with Lantus how long does it take

for a dose change to kick in?

 

George...it depends on the cat. If its an increase, some cats go up first which we call new dose wonkiness. Some don't get NDW. Because it varies by cat the protocol states to you should hold a dose for 3-5 days. Some cats Re slow responders and you may not see the dose really kicking in for a week.

 

Not familiar with NDW???

 

I have read about NDW (new dose wonkiness). That is a good name for it. When you give a dose change with Lantus it can make the cat's glucose go up for a little while before the change takes effect and lowers the glucose. No one seems to know what causes this. Hope this helps.

 

As they say "every cat is different" but Ruby responded right away. I started her in the evening, after several days in 200s and 300s. Late that night she was under 200 and by the next morning she was down to 72 on the AlphaTrak, which is about 42 on a regular meter. We've had lots of ups and downs since then but she did respond right away.

 

Here's a link to a thread with info on NDW: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=46012

In general, you want to hold a new dose for at least 3 days (6 shot cycles), some hold 5 days, especially if there is NDW. The only exception to that would be that a BG reading of below 50 calls for an immediate reduction. Also, reductions don't take as long to see if they're holding-you can usually tell within 2-3 cycles at the most. You don't get NDW with a reduction, but it can take a cycle or so to really show a difference.

Remember that Lantus works of a "shed" stored under the skin and when you raise a dose, that shed has to fill. When you reduce a dose, it has to empty. Some cats (like mine) react to changes very quickly, others take the full 10 cycles before you have an idea of how the numbers will really look. After a few times, you'll know where your cat falls.

I'm about the most impatient person in the world...this process will teach you patience like nothing else!