What is a common low/high spread on Lantus?

[Riddler]

Still early (just a few weeks), but Brutus (newly diagnosed) seems to be responding well (and relatively predictably) to Lantus. After some initial ups and downs, he looks to be settling in with his latest dosage. While he's begun to nadir in the green, the Lantus definitely wanes during the last part of the cycle such that his BG is usually 3x nadir or more by next shot. Just FYI, I try to feed twice during a cycle, once preshot and then at shot + 4-6 hours.

I am curious whether Brutus is likely always to see a 3x-4x low/high spread even if we're successful getting him to nadir consistently in the green, or if a decent percentage of kitties somehow narrow their spreads with time. I know all kitties are different, so Brutus will eventually give us his own, individual answer, but I'm still interested to know if there is a "bell curve" of sorts when it comes to spreads.

Thanks!!

 

[Larry and Kitties]

The spread of PS to lowests BG depends upon the cat.
You seem to frequently changing the dose. With lantus, a depot insulin, yo should maintain the dose for about 5 days before increasing. If yo gt a low BG you should immediately decrease dose.
I can maintain my:
- BunBun below about 100 with one unit Lantus
- Badger below 150 with one unit Lantus
- Patches II below about 150 with 2.5 units Lantus. Her PM PS' are typically lower than AM and I shot full 2.5 units with BG as low as 60

 

[jayla-n-Drevon]

some cats do not respond until the 6 cycle on the same dose or even longer....lantus likes consistency ....

 

[Riddler]

The spread of PS to lowests BG depends upon the cat.
You seem to frequently changing the dose. With lantus, a depot insulin, yo should maintain the dose for about 5 days before increasing. If yo gt a low BG you should immediately decrease dose.
I can maintain my:
- BunBun below about 100 with one unit Lantus
- Badger below 150 with one unit Lantus
- Patches II below about 150 with 2.5 units Lantus. Her PM PS' are typically lower than AM and I shot full 2.5 units with BG as low as 60

Actually, with the exception of one day, where I was a bit concerned about a low am shot number and then was faced with a shorter than 12 hour pm shot due to a personal schedule issue, Brutus has been at the same dosage for 15 consecutive cycles. He was producing low to mid blue nadir numbers (on the Alphatrak scale), but the aggressive protocols I have read say that it is ok to increase the dose to strive for green nadir numbers if the kitty is responding reliably to Lantus and nadir checks can be made. Hence, I increased the dose to 2.5 U from 2.0 U and got a nadir of 74 during the first cycle and a nadir of 92 on the second. However, because I will only be able to spot check for the next several days, I'm thinking I should play it safe and go with a dose of 2.25 U for the time being. If I'm seeing low blue nadir numbers consistently, but few, if any, greens, then I supposed I can consider going to 2.5 U.

Brutus, BTW, is 16 pds (at or close to IBW), so I have suspected from the start that a dose larger than 2.0 might eventually be where he ends up.

 

[Riddler]

Happy to report that after about 12 cycles, Brutus seems to have become pretty well regulated on Lantus (i.e., 80-200 for the most part, measured with an Alphatrak). In fact, throughout the last 4 cycles, he's been 85-120.

I've been splitting his meals into 4 servings. He gets one each with his shots, and the other two at shot +4-5hr. During the 5th cycle after I increased his dose, he went from 441 preshot to 60 mid-cycle (a classic "bounce" perhaps), so I began to think about how I could help him smooth out some. If his recent cycles are any indication, dividing his meals that way might be helping.

I'm hoping he stays as well regulated in the weeks to come.