New Member 5/28/24 Help w/adjusting Lantus Dosing

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adev

adev

Member Since 2024
Hi-

  • Our 16 year old Norwegian Forest Cat has had diabetes for many years;
    • had been controlled with 2 units of Lantus every 12 hours (under 300).
  • Earlier this year stopped eating; took to Vet; ran labs/urine. Only issue high white blood count; gave injectable antibiotic. Began eating fine again; worked with Vet on numbers as they were too low (hypo a couple of times); decided on 1 unit of Lantus every 12 hours after testing for couple weeks
  • She had failed to gain weight again a couple months in on new regimen, so we started testing regularly again; numbers are in the sheet in my signature (please advise if I've set this up properly)

We are struggling with determining right amount of units. Any thoughts/help on process to determine would be appreciated (link to spreadsheet in my signature I believe).

Thanks
 
adev said:
Hi-

  • Our 16 year old Norwegian Forest Cat has had diabetes for many years;
    • had been controlled with 2 units of Lantus every 12 hours (under 300).
  • Earlier this year stopped eating; took to Vet; ran labs/urine. Only issue high white blood count; gave injectable antibiotic. Began eating fine again; worked with Vet on numbers as they were too low (hypo a couple of times); decided on 1 unit of Lantus every 12 hours after testing for couple weeks
  • She had failed to gain weight again a couple months in on new regimen, so we started testing regularly again; numbers are in the sheet in my signature (please advise if I've set this up properly)
We are struggling with determining right amount of units. Any thoughts/help on process to determine would be appreciated (link to spreadsheet in my signature I believe).

Thanks
Click to expand...
Hi! I am trying to manage my cats diabetes for less than a year using Glargine (generic Lantus) using SLGS. I hope another member will correct if I am wrong, but it appears as if Kulani's glucose was 69 on an Alpha Track calibrated for feline blood.

My meter is a human meter. And when my cat dipped below down to 60 on a human meter, by following SLGS, this immediately earned him a reduction of .25 at one point. However, being that this is a feline meter, I am sure that more experieced member can confirm, but I am going to guess this earns Kulani a .25 reduction from 1 U . For now.
 
adev said:
Hi-

  • Our 16 year old Norwegian Forest Cat has had diabetes for many years;
    • had been controlled with 2 units of Lantus every 12 hours (under 300).
  • Earlier this year stopped eating; took to Vet; ran labs/urine. Only issue high white blood count; gave injectable antibiotic. Began eating fine again; worked with Vet on numbers as they were too low (hypo a couple of times); decided on 1 unit of Lantus every 12 hours after testing for couple weeks
  • She had failed to gain weight again a couple months in on new regimen, so we started testing regularly again; numbers are in the sheet in my signature (please advise if I've set this up properly)
We are struggling with determining right amount of units. Any thoughts/help on process to determine would be appreciated (link to spreadsheet in my signature I believe).

Thanks
Click to expand...

Do I need to post this question in another forum?
 
I would advise that you look into one of the dosing methods, either tight regulation or start low go slow, and choose one that works for you.
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

Giving extra doses of insulin in the middle of the cycle can be dangerous and result in a hypo. Lantus is dosed every 12 hours.. even if you think you missed or skipped a shot due to low numbers.

Edit: generally dose is changed based on the lowest number in the cycle so you wouldn’t change doses daily. Consistency is best with a long acting insulin like Lantus.
Also, great job testing! That will go a long way to getting her on the right path :cat:
 
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Hi and welcome to the forum. Great you are testing and have set up the SS.
If you could set up the signature to tell us about Kulani that would be great. Info in this link HELP US HELP YOU
As mentioned above. Have a look at the link to the 2 dosing methods that @SpotsMom gave you. See which one would suit you best.
We increase and decrease the dose in 1/4 unit increments unless the BGs are really high. So going from 2 units to 1 unit may not have been the best idea.
Also as mentioned never, ever, Give another dose of any insulin during the cycle. Even a little bit. You will end up with 2 nadirs and could run into all sorts of trouble. Always wait until when the next dose is due.

