New here. Jack on Lantus. Numbers up and down

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KyCatMeowmy

Member Since 2014
My cat Jack was diagnosed with diabetes last weekend. His BG was 457 at the ER. His numbers stayed high for a couple of days. The Vet had him on Humulin N 4 units per injection. The night I brought him home it was 79 but she gave him an injection anyway. At my request she switched him to Lantus but told me to give him 4 units twice a day. I spoke with my daughter, a cardiovascular ICU nurse, R.N., B.S.N. And she said even I unit could level a human and said to not give Jack that much. Jack's numbers have gone done each day ( a little higher in mornings) but drop very low at night (last night was 41 so I did not give him any insulin at all). This morning it was 171 so I gave him I unit. By late afternoon it was 280. I don't know why it spiked. Around 8 p.m. It dropped to 38 and yet NO insulin had been given since after the 280 reading this a.m. At 38 I have no intention of giving him more insulin tonight. I feed him fancy feast classic chicken feast pate. I hope his sugar is a better number by morning.
 
Please - no shot below 200 mg/dL using a human meter and 230 mg/dL with a pet specific meter.

The nadir, or lowest glucose between shots for Lantus usually is between +5 to +7 hours after a shot.

Lantus has a cummulative effect over 5 to 7 days for the first dose and 3 to 5 days for subsequant doses. Hold a dose at least 3 days so long as he doesn't go below 50 mg/dL on a human meter.

Going below 50 mg/dL earns a reduction of 0.25 units. We eyeball quarter units.

Stick to an every 12 hours schedule for the shots: Lantus works best with consistency.
 
How much does your kitty Jack weigh? Most cats do not need more than 1U of Lantus to start, unless they are really heavy.
 
KyCatMeowmy - I'm pretty new here too, so I can't really offer any advice, just wanted to say WELCOME!

Good luck with Jack! :smile:
 
Thanks for your replies. This a.m. Jack was still at 208, the same as last night. He is a big boy. He weighs 18.7 lbs.
 
KyCatMeowmy said:
The Vet had him on Humulin N 4 units per injection. The night I brought him home it was 79 but she gave him an injection anyway.
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I would not only find a new vet, but also consider reporting her to the vet board. This is just insanely dangerous! :o

KyCatMeowmy said:
Jack's numbers have gone done each day ( a little higher in mornings) but drop very low at night (last night was 41 so I did not give him any insulin at all). This morning it was 171 so I gave him I unit. By late afternoon it was 280. I don't know why it spiked. Around 8 p.m. It dropped to 38 and yet NO insulin had been given since after the 280 reading this a.m. At 38 I have no intention of giving him more insulin tonight. I feed him fancy feast classic chicken feast pate. I hope his sugar is a better number by morning.
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So, let me see if I have this correct:

7/6
PMPS (PM Pre-Shot) - 41 - no shot

7/7
AMPS - 171 - 1u
+8? (hours after shot) - 280 (did you also give insulin then?)
PMPS - 38 - no shot

7/8
AMPS - 208 - 1u?
 
Thanks so much for the input. Jack had 1/2 unit of insulin yesterday morning around 8 a.m. (Tuesday, July 8, 2014) At that I time his insulin was 208. I fed him Fancy Feast Classic Chicken Feast. When I got home at 5:30 his BG tested at 101. No insulin was given. This morning, at 8 a.m. (Wednesday, July 9, 2014) his BG was 99. It is dropping, even with food without insulin since yesterday morning and that was only a half unit. Should I hold off on insulin and monitor?
 
I just got home and took Jack's BG (have not taken since earlier this morning, July 9, 2014 when it was 99). At 4:30 p.m. His BG is 73---still dropping. Absolutely no insulin has been given since early yesterday morning (July 8, 2014 when he was given I/2 unit of Lantus). I am concerned since it is still going down even though no insulin has been given since yesterday morning. I just fed him. I am so glad you advised me to refrain from giving more insulin.
 
The last shot you gave was .5u of Lantus yesterday morning? It's highly doubtful that it's still affecting his numbers because you haven't given enough doses to create the Lantus depot so there's not much build-up of Lantus in his system. Even still, it can take around 3 days of no insulin to be sure that it's not the Lantus that's continuing to bring down Jack's numbers. I think you might have "broken" Jack and he might already be heading toward remission! :lol:
 
KPassa, I hope so. He has only been on the LAntus since last Thursday and this is just Wednesday. Never more then a 1 unit given (one unit was given twice last Thursday....only 1 unit each morning since then until yesterday when we gave him the 1/2 unit. Should I be concerned with the 73 reading since it has been going down since yesterday?
 
No, just feed him like you already did and keep an eye on his numbers. You might want to test him 2-3 hours from when you last fed him and see if his number drops further or stays the same (sign or a possibly working pancreas) or goes up (sign that he may still need a spot of insulin to help his pancreas if it goes higher than 150-200).
 
