I'm hoping someone can give me some advice. I've been giving Jimmy 4u of Lantus for about a week now after bumping him up from 3. His numbers were consistently high (in the 300 range) which is why I went from 3 to 3 1/2 to 4. About 3 days ago I went to 4 1/2 with very little change (low 300's, and once 285). So last night around 7 I gave him 5u and woke up this morning and he was at 185. Very good considering how high his numbers were. I've been gradually decreasing his food (he NEEDED alot of calories before). I got a little freaked out about 5u being such a high dose so this morning I gave him 4 1/2u. I know you need to be consistent and wait for the body to adjust with the Lantus, but my question is if at 7 tonight he has "good" numbers, what should I do? I don't want to give him 4 1/2u if he's in a normal range unless I'm "supposed" to. His numbers in the past were consistently in the 300 range, from 3u to 41/2u. I started feeding him less too. ANY suggestions would be most appreciated. Thank you in advance. Sincerely, Chloe
too much insulin?
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knolet
Member Since 2012
I'm really too new to be giving dosing advice, but it seems like you've adjusted the dose quite a bit within a small amount of time. I think it's recommended that you hold a dose for at least 3 days, my vet recommends holding for a week before making any changes. But you're also decreasing the food at the same time (which can affect the numbers). With Lantus, you're not supposed to adjust the dose based on a pre-shot number, you should make that decision based on the nadir (the mid-cycle time when the BG is the lowest) usually somewhere between +5 and +7. Do you have a spreadsheet that you can share? I'm sure the more experienced folks will chime in as well, and they'll ask for it so that they can see what Jimmy's numbers look like.
Thanks for your reply. I don't have a spreadsheat except that at 4u he was consistently in the high 300's. When I started giving him the 4 1/2u he went to the low 300's (once at 285) I gave him the 5u last night to see if I would get a change, and I did 185. This morning I went back to the 4 1/2u just feeling uneasy about a 5u remedy. I'm just not sure what to do tonight if he's at 185 (or thereabouts again). I don't want to not have food available during the night if he needs it, but during the day he's not eating as much, nor dousing himself with water. Initially he needed the extra calories so his high numbers "we" just had to deal with. He's now at a healthy weight. It's just this balancing with insulin that's got me a little flustered, especially at this juncture.
Hillary & Maui (GA)
Member Since 2009
Have you visited the lantus forum on this board yet? If not, I suggest you do, there is a wealth of information there, about changing doses that you should read up on.
Also, post your question on that forum as the people there, don't always come to health and will be best able to guide you on what to do.
Also, post your question on that forum as the people there, don't always come to health and will be best able to guide you on what to do.
Pumbaa
Member Since 2012
Hi Chloe:
If you do have a spreadsheet that people can look at, that would be a huge help. You don't have to set it up from scratch yourself, here are directions for using the template that most people here use: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
Also, what does Jimmy eat? Is he on low-carb canned food?
Suze
If you do have a spreadsheet that people can look at, that would be a huge help. You don't have to set it up from scratch yourself, here are directions for using the template that most people here use: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
Also, what does Jimmy eat? Is he on low-carb canned food?
Suze
Sue and Oliver (GA)
Member Since 2009
Agree that a post on the Lantus board would give you more guidance http://www.felinediabetes.com/FDMB/viewforum.php?f=9 Also be sure to read the starred stickies at the top of the page. They will give you lots of info about how to best use/dose lantus.
If you need help getting a spreadsheet up, just send me a private message and I'll help. (Small pm button on the bottom left hand side of my post)
If you need help getting a spreadsheet up, just send me a private message and I'll help. (Small pm button on the bottom left hand side of my post)
Sue and Oliver (GA)
Member Since 2009
The dry food can make a huge difference elevating his bg levels. Dry DM is 13% carbs. Also very dehyrdrating. This website by a vet explains why wet is best: www.catinfo.org
When we switched Oliver from dry to wet, he went down 100 points overnight. Eliminating the dry and feeding all wet would really help. If you want him to be able to graze, you can freeze the wet or use an automatic feeder.
