New to Lantus board

[hawkeyeal]

From suggestion on the feline diabetes board, I am here for help. Tuffy has been on Lantus for about 3 months now and we don't seem to be getting anyplace. He is an office cat so normally gets his 2/day at 6:30 am and 4:30 pm. We had him at 6.0 but based on recommendations, lowered it to 4.0 for about a week now. With this his numbers are getting higher so we will go to 4.5 this afternoon. I know the recommendation is 0.25 but my eyes are not that good and based on his numbers I don't think it matters. I have posted the spreadsheet and numbers wander all over the board. Suggestions are more than welcome.

Al

 

[Cyn and Cosmo]

Hi Al,
My first concern is the 630am and 430pm shots instead of a 12/12 schedule. Is there anyway to get closer to 12/12? it doesn't always have to be exactly 12/12, but it does seem to work best for the insulin.

Also, does Tuffy have any other medical conditions? How was she diagnosed? Since there's no one there to watch her overnight, I'm guessing it is not possible to get spot checks at night.

I'm going to let those with more experience advise about the dose, but I'm concerned that the dose is too high.

welcome to FDMB!

 

[Blue]

I also noticed the times being off the 12/12; Lantus works best on 12/12.
Think of your needing an amount of gas to get from a to z. What happens if you have enough gas to get to only w? You run out and that's what is happening every day with Tuffy.
Tuffy is getting his pm shot too early and then he's getting his am shot too late.
Cats also go lower at night, so combine getting his shot too early and then going lower over nite, he is likely just bouncing up every morn.

Is there any way that he can be taken home with someone, even just to be regulated a bit, to find a dose that works? I am betting that his dose is too high, so of course his numbers will be all over the place.

Another suggestion is to change the subject on your first post to ask about non 12/12 schedules. There are some people who must alter the times, due to work, but the no pm tests are concerning.

 

[hawkeyeal]

Tuffy is an office cat and that is why the shot times. As I have 4 droolers at home, taking him there does not work. We keep seeing the messages about the dose being too high but we started a 2, vet upped it to 3 and finally to 3.5. We have upped it since. He seemed to be doing better at 6 but based on suggestions, lowered it to 4 last week and now plan to go to 4.5. Others have suggested going to a different insulin that is not so dependent on the 12/12 schedule. We may try that but just opened a new bottle at $105 last week. Thanks for the help.

Al

 

[Sienne and Gabby (GA)]

One of the other difficulties is that you aren't able to get any tests at night. It is possible that Tuffy is dropping into lower numbers during the PM cycle. Much of the higher numbers and what appear to be inconsistencies may be resulting from a "bounce." When a cat drops into lower BG numbers than their system is used to, the liver dumps a form of stored glucose, along with counterregulatory hormones, into the bloodstream. The result is that numbers spike into higher ranges. It can take up to 72 hours for that bounce to clear. With the lack of PM spot checks and the tests that are missing on some weekends, it's very difficult, if not impossible, to extrapolate those numbers.

I don't want to overstep, but I do wonder if this arrangement is going to work for managing Tuffy's diabetes regardless of the insulin you use. Many cats have lower numbers at night. Tuffy could easily drop into dangerous ranges during the PM cycle. Without being able to spot check, there is no way you can intervene in order to bring your cat's numbers back into a safe range. I'm putting this information out there for you to consider. I don't know if there is an easy or straightforward solution but it is an issue that warrants some thought.

 

[hawkeyeal]

Probably the suggestion that I post something about other than the 12/12 is certainly something I can do. And to answer another question, he does not have any other problems. Ketones check is negative from our first check.

Al

 

[Karrie and Maverick]

It really took me a while to understand bouncing. Maybe you guys could explain what happens and if this is happening with the daytime numbers. It was a very confusing concept for me to digest.