The vet suggested I increase the lantus to 2 units in morning and one unit in the evening. I work night shift 3 nights/week and he was afraid that if I give her 2 units and then leave her alone, I wouldn't know if she went hypoglycemic. He said to do that for a week and see how her blood sugars did. Then I think he wants me to give 2 units in the evening and morning if she tolerates it.
new to this board--hi everyone!--questions
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Wendy&Tiggy(GA)
Member Since 2011
Lantus works best on consistent dosing, changing dose at night and morning isn't ideal.
Did you get any test results today? Before you increase you might want to check for bounces.
Did you get any test results today? Before you increase you might want to check for bounces.
So I ordered some EVO catfood and since it is 0% carbs (now hers is 18% I think) is it ok to continue the increased dose of lantus? Should I switch her food gradually? Do you think I should give her 2 units at night and 2 units in the morning? Her blood sugars have been between 250 and 400 most of the time.
BJM
Member Since 2010
Even dosing is preferred here. How about 1.5 units twice a day? (With monitoring)
I would transition the food gradually to avoid GI upsets like vomiting or diarrhea. Some cats react to food changes; some may not. If you give insulin thinking the food will stay down and it doesn't, you could run into a hypo situation.
If you are testing at the nadir - around +5 to +7 hours after giving insulin - you can monitor the effect of the food transition and adjust the insulin for it gradually, too. The glucose levels may change around 100 points and we don't have a rule of thumb for how much to reduce the insulin. It may need reducing, depending on the level of control so far.
I would transition the food gradually to avoid GI upsets like vomiting or diarrhea. Some cats react to food changes; some may not. If you give insulin thinking the food will stay down and it doesn't, you could run into a hypo situation.
If you are testing at the nadir - around +5 to +7 hours after giving insulin - you can monitor the effect of the food transition and adjust the insulin for it gradually, too. The glucose levels may change around 100 points and we don't have a rule of thumb for how much to reduce the insulin. It may need reducing, depending on the level of control so far.
terri1962
Member Since 2011
Terri
2 units is to much insulin for her weight, she should only be on 1unit in the morning and 1 unit to be safe. My cat only weighed 9lbs as well. The vets do not always know about dosing. My vet did the same thing to me, as my cat weighed 9lbs as well and she put her on 2 units twice a day which was to much.
Terri
2 units is to much insulin for her weight, she should only be on 1unit in the morning and 1 unit to be safe. My cat only weighed 9lbs as well. The vets do not always know about dosing. My vet did the same thing to me, as my cat weighed 9lbs as well and she put her on 2 units twice a day which was to much.
Terri
terri1962
Member Since 2011
Terri
To be conservative and starting new based on her weight their is formula for dosing insulin to start. It is she is 9lb which is 4.1 Kilograms. 4.1KG times .25 equals 1.025 which would be her starting dose.
So her starting dose based on her weight would be 1 Unit morning and 1 unit evening to start.
Why don`t you go over to the Relaxed Lantus board and post over there, Mel(Momma of Muse) is usually on there and is very helpful.
Terri
To be conservative and starting new based on her weight their is formula for dosing insulin to start. It is she is 9lb which is 4.1 Kilograms. 4.1KG times .25 equals 1.025 which would be her starting dose.
So her starting dose based on her weight would be 1 Unit morning and 1 unit evening to start.
Why don`t you go over to the Relaxed Lantus board and post over there, Mel(Momma of Muse) is usually on there and is very helpful.
Terri
MommaOfMuse
Member Since 2010
Terri,
With Lantus it isn't so much where they are at preshot as how far down the insulin is taking them at their lowest point that we base the dose on. So cats just ride high all day long and we need to increase the dose, some will fall very fast during the day and bounce right back up at preshot time. That is where testing becomes important so we know how fast and how low they are going. My little girl Autumn (although I can no longer really call her little) was under 6lbs when I adopted her as a diabetic, her BG was 528, and I started her on 1u eventually raised it to 1.25 but that proved to be too much for her once I transitioned her over to an low carb/high protein diet...today she is 14lbs (her ideal weight) and is on a scant .25u and may eventually completely give up insulin altogether. On the flipside of that is my Maxwell..he was 10.5lbs when I adopted him and never went higher than 1u and again once the diet changed he went into remission and has been insulin free for 2+ years now. He is also a large cat by frame and is currently 17lbs also his ideal weight.
