reintroducing myself and Princess -- lantus questions

Status
Not open for further replies.
patricia&princess(GA)

patricia&princess(GA)

Member
Well, I've been absent for quite a while now, so I'll give a brief reintro of me and Princess. Princess is my diabetic diva cat, probably about 15 years old now. We found her in a box with a litter of kittens in 1997, so her age is just a guess. 5 years ago, she was dx with FD, put on Humilin N, regulated within a few weeks and OTJ within 4 months. Oh, of COURSE that was all with the amazing support of this group, diet change to canned low carb, home testing ... A little over 4.5 years now of occasional BG tests, no insulin, and a very healthy cat. Well, three cats really, but who's counting! :lol:

Last week, we noticed Princess drinking three times in one evening. Broke out the meter and sure enough she was at 264. Normal for her is around 140-180. Two tests the next day were AM-237 and PM-230 before we had our vet appointment. Our vet is fabulous, in favor of home testing, familiar with the Janet and Binky food charts -- definitely a great partner in the care of all our animals. She prescribed Lantus for Princess, 1u once a day to start, knowing I'd do BG tests and monitor the progress.

Princess got her first unit of Lantus on a Saturday evening. I should have waited and started in the morning instead in the interest of doing home curves. Princess eats twice a day, so AM tests are before breakfast and PM tests are before dinner.
PM 312 -- AFTER eating dinner. Oops. 1 u Lantus
AM+14 = 218
PM+24 = 277 1u Lantus
AM+10 = 240
PM+23 = 450 -- What the heck??? Never seen a number like that from her. Ever. Figured it was an error. 1 u Lantus
+2 = 200 -- more in her range, reinforced my belief that the 450 was an error. should have continued a mini curve :roll:
AM+12 = 270
PM+24 = 242 1u Lantus
+5 = 70 -- 70?!?! Princess doesn't do 70. What the heck!!?? Rebound? Symoges? Are they the same thing?
AM+12 = 326 -- high number for her, but I'm at work and can't do a curve. DH is home in case of emergency, though.
PM +24 = 405 -- call vet to discuss, she agrees we might be looking at Symoges issue and recommends cutting dose to 1/2 unit, and that we may need to do BID 1/2 unit. That's fine with me. Give 1/2 unit (at +25), realize that 5 years have aged my eyes and despite bifocals, 1/2 unit is really hard to see!!!
+3.5 = 304
AM +11 = 316 (at work, can't keep rechecking)
PM +23 = 432 :sad: 1/2 u Lantus
+2= 416
+5=283 (go to bed)
AM+12 = 271
PM+24 = 393 -- 1/2 u Lantus
+4 = 204
+6 = 120 -- go to bed
AM+14 = 277
+15 = 355 --meal spike?
+20.5 = 325

I know I need to be patient and let the dose settle. However, I'm feeling frustrated with the numbers I'm seeing. These numbers are higher than we ever saw 5 years ago, and her numbers are running higher outside of the nadir than they were before starting her on insulin this time.

Would love some advice, some reassurance, and maybe some input on how I can move her once-a-day shots (for now) to morning instead of evening so that I can do full curves without staying up all night. Or should I just keep doing what I'm doing for now?

also posted this in Lantus ISG
 
I'm not an expert with Lantus, but I do know you need to be consistent with the 12 hour intervals and with the dose to let it "settle". I don't see you consistently giving her .5unit every 12 hours. Or am I misreading your information??
 
Hi Debby!! Been a while ...

Maggies Mom Debby said:
I don't see you consistently giving her .5unit every 12 hours. Or am I misreading your information??
Click to expand...
My vet started us on 1 u once a day, when Princess was rebounding it was cut to 1/2 u once a day, I believe she intended to let that dose settle before deciding whether we need to do twice a day. I do think we'll be going to twice a day, but at this point, I'm waiting to talk to our vet again Monday. The rebounding and her 70 scared me a little -- Princess doesn't handle lower numbers well at all.
 
Hi to you too. My uneducated guess is that you really need to go to twice a day. I hope some experienced lantus people show up who can really help you!
 
When you said your cat doesn't do "low" numbers near seventy, does that mean that in the past your cat has had hypo symptoms at higher than usual numbers? Many other members consider 50 or even 40s and safe range for the nadir (low point) of the curve. However, each cat is different and some do start getting hypo symptoms in the 60s. I happen to have one of those cats.
 
jan ellery said:
When you said your cat doesn't do "low" numbers near seventy, does that mean that in the past your cat has had hypo symptoms at higher than usual numbers? Many other members consider 50 or even 40s and safe range for the nadir (low point) of the curve. However, each cat is different and some do start getting hypo symptoms in the 60s. I happen to have one of those cats.
Click to expand...
In the past, on N, Princess showed mild hypo symptoms at 40-50. Over the past 5 years, she does very well on a daily basis with numbers in the mid to high 100s (120 is an unexpected low for her when not on insulin, and 140-180 is a normal range for her)
 
Lantus is not meant to be dosed SID - which is the reason you are seeing such swings in BGs. Her system is constantly filling with insulin, then being completely depleted of insulin. Lantus works off of a shed where each shot builds upon the next. That 70 you got out of the blue on 1u means that 1u was probably too much. I agree with others that you need to strongly consider giving 0.5u BID.
 
Thanks Kelly. Do you think I'd be in line to start BID tomorrow morning, or should I wait ' til I talk to my vet? I know I tend to be impatient, so I need some input to make sure I'm not jumping the gun here.
 
If you will be around to test throughout the day like you have been, then I would recommend starting tomorrow with 0.5u BID. 0.5u is a fairly conservative starting dose, so I would feel very comfortable giving that with the numbers you have been getting so far.
 
I've updated Princess' Spread Sheet, but I'm curious. Any guesses as to why we're getting consistently higher numbers now than a week ago when she first presented with increased thirst? Could we have caught it just as her pancreas was sputtering and stalling? Could the insulin regimen somehow be making her BG go wonky on me? She's been eating grain-free canned for 5 years now, so no diet change lately ...
??????????????????????????????????????????
 
One thing I am seeing is a more even set of numbers. Since going BID - you have no more red numbers, wohoo! My guess is the reduction to 0.25u the other day is the reason you haven't seen blues since then. The shed has to fill back up to get back to that level. Try to hold this dose for another 2 days and see where it settles into since you have only been at BID for 3 days now.

As for seeing 300s vs 200s off insulin - sometimes kitties respond this way when insulin is started because the body isn't used to having extra insulin to help things out and is freaking out a little bit. That's why the first BID dose is held for 5-7 days before changing the dose.
 
Status
Not open for further replies.
Back
Top