Yipes! My new vet wants to go to once a day lantus....

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MsBliss

Member Since 2012
It's been a long time since I've posted here, but I often come here to read and learn. I was overwhelmed in the past few years with the care of two other chronically ill pets.

I have a question about dosing. My kitty, Ginger, who has been diabetic since 2012 and always on twice a day lantus, has been having glucose readings that are all over the place, with lows of 130 to highs of 449. My new vet is convinced it was reflective of the Somogyi effect. I am not convinced that effect even exists, but she wants me to go to once a day shots, and at a relatively low dose of 1.75 to 2 units. This kitty also has early kidney disease, and other issues with her knees, which I am treating as well. I don't want to see her glucose skyrocket and find her planted in front of the water dish again, but my vet insists that one week of this new protocol and then a new sugar curve might nail down the issue of better regulation. Is anyone here doing lantus only once a day? My kitty was on about 2.5 units, twice a day. Before when I was using a different meter, which was under-measuring she was on 1.5 units twice a day.

Further to that, I switched from my Contour Next meter to the Alpha Trak2. The readings have been averaging about 70 points higher. I actually HATE the way the Alpha Trak2 works--it has really weak applications in terms of use and tool bars, but the new numbers reflect that I was under dosing for a long time apparently and that is why my kitty was on her water so much despite reading good glucose numbers.

Is anyone here using Lantus only once a day, and is it working well?
 
Welcome to FDMB.

Lantus lasts just a tad over 12 hours in the cat. This results in some overlap between doses, and that helps keep the glucose lower. We find that it is very important to keep the dose consistent and every 12 hours, and make changes in small increments while monitoring the glucose. Instead of going to once a day, reducing the dose and shooting every 12 hours could work better..

Human meters do read lower than pet meters; all of our guidelines here use human meter reference numbers (there are some notes on that in my signature).

When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.

Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.

 
Many thanks for your response. I am such a ludite--I can't find the settings!

BJM said:
Welcome to FDMB.

Lantus lasts just a tad over 12 hours in the cat. This results in some overlap between doses, and that helps keep the glucose lower. We find that it is very important to keep the dose consistent and every 12 hours, and make changes in small increments while monitoring the glucose. Instead of going to once a day, reducing the dose and shooting every 12 hours could work better..

Human meters do read lower than pet meters; all of our guidelines here use human meter reference numbers (there are some notes on that in my signature).

When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.

Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.
Click to expand...
 
When Saoirse was first treated with Lantus I used it once a day when she was getting close to remission but that was only a microdose and I piggy-backed it off her tendency to run lower at night to keep her in the tight regulation target healing range. When she was in higher numbers she received - needed - it twice a day as is the general recommendation for Lantus treatment.

If your vet did want to do a rebound check then perhaps they should consider giving a lower dose AM and PM (as BJ suggests above), wait for the depot to drain down to the new level and then review how the dose is working (and be sure to check for ketones frequently). If you could enter your BG data into one of the FDMB format spreadsheets you could post on the Lantus and Levemir asking for experienced members there to review the data and suggest a possible course of action for you to investigate.
If you can do AM and PM preshot checks plus daily spot-checks during both the morning and evening cycles it would probably give you better information on how the Lantus is affecting your kitty's BG levels. For one thing it would help far more to spot bounces than a one-off full curve. As you gather more data it should help you to spot patterns of response and help you towards a better dose (and possibly a refined feeding schedule) so as to better regulate Ginger.


Mogs
.
 
Dear Critter Mom,
Many thanks for your advice. When Ginger was first diagnosed, I was very ill advised as to how to care for her. They basically handed me a prescription for insulin and sent me out the door. Even though I kept going in for check ups, they didn't really guide me. As a result she was so poorly regulated that she really has suffered as a result. What is a tight regulation healing range? What is a depot? I test her before her am and pm shot, but I don't have a guide as to what those numbers actually mean. It's all been a disaster. I tried to get info from forums like this, and the advice sheets too.
 
The healing range means keeping the glucose in near normal numbers, letting the pancreas rest and possibly recover.

The depot is the overlap between shots which increases over several days. Lantus forms small crystals under the skin, which slowly dissolve to release the insulin. There are some left over at the time of the next shot, creating the overlap. Its like a little reservoir, or store of insulin.

There are some notes in my signature links you might find helpful.

When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.

Click the Save Changes button at the bottom.
 
After our vet did a glucose curve he put Snickers on 1 unit once a day lantus. A week later she was at the vets for 4 days after she quit eating and drinking. We got her back in the nick of time. Her glucose was all over the place, had ketones in urine, of course one vet said don't give her a shot until she eats and the other vet said oh yes give her a shot even if she doesn't eat. Almost had a dead cat. She's doing fine now after 2 weeks of them upping her dose at twice a day which only makes more sense. She's just getting more belligerent about getting 2 shots every day.
 
Does anyone know of a vet who is familiar with dealing with cat diabetes in the Los Angeles area?
 
Hi Ms Bliss,
Where are you in LA? I'm in Venice and there are two decent vets I've worked with who understand diabetes and home testing: Century Vet in Culver City (ask for Jeff Werber) and Overland Vet Clinic (they're all good but I usually saw Jane Parks).

If these locations don't work for you, let me know and I may be able to help find someone in your area. @tiffmaxee and @Cat Ma are also in LA.

Thanks for tagging me, Linda!

Shane
 
I love my vet at Brentwood Pet Clinic, Dr. Martin. He shows my ss to all his vet students. He's at Olympic and Barrington in West L.A. I used Dr. W. Years ago but switched to Brentwood. I also went to Overland when I first got Max and Tifffany. I switched back to Brentwood and switched to Dr. M. Never looked back. PM me if you have questions.
 
Last edited:
granadilla said:
Hi Ms Bliss,
Where are you in LA? I'm in Venice and there are two decent vets I've worked with who understand diabetes and home testing: Century Vet in Culver City (ask for Jeff Werber) and Overland Vet Clinic (they're all good but I usually saw Jane Parks).

If these locations don't work for you, let me know and I may be able to help find someone in your area. @tiffmaxee and @Cat Ma are also in LA.

Thanks for tagging me, Linda!

Shane
Click to expand...

Thanks for this....I've heard of Dr Werber! But I'm in Calabasas, and these kitties travel okay for short distances, but not long ones.....I think Culver City and West LA are a bit too far for them to tolerate the travel.
 
tiffmaxee said:
I love my vet at Brentwood Pet Clinic, Dr. Martin. He shows my ss to all his vet students. He's at Olympic and Barrington in West L.A. I used Dr. W. Years ago but switched to Brentwood. I also went to Overland when I first got Max and Tifffany. I switched back to Brentwood and switched to Dr. M. Never looked back. PM me if you have questions.
Click to expand...

Many thanks for the names....I am a bit too far for Brentwood, unless I come over the canyon, and even then, they would probably get car sick because it's such a curvey drive.....Anyone know a vet near Calabasas?
 
BJM said:
Welcome to FDMB.

Lantus lasts just a tad over 12 hours in the cat. This results in some overlap between doses, and that helps keep the glucose lower. We find that it is very important to keep the dose consistent and every 12 hours, and make changes in small increments while monitoring the glucose. Instead of going to once a day, reducing the dose and shooting every 12 hours could work better..

Human meters do read lower than pet meters; all of our guidelines here use human meter reference numbers (there are some notes on that in my signature).

When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.

Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.
Click to expand...
 
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