Starting Lantus, need initial dose advice

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Djamila

Djamila

Member Since 2015
Hi everyone!

Sam has been on Prozinc since 2/7/17 and has done relatively well. Toward the end of May, I bought a pen of Lantus because his progress seemed to have stalled, but of course as soon as the pen arrived, he started getting some NS days and I thought he might be nearly done with insulin.

So I dawdled a bit, and at this point the Prozinc is all petered out, but he still isn't done with insulin. I've tried a few NS days to see if he would maybe hold his own, but he's not getting great numbers on his own, and more importantly he doesn't seem to be feeling very well just hanging out in the low blues. When he was getting more greens he had better energy.

Do you think I should start on Lantus to help get down a bit lower? And if so, what dose should I start with? (remember that his 0.2 and 0.3 doses were with a six-month-old bottle of Prozinc, so probably not working at full strength).

Thank you to any and all for your time and thoughts on this!

ETA: This is his second round of FD - initial diagnosis was in 2015, and OTJ for a bit over a year.
 
I really don't know that I would give insulin yet. His numbers look pretty good for no insulin. If it were my cat, I would continue to take a reading each morning, and if it was a blue number, try to get another somewhere around +2 - +4 to see if he came down. As long as you are seeing green, IMHO, he doesn't need insulin.

I'm going to poke a couple of other veterans to get their take, though, in case they feel differently.

ETA: When was the last time he had a check up at the vet? Maybe he's feeling unwell for a reason unrelated to FD.
 
I guess I'm not clear on why I shouldn't give him any insulin at this point. This is his second round of diabetes, he's been in roughly the same numbers since mid-April. He's had some lower PS numbers in recent weeks, but has taken insulin well, even though it's Prozinc and he's been in the greens. They are high greens, and outside of the 50-80 range that was typical during his OTJ time.

It may require starting at a micro-dose, but if my Prozinc was still potent, I would be continuing to dose him. At this point it's either start Lantus because it's sitting in the fridge, or go get a new vial of Prozinc. It doesn't seem to me that his numbers are low enough to sustain being OTJ, and I'd rather not just wait until his numbers rise out of range to give him some support.

From the directions for earning reductions and starting OTJ trials:

OTJ TRIALS:

Prior to starting an OTJ trial, one wants to see kitty mostly in the range of a healthy cat (50 - 80 mg/dL), but under 100 overall... with only occasional readings in the 100 - 120 range.

Remission is achieved when kitty can go 14 days without insulin while maintaining normal blood glucose values under 100 overall. Most will stay in the 50 - 80mg/dL range. Although, some will occasionally experience BG numbers up to 120 mg/dL.
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At this point he is rarely in the 50-80 range, and only when he's had insulin, and is not staying under 100 overall, which leads me to think he isn't ready to be OTJ. If that reasoning is incorrect, I'm happy to take correction, I would just like to have a better understanding of why he shouldn't receive insulin.
 
I think the micro dose idea would be a good place to start. If he needs more or less, the numbers will tell you. :cat: I also think he might benefit from a little more time on insulin. I wouldn't want to buy a whole vial of prozinc for such a low dose.
 
On the second sticky note from the top, there are some pictures of how to draw fine doses. We typically take the dose of the existing insulin into consideration. Maybe try 0.1 unit? But if you switch, I would do it when you will be able to monitor closely for a few days.

How are you feeding him now? A small snack a few hours before preshot can help bring down the preshot number when the pancreas is sputtering. It would be nice to get him all green before going OTJ again.
 
Hey Djamila, I agree with you that he still needs a little bit of support. If it were me, I'd be inclined to start him at 0.1 unit of a dose and as Wendy said at a time that you can be with him to monitor. It might not take long at all to get him in the 50-80 range. He is so close to being well, I'm not going to say it.

Here is a picture of what the 0.1 looks like

upload_2017-7-11_7-35-36.png
 
Thank you so much everyone!!! I really appreciate all of your wisdom and support! We slept in a bit this morning since Sam hasn't been getting shots the past couple of days, so I'll aim to start tomorrow during the AM cycle (assuming he's still giving a shootable number).

I have been giving him the +9 snacks (thanks to @Bobbie And Bubba for that little trick a couple of weeks ago!), and it seems to have done a good job of getting lower PMPS numbers, but hasn't been as consistent in bringing the AMPS number down. Hopefully a teeny tiny dose will do the trick.

And again, much thanks for all of your help! I'm sure I'll be needing more of it in the coming days! :bighug::bighug::bighug:
 
lol Hi Bobbie! I've been busy and away from the house more than usual. Of course running home for Maury's schedule :). I finally caught his blues today! And he let them shine for a while so far :cool:. Will be starting my job in 2 weeks so trying to think of things I need and getting them together :)
 
Yong said:
lol Hi Bobbie! I've been busy and away from the house more than usual. Of course running home for Maury's schedule :). I finally caught his blues today! And he let them shine for a while so far :cool:. Will be starting my job in 2 weeks so trying to think of things I need and getting them together :)
Click to expand...
YEAH for the blues!!!! Good luck with the new job and the "getting ready process" .
 
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