7 days on Lantus.......still high!

Hi guys

Looking for some help please

Java is almost finished day 8 on Lantus, we switched from 4u BID caninsulin. Started on 2u BID and after day 3, Vet increased morning dose to 3u, left evening dose at 2u due to High flat curve. Java is still in the pinks, sometimes reds.

She said we could increase to 3 BID if we felt that he wasn't coming down - I think we need too, but I'd like some advise from the community. Java is 5.05 kgs at present, ideal weight is around 5.5.

Java is on friskies pate and ziwipeak. Haven't been able to test for ketones.........he WILL NOT use his litter box. We might have to move it into the bedroom and deal with the infernal yowling to get out just to get a test! I feel mean doing that. He drinks a very small amount of water each day and is looking good.

Do I increase to 3BID? Or, increase evening dose by .5 and reduce morning dose by .5 to give consistency?

Confusing!!

Charlene

Hi Charlene, looks like your vet is trying to dose Lantus like Caninsulin. My vet did the same. Lantus works best if you dose the same dose AM and PM. Otherwise you can get wonky readings. With Caninsulin, vet will often dose lower at night because people aren't awake at night. Normally we would have started Java on either 1.25U or 1.5U of Lantus because of his size (.25U times ideal weight or 5.5 kg). Then we hold the initial dose 5-7 days. Given that he's on 2U and still high, I think you should try dosing 2.25U both morning and night. Did you ever manage to get syringes with 1/2 unit markings? If think I gave you the link to dosing with calipers. If you haven't got those, try dosing to the top of the 2U line instead of the bottom. From the protocol:

"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).

Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Click to expand...

I've highlighted the relevant bit for you.

Hi Wendy

Thanks for that! No luck with the halfy syringes yet but LV is still looking . Looked at the caliper method and I'm going to need to youtube that one! :smile: I'll use the line pictures I've seen around here for the time being!

Thanks for the advise - shall I start on his next dose, in about 30 minutes?

And.....do I post daily on here his amps number? Or do I wait until we have him regulated?

C

Hi Charlene and welcome to LL. Most of us post daily and update the first post of the day each time we test.

Daily posting coming up!
This really is fantastic community

Yes it really is. Everyone is so supportive of each other. The first times I had to deal with low numbers it was such a relief to be able to talk to someone and get advice. There is almost always someone available to help. It looks like Wendy must have called it a night. From what I saw I think you can start the increase today.

We did the 2.25 he dropped to pmps 20.3 so obviously the depot is dispensing!

I'll post in the morning after first shot and get Tom ready for next week - I'm travelling with work so he's full time on the Furkid

Have a cool Saturday wherever you are in the world!

C

Welcome to Lantus Land!

It'll take time for the shed to build up in your kitty's system, and even more time for the #s to show anything. All you can do is have patience, a lot of it. There'll be a lot of trial and error, too, along the way. A lot, if not all, of us have gone through it time and time again. Good luck!

Hi Charlene!! Welcome to Lantus Land!

Just a quick note....Most of us here are in the US and while we've all been told since we were young children that the US was going to go metric (like the rest of the world), it still hasn't happened, so when you post your numbers in here, it'll help if you'll convert them for us.

The easiest way is to just multiply by 18, so your 20.3 is our 365

The World version of our spreadsheet offers both numbers depending on which one we choose to look at so at least you don't have to keep 2 spreadsheets for us silly Americans.....LOL

Look forward to helping you get your extra sweet Java under better control!

You might want to share the protocol we are using here with LV. The two sources are the TR Protocol and the article called Management of Diabetic Cats. It can be found in the Tight Regulation Protocol Sticky, 5th paragraph down. It's a PDF you can download and print. The TR protocol and the downloadable study are the only ones upon which a scientifically researched, based, and published protocol (the TR protocol was published in the Journal of Feline Medicine and Surgery) for treatment of diabetes in cats has been accomplished.

Inside the PDF article, on the 8th page, there are also some tips for using paper markers for getting partial units, but it only works with the BD Micro-Fine1 Demi 0.3-mL U-100 syringes if that is what you have. Have you tried asking at your local pharmacy/chemist about 1/2 unit syringes? They are also used for people with diabetic children. The link I gave you for using calipers for dosing did have a video embedded.

Someone put together a document on Urine Testing Tips that might help you get those ketones tests in.

ETA: A small bit of housekeeping, we like to include a link to our previous post in the current post so people can see what was previously recommended. Here is your last post in the Lantus TR forum: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=123326 and here is the first on on the Health forum http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=122602