Question regarding dosing

[lildude]

Today was my cat Lil' Dude's first day on Lantus, and though his blood sugar levels are a bit lower than before (he was always in the 400-500s range, and today he's been in the 200-300s), they've not dropped below 200. I gave him 1 unit this AM, and by this evening it still hadn't dropped below 275, so I gave him another dose. So far it has stayed right in the 250s range. He is on the BLUE Wilderness canned foods (low carb, high protein), so I know that is helping as well. My questions are should I go back to just 1 unit & wait a couple of days, or stay at 2 for a couple of days, or should I increase the dose? I have checked his BG about 4 or 5 times today (his poor ears!!). I know that eating can increase the number, but I have made sure to check his BG several hours after a meal, and they are still high. Though I must say I am really happy to see those lower numbers!!

TIA!!

Robin & Lil Dude

 

[mybuddybinks]

welcome to Lantus land!!
bumping your post up for more experienced eyes...

celi & binks

 

[Sienne and Gabby (GA)]

Welcome, Robin!!

Just so I'm sure I understand, you do know that Lantus should be given twice a day?

Lantus is what is called a "depot" type of medication. What this means is that it builds up a reservoir of microcrystals under the skin that slowly dissolve. It takes roughly 5 - 7 days for this depot to be formed. So, it's important to keep the dose consistent for this period of time and then evaluate the dose. (If Lil' Dude has other issues such as a history of ketones, his dose may need to be evaluated sooner.)

It sounds like you have used another type of insulin prior to switching to Lantus. If this is the case (and sorry if I'm misunderstanding), Lantus requires a very different mindset. First, dosing is based on the nadir and not on the pre-shot number. Thus, getting both pre-shot and spot checks during each cycle is important. Because Lantus is a long-acting type of insulin and doses are cumulative, doses need to settle. The specifics of how to use Lantus are described in the Tight Regulation sticky at the top of the Board.

The starred, sticky notes contain a great deal of information and will help you to better understand and maximize your use of Lantus. This is an overview of what they contain:

• 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 this 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.
• Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.

 

[Angela & Blackie & 3 Others]

Welcome to the group!

One other thing about Lantus is that the same dose is to be given every 12 hours consistently. This will help your cat better. So, if you're currently giving 2 units, you need to give 2 units once in the morning (for example at 6:00 a.m.), and again you need to give another 2 units 12 hours later (for example at 6:00 p.m.). This will mean that your cat is getting 4 units on a daily basis.

For example, I give my cat, Blackie, 3.50 fat units (a bit more than a regular 3.50 units) at 6:00 a.m., and then I give her another 3.50 fat units again at 6:00 p.m. She gets 7 fat units on a daily basis.

I hope that helps you get a better understanding of Lantus. Please feel free to ask questions, and again, welcome to the group! I look forward to seeing your posts, and reading how your cat's doing.