New cat on Lantus- is this normal?

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ewest

ewest

Member Since 2011
My cat's 17 years old and recently diagnosed with diabetes. She's been on Lantus for a month now and we're working on getting her regulated. She doesn't seem to be responding in the "normal" manner... that is having the lowest reading 6 hours after her dose. Her lower readings are all over the place. We just increased from just under 1 unit to 1 full unit on Sunday and her readings yesterday have remained high. Did 4 bg tests yesterday which were:
Amps- 371
Plus 6 -392
pmps- 422
Plus 6- very high plus 600
Amps- 407

She was having more 200's and 300's on the just under 1 unit. Not sure if her body is still adjusting? My vet wants to increase to 1.5unit. Have other folks had similar experiences with Lantus and their cat having more unpredictable results??

Thanks.
Elizabeth/Munchie
 
Welcome, Elizabeth.

Do you happen to have more blood glucose (BG) test data than just one day? It's also helpful to collect your data on a spreadsheet so everything is in one place. There is a template for the spreadsheet that we use that is in the Tech Support forum. There are also instructions for attaching the spreadsheet to your signature. I'm hoping that you've gotten the home testing routine down and are comfortable with it.

As far as the nadir, the lowest point of the cycle is not reliably at +6. My cat's nadir is more often at +3 or +4. Sometimes, it's even earlier or much later. The nadir can be a moving target. It all depends on your cat. If you take a look at the spreadsheets of some of the other people on this forum, you'll see a great deal of variability with regard to when the nadir falls.

I'm not sure where you started on dose - it sounds like you've been at 1.0u for a month. My guess is that Munchie does need more insulin, though. From your posts on Health, it also sounds like Munchie has a history of DKA. Are you testing for ketones? Given where Munchie's numbers are and the history of DKA, more insulin is a good idea.

I'd also encourage you to read the starred, sticky notes at the top of the Board. If you look at the Tight Regulation sticky, you'll see that past the first week, we encourage increasing the dose by 0.25u every 3 days if you're cat's still sitting in numbers that are above a normal BG level.

Please let us know how we can help. I hope you'll continue to post on a daily basis.
 
Thanks. Are there any possible negative effects of bumping up .5 instead of .25? I thought I read somewhere else on the board that if numbers above 300's to do .5 instead of the .25.
 
Hi,

I'm new to the board, also. I'm sorry to hear that your kitty is having difficulty regulating. What kind of food is your kitty on. Jynx, my kitty, was all over the place at first, with extremely high numbers before he was switched to wet food. If you are changing over to wet food, be extremely careful on dosage during the change. Good luck! Everyone here is extremely helpful/knowledgeable. Welcome!
 
What you recall is mostly correct. If nadirs are above 300, then you can increase by 0.5u. Otherwise, you increase by 0.25u. However, the dose change is based on the lowest point in the cycle, not the pre-shot. If you think that 0.5u is too much, you can increase by 0.25u. Just please keep checking for ketones. I'm presuming you have Ketostix (test strips for urinary ketones) at home.
Tight Regulation sticky said:
"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).

Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...
 
hi elizabeth - just want to say welcome. ask all of your questions - we'll try to answer! scritches to Munchie.

personally, i'd also increase to 1.25 tonight. it's safe. it just looks like munchie needs more insulin. and when you increase expect that the numbers might be a little crazy for up to 3 days. for whatever reason, that's the "normal" response to more insulin. you just stay the course through it til they settle down..
 
Thanks. I have Ketostix and have been checking her. She's on a raw meat diet and has been for years. I have a spreadsheet but not the same one as here and not able to upload at the moment but will try to see if can get access to this weekend. What I'm noticing is that her blood sugar numbers are actually higher with the slightly higher insulin dose... hm...

Also just noting I've heard the bs numbers can be higher initially on an increased dose..so that the first few days on a new dose might be higher than after that...have others found that to be the case for their cat?
 
Hi Elizabeth and Munchie and welcome to Lantus Land! I am not savy enough to advise you on dosing but I can vouch for the solid advice given by others on this forum. As you get more comfortable with the whole process, things will make more sense. Read the 'stickies' at the top of the Lantus Home Page, they help a lot. Good luck, happy to see that you've found us.
 
Does anyone know where the link is that shows pictures on measuring dosages in U100 syringe? Can't find it...
 
Read the new dose wonkiness bit and I guess when is it no longer wonky (i.e. if the numbers stay elevated and just don't go back down), is it saying you're supposed to then reduce the dose again? That confuses me because I know the prior dose wasn't enough...still having 300's and 400's for +6 with the prior dose. Munchie's dose was increased Sunday night and she still had increased readings on Thursday... Seems like she needs more insulin, but I hope increasing the insulin won't just cause more wonkiness and increase her blood sugar even more...I have to admit 'tis confusing to me...
 
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