New to FDMB-Lantus questions

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Jobeth77

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HI everyone,
I do see that there is a Lantus forum and may post there. I'm sorry if I posted in the wrong place. I have a 14 y/o cat that was recently diagnosed with diabetes. I have one other cat with diabetes but am considering doing some changes for her as she is on dry food and I want to convert her to wet food. I know how to home test but I am new to hearing about this German Method and wonder if I can get some general information about it?[/b] Milo was given one unit of Lantus (the vet said to give two but his first reading in the AM was 288 and I gave less because I wasn't sure how he would respond the first time. He responded well throughout the day (in the 100's pretty much all day- (low of 132 about seven hours after giving the insulin). He ended up being around 200 at the end of the twelve hour period. I didn't give him another unit because I was afraid he would be too low starting off at 200 in the evening. The next morning he was in the 500's (gave 1.5 units) and ended up at 129 12 hours later. On Monday morning he was 200 and I hadn't given him anything on Saturday evening.

I see that consistency is key and I want to be consistent but I'm afraid he's going to be too low. I was thinking about starting off at .5 for him and keeping it there for a few days as suggested on some of the posts. He's also tough because he doesn't always eat all of his food and is more of a grazer. I have switched to Wellness canned food.

I guess I am looking for a quick version of this German method that I see people posting about and wonder where I should start for dosing. If I had given the two units that the vet suggested he could have been in trouble.

The good news is that he seems to be doing well with the Lantus but I fear he will go too low during the day. I can only do a complete curve on the weekends as I work during the day.

I am sorry for making this long. I am just really frustrated and know this will take time. I just need a good starting point for him so that I can be consistent with his dose for a few days.

Help?

I appreciate your time

Joy and Milo
 
Hello Joy :mrgreen:

Here is a link to the Tilly Protocol: Tight Regulation with Lantus or Levemir for Diabetic Cats

I am at work right now, there is so much more that I want to say but I know that others will come along and offer advice as well. Most of us work as well so being home during the day to perform spot check is usually out of the question. Most also perform their curves on the weekend or any other day off. You can also get spot checks in the evening and before you go to bed.

Yes consistancy is key with Lantus. AND start low and go slow. I am reluctanct to give you dosing advice because there are much more experienced people here, however it you feel comfortable starting Milo on 0.5 units bid then you should. I started my Webber at 0.5 units bid. However-----you stay with the same dose for a period of cycles (the 12 hours after each shots is considered a cycle--so in one day you have two cycles) before increasing. This is discussed in the protocol that I linked above and below is Phase One...

Phase 1: Starting dose
In many cases, the starting dose of Lantus or Levemir has been 0.25 IU per kg of the cat's ideal weight and is always dosed BID (two times a day, 12 hours apart). If the cat received another kind of insulin previously, the starting dose should be raised or lowered by taking this information into account. When selecting a starting dose, it is important to know that while Lantus and Levemir have a longer duration than other insulins, they also have a lower potency in most cats.

The cat should be monitored closely on the first 3 days on Lantus/Levemir: do curves between the AM and PM-doses, e.g. AM pre-shot, +3 hours, +6 hours, +9 hours, PM pre-shot. Generally the starting dose is kept for 3 days. Test for ketones daily. Cats that have a tendency to get ketones and/or who are getting relatively high flat curves after the switch should have their dose raised earlier (after 24-48 hours). It is extremely rare that a cat will need to have its dose reduced in the first 3 days, but if the cat falls below 50 mg/dl, reduce the dose.

Measuring curves regularly is important, as well as measuring all pre-shots and taking random spot checks. It is important to know that most cats do not have reproducibly-timed nadirs. It also is not uncommon for a nadir to occur at +12 hours after a shot. If you are fortunate to have a cat with a very reproducible response, you can test less often than with a cat that has a varied response.

Please take time to create a spreadsheet of Milo's BG's so that others can help with dosing. Here is a link to help you set that up: Creating spreadsheets & attaching them to your signature

You are ahead of the curve since you have switched to wet food and know how to hometest to be PROUD!! :RAHCAT

BTW - this is the purrfect place to start. We usually try to get all the basics anwered over here in health and get you set up with a speadsheet etc before you start posting in the Lantus forum. That is only because of how much traffic LL gets. We don't want your posts to get lost in the shuffle. Lantus users have what we call daily "condos" where each cats BG's etc are posted.

One more thing----after you are not so overwhelmed with information please read this information as well. Very important!!
LANTUS & LEVEMIR - INSULIN DEPOT -AKA- STORAGE SHED This will explain how Lantus works (as a cumulative medication).
 
Hi Joy, and welcome!

Sorry to say there are no shortcuts to regulation but with Lantus properly used it may not be a lengthy process. Take the time to read www.catinfo.org to get your thinking about feline nutrition, particularly as it applies to diabetics, sorted out.

Yes, the Lantus forum will be of great help to you, but do check in on this board from time to time and let us know what's happening!

Gia & Quirk (GA)

Guilt trips are a detour from life
 
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