Lantus: much higher BG at AMPS than PMPS

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Ella & Rusty & Stu(GA), Jan 23, 2010.

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  1. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

    Joined:
    Jan 11, 2010
    I want to thank everyone for responding to my original post of 14 January. My cat, Stu (diabetic since Jan. 2006), who had been switched to Lantus from Idexx PZI Vet (5 units bid of PZI Vet) in early November, had been on 7 units of Lantus bid since early December because his BG level at +5 (at the vet's) had been in the high 300s (the vet had started him at 4 units bid in early Nov., raised him to 5 units, and then from 5 units to 7 units in early December). In early January (still on 7 units) BG had dropped to 78 at +5 at the vet's. I was worried at the precipitous drop and joined this message board! I received many messages of concern that 7 units were too much insulin, so I cut the dose at first to 6 units bid, and several days later (on 19 Jan.) to 5 units bid. On 21 Jan. I cut it to 4.5 units bid. I have been home testing 3 times a day (AMPS at 7 A.M., +6 at 1 P.M., PMPS at 7 P.M.) since 19 January (doing OK, but it is still not easy for Stu or for me!). I find that his AMPS numbers are consistently around 400, but his PMPS numbers have been between 100 and 225. At +6 his numbers have been between 83 and 89 except for 21 January, when the +6 number was 176. After reading other people's posts and a lot of the literature on feline diabetes, I suspect that I am dealing with carryover or overlap and the "storage shed". I would welcome your comments and advice. I have been giving 4.5 units bid for the past 2 days and also this morning (Sat., 23 Jan.) Should I lower the Lantus dose to 4 units bid beginning this evening? Stu is a large domestic shorthair and, except for diabetes, in excellent health. He weighs 15.8 lbs. He eats 4/5ths of a can of EVO turkey & chicken a day, spread out over 4 feedings (7 A.M., 12 P.M., 7 P.M., 11 P.M.) He gets about 1/4 cup of EVO high protein/lo carb dry food per day available for snacking. Thanks for your help.
     
  2. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    After experience a similar situation for a couple of years with my Bailey I found that I could get better control of his BGs by increasing only his PM dose. He is doing a lot better on 2.3 units of Lantus Am and 3.4 PM. However, using different AM and PM doses of Lantus is not the norm at all.
     
  3. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Ella,

    Have you been over to the Lantus Support group board? Everyone uses Lantus and they brainstorm about the dosage, etc. There are also some stickies on the top of the page that have excellent information on how Lantus works and how to dose. viewforum.php?f=9

    There are Lantus users on this board, along with people who use other insulins, but the Support group is full of experienced Lantus users. You might go over there and ask some questions, do some reading. It is great to read the posts since you will see that others are dealing with the same issues as you are.
     
  4. Steve & Jock

    Steve & Jock Member

    Joined:
    Dec 29, 2009
    I would gradually move his PM shot a bit later, leaving the AM shot in the same place, until the two preshots look similar. Try a half-hour later, and then every second day, another half-hour later.

    And once the two numbers do look similar, you can very slowly raise the dose until they both look good.
     
  5. jojo and bunny

    jojo and bunny Member

    Joined:
    Dec 28, 2009
    ella it is totally normal for AMPS to be the highest number of the 24 hours due to release of hormones that occur overnight. if you go to lantus ISG and scroll around you'll see how common that is for so many cats.
    another thing is maybe he snacks more on that dry food that is out overnight? even 'low-carb' dry can impact numbers in a big way for so many cats.i feed a lot of cats and i've always noticed they ate more over night than during day.

    do you have a spread sheet? sounds like you might have a bit of roller coaster effect happening?

    ~jojo
     
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