We are now up to 7.5U Lantus and sugars are still high. How quickly do I increase the dose when it is already this high? I feel like I’m looking at a case of IAA. Should we switch to Levemir with these high doses?
You may want to get your kitty tested for IAA or acromegaly. I'm tagging Wendy to get her thoughts. Switching to Lev isn't a matter of the high dose, per se. Lantus is acidic and can sting. That's why many people who are using higher doses of Lantus switch to Lev. @Wendy&Neko
You have been increasing by 0.5 units every six cycles. Keep doing that, as long as you are getting at least two tests per cycle, until you see some lower blues, at which point I might hold for eight cycles. Post back here when and if you get to 10 units, and we change the dosing strategy. I second Sienne’s recommendation to get testing done for acromegaly and IAA. One in four diabetic kitties has acromegaly, so it's not uncommon. Knowing what we are dealing with may change dosing strategy as well. As for Lev, are you seeing your cat respond to the shot with skin flinching or walking away, or other signs? I think if you get the tests done and one or both are positive, I would switch.
Thanks for the advice! I do not notice him reacting to the shot, but had read it could sting at higher doses. He has been extremely tolerant of this whole process!
I have seen cats on 25 units of Lantus with no reaction to the shot. It depends on the cat. Some low dose cats react to Lantus. My girl started walking away from her shot occasionally at higher doses, but purred through the Lev shot. Depending if there are secondary conditions causing a need for higher doses, Lev may be better.
