New Lantus user needs opinion/advice

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Jeannie & Cairo

Jeannie & Cairo

Member Since 2014
Ok, I need the opinion/advice of my Lantus users. Cairo (my sugar cat) is about 14 years and about 14 lbs. I'm very comfortable home testing her (I've been doing it a few times a day for about 2 weeks). She is on wet food only (Fancy Feast) 4X a day ... small meals seems to help keep her BG down. She consistently tests in the low to mid 200 range (although twice, in the past 2 weeks, she's been in the low 300's). I had the vet consult today to learn how to give her insulin shots. The vet prescribed 2 units twice a day. To me that still seems a bit much. Does anyone have any input, suggestions or advice as to how much you would recommend giving twice a day? Seems to me it would be better to start lower and increase if numbers don't improve. Any thoughts?
 
You are absolutely correct that's way too high of a starting dose. I personally start all of mine at .5 and work up from there.

Mel and The Fur Gang
 
You'll want to wait for someone more experienced to come along, but if you get a chance you might want to read this article: http://www.felinediabetes.com/start-low-go-slow.htm

It's excellent that you're home testing and that she's on wet food. You'll likely want to give the initial dose for at least a week to see how Cairo's numbers respond. The other thing to remember about Lantus is that it typically reaches its full effect between 5 to 7 hours after injection. If you can get a few tests in during those hours, it will be helpful information for determining whether she needs to a higher or lower dosage. My cat, Maddy is the same age and weight as Cairo and her initial dosage was 2 units twice a day. While I was still feeding her high carb, dry it was fine, but it was way too much once she was transitioned to wet food.
 
Hi Jeannie!

Is she underweight or about right?

There is a formula for the starting dose on Lantus

It's .25 unit per kg of the cat's ideal weight OR

if underweight, .25 unit per kg of the cat's actual weight

Take either her ideal weight or actual weight and divide by 2.2 to get kg (example 14lb cat divide by 2.2 = 6.36kg)

Take that number and multiply by .25....that's her starting dose (example 6.36 kg multiplied by .25 = 1.6 units) Rounding down to 1.5 unit starting dose

It's always safer to start lower and work up so you might want to start at 1 unit and test as often as you can to get the data on how she's doing
 
Like I said I personally start mine at .5 and work up. Although I should preface that with mine are all very special cases since they were adopted as diabetic, two were extremely underweight and one was grossly overdosed and morbidly obese. So I always start extremely low and work up because I figure I can always add more if not enough but I can't get it out of the cat once shot and since mine are adopted diabetics I don't know them well enough at first to know subtle personality shifts that would indicate an onset of a hypo.

Mel and The Fur Gang
 
Welcome Jeannie,

glad you found us.

You've gotten great advice to Start Low and Go Slow.

Like Mel, I adopt diabetic cats and regulate them. Some I keep and some I rehome. Always work on a Start Low and Go Slow plan. Currently, I have two on Lantus and one in remission.

How about setting up a spreadsheet so we can see the numbers you are getting? If you want to know how, go to the Tech Forum and you'll find instructions on how to set it up and how to link it to your signature. Look forward to seeing the numbers.

All the best,

Claudia
 
Wow! This site and all of you are absolutely AMAZING! I truly appreciate all the advice and support. I've been keeping a spreadsheet but I'm going to start a new one now that she'll be starting insulin (on Sunday evening). I will post the new one. I'm leaning towards starting her at 1 unit 2X a day. Chris asked about her "ideal" weight". The answer to that is ... I have no idea ;-) I feel like she's a little big for her frame but definitely not grossly overweight (maybe just a couple of lbs.). The vet said 2 units 2X a day (and she felt that was low). Would it be prudent to go with .5 unit or 1 to start with? I liked that Mel pointed out that you can always give more if that doesn't seem to be enough.
 
hi Jeannie
Welcome. i just joined this board about a month ago and it is great. these folks are experts and will help you to get your kitty well. even tho vets are trying to be helpful, they don't have as much experience as the folks on this board. we all follow the start low, go slow insulin dosing method. i am sure they will tell you that 2 units is too high to start with. you can always increase. we usually start with a low dose twice per day (12 hours apart) and test before each shot and at the low points usually between 5 to 7 hours after the shot. they will explain everything to you. i have learned so much here. anyway just wanted to say welcome. if i can help in any way, please let me know.
as Mel said, she usually starts at .5 twice per day and you hold that dose until you see how it settles with the kitty. i will defer to the experts here to fully explain everything. but if i can do anything to help, just ask. take care
nadine
 
Did you find the spreadsheet we use here? It really is just as important of a tool in dealing with this disease as a good insulin and correct diet.

Once set up, all you have to do is enter the numbers as you get them. You can see China's if you look in our signature and click on her SS link

My vet wanted to start China at 4 units and thought she'd need more...and at the time, she weighed 7.8lbs! If I'd listened to him, well...I don't want to think about what might have happened! She's never needed more than 1.75 unit, and has been doing really well lately at 1.5....and now she weighs about 15lbs (yes, she's a little too uh....uhhhh..."fluffy"....LOL)

Make sure you have syringes with half unit markings because we do increases in .25 unit increments. You have to just "eyeball" those, or you can use calipers to measure your doses. Here's some good info on How to dose with calipers

Whatever dose you start with, you're going to hold for at least a week unless it drops her below 90 (if you stay with the Start Low, Go Slow method)...On the Tight Regulation protocol, we don't decrease until they drop below 50, and we change doses more frequently based on how well they're responding

If you're going to do the SLGS method, I think I'd start at .5 and see how she does....You're totally right...you can always go up! Taking it out is a lot harder! :-D
 
Jeannie,

I'm sure you will get tired of my answers but...

Vets do not get current drug information on Lantus and Levemir insulins because they are human insulins. FDA rules won't allow the human drug reps to call on vets. So, they use the rules for whatever insulin they were trained on in school. Outside of the US, these insulins are the drug of choice for cats. So protocols have been determined. And, they work very well.

Often that older veterinary information results in overdosing our kitties. The insulins above are shed based insulins. They build up in the body and are topped off every 12 hours. Other insulins don't last this long in cats. Therefore, it is a good idea to dose at the low end because the dose last a long time. It is hard to counteract an overdose.

As you read more, you will come across someone who is dealing with a hypo or a very low blood sugar. You will be glad you know about Start Low, Go Slow.

Hope this helps. If you have questions, ask away, please. We all learn from each other.

All the best to you and Cairo,

Claudia
 
Great advice guys! And, I never get tired of answers :smile: So far, all of you are saying similar things so I feel much more comfortable making the decision to begin at .5 units every 12 hours. If I understand correctly I should continue that dose for at least a week, unless it drops below 90. I understand how to keep the spreadsheet. I've been keeping it, which was actually very helpful when I showed the vet the data. I'll add to it skipping a few spaces for when I start insulin. Thanks again everyone, and if you think of anything else that might be helpful, please let me know.
 
Hey there Jeannie,

Looks like you got a ton of great info...the only thing I would add, is if you can go to the User Control Panel and add a link to your spreadsheet in your signature line...

It will be very helpful to have it super handy when you have questions about dosing for the more experienced members to just click on the link.

And
picgifs-welcome-2-566738.gif
to the FBMD family!
 
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