? 8/4Milo +2 218 +4 180 +6 108 +7 84 +8 109 +11 109 PMPS107 +1 125 +2 101 +3 110 +4 116 +6 142 +11 398

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Danielle & Milo

Danielle & Milo

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Hi everyone! Milo and I are new to the diabetes world and he is currently on Lantus -One unit, twice daily. His numbers have been all over the place the past several days. Can anyone tell me how Lantus works and give me some advice? He is on his 4th cycle of this dosage.

Here is a recap of the past few days:

Friday, July 31st

-BG test reading: 509 at 7:30am - Gave 2 units of insulin
-BG test reading: 360 at 11:15am
-BG test reading: 266 at 7:22pm - Gave 1 unit of insulin
-BG test reading: 177 at 10:13pm

Saturday, August 1st

-BG test reading: 134 (His lowest number since on insulin) at 7:15am - SKIPPED INSULIN DOSE!!!!!!!
-BG test reading: 342 at 12:30pm
-BG test reading: 427 at 7:20pm - Gave 1 unit of insulin
-BG test reading: 291 at 12:00am

Sunday, August 2nd

-BG test reading: 394 at 7:15am - Gave 1 unit of insulin
-BG test reading: 224 at 12:30pm
-BG test reading: 636 at 7:15pm (His HIGHEST number he has ever been since diagnosed)
-BG test reading to determine if false reading: 641 at 7:20pm - Gave 1 unit of insulin
-BG test reading: 367 at 12:30pm

Monday, August 3rd

-BG test reading: 383 at 7:20am - Gave 1 unit of insulin
-BG test reading: 414 at 10:30am

***I still need to work on uploading my spreadsheet for him
 
Welcome to the forum Milo and Danielle.... the greatest place you never wanted to be....

There are several sticky's at the top of this forum that you will want to read. Tons of Info...

first off, the Lantus dose is based on how low they go during a cycle ( 12 hours)
It was a good call to skip the other day until you get more data.
And yes, getting that ss up will help tremendously. We all look at it.

Try not to react to the high numbers ( I know that's hard) .....
they are normal and a response to the low numbers... we call it a bounce.
It was likely a response to the 134....
Milo's body isn't used to normal glucose ranges anymore so it dumped hormones and his glucose shot up.
For now.... keep the dose at 1 unit....
He's looking good and after you are able to shoot continuously without skipping.... we'll be able to evaluate whether or not he'll need an increase or a decrease.
The depot has to fill up ( see the sticky) before we truly know how he responds to this dose.

And when it is time to increase or decrease, we use 1/4 increment changes.....
 
rhiannon and shadow (GA) said:
Welcome to the forum Milo and Danielle.... the greatest place you never wanted to be....

There are several sticky's at the top of this forum that you will want to read. Tons of Info...

first off, the Lantus dose is based on how low they go during a cycle ( 12 hours)
It was a good call to skip the other day until you get more data.
And yes, getting that ss up will help tremendously. We all look at it.

Try not to react to the high numbers ( I know that's hard) .....
they are normal and a response to the low numbers... we call it a bounce.
It was likely a response to the 134....
Milo's body isn't used to normal glucose ranges anymore so it dumped hormones and his glucose shot up.
For now.... keep the dose at 1 unit....
He's looking good and after you are able to shoot continuously without skipping.... we'll be able to evaluate whether or not he'll need an increase or a decrease.
The depot has to fill up ( see the sticky) before we truly know how he responds to this dose.

And when it is time to increase or decrease, we use 1/4 increment changes.....
Click to expand...


Thank you! This is helpful! I will be doing the spreadsheet tonight! He has been up and down and the lowest was the 134 a few days ago. He was so high last night in the 600s!!!!! I hope his +6 reading is better
 
Hi, Danielle and welcome to you and Milo to Lantus and Lev Land. This is the best place you never wanted to be!

I'm glad Rhiannon directed you to the sticky notes at the top of the Board. They contain an overwhelming amount of information and it's even more overwhelming if you read all of the links. The good news is there isn't a test! The even better news is that everyone here will help you make sense out of the information. The people here are very generous with their time and knowledge -- we've all been new to managing our kitty's diabetes.

One thing to keep in mind is that Lantus is a depot type of insulin. This is what makes Lantus a long-acting insulin. The depot is like a reservoir. A little bit of every dose goes to fill the reservoir. It can take up to a week for the depot to fill and with every dose change, it can take several days for the depot to stabilize. This is the long way of saying that you're still in the process of getting Milo's depot filled.

