Please help, trying to regulate for over 2 months, switched from Vetsulin to Lantus

Orangie4ever

Member Since 2025
Please help me, my cats numbers are horrible and I can't get him regulated no matter what I do. He was diagnosed last year and I was able to get him into remission with diet change and vetsulin. He came out of remission in March and it has been a struggle. He was not responding well to the Vetsulin like last time so we switched him to Lantus. There is some improvement but every time it seems to be getting better his numbers start creeping up again. I feel like I am doing everything wrong, I am so overwhelmed I don't know what to do. I took him off Young Again and started feeding FF twice a day. Please see spreadsheet
 
Please help me, my cats numbers are horrible and I can't get him regulated no matter what I do. He was diagnosed last year and I was able to get him into remission with diet change and vetsulin. He came out of remission in March and it has been a struggle. He was not responding well to the Vetsulin like last time so we switched him to Lantus. There is some improvement but every time it seems to be getting better his numbers start creeping up again. I feel like I am doing everything wrong, I am so overwhelmed I don't know what to do. I took him off Young Again and started feeding FF twice a day. Please see spreadsheet
Hello Orangie's parent! Let's go ahead and take care of some housekeeping issues first: please complete your signature; the directions are here: Sticky - New? How You Can Help Us Help You!. Also, go ahead and change your spreadsheet to note you're using Lantus now. You'll want to write Lantus as of (date); prior to that Vetsulin--note this also in your signature. (And while I'm at it, if your post is moved to the main forum, don't be surprised--the moderators like first posts to go there so that people don't get overlooked and so that we can go ahead and get signatures, etc., set up--you won't be able to move your post, so don't bother with trying--it's okay that you've posted here, but I just want to explain why the post might be moved).

Lantus is an insulin that likes consistency, so you'll want to get your kitty on a dosing method to get some consistency. Here on the forum, most of us follow one of two dosing methods. They are discussed here: Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR). TR is a more aggressive dosing method that has research behind it showing that it can bring kitties to remission. Each method has guidelines about when to increase/decrease in dosing and by how much. Take a look at the dosing methods and decide which one works best for you. Personally, I started out with SLGS, but once I moved to TR, I saw greater regulation in Jude's numbers. To follow TR, you need to be able to test once before each shot and grab at least two other tests in the cycle. Your kitty also must be eating canned food, only--no kibble. If any of this seems confusing, don't worry; we can help you here on the forum to make decisions about dosing as you move forward.

Also, you're going to need to grab some more shots in the p.m. cycle--otherwise, you have no idea what is happening to Orangie at night. I would try to grab at least a +2 or +3, but also getting a +5/+6 as you're beginning his treatment will start to build data showing you when Orangie's nadir (low point of the cycle) is.

Ask questions--we're here to help.
 
✨ how often are u feeding? only twice/day? does he get snacks? also, try to be as consistent w dosing as possible. increases are .25 u at a time; .5 u if higher than say 3-400 i believe like its been for u guys, will tag moderators tho for the right advice on dosing.. and you only increase after 6-10 cycles. get u a caliper, if you dont have one. that helps immensely and is the most accurate (syringe markings can be egregiously wrong)

great hes only on ff! ✨ no dry is best for now.. hang in there! ☀️ (and for future, taking him off might’ve been a bit premature.. but i cant say.) also the site has great info for everything. here: scroll all the way down too for info ✨

@Wendy&Neko @Suzanne & Darcy @tiffmaxee @Sienne and Gabby (GA) @Bandit's Mom 🫶🏼
 
A couple requests for your spreadsheet. In between the day you stopped Vetsulin and you started Lantus, could you add a blank line and label it "start Lantus". It's too hard to see over in the Remarks and is an important milestone we need to see at a glance. Also add a couple more lines after the last shot in 2025 so it easily pops out that you are now in 2026. Normally people have a different sheetsheet tab for each year.

As for what you should do next, let's start with food. If you can stick with low carb wet food (FF pate I think?) then that's great. But you need to spread meals out more in the AM and PM. Instead of once lump of food with each shot, think in terms of less food at preshot and some mini meals thoughout the day and night. A meal every couple hours to mid cycle is one way to start. You want some recent food to be available when the insulin is starting to work or onset, which is typically 2-3 hours after the shot with Lantus. That food will help keep his numbers more steady. Ideally he'd also have some food available around nadir (low point in the cycle) if his numbers are quite low then.

OK, next about Lantus dosing. We have two dosing methods. Take a read through the Dosing Methods Sticky Note and see if you'd like to follow one or the other. It depends on your goals for the cat and lifestyle that suits your situation - that is, as long as he's only getting low carb wet or raw food. With both the dosing methods, we determine how to change the dose baed on answering this question "how low does this dose take my cat?". Or, what sort of nadirs are you seeing. The low point in a Lantus cycle is typically 6 hours after the shot, but can vary a lot by cat to cat, or even between cycles in the same cat. One thing this also means, we don't vary the insulin dose based on preshot values. This dose mean you'll have to try to get a few more blood glucose tests in between the preshot values. You do want to be able to answer the question "how low can this dose take my cat" before you increase. Preshot values don't answer that question.

I suspect 5 units is too much insulin. Looks like you shot 6 units tonight. Please try to get a test before going to bed tonight to keep him safe. Maybe go back to 4.5 units tomorrow, and this time try to get some data mid cycle to try to get an idea how low he's going on that dose.

Are you home testing for ketones? With a reduced insulin dose, it's always good to make sure ketones aren't creeping in. Tips to catch and test a urine sample Ketones present are something to worry about. Anything above trace means a visit to the vet.

Next, take a read of the Sticky Note on the Depot. Lantus is a depot style insulin, meaning it takes several days for the depot to build and for you to see what a dose is really capable of. WIth our dosing methods, we find consistent dosing is best. Any time you skip a shot or shoot a reduced dose, you restart the clock on how many days you have to hold the dose.
 
In addition to the information above, I'm assuming you brought Orangie into the vet for a check up when he came out of remission. Did the vet run lab work? Any infection or inflammation can cause a cat to come out of remission. The biggest culprit that we see is that the kitty has gingivitis and needs his teeth cleaned and/or needs an antibiotic due to the inflammation.
 
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