Simba's latest curves, vet's advice (SLGS/Alphatrak)

[Mariella & Simba]

Hello everyone. We did two curves for Simba, a week apart, and reported them to his vet yesterday. They are on his spreadsheet. She said to do another curve in two weeks. If he starts trending consistently in the 90's or lower she wants to drop his insulin to 1u in the mornings and eliminate the evening 1u. I haven't seen that anyone on this board does only one shot a day. Her rationale is that his numbers are always higher in the mornings, typically in the 130's most recently, so "that is when he needs it". I am interested in the group's thoughts on that advice.

Since the curves are so close together lately, I haven't been testing much between them. Since he is not on the tight regulation protocol, I don't test throughout the day, but have been doing an occasional bedtime test to try to be sure he doesn't drop low at night.

Thanks in advance for your thoughts.

 

[Johann_marcel]

We are currently doing Lantus once daily, and are newly Dx'ed. Our vet suggested 1/2 unit once daily last time I spoke with the Dr, but Chuck doesn't always need to be dosed (according to his bgs on the alphatrak). We are still trying to figure out what is right for him, and going to do our overdo curve this weekend. I don't have answers for you, but just wanted to wave and say "hi" because we were advised similarly. I'm curious to see what other replies you may get here.

 

[Wendy&Neko]

You should always get a test before every shot and every day and night. That is the only way to know it is safe to give insulin.

If you are following SLGS, and you see a number below 90, you would reduce the dose to 0.75 units, twice a day. Lantus does not last 24 hours in cats, except in vary rare cases and with cats on mere drops of insulin. I have seen it work in just two cats in my time on the board.

Higher numbers in the morning are non uncommon. There is something called the dawn phenomenon in humans too, which means higher AM numbers.

@Johann_marcel if you start your own post, I can comment about your cats situation.

 

[Sienne and Gabby (GA)]

A cat's metabolism is such that you will not get duration if you shoot once a day. In other words, by 12 hours or so, the insulin will poop out!

The value of Lantus is that there is overlap between the cycles. This is what gives Lantus it's long duration and produces flat curves. If you shoot once a day, there's no reason to use a depot type of insulin. You'd do just as well with a short acting insulin that doesn't last 12 hours and you end up losing coverage.

A cat's numbers (or a human's for that matter) are sometimes higher in the morning. This is called dawn phenomenon. Our bodies routinely release stress hormones as a means of preparing for the day ahead.

No disrespect to. your vet but Lantus needs to be dosed twice a day. You also need to be getting some spot checks since dosing is based on nadir, not on pre-shot numbers. You could easily be missing low numbers that are indicative of hypoglycemia and/or that warrant a dose reduction. You also need to be getting spot checks during both the AM and PM cycle to insure that Simba is in safe numbers.

 

[Johann_marcel]

You should always get a test before every shot and every day and night. That is the only way to know it is safe to give insulin.

If you are following SLGS, and you see a number below 90, you would reduce the dose to 0.75 units, twice a day. Lantus does not last 24 hours in cats, except in vary rare cases and with cats on mere drops of insulin. I have seen it work in just two cats in my time on the board.

Higher numbers in the morning are non uncommon. There is something called the dawn phenomenon in humans too, which means higher AM numbers.

@Johann_marcel if you start your own post, I can comment about your cats situation.

Thank you for your reply! I've been a lurker, reading the board (and learning a lot), but was going to wait until we got a curve from Chuck this weekend to make a post so that more information beyond pre-shot numbers are available. I'll look up how to start/title a post and create one within a day or so. thanks for your help!