New to lantus- need guidance

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CathyLonghurst

CathyLonghurst

Member Since 2014
Spreadsheet is not up to date- will fill in tonight

Squeak was on vetsulin, went into remission for several months, starting having high numbers, and I am now trying Lantus.

I understood how to use the other insulin given his readings, but what do I do with Lantus if he has a 70 or 90 reading in the am and I give nothing, and his pm reading is 300?
Do I give a tiny dose (currently doing .25) am and pm regardless of the good number in the am? This is not everyday and sometimes the low numbers are evening. It seems either am or pm test is in a great range and the other is bad.

Should I go back to vetsulin? And how long do I have to wait after stopping lantus to use a different insulin?

I am very confused.

Thanks.
 
Welcome to Lantus (and Lev) Land.

First, it's going to take a shift in the way you think about dosing strategy when you switch from a shorter acting insulin like Vetsulin to Lantus, which has a much longer duration and is a depot-type of insulin. First, dosing is not based on your pre-shot number. Instead, it's based on the nadir. Because it is a depot-type insulin, the action is cumulative. In other words, you don't always see an immediate response to a change in dose -- it can take a few cycles for the depot to catch up with a dose increase or reduction.

Because Lantus dosing is based on the nadir, it's important for you to try your best to get some additional tests beyond your AMPS and PMPS tests. You'll want to try to get at least one additional test during both cycles.

I'd suggest that you start by reading the sticky note on the Tight Regulation Protocol and the sticky on the depot. Also, please remember to not shake or roll Lantus.
 
Hi Cathy!

When there are empty cells in the spreadsheet dose column, does that mean you didn't shoot anything? so a 0.0 dose? Can you fill that in if that's the case?

Lantus is a great insulin for cats and I think you'll be happy with it once you get the hang of it. It might be that you need a dose of less than 0.25u so you can give the same dose every 12 hours. As Sienne said, it's really important to wrap your head around the fact that Lantus dosing is based upon the LOW point in the cycle, not the high numbers. If 0.25u can get Squeak to the 50's, you'll basically ignore the high numbers and for the dosing, stay focused on that low.

Are you familiar with bouncing? When a cat gets into a range lower than they are used to, their liver lets loose with counter-regulatory hormones and stored sugars and sends the blood sugar high. That can last up to 3 days and during those 3 days you might see numbers bobble around high, maybe higher and less high, but not down into green numbers. When the body clears out that reaction, we say the "bounce has cleared." Skipped shot can send the BGs high too, so you've got a couple of factors making for high numbers.

Sienne's already given you lots of good information, so I'll stop there. I think a little persistence and understanding how Lantus works will make things easier. Hopefully you can post every day and we can teach you what you need to know to help Squeak. :)
 
You've got enough information to digest so I just wanted to say welcome and like Julie encourage you to post here daily. I'm sure you'll get the hang of it real soon with all the experienced people here to guide you :)
 
How do I go back to Vetsulin? I had great success with it and had him in remission very quickly earlier this year. I think that is the route we need to go.
 
Often times we find that when a cat needs to go back on insulin after having gone onto remission once, it's harder to get back into regulation. There are smaller Lantus doses you can try. In the New to the Group Sticky, there is a picture of a .1U dose.
 
I went to about .13 tonight. He is eating better than earlier in the month. Would still like to go back to vetsulin, but don't know how to do it safely.
 
Cathy:

If your preference is Vetsulin, there really shouldn't be a problem going back to that insulin. You might skip a dose of Lantus and then start. We've had so few people go from Lantus or Lev to a shorter acting insulin that the best person to ask may be your vet or to ask in one of the other forums (e.g., Health) here.
 
Thanks everyone for the help.
I can't ask my vet cause he has never had a home tester or anyone that requested or used Lantus.
I read somewhere that it is bad to switch insulin types and that is why I am so desperate to find out how long I need to wait.
 
I've never read about there being an issue with switching insulin. What I can relate to is that it's intellectually hard for a caregiver to be used to one type of insulin and then switch to Lantus or Lev which require a very different way of thinking about dosing and a different manner of testing. If you stick with it, this will all become second nature and I suspect it wasn't all that different than how overwhelmed you felt when Squeak was first diagnosed.
 
You use what works. If data show something isn't working for you, cut your losses and switch.
 
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