Is it time for an increase of Lantus?

Hi - Baby is at 5u 2x daily right now. I've been checking her BG very closely for the last several days and she is not coming down. Is it time for another increase? And if so, .5? Ugh. Or should I wait a few more days? Thanks for your help.

 

I would say an increase is in order. Over 5U, an increment of .5 is often recommended. My only hesitation is your excellent monitoring has only been done at this dose, so I can't say if an ideal loeer dose may have been missed.

I'm asking for some more experienced folks to please weigh in.
@Bobbie And Bubba
@Sandy and Black Kitty
@Mandy & Rex

 

I noticed the lack of testing before this dose. May I ask why you didn't test before now?

However, it does seem Baby needs more insulin. 0.5u increase is recommended once you get to 5u.

I'm tagging @Marje and Gracie since Wendy is gone on vacation. Maybe Marje can weigh in on if the ideal dose was skipped over.

 

@Sienne and Gabby (GA) is another person who can read numbers well.

 

Hi @Carol in Chicago and @Mandy & Rex - Prior to August 30th I had not yet purchased an at home meter because my vet said I didn't need one. I decided to get one anyway when Baby's numbers were not getting better after all these months. I found this site and saw the success stories and thought I owed it to Baby to do my very best to get her BG under control. I do not think my vet is very familiar with feline diabetes...she said as much. She's only had a few and she said they were all controlled with 2u or less. She is referring me to an internist now, but I am trying to figure this out on my own for a while first. The vet had never done a curve. I hope the data I have posted so far will be able to give enough information for you smart folks out there to advise me. So I will try the 5.5u tomorrow morning. She just had a 311 pmps. I will keep you all posted. Thank you so much.

 

Thank you, Mandy, for tagging me so I could offer some insight.

I don’t really understand why the vet increased the dose by 0.25u at some times and 0.75u at others. And with so few tests, it’s not possible to know if you’ve skipped a good dose.

However, just based on her numbers on the 5u dose and the fact that she could potentially need this much insulin, I wouldn’t do a rebound check to see if a lower, good dose was missed (just mentioning this as Carol said she didn’t know if a good, lower dose had been missed). IMHO, I’d continue up until you do hit a breakthrough dose.

We had another member here who dropped the dose back from over 4u to 1u and it has left the kitty in a sea of pink and red and she has just found out that he is also a high dose kitty. I would not want to see you go through the same thing. If she were mine, I would increase the dose to 5.5u bid.

 

Hi Mary Ann,

You have been doing an excellent job monitoring since you got your meter. Kudos to you for taking matters into your own hands, and to your vet for admitting she doesn't know much about FD (time for her to get some continuing ed??).

I agree with Marje about not going backward in dose (although no one did actually suggest it) to see if you missed something. I think, with your close monitoring, it's best to keep going and see what 5.5 units will do. Hopefully you'll get to the purrfect dose soon.

 

I think Baby needs an increase. It's been 9 cycles on this dose and nothing lower than 223. I would increase to 5.5.

 

I agree with Marje, Tricia, and Bobbie. It's time to increase Baby's dose.

Have you decided which dosing approach you're going to follow? There are 2 methods that we use -- Tight Regulation Protocol (TR) and Start Low Go Slow (SLGS). There are sticky notes describing each. Given how much you're able to test, I'd encourage you to follow TR. It's more aggressive (you can increase the dose as often as every 3 days) and it has published research documenting its effectiveness. SLGS was developed here and certainly works but it is a slower method. Having a reference to help guide you will allow you to have a better feel for when to change doses.

 

Hi all, Baby this morning AMPS 272, 5.5u at 7am, 323 at 9am. Will forge on! Thank you so much for all of your inputs!

 

Has anyone recommended you have Baby tested for acromegaly or IAA? If a cat gets up to 5 units, those tests are recommended.

 

Baby update - 215 at noon! Lowest number she's ever had!

 

Baby update - back up to 332 at 2:45?

 

No worries, she is probably having some New Dose Wonikess. It can occur within the first few cycles. Hang tight. She will start to come down.