UPDATE: Dora's first curve - and I'm sad

Dora the Explorer

Dora the Explorer

Member Since 2020
Edit to add that the vet tech called while I was at work today and couldn’t pick up. Her message was to go to 1.5 units and do another curve in a week. The 72 was “probably an anomaly”. But the thing is, it wasn’t. We had lots of later readings in the 100s but they don’t want to hear that. Is 1.5 good or should I try to go a little closer to 1.25? Thank you!

Hello Lantus experts - advice?

I am disheartened by Dora's pancreas after an initial seemingly positive response to Lantus. We did her first curve today at home using the AlphaTrack. A quick recap:
  1. Started Lantus 1 unit 2x per day
  2. the first reading we took (about a week in, we couldn't get a monitor due to COVID) was midday and was 72, called the vet
  3. Switched to 1 unit 1x per day
  4. after a few days, numbers began to fluctuate
  5. Switched to 0.5 unit 2x per day; At first this seemed to be going ok but then the numbers spent a lot of time in the 300s and 400s.
  6. 6. Switched about 6 days ago BACK to 1 unit and I was hopeful, but alas we are not seeing the same results we did initially.
Throughout all of this she has been eating either Fancy Feast or Friskies as recommended here. I do give her bits of dry (either TikiCat high protein low carb or the Doc Elsey's that is also recommended here - just managed to get a bag from Chewy). She only gets small amounts as a lure to come up for her shots, so at 7am and 7pm, just a coating on the bottom of a small cat food bowl. She used to free feed before this on dry and had wet 2x per day. This morning she had the Doc Elsey's with her AM shot.

She is not overweight and acts fine. She does not have ketones when I test her urine. She acts like a normal cat - she has even stopped drinking like a fiend, which she did for about a year before her diagnosis. (A year ago she did not have elevated blood glucose)

I didn't mean to get so long winded, I'm sorry. Oh, and I did call and report this all on the vet's answering machine.

Questions:
1. Could I have somehow tainted the Lantus with air so that it's no longer potent? My vet says to replace every two months, that will be in about two weeks.
2. Do cats adapt to dosages at first and require increases?
3. Any thoughts on the curve values? Aside from "she should not eat any dry food" is there anything we should do differently?

Thank you for reading, those who made it this far.

Jane and Dora
 
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If stored properly Lantus will stay good for over 6 months so your vet is wrong. Are you using a vial? I got boxes of 5 pens and used until the last drop, over a year. Store in the refrigerator where it won’t be jostled around. Air will not cause it to lose potency. You will know something is wrong if you see it’s cloudy or has particles in it.

What you are experiencing is normal fluctuations. I suggest that you read the yellow sticky on Lantus and the two dosing methods. With TR you increase more quickly and decrease if you get a test under 50. With SLGS you hold the dose for a week and do a curve and a test of 90 calls for a reduction. That’s the short version of differences but read the whole thread. Since you are doing SLGS I would increase to 1.25.

We increase in .25 increments. If you don’t have already get syringes with 1/2 unit markings. Lantus likes consistency so dose every 12 hours.
 
Thank you! That’s good to know about the Lantus. My vet gave conflicting information on how to handle it (it’s a pen) and I also watched a video that said inject air so I did and then found out you don’t do that with a pen.

I will try a slight increase with the next shot. I do have the very small syringes and just places an order for more. I have read the sticky but there’s just so much to process. I’ll go back to it again. Thanks again -

jane and dora
 
Dora the Explorer said:
Thank you! That’s good to know about the Lantus. My vet gave conflicting information on how to handle it (it’s a pen) and I also watched a video that said inject air so I did and then found out you don’t do that with a pen.

I will try a slight increase with the next shot. I do have the very small syringes and just places an order for more. I have read the sticky but there’s just so much to process. I’ll go back to it again. Thanks again -

jane and dora
Click to expand...