Are you able to get some tests in each cycle do you think? That will give us an idea how well the dose is working and how low the dose is taking Kulani. At the moment we don’t really have much idea how low the dose is taking him. And don’t neglect the pm cycle as that has 1/2 the data:)
Also as mentioned above, Lantus dosing up is based on the nadir or lowest point, and it is better not to be chopping and changing the dose as it can mess up the depot. If you can follow one of the two dosing methods you will soon be able to sort things out. We can help you with that.
Until the BGs are more in the normal range, he won’t put on weight as he can’t absorb all the nutrients in the food.
Can you tell us what type of food you are feeding and how often please?
Are you offering snacks during the cycles as well as the 2 main meals?
Looking forward to hearing back from you.
 
Hi-
Thanks for the warm welcome and information. I believe I have the signature now updated with the additional info.
  • She eats twice a day one can of FF Wet Turkey Pate with dry food avail during day of a combo of Hills Prescription diet gastro and RC Adult Vet diet gastro.
    • She has a 1 year old male Maine Coon companion who is the one who mostly eats the dry food. She tends to stick to the wet food only. Sometimes she is given Feline Greenies catnip treats during day.
  • I will work to get some +6 hour readings mid day to determine the nadir of the current dosing (which is 1 unit).
Thanks
 
I see you got a mid cycle test today… well done! Always great data for us.
Can you ask see I get a before bed test in as well each night? If that test is lower than the Preshot number that can indicate it’s an active cycle do you might want to get up and test later on to see it’s not dropping too much.
Also I would offer snacks during the day and evening as well as the 2 main meals. A snack is a couple of teaspoons of low carb food. Also can you leave some food out overnight?
The Hills prescription food is high carb food and not really suitable for diabetic cats
 
We encourage caregivers to get at least 4 tests per day. You want to test before each shot. In addition, you want to try to get a test during both the AM and PM cycles.

I'm glad to hear your cat leans toward eating the canned food. Both of the dry foods you're using are high in carbs. You might want to take a look at this information on a feline nutrition website that's authored by a vet. The bottom line is that cats are obligate carnivores. They are unable to process carbohydrates -- they do best on a diet that is high in protein. Dry food tends to be very high in carb. Both of your cats would benefit from a canned food diet.

I have two NFCs. I love the breed! They are such great cats.
 
Thanks for the feedback.
  • The prescription diet was for the male Maine Coon who had some GI issues that hopefully are resolved now (she doesn't really eat it, but we will switch back to Wellness core - we previously were using Wellness Core original - which I believe is low in carbs).
  • Is there another dry low carb one that folks have found likable by finicky cats? (they don't love Wellness)
  • I will attempt to get some more readings throughout the day; will keep you posted.
  • Right now it looks like we are getting her to a lower range - although as you can see overnight sometimes the numbers are really dropping in AM and concerned about giving full 1 unit when below 180.
 
Hi,
Any recommendations on low carb dry food that your cats have eaten? Not sure about switching back to Wellness Core.
 
There are only two low carb dry foods -- Dr. Elsey's Clean Protein and Young Again Zero Carb.

FWIW, Wellness is very high in fat. You have lots of choices for low carb canned food. This is a link to a chart containing the nutritional information on most of the canned foods available in the US. We consider low carb as under 10% although most of the members here feed their cat a food that's in the 5% range.
 
Thanks - we've switched to Dr. Elsey's clean protein chicken formula.

We've noticed she is starting to pee outside the litter box - is this sometimes typical of a diabetic cat? (Perhaps related to her condition)?
 
Any thoughts on her numbers? Looks like a rebound effect for her? Should I reduce down to .5 per dose of Lantus tonight?
 
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Not to be a nag but you have to get more tests. There's no way to gauge how low you dose it taking Kulani's numbers. By not getting any PM tests, you're also missing half of your data.

This is a link to information on Lantus dosing. Because your cat is eating dry food, you need to follow the instructions for the Start Low Go Slow method. It requires that you do a curve once a week and the you test a minimum of 4 times daily (your two pre-shot tests and at least one test during both the AM and PM cycles). Lantus dosing is based on how low the dose takes your cat's numbers. Just as an example, with the 54 on 6/9, you haven't any idea how low Kulani's numbers went during the previous PM cycle or if her numbers kept dropping that morning. With the SLGS method, you reduce the dose if your cat's numbers drop below 90.
 
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