What do you think a good starting dose for Lantus would be

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lovey11

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I met with a new vet today. She was helpful and looked at Lovey's records, She did a urine test on Lovey to help determine any reasons for insulin resistance.
She wanted to make sure she didn't have a bladder infection or problem with kidneys. One number on her blood work was elevated. The pancrease lipase test for pancreatitis came up in normal range this time around.
She wanted me to change from chunky chicken fancy feast to a classic variety. Do you agree? She also mentioned switching to Lantus after changing the food with a possible staring dose of 2.5. Lovey is 11 pounds 13 ounces. I need to update my spreadsheet, but my numbers on 1.75 of pro zinc have been about the same.

She tested lovey's BG about 1 hour 45 minutes after shot and it was 363. Does this seem like a good starting dose? I don't know much about Lantus.
 
Re: What do you think a good starting dose for Lantus would

The FF Classics are low cars than the Chunkies.
I think 2 1/2 units is too high of a starting dose. I would start at 1 or maybe 1 1/2 units. I would first change to the Classic's for a few days before changing insulin so you only see the change in BG from one variable at a time.
 
Re: What do you think a good starting dose for Lantus would

What is you cat's current weight and what is his ideal weight?
Which is lower?
Take the lower and convert it to kilograms (pounds/2.2)
Multiply that by 0.25.
That is a formula for estimating the starting dose for Lantus.

Since you're using ProZinc already, you might go halfway between the estimated starting dose and what you are currently giving.

Lantus works differently than ProZinc. It has a cummulative effect. You will NOT get immediate results. You MUST be patient. NO dose changes for the first 5 days unless to reduce! Be sure to get tests around the nadir (5-7 hours after injection).
 
Re: What do you think a good starting dose for Lantus would

Thank you. Yes, I will only change food first. The PIerson chart said that the chunky is only 5% carb, but my vet said the classics are better. She said that she has seen better results with classics?

My cat is 11 pounds 13 ounces. My vet said she was a little heavy. I am not sure the ideal weight. I will ask. I think it may be around 11 pounds?
 
Re: What do you think a good starting dose for Lantus would

If 11 is ideal weight,

11 pounds would be 5 kilograms.

5 x .25 = 1.25 units

Larry, your starting dose sounds right according to this.
 
Nadir with Lantus and How long to keep a dose

Is there a definite nadir with Lantus. My vet said that it was a peakless insulin. Is it that it is not as a dramatic rise and fall as other insulins? At this time, I can't test my cat as much. Would checking midcycle and preshots be enough to check? So you hold a dose at least for 5 days unless readings are too low. What is the optimal time to hold a dose?
 
Re: What do you think a good starting dose for Lantus would

Heres more info on Lantus - the curve info is halfway down the page but essentially the nadir is 5-7 hours after the shot http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139

And protocol is here http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

I usually recommend 4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Wendy
 
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