New to Forum - Lantus dosing questions

[kryskat]

Hi - my 18 yr old kitty, Kasha, was diagnosed approx 4 weeks ago. I was giving 2 units Lantus twice daily. I've gradually lowered dosage as she's had some pretty low numbers in between shots (using my one touch mini glucometer). Last night she hit an all-time low of 41 at 2 hours after a dose of 1 unit Lantus (her pre-shot was 208). She stayed low for a few hours even after I gave her some low-carb snacks (and then I went to sleep). Her AMPS was in the 400s - so I was guessing rebound maybe? I only gave her 1/2 unit this morning because of her low numbers last night. Her PMPS tonight was 266 and I gave about .75 units Lantus. I feel like I'm doing a constant science experiment and I'd like some advice on what I should be doing to even out her numbers and hopefully stabilize her and maybe get her into remission - the ultimate goal, of course. I added her numbers to the template, but it's a little wonky since on some days she's been so low I wasn't comfortable giving insulin so I waited several hours (up to 5 or 6) and gave insulin when her numbers were higher. Then I had to adjust by giving late doses for the next few shots to get back to my work schedule.

 

[Roni and Moonie]

Hi! Welcome to lantus..Please come over to the lantus forum when you can-tonite, or tomorrow, so we can help you get aquainted with the proper use of lantus & our protocol there...
You will need to collect some data, spot checks during the day, have a spreadsheet, and read the stickys on the top of the lantus page..
The starting dose for lantus is 1.00 Units, but I see you have been jumping around with the dose, thus feeling like a science experiment!
We have dosing helpers who can help you with the dose--Lantus is a 12/12 hour dose, and we do dose increases or decreases in 0.25u increments..
Please give us your name & the cat's name, acesss to your template(spreadsheet), and please let us know your dosing schedule--
Click on the forum lantus(glargine) and post your numbers & events there--OK?
We are here to help you--Lantus is different than other insulins, longer lasting, more gentle, needs to be given every 12 hours, consistant doses, and you will need some patience..Welcome.

 

[Kathy and Kitty]

Also wanted to say hi, and come on over to Lantus Land -- ideally before your next shot. Sounds like you already know a good deal, which is great! You'll find lots of help for getting Kasha on a regular schedule, the faster to get her regulated!

 

[Sienne and Gabby (GA)]

I'm stopping by from the Lantus Board, as well. Great job on getting a spreadsheet set up and mastering home testing! It really looks like you've been working hard at keeping Kasha safe.

I'd like to suggest you take a look at the dosing protocol(s) we use. One of the big differences between Lantus and other insulins is that dosing is based on the low point (nadir) of the cycle -- not the pre-shot blood glucose (BG) values. We get the AMPS and PMPS tests to make sure that it is safe to give a shot. What is sounds like you've been doing is adjusting your dose based on Kasha's pre-shot values. In addition, Lantus likes consistency. You will get wonky numbers if you do not shoot on a 12-hour cycle. Early shots act like a dose increase whereas a late shot acts like a decrease, so shooting as close to a 12/12 schedule as possible is best. Likewise, keeping the dose constant, unless the numbers dictate otherwise, is also important. We generally hold a dose for 3 days. This gives it enough time to settle. All of the shifting of times and doses is contributing to how confusing the numbers look.

What I would suggest is posting over in the Lantus forum. We will be happy to give you a hand getting your dose on track. I think it will help if we can come up with a dose that you feel comfortable with and can consistently shoot every 12 hours.