Rhiannon's interpretation of Milo's numbers is much the same as mine. Milo bounced after seeing that 134. Not only did he bounce, by skipping the shot, his numbers soared.

Please let us know how we can help.

 
Sienne and Gabby said:
Hi, Danielle and welcome to you and Milo to Lantus and Lev Land. This is the best place you never wanted to be!

I'm glad Rhiannon directed you to the sticky notes at the top of the Board. They contain an overwhelming amount of information and it's even more overwhelming if you read all of the links. The good news is there isn't a test! The even better news is that everyone here will help you make sense out of the information. The people here are very generous with their time and knowledge -- we've all been new to managing our kitty's diabetes.

One thing to keep in mind is that Lantus is a depot type of insulin. This is what makes Lantus a long-acting insulin. The depot is like a reservoir. A little bit of every dose goes to fill the reservoir. It can take up to a week for the depot to fill and with every dose change, it can take several days for the depot to stabilize. This is the long way of saying that you're still in the process of getting Milo's depot filled.

Rhiannon's interpretation of Milo's numbers is much the same as mine. Milo bounced after seeing that 134. Not only did he bounce, by skipping the shot, his numbers soared.

Please let us know how we can help.
Click to expand...


Thank you! To make matters worse we just found out today that the vet gave us the WRONG syringes and we were giving him more insulin that we thought! He was on the U100 instead of the U30 but I bought the right ones tonight. I shot a fur shot this morning so his numbers have been high today and tonight we start his 6 cycle over with 2 units twice a day for the next 3 days (6 cycles). I made sure I got the insulin in tonight.

Questions:

1.) What happens if he will not eat before I shoot? That was the case tonight. He ate immediately after I shot
2.) Where do you shoot at and what method do you use, tent or roll? I shot him on the scruff tonight and it went in fine
3.) How often do you feed your kitty?

I am still lost on all of this and have been reading but it is a lot.
 
Danielle & Milo said:
He was on the U100 instead of the U30 but I bought the right ones tonight. I shot a fur shot this morning so his numbers have been high today and tonight we start his 6 cycle over with 2 units twice a day for the next 3 days (6 cycles).
Click to expand...


Would you clarify this for us? You should be using u-100 syringes. Those go with Lantus & Levemir, both U-100 insulins. This is really important.


Danielle & Milo said:
1.) What happens if he will not eat before I shoot? That was the case tonight. He ate immediately after I shot
2.) Where do you shoot at and what method do you use, tent or roll? I shot him on the scruff tonight and it went in fine
3.) How often do you feed your kitty?
Click to expand...

As long as he's eating some, I wouldn't worry too much. Lantus begins its action a couple of hours after the shot, at least in most cats, and as long as he's not obviously sick and not eating, most of the time you would go ahead and shoot.

I pulled up a hunk of scruff and put the needle in near the body and shot. For 2.5 years, and it worked just fine.

Most people feed their cats more than twice a day. If a cat will graze and not binge themselves on any food you put down, that's ok. You'd want to pick the food up at +10 so they haven't eaten in the 2 hours prior to the preshot test.

If you've got a gorger, which is what I had, you'll need to be more restrictive on the feeding. Punkin would've eaten everything I put down immediately, and it helps even out blood sugar if food is eaten throughout at least the first few hours of the cycle. We fed Punkin 3oz of food with his shot and 1.5 oz at +3, both am and pm cycles. It worked for us. As you get more tests in, it might be that you need a different food plan for your Milo, but that's a pretty good plan to start with.

The amount you feed should be enough to hold his weight stable if he's about the right weight. Those amounts were for punkin - you'll want to adjust for Milo.
 
Thanks Julie for your story and information/advice!!

In regards to the syringes, I was told that I should NOT use the U100 syringes for Lantus because they do not have the .25 or .50 markings which is what I need. I now use the U30 syringes/needles.
 
Danielle, I was just reading through your last post on Main Health and saw that someone said it was critical for Milo to eat before you shoot. That's not true with Lantus or Lev. It IS true of the older insulins that begin their action faster in the body. As long as Milo isn't sick and you can reasonably anticipate that he will eat, go ahead with the test/feed/shoot process.

My other problem is when I give him insulin sometimes he moves on me and then I miss and it gets on his fur and then other times I feel like I am not getting it into his fat like this morning he got insulin on him and i am not even sure how much insulin I got in him and correctly :(

Everyone does fur shots - where not all of it goes in. The important thing is to not reshoot. Just let it go and give the next shot 12 hours or so later.

