9/7 Tigger AMPS 328 PMPS 425 +1=357

you've asked a few times about why an increase in dose might make missy's numbers time. i looked through all the posts but am not seeing that answered. It's really important for you to understand how Lantus works - a lot of what we do on the Lantus forum is teach that. when you understand how it works you'll be able to apply what you learn to helping missy.

Lantus is injected as a liquid, but it forms a crystalline micro-precipitate (think tiny crystals) under the skin after injection. then those crystals dissolve slowly. when you start out on lantus at first it's nearly all crystallizing, so not much is available to work on the glucose in the cat's body. as shots continue the lantus precipitate increases in the cat's body and more of the earlier injections is dissolving and becoming available to work on that glucose. you're injecting it in, it's forming crystals and the crystals are dissolving, all at the same time - so a constant supply and release system is being created.

getting an image of how it works?

at some point you reach the "sweet spot" in dosing and now you've got enough being released from the precipitate, and enough being injected in, so that the kitty's blood sugar is evening out and becoming regulated.

lantus is a slow-acting, gentle insulin. because of its slow action, we have to be patient in waiting for it to work in a cat's body. when i increase punkin's dose by .25 (that's 1/4 of 1 unit - a teeny tiny amount) i then wait about 3 days before i even consider making a change in his dose. that's a very safe way to change doses. if a kitty has sustained blood sugars of over 300 all the time we have the option of increasing by .5 units. we never change by a whole unit unless a cat has a diagnosed condition that changes the game plan. for the majority of cats we change doses by .25 units.

there is also something we call New Dose Wonkiness It's counter-intuitive, but when a dose is increased, sometimes the cat's blood sugar raises and it might take 3 days for that to pass. we wait for it to pass before we change doses again.

also because of how Lantus works, the lowest point of the 12 hour cycle determines dose changes. that's why Sam is suggesting a test 3 hrs after her evening shot. a lot of cats have lower blood glucose at night, for some reason. so we don't know when that lowest point is going to be, but we chase after that elusive number so that we can adjust doses properly.

one last little teaching point - most of us feed our cats in the first 3-4 hours after their shot. there is a waning action in the second half of the 12 hour cycle, so if you're giving food at that time there isn't as much insulin available to deal with the carbs. unless a cat is in a crisis (ie, not eating, diabetic ketoacidosis, etc.) we usually don't feed anything within 2 hours of the next shot. that lets us see clearly what the "real" blood sugar is that isn't affected by food when we're checking to see if it's safe to shoot. there are times when a cat is in a crisis that eating trumps everything else, so this doesn't apply all the time, but as long as missy is overall doing ok, not feeding her in the second half of the insulin 12 hour cycle would be helpful. shooting consistently (ie, trying to shoot as close to 12 hr intervals as possible, having an appropriate dose so you don't have to skip shots, etc.) will also help missy get stabilized as quickly as possible.

Click to expand...