Keep asking questions. Didn’t mean to tell you to read it because you should not ask. It just explains better than I was. There’s a ton to process. You are ahead of where I was when Max became diabetic as I didn’t want to test. I didn’t trust the people here as my vet is an internist. He’s great and supportive but didn’t move fast enough, partially because of my reaction. I learned pretty fast when I did start to test. He actually got me to do it. Then one night at about 10:00 Max dropped under 50. This forum got me through that night.
 
Well I did go back and read again. My vet told me to get the glucometer- she had a diabetic cat herself. But she also just tells me to test once in a while. When we were first doing the one unit and Dora was at 72, maybe I should have had more readings before we dropped her dose- maybe it was an anomaly? Maybe dropping to once a day messed her up and we are struggling to recover?

Anyway I think I was mistaken about the syringes and 0.5 markings. They do not have them; and I just reordered the ones the vet sold us when we were diagnosed.

Added twist: I don’t know this doctor! Long story short, Dora is a handful. She got a really bad infection on her spay incision and it took three weeks to get her through it. Three years later she would still growl if I took her to that vet. I tried a cat vet and she came into the room in animal handler gloves! So we once went to an emergency vet and Dora was great. So she is a patient there now, but this was her first regular visit.
 
Okay. So this vet doesn’t understand Lantus. It needs to be dosed every 12 hours. Walmart has syringes with 1/2 unit markings. So does ADW.com. The once a day dosing is the problem. Your spreadsheet shows you are dosing morning and night so I confused. If once a day I would give .5 morning and night rather than increase.
 
Dora the Explorer said:
Hello Lantus experts - advice?

I am disheartened by Dora's pancreas after an initial seemingly positive response to Lantus. We did her first curve today at home using the AlphaTrack. A quick recap:
  1. Started Lantus 1 unit 2x per day
  2. the first reading we took (about a week in, we couldn't get a monitor due to COVID) was midday and was 72, called the vet
  3. Switched to 1 unit 1x per day
  4. after a few days, numbers began to fluctuate
  5. Switched to 0.5 unit 2x per day; At first this seemed to be going ok but then the numbers spent a lot of time in the 300s and 400s.
  6. 6. Switched about 6 days ago BACK to 1 unit and I was hopeful, but alas we are not seeing the same results we did initially.
Throughout all of this she has been eating either Fancy Feast or Friskies as recommended here. I do give her bits of dry (either TikiCat high protein low carb or the Doc Elsey's that is also recommended here - just managed to get a bag from Chewy). She only gets small amounts as a lure to come up for her shots, so at 7am and 7pm, just a coating on the bottom of a small cat food bowl. She used to free feed before this on dry and had wet 2x per day. This morning she had the Doc Elsey's with her AM shot.

She is not overweight and acts fine. She does not have ketones when I test her urine. She acts like a normal cat - she has even stopped drinking like a fiend, which she did for about a year before her diagnosis. (A year ago she did not have elevated blood glucose)

I didn't mean to get so long winded, I'm sorry. Oh, and I did call and report this all on the vet's answering machine.

Questions:
1. Could I have somehow tainted the Lantus with air so that it's no longer potent? My vet says to replace every two months, that will be in about two weeks.
2. Do cats adapt to dosages at first and require increases?
3. Any thoughts on the curve values? Aside from "she should not eat any dry food" is there anything we should do differently?

Thank you for reading, those who made it this far.

Jane and Dora
Click to expand...

I would suggest going a few days with no TikiCat. My Philly had the exact same results as you. He had a very quick positive response to Lantus. Because he prefers dry, I was excited to find TikiCat after reading some articles, so I bought some to use as wet food toppers. Philly has had numbers in the 400 and 500s since. We ran out of TikiCat yesterday, and today Philly had numbers back down in the 70s.