As much as I wish this was an easy formula of if the cat weighs x, and eats y, then the dose is z that just isn't the way it works, there are many many factors to figuring out the correct dose and only a very few do we have any control over whatsoever. While yes she will probably need more insulin while still eating dry food without knowing how low the dose is taking her and now with a diet change we would rather be conservative than risk her health by giving her too much insulin and sending her into hypo...High numbers kill over time, too low of numbers kill very quickly.
Autumn went 10+ months without any treatment whatsoever when she was first dxed until I adopted her, but she is still here and now is trying very hard to give up her shots. If you would like to post over on Relaxed Lantus I will try to help you figure out what is best for your little girl.
Mel, Maxwell, Autumn & The Fur Gang
With Lantus it isn't so much where they are at preshot as how far down the insulin is taking them at their lowest point that we base the dose on. So cats just ride high all day long and we need to increase the dose, some will fall very fast during the day and bounce right back up at preshot time. That is where testing becomes important so we know how fast and how low they are going. My little girl Autumn (although I can no longer really call her little) was under 6lbs when I adopted her as a diabetic, her BG was 528, and I started her on 1u eventually raised it to 1.25 but that proved to be too much for her once I transitioned her over to an low carb/high protein diet...today she is 14lbs (her ideal weight) and is on a scant .25u and may eventually completely give up insulin altogether. On the flipside of that is my Maxwell..he was 10.5lbs when I adopted him and never went higher than 1u and again once the diet changed he went into remission and has been insulin free for 2+ years now. He is also a large cat by frame and is currently 17lbs also his ideal weight.
As much as I wish this was an easy formula of if the cat weighs x, and eats y, then the dose is z that just isn't the way it works, there are many many factors to figuring out the correct dose and only a very few do we have any control over whatsoever. While yes she will probably need more insulin while still eating dry food without knowing how low the dose is taking her and now with a diet change we would rather be conservative than risk her health by giving her too much insulin and sending her into hypo...High numbers kill over time, too low of numbers kill very quickly.
Autumn went 10+ months without any treatment whatsoever when she was first dxed until I adopted her, but she is still here and now is trying very hard to give up her shots. If you would like to post over on Relaxed Lantus I will try to help you figure out what is best for your little girl.
Mel, Maxwell, Autumn & The Fur Gang
rhiannon and shadow (GA)
Member Since 2012
TMR said:
Did you order Young again... zero %?
or Evo which is 8%?
Since Evo can be found in stores and Young Again can not. I assume you ordered the Young Again.
BJM
Member Since 2010
There is no fixed amount of insulin per glucose level, so you'll be guessing, based on what you observe. As it takes 3-5 days to adjust the dose on Lantus, you'll have an idea of the effect if you test around the nadir while transitioning slowly to avoid GI upsets. Vomiting will throw the glucose to dose relationship right out the window into hypo territory if you aren't careful.
It has been a rough week. First I was really sick and then both my kids had health issues--one even went to the ER---so I haven't been checking Midnight's blood sugar every day. But I am getting the EVO catfood tomorrow (0% carb) so I will transition her starting then. I have still been giving her 2 units lantus in the morning and 1 unit at night--it has been almost a week since I increased the morning dose from 1 unit to 2 units. I checked her blood sugar today and it was 284 before breakfast/insulin and 250 6 hours later. I will check it again tonight before dinner/insulin. That will give me a starting point before switching her food. Does this make sense? Then as I transition her food I can keep an eye on how it affects her blood sugar. I had one more thought today: the vet wanted me to only give her 1 unit insulin in the evening in case her blood sugar dropped while I was working nightshift. But if I am home at night I would probably be asleep--so what difference does it make? Doesn't it make more sense to give her the same dose in the morning and evening?
Deb & Wink
Member Since 2013
Please, double check to make sure the EVO dry food you are getting is not part of the recall.
http://www.fda.gov/Safety/Recalls/ucm345971.htm
http://www.fda.gov/Safety/Recalls/ucm345971.htm
BJM
Member Since 2010
Just start at the top and work your way down.
Use the SQRRR approach you may have learned in school - survey, query, read, review, recite
Survey - Skim over posts to get an idea what they're about - this sets up "advance organizers" in your brain where you'll put in more detail.
Query - figure out what questions you want to be able to answer after studying.
Read - take notes, if you want
Review - see how your content recall is
Recite - see if you can answer the questions you generated.
