Welcome Theng. Sue asked me to stop by.
When beginning to use Lantus, you want to inject the same amount of Lantus for 5 - 7 days. As Sue and others noted, it takes this amount of time for the dose to begin working. Further, your dose is NOT based on your pre-shot test data. Lantus dosing is based on the nadir. I put your records in a format that most people here understand -- we do not report blood glucose in mmol/L. We record our blood glucose in mg/dL From your information, you started Miko at 2.0u of Lantus? This may have been too high of a starting dose.
March 19 - 26 - shot 2.0u
March,28 -- began 3.0u on March 26
4.10pm - 14.4mmol -- 225
7.18pm - 7.2mmol -- 130
8.50pm - 5.9mmol -- 106
10.00pm - 3.8mmol -- 68
10.33pm - 4.0mmol -- 72
11.48pm - 4.8mmol (1unit) -- 86
March,29
1.10am - 6.2mmol -- 112
3.10am - 9.2mmol -- 178
6.10am - HI
6.15am - 27.3mmol -- 491
6.55am - 24.5mmol -- 441
7.35am - 25.9mmol --466
The lows that you were seeing are
not dangerous. It is best to have someone helping your who is familiar with managing low numbers with food, though. The numbers you are seeing are what we call a "bounce." When a cat experiences numbers like you saw on March 28, the liver dumps a stored form of glucose into your cat's body and the numbers rise. This is normal. You need to keep the dose consistent because the bounce will clear. If you increase the dose and the bounce clears, you will be giving too much insulin.
This is what I would suggest:
- Reduce Mico's dose to 1.5u or 2.0u at the most. (Do you have syringes that are marked in half units?) If you are using the needles that come with the pens, using a regular syringe is much better. The pens will only allow you to dispense in full unit amounts. If you follow the Lantus dosing protocol, you will need to increase or decrease doses in the amount of 0.25u.
- Please familiarize yourself with the information on Lantus that's on the Lantus support Board.
- Testing as frequently as you were doing this morning isn't necessary with high numbers. It's very important to test often if a cat is experiencing low numbers, though.
- Talk to your vet about why Miko is needing insulin again. Make sure there is no infection, that your cat doesn't need a dental procedure for gingivitis or an infected tooth, and depending on how old Miko is, make sure your cat isn't hyperthyroid.
- Set up a spreadsheet so we can better help you. Please use the World template in this link.
Here are links to the information on the Lantus board:
- Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
- New to the Group: Everything you wanted to know about the Lantus forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
- Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
- Lantus depot/shed: This is an important concept for understanding how Lantus works.
- Becoming Data Ready: What data you need in order to be able to work toward remission or tight regulation.
. Thanks a lot. But now already 12.20 am (MALAYSIA TIME) . A bit tired. Have to go to sleep. And get up test blood every 2 hour. Hopeful my sister can help me at night. Tomorrow will continue spreadsheet . Thanks again.
