Need dosing advice...first full day on Lantus

Discussion in 'Lantus / Levemir / Biosimilars' started by georgecat, Oct 13, 2018.

  1. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    Question?? George has only been on Lantus 1 day (was on Vetsulin).
    His numbers are great today. Soooo much better than Vetsulin. +6 102, +8 75, +10 at 83
    He probably hasn't built up an insulin depot yet. Should I be concerned that he
    might be overdosed once his depot is built up in a few days and reduce his next dosage abit...or just keep the dosage at 1.8???
    He is now a much happier cat!

    [​IMG] Thanks
     
  2. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    What a great response to the Lantus, he had today. Some kitties do show a great response when first on the Lantus. Looks like the PMPS is in less than 2 hours. He could soar from now till then from being in greens for a bit today. You have not ever shot a blue If he is not at least 150 at PMPS, stall without feeding and retest in 20 minutes. If he has come up to 150 or higher, then if you can monitor him and have plenty of testing supplies and higher carb food, then I would shoot . And then get a +1 since it would be your lowest number that you shot. Then get a +2. If the +2 is the same or lower than the PMPS then it could be an active cycle.
    Yes, the depot has to fill yet.
     
  3. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    thanks... and no never shot in the blue, never got there on Vetsulin. Too late on the food, the other cats wanted to be fed, so George got a medium snack.
    He is due for his next shot in 20 minutes, I will report it here before shooting. If not up to 150, no shot? or a reduced dosage. If it is slightly above 150, same dosage, or slightly reduced?
    I am trying to do him on a TR .. however I may have started too high a dosage.

    I can monitor him for probably 4-5 hrs after the shot, then most likely I will be nodding off.
     
  4. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    That food can impact his PMPS. At what + number was the medium snack? Was it the lite feed at +9 on your SS? If so, your PMPS should be a true number. We say no food within 2 hours of the pre shot.
     
  5. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    Unfortunately his med. snack (1/2 can FF) was after hr 10. Before George's DX, the cats were grazers ...all day long, on mostly dry food. They all are now on canned food, however still eat smaller meals all day long.
    Just did his PMPS, it came out 178.. after eating about 1 hr ago. I have never given him Vetsulin at this low a level. So not sure what to do now, as Lantus is a different insulin.
    I can give him the shot (1.8), lower the dosage (defeats the purpose of the TR), give it to him in several hrs, or just skip it.
     
  6. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    How comfortable are you to shoot this low? And how far off can your shooting schedule be? He is likely to keep going up since he hasn't seen any greens since 9/13.

    ETA: Since this number is impacted by feeding an hour ago, it might be prudent to wait and retest in 2 hours from that meal. And then decide.

    I won't be up by then so put a ? mark in your title and ask for dosing advice.
     
  7. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
  8. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    thanks for both your reply's.
    yes agreed .. 1.5 probably was a better starting dose, however I had already given George is first dose at 2, which was reduced for the am shot after the headshaking episode.
    I am now inclined to reduce it down now to 1.5 based on such low numbers, so close to his PM shot.. however I hate to muck up his system if for some reason this dosage is the correct one. I am just not used to seeing such great numbers, especially at dosing time. With no data to work from yet, I am not sure what is the best path.
    With Vetsulin, I would never shoot in the greens or even blues, however Lantus is different.

    George sleeps with us at night (in the crook of my arm...so sweet), so I can semi monitor him at night ..in case of issues. Not uncomfortable giving him a night time shot, just hate to break the TR dosage if this is a relatively typical response when shifting over to Lantus.
    I guess at this point I will push back the PM shot another hr, test him, if his number is in the high 100's ++, then give him a shot. I am inclined to reduce it down to 1.5 and start a new TR from this point on.
    I may be corrupting the data, however I have no history yet with Lantus. Any further input is welcome. Will post another BG within the hr.... before dosage.

    Thank you all for being so supportive and caring for all our little ones!
     
  9. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Start with delaying 1/2 hour without feeding, and test again to see if he's high enough for your comfy zone. A half hour is easy to make up when getting your shot time back on schedule. If you delay an hour, you can go back 1/2 hour a day, or 15 minutes a shot.
     
  10. Olive & Paula

    Olive & Paula Well-Known Member

    Joined:
    Sep 6, 2015
    If I'm not mistaken your going to hold the dose for 7 days so the depot can build. So this one off dose really won't matter as the depot isn't fully established yet. You shouldn't have to restart TR.
     
  11. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    + 13.5 hrs 181 ... been over 2 hrs since food
    so stay at 1.8 and dose now...or reduce?


    Ok... decision made...I just fed George and will shot him with 1.5 since I know he won't eat for atleast 9 hrs. Will monitor him for as long as I can stay awake.
    I know I just went off the TR, however watching him today, he is more alert than he has been for along time, so something is working correctly right now...without the depot reserves.
    I am thinking I should adjust down slightly before the depot builds up and starts to kick in.

    (He just started Lantus last nite.. tonight will be his 3rd shot )
     
    Last edited: Oct 13, 2018
  12. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Why won't he eat for at least 9 hours? We recommend feeding several smaller meals, most of the carbs in the first half of the cycle.

    He's probably feeling so much better, not zooming up high at the end of the cycle like Vetsulin did to him.
     
  13. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    He just finished his late meal, bedtime now for me, so no food till the am. Can't wait to see what his numbers will be in the am!
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Any chance of a before bed test? Might let you know if you have to leave food out for him to stay safe overnight.
     
  15. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    Just tested +3.4 102. Will give him a snack now.
    Can't leave food out for just for him, his 3 buddies gobble it down first
     
    Last edited: Oct 14, 2018

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