Just saw your reply about the syringes. Would you copy the link to the syringes you're now using and post it here? I haven't gotten to the discussion yet in your other post about the syringes, but I want to make sure you're using the right thing. I'm still looking.
 
Julie - I just posted your comment on the main forum too so people can weigh in. Chris helped me with the changing of the syringes. Sorry I do not have a link to share for the syringes I use, but they are the Reli On 3/10mL, 31 gauge syringes, 8mm
 
Or if it's easier, you can take a photo of the box, then upload it as an attachment to post it here.

I got to the part where the syringes markings were each 2u. But your new syringes should still have a label that says "u-100" on them.
 
The important part of is that they are still u-100 syringes, though, Chris, not how much total the syringe holds. I'm just trying to confirm that she is using u-100 syringes.
 
Yes...they're U100 syringes...I sent her a picture of the box I use and she took it to Walmart with her....she's got the same ones we use
 
Danielle, would you fix Milo's ss with the actual amount of insulin that he got with the other syringes? So if you drew up what you thought were 2u, it was 4u - can you fix the ss so it shows that? It'll be important for helping figure out dosing as you move ahead.

Thanks for bearing with me on the syringes - I also had the wrong syringes and was giving punkin his shots in u-40 syringes, which meant he was getting 2.5x as much insulin as I thought. That's why I was confused by the u-30 and wanted to make sure we had it all straight!
 
Yeah...she misunderstood the difference between a U100 syringe that holds 30 units and a U100 syringe that holds 100 units

It's a matter of the "U"...on her Health post I explained what the U means when it's in front of the number

She is still unable to access her spreadsheet to edit it....I set it up for her and she had to get a Google account and download the app, etc. etc. etc....then we found the mistake in the syringes so things have been kind of hectic

I changed the dosage when we found out about the problem with the other syringes...it's correct now
 
julie & punkin (ga) said:
Danielle, would you fix Milo's ss with the actual amount of insulin that he got with the other syringes? So if you drew up what you thought were 2u, it was 4u - can you fix the ss so it shows that? It'll be important for helping figure out dosing as you move ahead.

Thanks for bearing with me on the syringes - I also had the wrong syringes and was giving punkin his shots in u-40 syringes, which meant he was getting 2.5x as much insulin as I thought. That's why I was confused by the u-30 and wanted to make sure we had it all straight![/QUOTE

Yikes! Glad I wasn't the only one who did this! It's my vet and pharmacy's fault :( but now I'm on track so that's all that matters
Click to expand...
 
Since we are on the subject of syringes, we went to WalMart today and got U-100 syringes. I gave the gal the old packaging Capacity 3/10 mlcc Gauge 30 Length 8mm(5/16"). She brought me a pack of 100 in a bag and I paid for it. When I got home (26 miles later) and opened the bag what was in it was Capacity 3/10mlcc GUAGE 31 Length 8mm(5/16"). From what I can deduce the needle is just smaller around than the 30. Is this correct? and OK to use?
 
So it sounds like the gauge is the only difference, Kathe? If so, yes, that's the thickness of the needle. You can use whatever you want on that.
 
I would think so, as long as they are marked U100. Coral Sea (great name! and beautiful cats the both of them) might enjoy the thinner gauge.
 
Brashworks said:
I would think so, as long as they are marked U100. Coral Sea (great name! and beautiful cats the both of them) might enjoy the thinner gauge.
Click to expand...
Yes! they are U100. I guess these smaller gauges are for babies and children and now good for small cat bodies. She does well with her shots.

Thanks to you from the girls (Mother Coral and Joy Daughter). Their former Pet Parent was a veteran. He served on the Coral Sea an aircraft carrier and Joy was named after a destroyer, Turner Joy. Both girls were show cats! They came to us because the breeder wanted to place them together and since we were retired we agreed we could handle the two beautiful ladies. They have been a part of our family for two years. Thanks for the compliment.
 
****UPDATED***** GOOD NEWS!!!!!!!!!

At +6 last night Milo was 353 (YAY bye bye 400s....for now)

His AMPS was 263..............DO I SHOOT HIS 2 UNITS STILL? He is eating now!

HELP!!!!!!!!!!!!!!!!!!!
 
Chris & China said:
SHHOOOOTTTTT!!!!!

As long as you're home to test today, he's over 200, so you shoot the scheduled dose.......If you're really concerned, get a +1 and a +2 to see where he's going

This is GOOD news!!
Click to expand...


