Starting Lantus 6/13: T AMPS 250; +3 339

Discussion in 'Lantus / Levemir / Biosimilars' started by Tomlin, Jun 13, 2019.

  1. Tomlin

    Tomlin Well-Known Member

    Joined:
    May 30, 2019
    This is Day 1 using Lantus & starting with 1U. Switched from Vetsulin & was using 2.5Us. I know its super early but the jump to 339 made me curious. He did eat 3/4 of a 3oz can of his Royal Canin Gastro Diet between 6:45-8am but the 3+ was still 2 hours out from his last bite. His body was used to some significant drops after injections when he was on the Vetsulin, so I'm just not used to seeing an increase vs a decrease. Is this common?
     
    Last edited: Jun 13, 2019
  2. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    Mr. T will have to build up his Lantus depot, so you might see some higher numbers for a few days, I think it can take up to 7 days for the Depot to build.

    Good luck with the switch :)
     
  3. Tomlin

    Tomlin Well-Known Member

    Joined:
    May 30, 2019
    Thank you for your reminder about the 7 days!! I just input his +6.5 into my SS --it was 398 :(. His highest since being diagnosed but I'm trying to keep in mind that he probably had something higher pre diagnosis because his initial diagnosis was based BG taken while fasted & no Pred first thing in the morning for his annual appointment (it was 316). He also had a 338 on 6/10 before his evening dose of Vetsulin. That definitely did not result in him being anywhere good past 6 hours. The good news is he's eating normally today--small meals-- vs right after his diagnosis when he was eating much more at one time then normal & also looking to drink out of the sink (not something he does typically).
     
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  4. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Hi and Welcome to the L, B& L forum!

    As said, it takes about 5-7 days for the depot to get stable when you first start on Lantus. You’ll be holding the dose that long unless Mr T goes below 68 if you are following TR. If you are following SLGS, the reduction will be
    90 on the AT2 meter.

    Do you know what the carb % for the Royal Canin you are feeding? I tried to look it up , but not finding in on the food chart.

    Is he currently on Pred? That will impact his numbers to be higher.
     
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  5. Tomlin

    Tomlin Well-Known Member

    Joined:
    May 30, 2019
    Thank you for your response! I really appreciate the support, thoughtfulness & help. I wish we could speed it up, but I guess we kind of did with the Vetsulin and that didn't turn out so well :(! I'm planning on getting as many BGs as I can over the next couple of days so that I can share the info with my team & decide whether a change will be made (more the TR) or if we are going to hold until day 7 & go more SLGS. Right now I'm calling it Slow on my SS.

    The carbs for the Prescription Royal Canin GastroIntestinal Moderate Calorie 3oz can is is only 2.0% max. Protein is 6.0% min. Another key for T is its only 1.5% crude fat. Its frustrating that so many of the foods that are high protein & lower carb are high in fat...at least too high for my guy & his chronic pancreatitis :(. He's great with this food though so I feel lucky! The moisture is 84.5%.

    He currently is & will always be on prednisolone. Multiple attempts in the past to reduce the dose beyond a certain point failed :banghead:. In addition, there's evidence that he may also have Addison's disease so the pred is needed for that. Interestingly, as you stated, the pred definitely can impact glucose & make it higher, however, if you reduce the dose or stop it in felines with inflammation from a chronic issue like pancreatitis, it can actually result in an increase vs a decrease in glucose if the reduction or discontinuation results in increased inflammation &/or pain. The first instinct for many vets is to reduce or stop the pred when diabetes is diagnosed & while that may make sense with some felines, in others, like mine, it could potentially make matters worse...the glucose can actually increase because of the inflammation &/or pain increases. I'm blessed to have a team that knew that so they didn't try to go that route. I can't imagine what a mess we would've been in with higher glucose AND most likely a serious exacerbation of his pancreatitis :arghh:.

    Thanks again for your help! Sorry you went looking for the cat nutrition. I should have posted that!
     
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