He went back up tonight, so we still have work to do, but I'm wondering if TikiCat dry contributed.
 
tiffmaxee said:
Okay. So this vet doesn’t understand Lantus. It needs to be dosed every 12 hours. Walmart has syringes with 1/2 unit markings. So does ADW.com. The once a day dosing is the problem. Your spreadsheet shows you are dosing morning and night so I confused. If once a day I would give .5 morning and night rather than increase.
Click to expand...

The once a day was short lived but I feel like it messed us up. You can see in the spreadsheet where we went from the one unit once a day to the 0.5 twice a day, fairly early on.
 
Beck and Philly said:
I would suggest going a few days with no TikiCat. My Philly had the exact same results as you. He had a very quick positive response to Lantus. Because he prefers dry, I was excited to find TikiCat after reading some articles, so I bought some to use as wet food toppers. Philly has had numbers in the 400 and 500s since. We ran out of TikiCat yesterday, and today Philly had numbers back down in the 70s.

He went back up tonight, so we still have work to do, but I'm wondering if TikiCat dry contributed.
Click to expand...

I’ll try that. Although she was eating more tiki cat early on when she had lower numbers than she eats now. But I’ll try. It’s her reward for coming back to get the shot, but she actually eats less and less of it lately anyway. Thanks!
 
Dora the Explorer said:
Edit to add that the vet tech called while I was at work today and couldn’t pick up. Her message was to go to 1.5 units and do another curve in a week. The 72 was “probably an anomaly”. But the thing is, it wasn’t. We had lots of later readings in the 100s but they don’t want to hear that. Is 1.5 good or should I try to go a little closer to 1.25? Thank you!

Hello Lantus experts - advice?

I am disheartened by Dora's pancreas after an initial seemingly positive response to Lantus. We did her first curve today at home using the AlphaTrack. A quick recap:
  1. Started Lantus 1 unit 2x per day
  2. the first reading we took (about a week in, we couldn't get a monitor due to COVID) was midday and was 72, called the vet
  3. Switched to 1 unit 1x per day
  4. after a few days, numbers began to fluctuate
  5. Switched to 0.5 unit 2x per day; At first this seemed to be going ok but then the numbers spent a lot of time in the 300s and 400s.
  6. 6. Switched about 6 days ago BACK to 1 unit and I was hopeful, but alas we are not seeing the same results we did initially.
Throughout all of this she has been eating either Fancy Feast or Friskies as recommended here. I do give her bits of dry (either TikiCat high protein low carb or the Doc Elsey's that is also recommended here - just managed to get a bag from Chewy). She only gets small amounts as a lure to come up for her shots, so at 7am and 7pm, just a coating on the bottom of a small cat food bowl. She used to free feed before this on dry and had wet 2x per day. This morning she had the Doc Elsey's with her AM shot.

She is not overweight and acts fine. She does not have ketones when I test her urine. She acts like a normal cat - she has even stopped drinking like a fiend, which she did for about a year before her diagnosis. (A year ago she did not have elevated blood glucose)

I didn't mean to get so long winded, I'm sorry. Oh, and I did call and report this all on the vet's answering machine.

Questions:
1. Could I have somehow tainted the Lantus with air so that it's no longer potent? My vet says to replace every two months, that will be in about two weeks.
2. Do cats adapt to dosages at first and require increases?
3. Any thoughts on the curve values? Aside from "she should not eat any dry food" is there anything we should do differently?

Thank you for reading, those who made it this far.

Jane and Dora
Click to expand...
Just replying to myself to share the updated original post. I don’t think I’m doing this right...
 
Thanks both! I’ll try it starting tonight. If she does start responding again as she did at first I don’t want to be overdosing her.
 
That’s exactly why we increase in .25 increments. I swear some vets don’t know those small increases are possible and can make a difference. Heck with Max his decreases were 1/8 at times.
 
Sadly it’s hard for me to tell. I need to get those syringes with the smaller increments. At least we gave her a break from testing. 404 when I got home from work! How long usually until a higher dose has an effect?
 
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