Ginger's LANTUS Curve

Previously tried Humulin N- with bad results.

Lantus Day 1 (9-27-10)
8am 516 (gave 1 unit)
10am 381
12pm 309
2pm 298
4pm 339 (gave 1 unit)
6pm 355
8pm 370
10pm 386
Although her numbers were high, they were more steady and she seemed to feel better.
I am confused tho as to why her numbers continued to go up after shot #2.

Lantus Day 2 (9-28-10)
7:30am 449 (gave 2 units)

 

Lantus has to build up in the body. Please read the sticky posts in the Lantus ISG so you understand the differences in how it works.

Give 1u BID for a week before doing another curve, ok?

(and don't be changing the dose a million times -- Lantus and Levemir really need pretty steady dosing to work properly)

Lantus and Levemir are VERY different from Humulin N and PZI. The advice that I've given you for Humulin N and PZI DO NOT APPLY to Lantus or Levemir. (NO 8 hr dosing, NO changes in dose for every shot --keep it steady)

With Lantus and Levemir, you need to test at nadir more often to make sure Ginger is not going too low (when you are getting close to the right dose.

DAY 2 is too soon to be increasing the dose.

IF you _know_ your kitty has a high dose condition like Acromegaly, then it is ok to increase the dose after 3 days instead of waiting a whole week.

Diabetes treatment requires patience, so take a deep breath and give Ginger a hug.

 

Agree with everything Phoebe said, just want to ask when did you feed during the curve? Maybe you could note that next time. Sometimes food will cause the BG to rise temporarily, this is why we encourage food when cats are going to low.

 

Well since I already raised her dose to 2 units today, its kinda late. The doctor figured 1 unit would be too low and I would have to increase it.

I will test her every 2 hours again today to watch how low it goes.

I test her in the am before food, get her reading, then feed her, then give the insulin.
Same at dinner time.
But she is on EVO dry food right now so nibbles all day long.
Last night I took away the food totally at 8pm.

NONE of my cats were happy that there was no food sitting there. lol
I have 3 cats.

 

It's not easy to switch all the cats from free feeding to a set schedule, but it can be done. I've switched my group.

Going up an entire unit is not really a good idea. As Phoebe mentioned, it takes time for the Lantus to build up in your cats system. They call it a shed on the Lantus ISG. You may find that 2U will prove to be too much in a short time. I'd highly recommend you back down the dose to 1U, but if you don't feel comfortable doing that, maybe back it down to 1.5U BID but please do continue getting AM/PM preshot numbers and get some spot checks.

 

It is day 2 -- it is not too late to go back to 1u for the rest of the week.

Both my diabetic cats only get 0.25u BID. Give the insulin time to settle into Ginger's body.

I have 5 cats - 2 diabetics. We leave canned food out 24 hours per day. (fresh in the morning at shot time, add some fresh at bed time to make sure they don't run out at night and wake us up)


Also -- doing a curve during the first 1-2-3 days of Lantus is not necessary because the whole kitty / system will change as the "Storage Shed" of insulin fills up.

Lantus is an insulin that builds up in the body -- your curves yesterday and today do not reflect the same response that you will see NEXT WEEK after it has a chance to build up.

 

Lantus is not at all like Humulin-N. Neither of my vets understood that either, and myself least of all. It builds in the system and the peak or nadir doesn't always come in the middle--my cat's lowest point came 12 hours after her first shot. But it takes at the very least 3 days for the "storage shed" of insulin to build up. The difference of 1 to 2 units is huge--it can send your cat down much quicker, but the hypo can last 6, 7, 8 hours.

Please take the time to read the stickies at the top of the Lantus forum (viewforum.php?f=9). If I hadn't read those stickies and listened to the advice on this board, I would be nowhere good right now.


Am I reading correctly that you gave a dose @ 8 am & 4 pm?

 

The 2nd shot of Lantus yesterday was at about 5 pm.
I did not give her a 2nd shot today.

My reason for doing the curve testing again today, was so I could monitor how low it goes........just incase it were to go too low. (Since I gave her 2 units this morning)

Tomorrow I will go back down to 1 unit, but only 1x per day as suggested and continue that way for this week.

Her readings today were:
7:30am 449 (Gave her 2 units Lantus)
10 am 309
12 pm 243
2 pm 258
4 pm 314

Thats all the testing I will do today, since it doesnt look like her readings will go too low.
I think she needs a break. lol
She has been such a good girl throughout all this testing.
And she is feeling soooooooo much better.

Thank you everyone for your suggestions and Knowlege I appreciate it.

 

I just want to make sure you meant 1 unit 2x/day, not 1 unit 1x/day. And I notice that you changed the shot times--on Lantus that's the same as lowering or raising the dose (if you give it 8 hours after it's a dose increase, 14 hours after is a decrease). 30 minutes is the most you want to vary without from 12 hours without shifting the next dose accordingly.

