a costume? and welcome!
 
Hi Doombuggy!
Great to see you in the Lantus thread. I think you and Cedric will like it here. :mrgreen:
 
Hi, Doombuggy,

Welcome to Lantus Land! You are in the right place!

I third what Sienne and Libby said -- and they know their stuff. :-D Sounds like you have great instincts and a good vet. The option to take Cedric to the office if necessary is wonderful.

Looking forward to watching Cedric's progress.
 
I checked on you guys yesterday before I ran out the door to job #2 but didn't get a chance to post back. That 51 doesn't surprise me! I was scared Cedric might go hypo and I'm super relieved he's ok and doing great! :smile:

I agree with everyone else to stick with 1u for a while and see how he does. You may see a little bouncing around with a high number here or there, but that should even out eventually with a consistent dose.
 
Hi Doombuggy and I want to welcome you to LL as well. You'll get the best advice available from the people here. FDMB is a blessing to so many!
 
Hi there! Just another quick welcome to Lantus Land! You've already gotten some great suggestions, and you are doing a fabulous job. As Sienne said, your instincts are spot on!

Keep asking questions...this place is full of incredibe FD knowledge!

Amy & Trixie
 
Welcome to Lantus Land!!! We're all here to help.....we're a closeknit group and there's usually always someone around to give you support. We've got some amazingly knowledgeable folks regarding FD. Ask as many questions as you can think of and welcome to our family.
 
Thanks for the warm welcome, folks! We did 1 unit at 7am and 7pm yesterday, as his readings were mid-100s. This morning, I tested him twice and rec'd first a 64 then at 73, so I elected to give him nothing, as I'll be leaving for work at WDW in a couple of hours. He's doing well, and right now is watching for birds & squrrils.... :lol:
 
just so you know, lantus' strongest action is mid-cycle most of the time, for most cats. it can vary though - it also has a delayed ongoing action because of the "shed." your preshot tests don't tell you nearly as much as your mid-cycle tests about what the dose needs to be, although they likely are telling you that your cat was quite a bit lower a few hours before. you want to find a dose that you're comfy with giving every 12 hours without skipping any, although i would've skipped this morning too. skipping shots gives you wonky numbers for a couple of days. changing doses also affects numbers for a couple of days - lantus likes consistency in both dose and time.

have you read the stickies at the top of the lantus forum yet? they have so much info in them - it takes reading multiple times to absorb it, and i found some of it still didn't make sense until i needed that particular information.

those are low numbers for a newly diagnosed kitty - i can appreciate why you skipped the shot today. someone who can advise on doses will no doubt be around to help you with that. hope you had a great day at work!
 
Thanks. His reading this evening pre-food was 71, not much different than this morning's 73 reading. I didn't give him anything b/c I thought that these are a normal cat's numbers and giving him insulin would make the numbers drop. i will keep an eye on him tomorrow, and decide if I might take him to the office with me Tuesday and do a curve then instead of on Memorial day (my next day off).
 
you don't have to wait to do a full curve - it really helps to just get a +3 or a +6 from the intended shot time, anytime you can. really any extra checks are going to give you more information. more information is really important!
 
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