Re-posting from Lantus thread - AM vs PM units different

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Tara and Austin (Aussie)

Tara and Austin (Aussie)

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Just wondering does anyone have experience with Lantus shots that differ? My vet, who I love and trust just advised we try 4 units AM and 3 units PM to basically "split the difference" (her words) instead of doing 1/2 unit increase.

Austin has only been on Lantus about a month and is slowly starting to come down - she just wants to really get him to 100 and regulated a bit faster. He is a big boy, 20 lbs - wet food diet only.
 
Are you hometesting or are these numbers from the vet? If you're hometesting, do you have numbers from this week, the past few days?

It's hard to give any advice without knowing what the BGs are. From the spreadsheet I see a blue number on 8/21 and that would tell me that the dose should not be changed just yet. The shed filled up and now the insulin being given is getting put to use and not stored. It takes time to build that shed. Since we don't know what the current numbers are, your cats blood sugar could be going even lower now.

If you are hometesting and just have not been able to get BGs consistently, please keep trying. I've been doing this for a long time and just recently my Tucker had an evening number of 33, had I given him insulin I don't know what would have happened, I don't even want to think about it.

Regarding the dose and weight, the size of your cat doesn't matter. At Tucker's best weight of 17.6 pounds his dose was 1.5U BID of Levemir. There are smaller kitties on higher doses and larger kitties on even smaller doses. It's how your cat utilizes the insulin that matters and that can only be gauged by home testing the blood sugar.

Also, keep the dose the same AM and PM, lantus and lev both do better with consistent dosing.

You're doing a fantastic job so far, keep it up :)
 
My Bailey has done better on 1 1/2 Units AM and 2 1/2 PM. I tried keeping them the same but with the same does either the AM PS would be very high or the PM PS very low. Not all kitties react the same.
 
Thanks Larry - thats really more the response I was hoping to get.

To answer a few questions - yes I am home testing. I have a wonderful vet who is willing to work with me on BG numbers and calling them in, doing curves, etc. I do Austin's shots at 630am and leave about half an hour later for work an hour away. I get home in time for his PM. I'm tired about 3 hours after that. I don't do them consistently simply because it isn't possible. Austin also went unregulated for a long time because I had a bad vet experience. We switched vets after an ER visit from neuropathy - and he is about a month into his doses and seeing what will work. So far his numbers are looking much better than a month ago - but they do need some tweaking.
 
Sorry Tara but have to completely disagree on the 2 different doses. Works with PZI but not Lantus.

Lantus builds a shed (petrol tank).Once this is full the insulin starts working on the bg's. That is what has happened today.

Your vet advised you to increase too soon from your initial dose. FD is a marathon not a sprint and Lantus also takes time to get working.

Recommend starting dose is 1u and increase in .25u increments.
Those reds you saw on day 2 and 3 could have been a response to his numbers dropping and his body's life saving defences kicking in and releasing glucagon (will do this even at 300 numbers because body at the time may think this a low number if has regularly been say in the 500's).Also depends how carb sensitive kitty is.
Often you get an initial reaction with Lantus on first dose and then numbers start to go up.
This is why it is important to hold the initial dose for 5-7 days. After this, if you increase, you do this every 3-5 days (depending on your numbers).

I would cut back to no more than 2u am and pm.
Test for keytones
Need those preshot tests am and pm.Lot of people work 12 hour days, so have to get spotcheck in at night (the last one being just before bed-+3 I think you said?) Then they do a full curve on a w/e or day off to see how low the dose is taking bg's. Such beans also increase at a slower rate as can only do generally once a week when they are at home to test.

There is no way of knowing how fast you can get your cat regulated as each cat is different.
If you haven't already, I'd urge you to go back to Lantus isg and read the stickies.
Good luck :mrgreen:
ps-next tests may be sky high because of such a low number. Can take 72 hours to clear, please don't increase dose but look at cutting it and starting over.
 
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