new to lantus and running a curve

Hi. Several years ago I had a sugar kitty and, with help here, got him regulated. Eventually he went into remission .He's been gone for seven years, and now my husband and I have another diabetic cat. Widdershins was diagnosed a couple of weeks ago with a bg of 576.

I did not use a long-acting insulin with the first cat, and we're using lantus for the current one. We started at 1 unit every twelve hours, but it was really obvious he was rebounding, so we dropped it to 0.5 every twelve hours.

Today I'm working from home and running a curve, but I'm not sure how lantus takes effect, so I don't know whether these numbers are heading to a bad place.

0 hours 199 (gave 0.5 unit lantus)
+1.5 155
+3 92

I'm continuing the curve, but I'm wondering if I should be worrying about a hypo at this point .It looks like we're at or past whatever peak it has (according to google). Can anyone give me an idea of what to expect from this insulin?

 

Are you using a human meter or a pet meter? A human meter reads lower and has a "take action" number of 50 - ie., when you should feed a snack to prop up BG. That number is 68 on a pet meter. The general time range for Lantus' nadir is 6 or 7 hours after the dose is given so he's about half way there. The drop at +3 is significant so I'd test again at +4.

 

Thanks! That drop is what's got me so worried. Human meter, but I can set the ranges. Good to know that it reads lower.

I really hope he's not going to rebound on .5 unit. He's probably around 18 years old; Kim, my first diabetic, was 9 at diagnosis. I don't know whether Widder's age matters in terms of dosage. I've read up a bit, but Lantus is pretty much entirely new to me.

 

I'm now watching him like a hawk. +4 was 85, so it's still dropping. I'm testing again in another hour.

 

Whether he rebounds or not depends more on how fast or how low BG drops regardless of dose. Also, his age shouldn't be a factor in determining what his good dose range will be.

 

0 hours -- 199, .5 unit Lantus
+1.5 -- 155
+3.0 -- 92
+4 -- 85
+5 -- 76

+5 is a 9 point drop. We're close to nadir, but if it drops like that again, we'll be in hypo land and it'll be snack time.

 

That's probably close to nadir. If this is about the lowest for this dose I'd stay at 0.5 u for now.

 

0 hours -- 199, .5 unit Lantus
+1.5 -- 155
+3.0 -- 92
+4 -- 85
+5 -- 76
+6.5 -- 73
+8 -- 88
+10 we couldn't get blood
+12 -- 143

At this point I'm wondering if we should hold the shot .On the one hand, he is on an upward trend and it's slow-acting. On the other, I'm worried about him going hypo. This is where not being really familiar with Lantus is a problem. I could hold it for an hour or two and test him again, but I really don't want to poke more holes in the poor baby. His morning numbers have all been around 200 since we went to .5 unit, so I'm kind of inclined to shoot. What do y'all think?

 

That's actually a nice curve. I suggest you go post on the Lantus forum. There's a lot of expertise there. If you're willing to set up the spreadsheet we use here it'll be much easier for the Lantus folks to help.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

I'd be inclined to give a 0.5 u dose on that 143 pre shot number. Your nadir was well above the "take action" value of 50 for a human meter.