Use the SQRRR approach you may have learned in school - survey, query, read, review, recite
Survey - Skim over posts to get an idea what they're about - this sets up "advance organizers" in your brain where you'll put in more detail.
Query - figure out what questions you want to be able to answer after studying.
Read - take notes, if you want
Review - see how your content recall is
Recite - see if you can answer the questions you generated.
KPassa
Member Since 2012
You've probably already been pointed to most of the "Stickies" at the top of the Lantus Forum, but I'll summarize them for you below:
:thumbup Fascinating. Never heard of this approach before now. :idea:
- New to the Group?: General Info on Lantus, glucometers, syringes, dosing, what a typical Lantus curve might look like, food lists, etc....
- Tight Regulation Protocol: dosing information.
- Info, Proper handling, & Storage: syringes, pens vs. vials, etc....
- Insulin Depot: explaining how the depot works and how Lantus and Levemir differ significantly in dosing from all the other insulins available (i.e. PZI/ProZinc).
- Shooting and Handling Low Numbers: What to do when you see numbers under 200 when first starting out or 150 after you've been doing it for a while. Specifically for introducing the "shoot low to stay low" method of the Tight Regulation protocol. (I wouldn't worry about this one just yet.)
BJM said:
:thumbup Fascinating. Never heard of this approach before now. :idea:
Jill & Alex (GA)
Member Since 2009
TMR said:
if you scroll past the "Announcement" section to the "Topics" section, the six Lantus & Levemir TR Stickies are marked with yellow stars.
http://felinediabetes.com/FDMB/viewforum.php?f=9
I got the EVO chicken and turkey and it is not part of the recall. Phew! However, the bag says it is 7% carbs. The list from this website I found (which now that I think about it might have been wet food, but I thought was dry food) said it was 0% carbs. Well, I spent almost $60 on it and it is 15 pounds, so it will probably last me a couple months, so as long as Midnight tolerates it, I will feed it to her. Then next time I will try to find a lower carb dry food. Believe me, I am really trying to do all the right things!!
Deb & Wink
Member Since 2013
Here's hoping she loves the new dry food. It is so hard when a kitty throws up all the time with the canned foods. I've had cats that could not tolerate any grains or even rice in their food (ibd), fish allergies and beef allergies.
Now Midnight. Mommy got you some yummy new food. Please let us know how you like it.
Now Midnight. Mommy got you some yummy new food. Please let us know how you like it.
terri1962
Member Since 2011
Terri
Are you giving Lantus 2 units in the evening and 1 unit in the morning? Is midnight having strange BG readings? I saw you questioned the vet in one of your previous posts about that dosing.
You were correct, Lantus is dosed evenly. If you give 1unit in the morning, then you should give 1 unit in the evening, otherwise it will cause wacky numbers.
Terri
Are you giving Lantus 2 units in the evening and 1 unit in the morning? Is midnight having strange BG readings? I saw you questioned the vet in one of your previous posts about that dosing.
You were correct, Lantus is dosed evenly. If you give 1unit in the morning, then you should give 1 unit in the evening, otherwise it will cause wacky numbers.
Terri
How can I really monitor her after her evening dose? I usually give it around 7 pm. I work night shift 3 nights a week: 7 pm to 7:30 am. So I give it to her as close to 7 (am and pm) as I can. Even if I am off work and home, I might go to bed around 9 or 10 pm, so I wouldn't be awake to monitor her during the night.
Wendy&Tiggy(GA)
Member Since 2011
Welcome to the vampire club. I routinely set the alarm for middle of the night to do a test. Not every night, but easily twice a week. Or if I need to get up at night to use the washroom, or if I happen to wake up naturally I will go test then too.
Wendy
Wendy
rhiannon and shadow (GA)
Member Since 2012
We test. You can't always tell just by looking. Some cats don't show signs until they are too low.
It has been about a week switching to the new food. I am almost out of the old food. She is eating well. The first couple meals, I don't think she liked it or just seemed confused about it, but now she eats it all. I don't think Midnight's bowel movements (still loose) or urination (still a lot) have changed. I have been giving her 2 units lantus every 12 (ish) hours. I checked her blood sugar this morning. It was 294. I will check it again mid-day and this evening before dinner. But if it is still just as high as it was on when we started (1 unit twice a day and higher carb food), should I go up to 3 units twice a day?
rhiannon and shadow (GA)
Member Since 2012
It is a bad idea to increase in whole units.....You could miss the optimum dose and also possibly find yourself in a hypo situation .
