? Lantus Curve

Good day -

I'm new to the whole sugar kitty world. I've been taking Chester in for blood tests every week to try to dial in his Lantus units. He is extremely stressed at the vet's office, so I wanted to start doing readings at home. I'm going to do a curve this Sunday, to see what his numbers come in at through the day.

My question is, that upon telling my vet this, they drew out a standard glucose curve, but I've been reading and I've seen that Lantus is not a 'peak' insulin and that curves don't really work. My vet gave me a diagram and instructions, but I'm guessing the curve won't look like this due to the non peaking Lantus. Is this correct? I'm still happy getting results in a less stressed environment, but I don't want to be comparing results to the curve she drew if they the shouldn't be matching. I tried searching the forums but didn't see anything that fit what I was looking for.

Thoughts? I'm attaching a photo of the curve she drew. Thanks in advance, I'll check back in when I can. I'm doing the testing on Sunday so I wanted to have some thoughts down before then in case I need to call and discuss with her. Cheers!

 

Hello and welcome. We have a saying here, ECID or each cat is different. In the New to the Group Sticky Note is a description of a typical curve showing what Lantus action can look like. But that can vary by cat. With my Neko on Lantus, it didn't take effect or onset until three hours after the shot. Her nadir was also later than typical, some cats are earlier. You will have to find out what Chesterfield looks like on Lantus. And good on you, by the way, on deciding to home test, my non diabetic cat registered over 150 points higher at the vet. Stress can make a difference, though again, not for all cats. Home testing is the best way to keep him safe.

If people here are doing a curve, we suggest either every 2 hours for one cycle, or every three hours for 18 hours. If you find they are going lower, like under 100, more frequent testing at that point is a good idea. That's not far off what your vet has suggested.

Can you tell me a little about Chesterfield. How was he diagnosed? Any other issues present? What type of food is he eating, and how often?

 

Thank you for the reply! Chesterfield absolutely hates the vet and I have no doubt he is registering higher due to that.

Chester was diagnosed after I noticed a large, sudden increase in urination. It was caught quick and we got him going on insulin within the week after doing blood work and then a urine sample. He has a history of a urinary blockage so he eats Science Diet C/D. He used to get 1/2 a can three times a day, and now we've moved him to 3/4 of a can in the morning and evening along with the insulin injections. No other issues are present at the moment. We started him with 2 units twice a day and then brought him in to test glucose and increased to 4 units twice a day, and then earlier this week we tested again and he got moved to 5. I'll be doing the curve tomorrow and will post back here with the results.

 

Yikes! Your vet has been increasing the dose by too much at once! The majority of kitties here are on much smaller doses and we increase by 0.25 units at a time. I am glad you are going to start home testing.

 

I've been reading up on things, and find it disheartening how much counter information there is on the web. Some sources say curves are good with Lantus, others say they do no good because of it's consistent release.

I went ahead and did one yesterday (Sunday 7/1) at the suggestion of my vet. Prior to doing the curve on Saturday I did a test run to make sure I was comfortable with the procedure and the reading was 286, which is the lowest reading I've seen from him since this whole thing started. Unfortunately, nothing was nearly that low yesterday. I was expecting to see low numbers just prior to his PM feeding but came back with a higher reading than I expected pulling from his right ear (426), so I tried his left ear and tried two other readings from that spot with new test strips and got a 364 and 381. I understand that glucose meters can vary as much as 20%, which compared to the 426 reading is 85.2 points, so both of the left ear readings fall within that range. I averaged the three to show 390 which isn't the end of the world, but not as nice as the 286 I saw the day before. The lowest reading we've seen at the vet's was 393 5 days before, which is when we raised to 5 units.

Spreadsheet created and updated.

Anyone have any thoughts I should present to my vet when I call today? Should I be concerned that she showed a standard curve (see original post) when other resources say there won't be much of one on Lantus?

 

Curves are always good to help you find Chesterfield's onset, nadir and duration with the insulin. Knowing that will help you test strategically. After that, you can usually do mostly spot checks. Always test before injecting insulin and try to get some tests in the middle time frames of the cycle. A test before bed is a good one, as many cats go lower at night.

It looks like you chose a bad day for a curve. I think Chesterfield is bouncing. From the New to the Group Sticky note (which I hope you have read):
Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).