Vet wants to go to once a day dosing...
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Deb & Wink
Member Since 2013
Lantus is a depot type insulin, not an in and out insulin. Lantus has a duration of somewhere around 14-18 hours in most cats. Because one 12 hour cycle goes onto the next 12 hour cycle, you get what is called overlap. Some of the insulin from the last cycle is still around for the next cycle.
Because of that 14-18 hour duration, if you switch to once a day dosing with Lantus, you will be draining the depot and leaving your cat without insulin for 6-10 hours every day. This will simply cause the BG numbers to be even more erratic.
Every shot you give, some of that insulin goes to building back up that depot. With once a day dosing, you are constantly draining and refilling that depot, leaving less insulin for working to process the food properly.
Because of that 14-18 hour duration, if you switch to once a day dosing with Lantus, you will be draining the depot and leaving your cat without insulin for 6-10 hours every day. This will simply cause the BG numbers to be even more erratic.
Every shot you give, some of that insulin goes to building back up that depot. With once a day dosing, you are constantly draining and refilling that depot, leaving less insulin for working to process the food properly.
Hi Deb,
Do you, or does anyone else, know of any good research articles I can share with my vet regarding this topic or the fact that because Shadow was mis/undertreated for so long, when his body sees a normal blood sugar value it will respond by releasing more glucose resulting in a high blood sugar value, until his body gets used to a lower number? I'm not sure the vet understands or realizes these things.
Does anyone agree that it's time for a dose increase for Shadow?
Do you, or does anyone else, know of any good research articles I can share with my vet regarding this topic or the fact that because Shadow was mis/undertreated for so long, when his body sees a normal blood sugar value it will respond by releasing more glucose resulting in a high blood sugar value, until his body gets used to a lower number? I'm not sure the vet understands or realizes these things.
Does anyone agree that it's time for a dose increase for Shadow?
Shadowboy said:
I have no idea why the vet said to dose once a day. The insulin does not last that long for a cat, so you need to dose every 12hrs.
For the dose, I don't know if I would want to increase the dose just yet...I don't know if the 3u is maybe too high or not. You give a 3u shot, then there's a big drop followed by a bounce which clears in a day or so, and you give another 3u and everything repeats.
I don't know if the dose it too high or if you have got yourself some insulin resistance going on.
Gayle
Should I just hold steady at 3 units? If yes, for how much longer? I feel like I have seen the same pattern whether I give 1 unit, 2 units, or 3....
I think the discussion on insulin resistance has come up before. At what point or dose is it decided a cat is insulin resistant? What do you do in the case of insulin resistance?
I think the discussion on insulin resistance has come up before. At what point or dose is it decided a cat is insulin resistant? What do you do in the case of insulin resistance?
Deb & Wink
Member Since 2013
See this article, page 3, second and third paragraphs under Glargine heading where it talks about twice daily dosing giving superior glycemic control over once daily dosing. http://www.uq.edu.au/ccah/docs/diabetesinfo/article5.pdf
I think this is one vet research article that talks about twice daily dosing. http://www.anzcvs.org.au/samedicine_assets/documents/2005 sam proceedings/marshall.pdf This is only the abstract, not the full article.
I think this is another vet research article that talks about twice daily dosing: http://www.uq.edu.au/ccah/docs/diabetesinfo/article5.pdf abstract only, not the full article. I don't have access to the full article.
Got these references from this article: http://www.uq.edu.au/ccah/index.html?page=43391&pid=0
This journal has a special Feline Diabetes version published in March 2013 with a lot of the recent research. Again, I do not have access to the entire journal but your vet should. Veterinary Clinics of North America: Small Animal Practice Volume 43, Issue 2, March 2013
Hope that helps to steer your vet to some feline diabetes research. Some of it is ten years old.
I think this is one vet research article that talks about twice daily dosing. http://www.anzcvs.org.au/samedicine_assets/documents/2005 sam proceedings/marshall.pdf This is only the abstract, not the full article.