Increases are in 0.25 units at a time. ( they are some times 0.50u when all test numbers are above 300 )
It would be really helpful if we could get a spreadsheet set up for you.
setting up a spreadsheet instructions
I'm not good at tech but there are some here who will help you actually get one set up if you have trouble.
Increases are in 0.25 units at a time. ( they are some times 0.50u when all test numbers are above 300 )
It would be really helpful if we could get a spreadsheet set up for you.
setting up a spreadsheet instructions
I'm not good at tech but there are some here who will help you actually get one set up if you have trouble.
rhiannon and shadow (GA)
Member Since 2012
I would like to share with you a spreadsheet of a cat who absolutely would not eat wet food....
She was on the Evo dry until she found the Young Again Zero Carb and it made a huge difference.
You can see what happened on this spreadsheet dry fed diabetic
I'm not an advocate of dry. I feed canned to my cat but if you are staying with dry. ( And it is your decision )
I would get the young again zero carb when you finish that bag of Evo. Heck. I think I would get one sooner and mix them now.
Dry food keeps their numbers higher.... It is metabolized differently and stays in the system longer .
I believe your numbers will stay higher even on the Evo. As it did for the cat in the example.
That cat had to work its way up to a much higher dose to compensate for the evo dry. ( And she didn't do the increases right... she jumped in whole units early on before she learned not to do it that way )
Perhaps you could introduce canned food as a treat when you are home and eventually get your cat to a canned diet.
The spreadsheet helps everyone see your numbers and that will help with advising you when you need to adjust your dose.
She was on the Evo dry until she found the Young Again Zero Carb and it made a huge difference.
You can see what happened on this spreadsheet dry fed diabetic
I'm not an advocate of dry. I feed canned to my cat but if you are staying with dry. ( And it is your decision )
I would get the young again zero carb when you finish that bag of Evo. Heck. I think I would get one sooner and mix them now.
Dry food keeps their numbers higher.... It is metabolized differently and stays in the system longer .
I believe your numbers will stay higher even on the Evo. As it did for the cat in the example.
That cat had to work its way up to a much higher dose to compensate for the evo dry. ( And she didn't do the increases right... she jumped in whole units early on before she learned not to do it that way )
Perhaps you could introduce canned food as a treat when you are home and eventually get your cat to a canned diet.
The spreadsheet helps everyone see your numbers and that will help with advising you when you need to adjust your dose.
Thanks for the suggestions. I thought I was getting the 2nd or 3rd lowest carb dry cat food, from the list I saw. I spent about $60 on a huge bag so it won't be empty soon. Maybe I will mix it with what was recommended. This is so frustrating! I can't believe I have spent $1000 on my cat and she didn't even have surgery or anything like that! It is a lot of money!
rhiannon and shadow (GA)
Member Since 2012
It is a lower carb ....
I just happen to be able to provide an example of one cat's experience. And I want all kitties to have the best shot at doing better or remission as they can have.
I have a step mother in law who takes her vets advice over mine ( and he's telling her bad info )
Her cat is probably diabetic or borderline and she's feeding much higher carbs. It's hard to watch and keep my mouth shut.
:YMSIGH: :roll:
Good thing you found this board....
You should be able to save money in the future by doing your own curves. The vets love to do those for you and it's not necessary.
Everyone has great money saving tips.
I just happen to be able to provide an example of one cat's experience. And I want all kitties to have the best shot at doing better or remission as they can have.
I have a step mother in law who takes her vets advice over mine ( and he's telling her bad info )
Her cat is probably diabetic or borderline and she's feeding much higher carbs. It's hard to watch and keep my mouth shut.
:YMSIGH: :roll: Good thing you found this board....
You should be able to save money in the future by doing your own curves. The vets love to do those for you and it's not necessary.
Everyone has great money saving tips.
OK. So it has been a week since I have been switching Midnight to EVO 8%. Most of her meals have been that, with just a little Purina DM mixed in to get rid of it. On the Purina DM, her blood sugars were in the 200s to 300s before breakfast, mid-day, and before dinner. Today it was 294 before breakfast and 66 six hours later. Do you think that means the lower carb food is helping and I should cut down on her insulin?
