Terwilliger New Lantus User

[Sue and Oliver (GA)]

Hi All,

Terwilliger posted at the end of Daphne's thread. I thought she might get lost down there so reposted here.


Hi Daphne,
My 17 year old cat was diagnosed recently and has been on Lantus for two weeks. Her very first injection dropped her BG from 327 down to 59, but after about a week here numbers leveled out and were staying in the 170-270 range. I felt like everything was going great. The vet alo prescribed her 2U twice a day. This week the numbers are all over the place. I'm unable to give her two doses a day because her number drop so low after one dose, and don't come back up after 12 hours (400 pre-test down to 136 at +4 hours, then down more to 85 at +12). I think her body has adjusted and now the insulin needs to be lowered. She is only 8 1/2 pounds. She sleeps nearly all day, but eats and drinks normally. I have given her little 1 ounce canned food snacks as well when I'm worried her BG will drop too low while I'm asleep or at work. I think if the food is low carb, it shouldn't be a problem. I feed her Fancy Fest cat food, although I bought the prescription canned food from the vet. She only sort of likes it and threw it up once, so I said to heck with it. It is extremely nerve-racking trying to figure out all this stuff. I've been obseesed with BG numbers and reading everything I can. I haven't read much from people who are using Lantus, so I don't know how unpredictable it is. Waiting for a call from the vet today. Good luck to you.

 

[MommaOfMuse]

Good Morning,

I have two diabetic cats both either are or were on Lantus. Maxwell went into remission on Lantus and has been there for over a year now, and Musette is still insulin dependent.

Lantus is a nice gentle insulin for cats, but it does sound like your vet may have started your kitty (name please?) on too high of a dose, which happens a lot since they base the dose on the numbers they see at the clinic which are often influenced by stress. Stress will raise blood glucose so once kitty gets home and relaxed their insulin needs go way down. That is why we like to see kitties started on either .5u or 1u twice a day and then raised from there if needed. Some of those really high preshot numbers that you are seeing are more than likely a bounce from going low towards the end of the cycle.

It does sound like you are home testing ... EXCELLENT!!! That is one of the best things you can do to keep your cat safe while s/he is on insulin. The other thing about Lantus is that it works off a shed or depot so it likes consistant dosing 12 hours apart, if you are getting numbers at +12 that are too low to shoot then you do need to lower the dose so that you have shootable numbers every 12 hours. Personally if this was my cat I would reduce back down to 1u twice a day, hold that dose for 3-5 days and test as often as you can to see how it is working and then base changes on that. Lantus dose changes are based on the nadir (the lowest point in the cycle) and that nadir should hit right around +6 so if it is coming way late in the cycle (the time between 1 shot and the next) the dose is too high.

Also sounds like you are feeding a good diet. Which Fancy Feasts are you feeding her? Many Fancy Feasts are terrific for Diabetics but not all, you want to stick with the Classics that are pate style, and stay away from anything that says "In Gravy" or "Grilled" etc.

Mel, Maxwell, Musette & The Fur Gang

 

[Terwilliger1]

Thanks for the post MommaofMuse. It's nice to hear feedback. I am feeding only Fancy Feast classics and low carb versions. I've already seen the Binky and whatsits chart so I feel pretty confidant I'm on track there. Just spoke with the vet and I'll be reducing the insulin dose. I'll be pre-testing before every dose and giving her a dose based on the BG level as per guidelins layed out by the vet. I'm feeling very relieved now, and hopefully this is a step closer to remission. I'm glad I registered for this message board. It's nice to talk to others who are dealing with the same issues.

 

[MommaOfMuse]

One of the most important things to remember about Lantus is that it is dosed off the nadir (lowest point) not the preshot values...It also has a shed or depot so it can't be dosed on a sliding scale. It needs consistency to work properly.

We have an excellent support group here that works with a proven scientific approach that will give your girl the very best chance at remission. You might want to go stick your head in at the Lantus-Tight Regulation ISG, they all use your insulin and work with a proven protocol that has about an 85% success rate of remission

Mel, Maxwell, Musette & The Fur Gang