YAY!!!!!!!!!! Thanks Chris! I NOW know if this happens again what to do! This was a first for me! Thank you for your help!!!!

Hopefully Milo is taking a GOOD turn today!
 
Yeah for nicer numbers! Not sure what time zone you are in, just know you 7:30 isn't mine.

On this forum, we suggest that it's OK to shoot anything above 150 on a human meter, so it'd be a bit higher on that AlphaTrak. If you get a lower number at PMPS time, do the test and post the number here for help. But do not feed. There are a few options for what you can do, skipping the shot is just one of them. One of the options is to stall 30 minutes without feeding, to see if the numbers are coming up, hence we ask you not to feed.

Have you taken a look at the Tight Regulation Protocol (TR) and Start Low Go Slow (SLGS) method Sticky Notes? People here choose one or the other for determining doses. If you do pick one, put it in your signature, so we stop asking you. ;) It also impacts what we might get you to do tonight.
 
***UPDATE****

At +7 he was at 84. I am guessing I will not be giving him his 2 units of insulin tonight at 7:00pm.

Thoughts anyone?
 
If you are using the SLGS method for dosing, Milo would have earned a reduction to 1.75 units. If you are using the TR protocol, the reduction point is 68 on the ATrack.

I would test again in 1/2 hour. At 68 on the AT is the point where we take action and give high carb food.
 
Wendy&Neko said:
Yeah for nicer numbers! Not sure what time zone you are in, just know you 7:30 isn't mine.

On this forum, we suggest that it's OK to shoot anything above 150 on a human meter, so it'd be a bit higher on that AlphaTrak. If you get a lower number at PMPS time, do the test and post the number here for help. But do not feed. There are a few options for what you can do, skipping the shot is just one of them. One of the options is to stall 30 minutes without feeding, to see if the numbers are coming up, hence we ask you not to feed.

Have you taken a look at the Tight Regulation Protocol (TR) and Start Low Go Slow (SLGS) method Sticky Notes? People here choose one or the other for determining doses. If you do pick one, put it in your signature, so we stop asking you. ;) It also impacts what we might get you to do tonight.
Click to expand...
I want to do the TR method and have started that. I also just added this to my signature :)
 
I think what Wendy meant was IF he's below 150 (about 200 on the AT I think) at PMPS time, DON'T feed, and post and ask for help

Right now, you might want to go ahead and give him a teaspoon or two of his regular low carb food to see if you can get him to surf (stop dropping and stay where he's at now)
 
Actually Chris, she should post here if he's below 200 at PMPS time. She is using the AT meter - not exactly sure what the 150 on a human meter is compared to the AT, but it's higher than 150. Eventually you will shoot even lower numbers without asking, but it's good to gather the data to do so first.

Danielle, could you also update Milo's spreadsheet with the latest numbers? It's a tool we use a lot.
 
Great to see progress - we love those green numbers - that's your goal and VOILA, Milo just gave you a bit of it!

I saw you gave him a couple of bites of low carb - awesome choice. Feeding a little bit of regular low carb when they hit green can help a kitty surf - stay flat in greens - for a while. Well done!

He may very well bounce from hitting the green number today - if so, don't worry. That's a normal response by his body to a range he's not used to anymore. There's more on bounces in the second post here. Bounces are important to understand because you don't increase the dose in response to high numbers from bouncing. Instead, you focus on that sweet 84 he got today and celebrate that says this is a good dose for the moment!

You don't need to intervene til he drops below 68, and at that point you'll have time to take action and give him some carbs to pull him up. He's doing great.
 
Just a housekeeping note

When you start a new post each day, you put the date, name and the AMPS number in the title and as the day goes on, just add the newer values, so today's title line would read

8/4 Milo AMPS 263,+2 218,+4 180,+6 108,+7 84 (since you're using the AT, I'd add (AT) to it too)

That way, as the day goes on, the people that watch the forum will be able to easily see Milo's "whole day" in numbers so if they see something important, they can let you know without going through and reading all the comments
 
oh - i wanted to add 2 things.

1 - we ask everyone to start a new thread (condo) every day. It keeps the length of the condos manageable.

2 - just wanted to point out on Milo's ss - if you look at 8/1 ambg 134 - that caused a bounce that lasted 3 days. Count forward 3 days from 8/1 and you get to this morning, and VOILA, a yellow - the beginning of him clearing the bounce that resulted in the green number this afternoon.

As he gets more used to being in normal numbers, the bounces will lessen in both intensity (he won't go as high as those ugly black numbers) and duration (they won't last 3 days). It's a process.
 
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