Need Advice! 2nd day of Lantus

NEED ADVICE!! First 24 HOURS On Insulin

There is so much information and rules and do’s and don’ts I just want to be sure what I’m doing is right. I am also working on trying to get a spreadsheet done up too.

My girl Missy started insulin yesterday. She takes 1 unit of Lantus every 12 hours.

Dec 30th (1st starting dose)

6:53am Her pre-shot BG - 284
8:00am +1 252
10:00am + 3 255
1:00pm. +6 273

6:45pm Her pre-shot BG - 264
10:00pm +3 203
12:00am +5 178
2:15am +7 171

I was very happy to see her body’s response to insulin. She is due for her next shot at 7am (so in 30 min). I have not taken her BG again but I will be shortly.

Seeing she responded so well (at least I think she did) to the insulin do I continue with the same dose of 1 unit/12 hours?

From what I read and understand I hold the dosage for 7-10 days unless I ever get a low reading in the 40’s or 50’s. Then I may need to decrease 0.25 units. As you can see I have not gotten any low readings but if her BG continues to trend downward I was concerned 1 unit may be too much.

When I test her pre-shot BG what if she is still in the 170’s? Do I continue with the 1 unit?

ALSO.....About 30-45 min after insulin she gets very sleepy. Is this normal? She is eating well throughout the day and before shot.

Thank you for your help!

 

Hi Tammy, if you need help setting up your Signature and your Spreadsheet, please let me know and I will set them up for you.

Here are your previous posts for continuity:
https://www.felinediabetes.com/FDMB/threads/high-ketones-please-help.240713/
https://www.felinediabetes.com/FDMB/threads/new-member-introduction-and-help-needed-pls.240577/

Have you decided on the dosing protocol you want to follow? Tight Regulation (TR) or Start Low Go Slow (SLGS)?

The initial depot of Lantus will take a week to build, so you hold the dose of 1 unit for 1 week.
The dosing protocol you choose will determine future dosing actions - reductions, increases etc.

If you encounter a lower number than you are comfortable shooting, you stall without feeding Missy and post her for advice.

 

Welcome Tammy to the best place for a diabetic cat and her caregiver. Kudos to you for home testing! There’s so much to learn but we will help you. Read the stickies and ask questions. I’m going to read your previous posts now and see what more I can add at this time.

 

I just want to say that those are GREAT numbers for a cat just starting Lantus!!

 

Hi there thank you for your help. So much to learn I’m feeling overwhelmed at times trying to do it all right. I have no idea if I should do tight regulation TR or SLGS. I need to educate myself on all this. I’m also exhausted waking up throughout the night to check on her and test here and there. Doesn’t help I got no sleep the prior night due to being at emergency with her for 4 hours till 5am. Her ketones were high and I was concerned about DKA. Thankfully she had no acidosis. I’m grateful I started this journey with her and my hope is to get her into remission. I so badly want to do it all right. Thank you for your advice. I will consider what route I should take with TR or SLGS.

 

With ketones in the picture if you are feeding all canned food I would opt for TR. What are you feeding her? It also has the best chance for remission. I urge you to start a spreadsheet and add a signature while you ponder the method to choose. It’s not set in stone either. You can always change and you don’t need to decide immediately.
Are you using a pet or human meter?

 

Hi Tammy and welcome! I know exactly how you feel about being overwhelmed. It took me a few weeks after my Ruby's diagnosis to find this forum but I was so very glad I did. I read everything, followed other people's threads, studied the spreadsheets of other cats and heeded the advice of the many generous and experienced people here. It does get easier.

I started with SLGS and then went to TR. I was having a lot of trouble testing Ruby and couldn't get enough data for TR, she was eating some dry food still, and I was still following the advice of my vet on dosing. After 6 weeks of trying, I finally finessed the technique to draw blood, took her completely off wet food, and started TR. She's been on an uphill trend ever since and she's now tightly regulated. TR is a lot of work: not only is there a lot of testing, but I feed Ruby 6-8 times a day depending on her numbers and how I can steer them with varying carbohydrate combinations. Seems like you've got the testing down, you're willing to lose a little sleep! If you're home enough to monitor the early parts of her cycles (shot time to 6 hours later) I think TR would be a good option for you as it would be the fastest way to get your kitty to remission.

 

Let me send you a PM with the details I need to set up your spreadsheet and signature. One less thing for you to worry about!

 

Let us know how we can help you get things sorted out. You're absolutely correct -- the front end of this learning curve is completely overwhelming. We've all been there and we've survived. More importantly, our kitties have survived and thrived!

What Bandit's Mom suggested in terms of getting started on this adventure is important. You will need to put some information in your signature and get a spreadsheet set up. This will allow us to be able to give you informed recommendations. This post has information on helping us to help. you.

Dosing methods: Tight Regulation (TR) is a method that was developed by a vet and a researcher who have published a number of studies using Lantus. The TR protocol was published in a leading veterinary journal so it has science supporting the outcomes. It is more aggressive than the Start Low Go Slow (SLGS) approach that was developed here before TR was published. Both have a good track record for getting cats into remission -- although TR is more successful. The point at which you take a dose reduction and the length of time that a dose is held differ between the two approaches. It sounds like you may have read more about TR (i.e., dose reductions occur when numbers drop below 50).

Holding the dose: You hold the initial dose for no more than a week. It takes the Lantus depot 5 - 7 days to stabilize. With TR, doses are increased every 3 -5 days (depending on where the nadir is) vs SLGS where doses are increased every 7 days. The caveat is that you decrease the dose based on the point that the dosing method indicates (TR = <50, SLGS = <90).

Food: Low carbohydrate food, preferably canned food, (i.e., below 10% carb, although most people feed in the neighborhood of around 5%) is a must. If you are using any dry food, you cannot use TR.

 

I tried to reply to the message you sent with the information below but when I pressed POST REPLY it gave me an error message saying "The following error occurred: Your content can not be submitted. This is likely because your content is spam-like or contains inappropriate elements. Please change you content or try again later. If you still have problems, please contract an administrator.

So I have no idea what is going on with that message.
Here is my reply below................


Awe thank you so much for offering to do this for me. That is so sweet of you.
How will I send you my FDMB password without everyone being able to see it?

Kitty's age - 10 years old (born August 2010)
Date of diagnosis - Dec 2, 2020
Date starting testing - Dec 3, 2020
Glucometer using - One Touch Human Meter
Location - British Columbia, Canada... yes we use mmol.
Feeding - Fancy Feast Pate (I was feeding grain free WELLNESS pate but switched after joining group)
No other health issues - yes did have high ketones when we went to emergency on Dec 30th. No acidosis.

Would you say that it is easier to navigate through this site on a computer or can it be done easily as well on an iPhone?

Thank you so much for your help!

Tammy

 

Check your PMs. I have sent you a message there.