When we switched Oliver from dry to wet, he went down 100 points overnight. Eliminating the dry and feeding all wet would really help. If you want him to be able to graze, you can freeze the wet or use an automatic feeder.
HI Chloe - here is Janet & Binky's food list - http://binkyspage.tripod.com/canfood.html - stay with the canned food that is under 8% carbs. There are many economical choices using Friskey's, Fancy Feast, etc. Definitely get your cat off the dry food and you'll see his insulin need go down dramatically. Jan
Cindy & Pets
Member Since 2012
Do watch his bG really carefully when switching though, he will likely need a drop in insulin doseage. It might be good to slowly change over to a canned food that's less than 8% carbs so that you can avoid a possible hypo problem.
Ann & Tess GA
Member Since 2010
Welcome! Do come over to the Lantus forum. :YMHUG: :YMHUG: There is a ton of info and great dosing advice there. They do like to see a good record of where Jimmy's BGs have been, so do get the SS set up on Google Docs. You don't need a SS program on your computer, it's all in the cloud. You do need to be join Google, but it's free. Your meter should keep a record of a lot of past tests, just fill in as many as you have.
Dosing on Lantus and the other long lasting insulins is different from the traditional fast acting insulins. As Knolet said, dosing is based on the lowest point in the cycle, nadir, not on the preshot, which is usually the highest point. We do preshot tests, but only to be sure their BG isn't too low to safely give insulin. Without midcycle tests, you don't to know what to dose. Getting mid cycle test is important also because if your cat goes very low during the cycle those high preshots you are seeing could be a result of the liver "panicking" and dumping glucagon and regulatory enzymes for protection when it feels lower glucose levels than it is used to. That could be what you are seeing.
W/ Lantus a reserve is built up in the body and slowly released over time. Every time you change a dose the reserve needs to adjust. That is why we hold a dose for at least 6 cycles (3 days) after a change. Some cats will settle in right away, some go to the very end of the 6 cycles before showing what the new dose can do. Others need longer, every cat is different. Until you have enough data to make that call for yourself, the 6 cycle rule is a good one. Shooting exactly 12 hours apart is important too. Anything more than 15 minutes early or late can act as an increase or decrease and you start counting the 6 cycles all over again.
I agree on the dry food keeping numbers up. Take at least a week of slowly giving more wet food and less dry to transition and avoid drastic BG drops. Also, how close to testing time is he eating? Food within 2 hours before the test ran raise BG number significantly.
Dosing on Lantus and the other long lasting insulins is different from the traditional fast acting insulins. As Knolet said, dosing is based on the lowest point in the cycle, nadir, not on the preshot, which is usually the highest point. We do preshot tests, but only to be sure their BG isn't too low to safely give insulin. Without midcycle tests, you don't to know what to dose. Getting mid cycle test is important also because if your cat goes very low during the cycle those high preshots you are seeing could be a result of the liver "panicking" and dumping glucagon and regulatory enzymes for protection when it feels lower glucose levels than it is used to. That could be what you are seeing.
W/ Lantus a reserve is built up in the body and slowly released over time. Every time you change a dose the reserve needs to adjust. That is why we hold a dose for at least 6 cycles (3 days) after a change. Some cats will settle in right away, some go to the very end of the 6 cycles before showing what the new dose can do. Others need longer, every cat is different. Until you have enough data to make that call for yourself, the 6 cycle rule is a good one. Shooting exactly 12 hours apart is important too. Anything more than 15 minutes early or late can act as an increase or decrease and you start counting the 6 cycles all over again.
I agree on the dry food keeping numbers up. Take at least a week of slowly giving more wet food and less dry to transition and avoid drastic BG drops. Also, how close to testing time is he eating? Food within 2 hours before the test ran raise BG number significantly.
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