old time member reintro'ing with Lantus questions

Status
Not open for further replies.
patricia&princess(GA)

patricia&princess(GA)

Member Since 2009
Well, I've been absent for quite a while now, so I'll give a brief reintro of me and Princess. Princess is my diabetic diva cat, probably about 15 years old now. We found her in a box with a litter of kittens in 1997, so her age is just a guess. 5 years ago, she was dx with FD, put on Humilin N, regulated within a few weeks and OTJ within 4 months. Oh, of COURSE that was all with the amazing support of this group, diet change to canned low carb, home testing ... A little over 4.5 years now of occasional BG tests, no insulin, and a very healthy cat. Well, three cats really, but who's counting! :lol:

Last week, we noticed Princess drinking three times in one evening. Broke out the meter and sure enough she was at 264. Normal for her is around 140-180. Two tests the next day were AM-237 and PM-230 before we had our vet appointment. Our vet is fabulous, in favor of home testing, familiar with the Janet and Binky food charts -- definitely a great partner in the care of all our animals. She prescribed Lantus for Princess, 1u once a day to start, knowing I'd do BG tests and monitor the progress.

Princess got her first unit of Lantus on a Saturday evening. I should have waited and started in the morning instead in the interest of doing home curves. Princess eats twice a day, so AM tests are before breakfast and PM tests are before dinner.
PM 312 -- AFTER eating dinner. Oops. 1 u Lantus
AM+14 = 218
PM+24 = 277 1u Lantus
AM+10 = 240
PM+23 = 450 -- What the heck??? Never seen a number like that from her. Ever. Figured it was an error. 1 u Lantus
+2 = 200 -- more in her range, reinforced my belief that the 450 was an error. should have continued a mini curve :roll:
AM+12 = 270
PM+24 = 242 1u Lantus
+5 = 70 -- 70?!?! Princess doesn't do 70. What the heck!!?? Rebound? Symoges? Are they the same thing?
AM+12 = 326 -- high number for her, but I'm at work and can't do a curve. DH is home in case of emergency, though.
PM +24 = 405 -- call vet to discuss, she agrees we might be looking at Symoges issue and recommends cutting dose to 1/2 unit, and that we may need to do BID 1/2 unit. That's fine with me. Give 1/2 unit (at +25), realize that 5 years have aged my eyes and despite bifocals, 1/2 unit is really hard to see!!!
+3.5 = 304
AM +11 = 316 (at work, can't keep rechecking)
PM +23 = 432 :sad: 1/2 u Lantus
+2= 416
+5=283 (go to bed)
AM+12 = 271
PM+24 = 393 -- 1/2 u Lantus
+4 = 204
+6 = 120 -- go to bed
AM+14 = 277
+15 = 355 --meal spike?
+20.5 = 325

I know I need to be patient and let the dose settle. However, I'm feeling frustrated with the numbers I'm seeing. These numbers are higher than we ever saw 5 years ago, and her numbers are running higher outside of the nadir than they were before starting her on insulin this time.

Would love some advice, some reassurance, and maybe some input on how I can move her once-a-day shots (for now) to morning instead of evening so that I can do full curves without staying up all night. Or should I just keep doing what I'm doing for now?
 
Hi Patricia! Sorry you are finding yourself back here.

We find that Lantus is pretty much always a BID insulin in cats. People can take it once a day, but cats' metabolisms are faster and they need Lantus every 12 hours. I'm betting that if you switch to dosing BID, you'll see much flatter (and lower) numbers.

Be sure to read through the stickies at the top of this forum for links to basic information and the dosing protocols we follow here.
 
not sure if "welcome back" is quite the appropriate phrase here...but at least you're in the right place for support...

celi & binks
 
Thanks for the welcomes and input so far!

Let me clarify my pressing question for now: I have a call in to my vet re: moving to BID .5 u. She will be back in the office Monday AM. I normally feed and test around 5AM on work days, weekends a little later. Since I have tomorrow and Monday off, making a change to BID while I'm off and home to spot check and/or curve would be ideal, but I won't hear back from my vet until after normal feeding (and hence shooting) time.

It's only been a week today that we started her on lantus, and three days since we lowered the dose to .5

Do I go ahead and go BID before I hear from her, or am I being too impatient?

Gaaahhhh I hate these numbers! nailbite_smile (and yeah, I know other people have much higher numbers -- I'm just a weenie here :YMSIGH:
 
Welcome -- and sorry you're here.

To be honest, with once a day dosing, you weren't getting enough insulin into Princess for her to build the depot (we call it a "shed") that she needs for the Lantus to really work. The insulin begins to pull numbers down during the first half of the 12 hour cycle and then since you're dosing only once a day, the numbers zoom back up. Like Libby noted, Lantus is dosed BID in felines. You might want to take a look at the sticky note at the top of the Board on the tight regulation protocol. It takes roughly 5 - 7 days of BID dosing for the dose to stabilize.

The other issue with Lantus is one of consistency. Unlike N, the closer you can shoot on a 12 hour schedule, the better. There is nowhere near the flexibility with shot times with Lantus (or Levemir) as there is with other types of insulin.
 
Thanks Sienne! Do you think I'm in line to go to BID tomorrow AM or should I wait until I talk to my vet? I'd like to make any changes a while I have a couple of days off, so tomorrow or Monday would be good to do spot checks or a curve. But I don't want to jump the gun because I know I tend to be impatient.
 
I would start shooting BID. It looks like 0.5u BID should be fine, but if you're nervous about that, you could just split your current dose and shoot 0.25 units AM and PM. Then it's the same amount of insulin, just spread out differently. Even just making that change will probably help quite a bit. Then collect as much data as you can and reevaulate the dose in a few days (unless she goes too low, then of course you'll have to adjust sooner).
 
Status
Not open for further replies.
Back
Top