Also, I would test before you shoot and shoot the 1 unit 12 hours after the shot you gave this morning. Like I said, my cat's nadir was 12 to 13 hours after a shot (not the case with Humulin-N she was on briefly). Since you don't know yet, I would check just to be safe.

Tomorrow, try posting your AMPS (AM Pre-Shot) in the Lantus forum (http://felinediabetes.com/FDMB/viewforum.php?f=9)-- that's where the people are who really know there Lantus stuff. Actually, it might be best to start that tonight--posting your PMPS there.

Good luck!

 

No, usually it is 1u twice a day for the first 5-7 days. So find a time 12 hours apart that works for you. Mine is 7am and then 7pm.

Please slip over to this forum and read the stickies at the top. There is important information there you need to have regarding Lantus insulin, dosing protocols, etc.

viewforum.php

 

One of the reasons I chose Lantus is because it was suppose to be a once a day injection.

The vet said if they go to 2 injections, they dont have to be exactly 12 hours apart.
She said 9-10 hours was fine.

Many days we are not home from 5 pm to 10 pm to give a shot in those hours.

I am getting completely confused now.
I will call my vet tomorrow.

 

I had a vet tell me the same thing about Lantus--that it could be used once a day. Another one said give or take an hour with regard to shots. Neither statement turned out to be true. At all.

The stickies in Lantus explained the insulin better than any vet ever did to me. Generally speaking, they just don't seem to know much about it, and don't/won't take the time to read up on it.

I'm not too familiar with it, but from what I've seen on this board, PZI has the most flexibility. You may want to take a look at that primer before you talk to your vet tomorrow.

It is confusing. But you'll get it figured out.

 

She was going to put her on the PZI, but would have had to order it.
With how crazy Gingers numbers were, I did not want to have to wait.
I had read how Lantus was used once a day, instead of 2, so I thought that would be a better choice, plus I could buy it at any drug store.

I am not thrilled at the thought of getting up at 4 or 5 am to do an insulin shot.
I also do not like that I will have to throw a half of a bottle away after 28 days of such an expensive insulin, so I may switch her anyway.
I had her on the Humulin N for 20 days and I have over a 1/2 bottle left.

I just hope all this switching wont mess her up even more.

Yes, I am stressing. :?

 

Lantus is an excellent insulin and PZI is pretty darn good too. Lantus does need consistent dosing regarding times and amounts.

Again if you have not ventured over to the Lantus Insulin Support Group forum to read the information there...you really should and since PZI is the other option you might want to compare the two insulins before speaking with your vet.

I am sorry you are feeling stressed, but it does get better once it is worked out as to the best insulin for your cat...and your lifestyle too. You sound like you do your research, so look just a bit further. I think it will be worth your time.

Lantus ISG: viewforum.php?f=9

If you decide to stay on Lantus, have your vet prescribe the solostar pens/cartridges. They come 5 to a box, you use one pen more or less a month(all of it in many cases), and you have 5 months on insulin on hand. While there is the convenience of being able to walk into the pharmacy to buy Lantus....many find the pricing much better going through Canadian pharmacies online.

 

In humans the once a day dosing is accurate, but the cats metabolism is much faster and that necessitates twice a day dosing.

 

Dear Blue,

Thanks for the advice.
I have read some on the Lantus page and I am understanding things a little better.

I definetly will get the pens next time if I decide to stay on Lantus.
Do you have to buy all 5 at once or can one pen be bought at a time?

I am just thankful that Ginger is such a good girl when I do the BG testing.
I had tried to test her brother (born in the same litter). He is a huge Russian Blue, and I could not even hold him down.
He is soooooo strong. lol
I was able to test my black cat. His BG was normal. I was really worried about him because he is losing alot of weight and always hungry.
I did have a blood work up done on him about a yr ago because of his weight loss, and it was all normal. He is 15 now, but is very active.

Right now, I will just concentrate on Ginger and getting her BG regulated.

 

The Lantus and Levemir pen cartridges come in 5-packs, but sometimes you can split with someone who lives nearby.

They are only 1 shot per day for Humans... Cats have a faster metabolism, and need shots every 12 hours.

Have you said where in Ohio you are located? I travel to Toledo on average once per week --

 

I live between Cleveland and Akron.
I added that to my profile.

 

Thanks - so a road trip for us to meet might take a few hours. My brother and his wife live in Medina, which might be near you.

We do have some members between you and Pittsburgh who might be able to split a 5 pack of insulin.

I use Levemir because it is less fragile than Lantus -- meaning it doesn't go bad as quickly.

For my two low-dose diabetic cats, a 5 pack of Levemir will last more than a year, where Lantus may go bad after 6 weeks or so (after cartridge is punctured with the first needle).

Heather and Boo did offer to send you the insulin that Boo no longer needs (Boo has an acromegaly tumor that was treated with radiation -- Boo is now off insulin).

Cold overnight shipping is a significant expense - which is why it is a good idea to split with some local folks.

 

I am not sure if I will stick with the Lantus, but thanks for the suggestion.