I didn't get to get Jack's numbers last night (I have to take care of my mom with Alzheimer's) but the good numbers yesterday (July 9, 2014 at 8 a.m. were 99 and at 4:30 were 73 and looking good). He did eat well yesterday....Fancy Feast Classic Pates and a small jar of Beechnut Beef and broth baby food.

At 8 a.m. this morning before feeding him his BG was 239. Should I give a half unit of Lantus? He has had no insulin since early morning July 8, 2014 and that was a half unit of Lantus.
 
Can you eyeball 0.25 units? Or draw up 0.5 then expel a drop or two?

If you'll be home to monitor, it isn't a problem, but if you won't, skipping may be safer.
 
I can stay home until 11 a.m. today. He just ate more Fancy Feast Chicken Feast Pate after I tested him so it probably will go up. We have been eyeballing the half unit. We can try to get it to .25 or even a drop if you think I should.
 
If you can't monitor through +5 to +7 hours post shot, I'd skip.

It would be really helpful if you'd set up a Google Drive spreadsheet of the tests. Its nothing more than a color-coded grid of the date, tests, insulin, and notes. Instructions are in the Tech Support forum here.
 
If I give him even .25 to .5 units Jack's BG goes below 100. If I skip it goes to the mid 200's. I have doe a spreadsheet but it doesn't look like everyone else's yet. Still trying to upload on my iPad. But I did one that is easy to follow. I haven't done color codes (still trying to figure how on my iPad and I put in times and will change to +7 etc. once I get the hang of creating the spreadsheet. I am trying to upload but don't see it when I do.
 
How low & what meter.
On a human glucometer, it is safe to go as low as 50 mg/dL and on a pet glucometer, 80 mg/dl.
 
I am using the Relion Micro. I was able to test 3 times yesterday (Saturday, July 12, 2012) here are the one-day results
7/12/14 Saturday: 8:30 a.m. BG 249/ .25 unit given. At 3p.m. BG was 92 (no insulin given). 10 p.m. BG=180, .25 unit given.
 
KyCatMeowmy said:
...
7/12/14 Saturday: 8:30 a.m. BG 249/ .25 unit given.
At 3p.m. BG was 92 (no insulin given).
10 p.m. BG=180, .25 unit given.
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The way we write it, since folks are in different time zones and interpretation is in reference to shot time:
AMPS 249, 0.25 units
+7.5 92 (nice number)
PMPS @ +13.5 180, 0.25 units

The nadir, or lowest glucose level between shots, often falls between +5 to +7 hours after the
shot. Varying your mid-cycle tests in that period helps insure you see how low he truly goes. He may have gone lower than 92.

Lantus works optimally on 12 hour dosing.
Shooting early can act like a dose increase because there is more overlap in effect.
Shooting late can act like a dose decrease because there is less overlap in effect.
 
Sunday, July 13, 2014, at 9 a.m, Jack tested at 107 (.25 unit given)---at 3 p.m. BG=115 (no dose). At 11pm BG=291 (.5 unit).
Monday 7//14/14 at 9 a.m. BG=105 no dose. 10 PM BG = 74 no dose
Tuesday 7//15/14 at 9 a.m. BG =67

He has remained low since the .5 unit Sunday night.. I am leery about giving him more insulin when his numbers have remained low for nearly two days. I think the 291 Late Sunday night was a result of him getting into some dry food that had been put away (science diet DM pushed on me to buy by his vet that I intended to return but can't since the bag was "opened" by some determined kitty cats.) I am not home midday on weekdays to test. I usually don't get home until late evening.
 
(science diet DM pushed on me to buy by his vet that I intended to return but can't since the bag was "opened" by some determined kitty cats.)
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I thought the Science Diet had an unconditional guarantee. You should be able to take it back, even if the bag has been opened.

You probably want to think about getting that bag of dry food out of your house, so Jack can not sneak any of that dry food again.
 
Since Jack's BG numbers have been low since Sunday night (when he got the SD DM because the kitties tore the bag open) I have not given insulin since late Sunday night.

Monday morning at 9 a.m BG =105 and 10 PM BG=74
Tuesday at 8 am. BG=67 and 10:30 PM. BG=87
Wednesday at 8:30 am BG=72 and 11pm BG=85
Thursday at 8 am BG=65 and 10 PM BG=65

I came home on a lunch break and checked his BG today at 1pm. His BG is 47

I am concerned that his BG continues to go down without insulin. He is eating and acts normal. I just fed him again. Should I give him some food with more carbs in it?
 
Nope. He's working on remission. :smile:

Some cats OFF insulin may go down in the 30s on a human glucometer. If he's eating, drinking, peeing, and pooping, plus behaving normally off insulin, let him be and enjoy it.
 
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