Oh, I'm not very good with the spreadsheet either; I had to have another FDMB member help me get it set up. I've never used Google docs before. But, I can tell you how I get mine updated.
*I sign-in to check my email (gmail).
*On that main page where all your emails are listed, at the top right-hand corner of the page is your email address written out with a little triangle or down arrow next to it.
*Left click on the arrow and a drop down box will appear and will have some selections: Account - Privacy, Sign-Out and another selection or two.
*Select Account and it will take you to an "Accounts" page and on the right side of the page it has a menu for "Other Tools"
*Under the "Other Tools" menu select "Go to the Dashboard to see all Data"
*On the "Dashboard" page, scroll down to the "Docs" heading. Select "owned by me" or "shared by me" and Midnight's spreadsheet should be one of the documents listed
*Any changes you make to the spreadsheet from within your gmail account (like how you accessed it by these directions) is automatically saved so you don't have to "save" it before closing it or logging-off/out
I'm sorry these directions are so convoluted and round-about. I hope this works for you. It is the only way I know to access my spreadsheet to make updates. If someone has a more direct way to access and update the spreadsheet, I am all ears!
*I sign-in to check my email (gmail).
*On that main page where all your emails are listed, at the top right-hand corner of the page is your email address written out with a little triangle or down arrow next to it.
*Left click on the arrow and a drop down box will appear and will have some selections: Account - Privacy, Sign-Out and another selection or two.
*Select Account and it will take you to an "Accounts" page and on the right side of the page it has a menu for "Other Tools"
*Under the "Other Tools" menu select "Go to the Dashboard to see all Data"
*On the "Dashboard" page, scroll down to the "Docs" heading. Select "owned by me" or "shared by me" and Midnight's spreadsheet should be one of the documents listed
*Any changes you make to the spreadsheet from within your gmail account (like how you accessed it by these directions) is automatically saved so you don't have to "save" it before closing it or logging-off/out
I'm sorry these directions are so convoluted and round-about. I hope this works for you. It is the only way I know to access my spreadsheet to make updates. If someone has a more direct way to access and update the spreadsheet, I am all ears!
terri1962
Member Since 2011
Terri
You might want to start a new post, this one is getting over 3 pages. Put in it you need help with dosing information. Also include in the post how much insulin you are currently giving. You might also want to include what you are currently feeding Midnight.
Otherwise they would have to read back through 3 pages of previous posts.
Terri
You might want to start a new post, this one is getting over 3 pages. Put in it you need help with dosing information. Also include in the post how much insulin you are currently giving. You might also want to include what you are currently feeding Midnight.
Otherwise they would have to read back through 3 pages of previous posts.
Terri
KPassa
Member Since 2012
66 is a great nadir number! As long as he didn't drop too low before or after that 66 (since it was +6 hours after his shot, he probably didn't), I'd be very happy to see that number myself. :mrgreen:
From the looks of things, you're giving 2u in the AM and 1u at night. This is NOT an effective way to use Lantus since the Lantus depot never properly forms. You want to be able to safely shoot the same dose both AM and PM and I have a feeling that 2u twice daily will be too much for him. If I were you, I'd split the difference and give 1.5u AMS and 1.5u PMS for a couple of days and see how Midnight does.
ETA: Just noticed the dates on the spreadsheet. My suggestion would be to insert an extra line between 4/9 and 4/18 so others don't make the same mistake. ;-)
Since you've got a spreadsheet set up, I would suggest you move over to the Lantus Board where more eyes can see your posts. We post daily "condos" about our cats with their numbers and this is where we can any questions we might have or advice we might need from others using Lantus. Feel free to check out a few of the posts and see the formatting. My suggestion would be to make your subject something like this:
"3/18 Midnight AMPS 294, +6/66 - New Here, Need Dosing Advice"
ETA: Just noticed the dates on the spreadsheet. My suggestion would be to insert an extra line between 4/9 and 4/18 so others don't make the same mistake. ;-)
terri1962 said:
Since you've got a spreadsheet set up, I would suggest you move over to the Lantus Board where more eyes can see your posts. We post daily "condos" about our cats with their numbers and this is where we can any questions we might have or advice we might need from others using Lantus. Feel free to check out a few of the posts and see the formatting. My suggestion would be to make your subject something like this:
"3/18 Midnight AMPS 294, +6/66 - New Here, Need Dosing Advice"
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