Newly Regulated-Dosage Question-Low BG

Hi, Racci and I are returning members of this board. I'm not sure yet if our old info is still here or not. She's on Lantus Glargine 4.5U bid, has diabetic neuropathy for which she takes methyl B12 3mg sublingual tab 1x daily and has asthma ( Flovent inhalant 220 1puff bid).

Racci is newly regulated after a long hard battle to get her there. The 4.5U dose keeps Racci usually between 167 and 280 bg. She's been on this dose for about 2 weeks. The 4U dose had her above 300 at the 12 hour test so this dose has kept her mch better regulated and I thought we were okay. The last couple of days she has been getting lower and lower though. Today at the 12 hour test she was only 70 BG! I was afraid to give her reg dose so gave treats & waited 2 hours. She was still only 123! BTW, no signs of hypo. I still was afraid to give such a large dose so gave 2.5U finally but am wondering what you would have done? Did I do right or should I have let her go without her dose at all? Given her regular dose?

I will be watching her and worried all day even at the reduced dose and will test every few hours until she's over 200 but what should I do next time? I'm hoping she goes up naturally before it takes effect since she is always slow in reacting to it but I also worry that I ruined her good streak by not giving her enough.

I'd appreciate your help. PS: I have a current chart but it's not online, it's written.

Thanks,

Melanie & Racci

 

Hi Melanie,

Have you been over to the Lantus Support group board? viewforum.php?f=9 All the people on that part of the site use Lantus and can give you great advice on dosage.

They will urge you to do a spreadsheet so they can look quickly at the pattern of Racci's doses and responses. It really isn't too hard. This page tells you how to set it up: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=16 It is color coded and a great tool for you as you can really see what is happening over time.

I am sorry I can't help with dosage. Oliver used PZI and Lantus is very different. But I know the people on the Lantus page can help. In the meantime, you are exactly right to watch her and take some more readings (so glad you are hometesting!) so you can catch her if she goes too low. You are looking for secretive and unusual behaviors also, although every cat is different in how they react Some cats howl, act as though they are blind or hide in unusual places. But if you are testing every couple of hours (at the minimum) you should be able to stay on top of it. Do you have some high carb food on hand that you could feed her if she goes into dangerous territory?

The good news is it looks like the insulin is working and you may need to reduce the dose.

Hope that helps.

 

Hi Sue,

Thanks for your quick reply. I Used to have spreadsheets online for Racci and was a member of this board but moved and had limited access to the computer for a while so it got helplessly out of date. Thanks though, I'm sure I'll need a refresher on some of it.

Racci was on PZI before also and got nowhere on it. When we switched to Lantus we started to see results. I haven't been to that board yet but I will go over there and pose my question. I figured this would be a general question though and wanted a quick answer in case I was wrong and should give her more right away.

I was thinking the same thing that she is probably ready to reduce dose again. It's just been such a long time getting here that I hate to take a chance of getting unregulated again. She's only been regulated for about a month now. It's amazing to me that she's getting such low readings consistently instead of randomly and may actually be finally on the right track finally.

I'm sorry for your loss of your baby after getting him under control. It's great that you were able to do that so quickly!

Thanks again!

Melanie & Racci

 

I am by no means a dosing advice giver, but looks to me like you reacted well to a low number by giving a reduced dose instead of shooting what is a fairly high dose on Lantus on a very nice number. One of the great things about Lantus is that it can allow the kitty to heal and start producing its own insulin, so your dose requirments could go down.

It sounds like you home test and that is really good, especially at such a high dose of Lantus. I recommend setting up a spread sheet again and maintaining a condo in Lantus Land (support group) as much as possible. We've recently had a some longer-term higher dosers come running down that dosing scale and go completely off the juice extremely fast.

As scary as losing regulation is, giving more insulin that the kitty needs any more is scarier so keep doing those tests and start gathering the information in a spreadsheet so when you see a 70 preshot you can look back and see how Racci handled that previously and make informed dosing adjustments.

 

Hi Melanie,

Thanks for your reply. It seems that it did turn out to be the correct thing to do. Yesterday Racci ended the night with a PMPS of 160 so she never shot up even at the reduced dose in the AM. I gave her regular dose of 4.5U at the pmps and have not done her amps yet. She's due in an hour. I did post on the Lantus board and recieved a couple of replies but for some reason I was unable to reply last night. My browsers were acting up. Hopefully this one goes through. I will get a new spreadsheet going asap. Thanks for your reply and the advice. It is helpful to know others have been experiencing the same thing and that you feel it was the right move also.

Thanks again,
Melanie & Racci