I think this is another vet research article that talks about twice daily dosing: http://www.uq.edu.au/ccah/docs/diabetesinfo/article5.pdf abstract only, not the full article. I don't have access to the full article.
Got these references from this article: http://www.uq.edu.au/ccah/index.html?page=43391&pid=0
This journal has a special Feline Diabetes version published in March 2013 with a lot of the recent research. Again, I do not have access to the entire journal but your vet should. Veterinary Clinics of North America: Small Animal Practice Volume 43, Issue 2, March 2013
Hope that helps to steer your vet to some feline diabetes research. Some of it is ten years old.
Shadowboy said:
Well, you could hold the 3u and see how it goes once the bounce clears, but if you start to see a pattern where you have a couple cycles of high numbers from the bounce, then you get a cycle were the numbers steadily drop from one shot time down to the next shot time, and then you have another bounce..... it may be an idea to drop the dose a bit.
For resistance, if you were to get to a dose of 5u BID or higher, and are still getting those high numbers, the pulling up to the high numbers after getting a good few numbers, you can ask about it then.
Gayle
Wendy&Tiggy(GA)
Member Since 2011
Gayle - can you take another look? I think they are using an alphatrak.
Wendy
Wendy
Wendy&Tiggy(GA)
Member Since 2011
yeah they are kinda expensive. the human ones are cheaper.. and pretty much as good. We like the walmart relion and Arkray ones here.
I posted in your other thread. I wantGayle to take another look at your sheet because 83 is almost a dose decrease when using an alphatrak.
I posted in your other thread. I wantGayle to take another look at your sheet because 83 is almost a dose decrease when using an alphatrak.
Yes, if you are using the pet meter, then the numbers that people mention here would differ by I think around 50 points.
So, the people who use human meters say the cat gets a decrease for 50 and under.... that means on a pet meter, you would decrease the dose when you get a number that's under 100.
You will save yourself alot of money if you switch to a human meter. If you are in the US, check the price of test strips for the Relion meters and compare it to what you are paying for the test strips for the pet meter.
On your ss, if you switch to a human meter, leave a blank line and add a note on that line to say switching from pet meter to human meter.... that way, people will not be puzzled by the change in your numbers. You will be getting lower numbers on the human meter and without a comment, people will think you are doing much better on the insulin.
And again, once a day is not good for cats..... maybe for dogs, but not for cats.
ETA: since you are getting numbers that earn a decrease in dose, you could drop to the 2.75u again. And, if you are still getting numbers under 90 after giving the new dose time to settle and clear any bounce, then decrease again to 2.5u.
So, the people who use human meters say the cat gets a decrease for 50 and under.... that means on a pet meter, you would decrease the dose when you get a number that's under 100.
You will save yourself alot of money if you switch to a human meter. If you are in the US, check the price of test strips for the Relion meters and compare it to what you are paying for the test strips for the pet meter.
On your ss, if you switch to a human meter, leave a blank line and add a note on that line to say switching from pet meter to human meter.... that way, people will not be puzzled by the change in your numbers. You will be getting lower numbers on the human meter and without a comment, people will think you are doing much better on the insulin.
And again, once a day is not good for cats..... maybe for dogs, but not for cats.
ETA: since you are getting numbers that earn a decrease in dose, you could drop to the 2.75u again. And, if you are still getting numbers under 90 after giving the new dose time to settle and clear any bounce, then decrease again to 2.5u.
Just saw this post.... Guess I will decrease tonight- got a 84 today.
I just looked back at when he was at 2.75. I thought he wasn't doing good, but were those blacks on the 20th and 23rd after the PM dosing bounces from the 190 numbers we had during the day? After the highs on the 23rd I didn't really give a full 3 days for him to clear before going up to 3units..... hmmmmm
I just looked back at when he was at 2.75. I thought he wasn't doing good, but were those blacks on the 20th and 23rd after the PM dosing bounces from the 190 numbers we had during the day? After the highs on the 23rd I didn't really give a full 3 days for him to clear before going up to 3units..... hmmmmm
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