Lantus is freaking me out - in a good way though.

Okay, I know Lantus works differently from Vetsulin, but I am still scared to give him another shot when he is so low from the first one.

Here is what I have from today.

7:30 AM 387 gave 1.5
1 PM 110
4:30 PM 97
6:30 PM 70
7:30 PM 73
8:15 PM 82
10 PM 74
1:AM (now) 113

If I would have given him a shot at 7:30, wouldn't he be in danger right now?!?! He is at +6 and 113 with no insulin since 7:30 AM.

 

With some insulins, the effect of the insulin can last past the expected normal duration (carryover); Lantus is one of those insulins. Many Lantus users gather a lot of data so that they can take advantage of this effect, by giving a low dose of insulin while the previous dose is still wearing off, and keeping their cat's BG levels comparatively low much of the time. IIRC, it's called coasting.

I didn't see a spreadsheet, and I'm not sure how long you've been on Lantus. You may want to check out the "ready to shoot low numbers" sticky on the Lantus forum here.

 

Thanks. I will do that. I have not been able to put together a spreadsheet and we have only been on Lantus since Sunday so I'm still trying to figure it out!

 

You've been at 1.5U since Sunday? Then you've reached a full shed, possibly surpassed it since he had such a high preshot, which could mean a bounce from a BG lower than his body has been used to, not necessarily a hypo number.

Please consider lowering the dose. Not sure why you began at 1.5U. Standard "safe" starting dose on Lantus or Levemir is 1U only. The way these insulins work, some cats do very well at less than 1U.

Yes, the numbers you got today are great numbers and normally the surfing you saw would say you're at a great dose, but I'm very concerned because he started out so high. You did fine by not dosing at the 73. Unfortunately, what you're going to see now is a depleted shed with resulting higher numbers. It will be tempting to remain at the 1.5U dose, but that seems to be too much.

 

In order for folks to properly help you, would you please put a spreadsheet together - instructions are located on the tech forum.

 

I agree - you may have overshot your perfect dose.

I would suggest reducing to 1 unit BID -- let it settle a few days unless he continues to go low -- in which case reduce to 0.5 units BID

I have two diabetic cats on Levemir (similar to Lantus) -- one gets 0.25 u BID and one gets 0.5 u BID and both are "well regulated", with blood sugar staying in the normal range for most of the day.

So -- your perfect dose could be much lower than 1.5u BID.

 

Thanks. I am going to work on a spreadsheet.

My vet almost insisted on 2 u. I started at 1 u just because of everything I read on here and some feedback I got when I asked. My cat was going up to 2 u and more on Vetsulin, but then all of a sudden he was very sensitive to it for weeks and was only at 1/2 and then 1 u.

When I gave him the first 1 u of Lantus, it didn't do much and his numbers were really high and I felt bad and got impatient so I increased the dose. When I talked to the vet about how well his numbers are doing, he sounded a little agitated that I didn't stay with 2 u as he recommended based on weight. Not sure why it is based on weight. At 4 AM he was at 224 so I gave him 1 1/2 u. I checked him at 10:30 AM and he was at 169 and now at 1:30 PM he is at 83! So 1 u does sound sufficient.

 

You have to be patient with Lantus. It takes about a week for it to "settle" and to work on the blood glucose levels. You should not bounce around with different doses just because the bgs are too high or too low. Too frequent dose changes makes it harder to get the bgs under control. Give a dose at least a week, if not longer, to work. Then do a curve and based on the numbers you get and from the advice from this board and from your vet, you may need to adjust the dose by no more than half a unit if needed.