Time to go up in Dose??

B

Bowie

Member Since 2026
Hello everyone -

Bowie is 10 and was diagnosed in May with Pancreatitis and Diabetes. We got him through the pancreatitis and with the guidance of an internal medicine vet and the community here, now have him at 1.75 units. He gets Purina DM with gravy (not the dried except as a treat), cooked chicken, some raw food and Fancy Feast pates for his meals.

His spread sheet should be attached here. Given our previous challenges with wide swings in BG, we have been happy there haven't been any huge dips. We think it is time to bump his Lantus to 2. Any thoughts on this?

Thanks,

Bowie & Co.
 
The answer to an increase is no at this point in time. You may wish to think about whether you'd like to use one of the dosing methods we use with Lantus here. More information here: Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR). Once you've made that decision, we'll be better able to help you. Other things that can make it faster/easier for us to help you is to add information to your signature. Information described in this post: New? How You Can Help Us Help You!

Your spreadsheet indicated ketones = yes. Are you still testing for them regularly? Presence of ketones can change our suggestions on dosing.
 
Hi Wendy and Neko -

Thanks for getting back. We have taken your advise to slow down and finally moved from 1.5 to 1.75 vs a .5 unit jump. I read through that and can see why it was not recommended to increase.
(Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.)

Isn't the goal to get them in the green though and wouldn't an increase in dose help with that?

No we haven't. We were told by the vet we didn't need to check for ketones after they were put on Lantus.

Thank you again.

Bowie & Co.
 
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Bowie said:
No we haven't. We were told by the vet we didn't need to check for ketones after they were put on Lantus.
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That would be wrong. Lots of examples here of cats relatively new to Lantus that were seeing ketones. Some to the level that you need to see a vet. You can either get ketones testing sticks, such as Ketostix Tips to catch and test a urine sample. or you can buy blood ketones meters. Think of it as insurance.

Bowie said:
Isn't the goal to get them in the green though and wouldn't an increase in dose help with that?
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Eventually yes, but we want safe upper greens and low blues. But we don't know how low 1.75 units is taking him yet because of gaps in the spreadsheet in the PM cycle. Yes, you do eventually want to get him seeing more green than he is now. But if you are following SLGS for dosing, you reduce by 0.25 units if you see them below 90. Which you have on this dose, notably August 4 PM, 7/31 AM and 8/01 AM. The reduction is for safety. The 70's he has seen are very close to what we consider too low with the AT, which is below 68.

What you may be seeing with the higher numbers is what we call bounces, in reaction to those unfamiliar numbers under 100.
  • Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
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