Once daily Lantus? Is this possible?

[KarenAmelia]

Hi, I haven't posted in a while, stopped doing the tight regulation and tried a less rigorous approach. Terra seems to be experiencing the effect of the Lantus well past the 12 hours; sometimes she seems to be getting to nadir at +12. My vet thinks going to once daily shots is worth a try. He said that worked with one cat in his experience. Wondered what anyone here thinks. See the spreadsheet: I've skipped shots three times recently because of low numbers and not wanting to deal with hypos or near hypos. Today Terra's BG went along in a nice level range, even though she had no shot this a.m.

Any suggestions?? Thanks!

 

[Blue]

Hi, I haven't posted in a while, stopped doing the tight regulation and tried a less rigorous approach. Terra seems to be experiencing the effect of the Lantus well past the 12 hours; sometimes she seems to be getting to nadir at +12. My vet thinks going to once daily shots is worth a try. He said that worked with one cat in his experience. Wondered what anyone here thinks. See the spreadsheet: I've skipped shots three times recently because of low numbers and not wanting to deal with hypos or near hypos. Today Terra's BG went along in a nice level range, even though she had no shot this a.m.

Any suggestions?? Thanks!

no. cats have faster metabolism so BID is the way to keep levels smooth.

if you are getting to a dose of .1u BID and are finding Terra is still needing to skip shots, then go for a trial of no insulin.
if not down to a .1u dose, then head to that direction.

ETA: your current dose is 2u BID so it's likely too high for Terra. Instead of skipping you should try decreasing the dose... Why don't you try 1u BID dose for a few days and you are going to find you won't need to be skipping shots.
Shots once a day will not work for cats.

 

[KarenAmelia]

Thanks for the reply. The folks at tight regulation board were so adamant about not changing doses so quickly, so I'm glad to hear your suggestion. I will go with that tonight. I had been thinking to reduce dose but didn't know how much to reduce. Your suggestion is surely better than no shot at all, which would make 24 hours consecutively without insulin.

best, Karen

 

[Blue]

Thanks for the reply. The folks at tight regulation board were so adamant about not changing doses so quickly, so I'm glad to hear your suggestion. I will go with that tonight. I had been thinking to reduce dose but didn't know how much to reduce. Your suggestion is surely better than no shot at all, which would make 24 hours consecutively without insulin.

best, Karen

From the looks of the ss, 2u is just too much. The shed fills and each ps number gets lower and lower until you are at a green number by the 4th cycle. You skip and drain the shed and then Terra goes high again. So you go back to the 2u again and the whole pattern repeats..... you are on a rollercoaster and you want to be on a close to flat curve, and not for just a day.

The TR group is likely saying to decrease by maybe .25u down to 1.75u, and for all I know, they could be right, but I do know that no insulin is going to last 24hrs for a cat, and that skipping shots regularly is not good for a cat either.

Your ss starts at 1.5u and just look at how Terra dropped to blue by 1/4/12.... it could well be that your starting dose was too high from the get go. By the morn of 1/5/12, Terra was up to pink, so I bet there was a big overnite low BG and Terra bounced to that pink by morn.


For the above reasons, I think you may be safer to cut Terra's dose back to 1u BID and then let it settle. You want to see a nice fairly level curve with the highest numbers at ps and a dip to the lowest number, nadir, somewhere in the middle. That's for a normal curve which is most common.

Then after a couple days, I bet you will see some better numbers..... Sure, they may be a bit higher, maybe in the 200s, but you hopefully will have no need to be skipping shots or thinking about one shot a day.

Give the 1u dose of Lantus twice a day a chance and then review in a few days.

 

[KarenAmelia]

Thanks for the good advice, Gayle! I went with .5 unit this evening but perhaps will go to 1 u tomorrow morning. I guess alternatively I could stick with .5 u for a couple of days and see how she does.

 

[Blue]

Thanks for the good advice, Gayle! I went with .5 unit this evening but perhaps will go to 1 u tomorrow morning. I guess alternatively I could stick with .5 u for a couple of days and see how she does.

Sounds good.... just remember to stick with a dose for at least 4-6 cycles because Lantus does not like frequent dose changes.... your numbers will be all over the place.

Ultimately, you are wanting to get as close to sort of flat curve as you can.

Good luck with the lower dose.

 

[heidi]

My Frodo was doing the same thing. Three hypos in two weeks, then lots of skipped doses because his nadir seemed to come at +14 or +15. I stopped insulin for a few days (I didn't realize I should have stopped it for a week). Then I started back at a very low dose and have slowly been building up. As you can see, his numbers haven't been good since (and I've been so busy with school this past week that I've been horrible about everything to do with testing/shooting etc.). I still think this was the best course of action for us. His nadir is now at a more appropriate +4 or +5 hours on the low dose. I just started him back at 0.5 units today (a dose he previously hypoed at), because 0.37 wasn't cutting it. We'll see. Just wanted to say that even if if the low dose isn't right and I haven't regulated him yet, at least he is responding to the insulin in a "more normal" way.

Heidi and Frodo