Pig 2/20 amps 333

Yesterday's

He is doing really good today, despite a bit of a reaction to the injection...?? I am still not really sure what is causing this. He seems to be doing fine other than the knotting. He had one come up on either shoulder, but both are almost nearly gone now and barely noticeable.

I did shoot the scruff per @Ella & Rusty & Stu(GA) suggestion, but still saw a small knot come up.

I recently got a new box of syringes, but they are the same brand (Sure Comfort) with the only difference being they have 1/5 unit markings on the barrel. They are the same gauge and length. Identical to the last, except for markings.

The reaction to the scruff shot was markedly smaller than the ones where I shot the shoulders, but it did still raise a small knot. None of the spots are hot to the touch, nor do they seem to give him pain. Perhaps it is due to the size of the injection and it is just taking a bit longer for the dose to absorb? Honestly, that is what the sites feel like. Like when you give sub-q fluids.

On another note, he is feeling much better with the few yellows and lower pinks mixed back in. He is getting up to use the litter box (pee) again, instead of just sleeping and leaking.. lol. He cleaned himself really well and has actually been awake all morning, even though the L dose has not cycled in yet! Looking good! It seems he is holding the lap over longer and that is working out well...

 

This quote is from the Sticky on Lantus and Levemir. Maybe it explains why Lev in your case (high dose) might be causing those knots? Nice to hear that Pig is feeling better.

depot
[dē′pō, dep′ō]
Etymology: Fr, depository
1 n, any area of the body in which drugs or other substances such as fat are stored and from which they can be distributed.
2 adj, (of a drug) injected or implanted to be slowly absorbed into the circulation.
Mosby's Medical Dictionary, 8th edition. © 2009, Elsevier.
Lantus and Levemir both fall into the category of “depot drugs.” Pharmacologically, the two insulins work in different ways, but both have the characteristic of being absorbed slowly by the body. The result is an extended action. These insulins tend to display a cumulative effect, meaning that what happens in one cycle can affect the next cycle, or even the next several days. This is part of what allows Lantus and Levemir to create those beautiful, flat curves, so it is worthwhile to spend the time to understand the depot.

Here is a great reference that explains the Lantus and Levemir depots in layman’s terms:

Lantus and Levemir: What’s the Difference?

Glargine (Lantus):
Lantus and Levemir: What's the Difference said:
After you inject it into your subcutaneous tissue, the acidic solution is neutralized by your body to a neutral pH. Because glargine is not soluble at a neutral pH, it precipitates out into a form that's not soluble in subcutaneous fat, and there forms a relatively insoluble depot. From that pool, or depot, of precipitated glargine in the tissues, small amounts slowly move back into solution over time and then to the bloodstream.
Detemir (Levemir):
Lantus and Levemir: What's the Difference said:
Unlike glargine, detemir does not form a precipitate upon injection. Instead, detemir's action is extended because its altered form makes it stick to itself in the subcutaneous depot (the injection site), so it's slowly absorbed. Once the detemir molecules dissociate from each other, they readily enter the blood circulation, but there the added fatty acid binds to albumin.

More than 98 percent of detemir in the bloodstream is bound to albumin. With the albumin stuck to it, the insulin cannot function. Because it slowly dissociates from the albumin, it is available to the body over an extended period.

 

Oh! You know I read this many times... And I knew they were both depot insulins, but I did not actually think about one of them building a pool in the sub-q tissue... I don't know why, I just assumed they both disappeared and then chemically altered to be available in the body... How did I miss this?

That is most likely exactly what is going on and would explain why the one knot was larger than the others if I accidentally shot the same shoulder two cycles in a row.... It makes perfect sense as the other sites had a smaller knot and those knots went down pretty quickly!

Thank you! I cannot believe I missed this! Your a life saver!

 

I am planning on gearing up the R again tonight, unless instructed to wait. This would be the 3rd cycle at 25uL. I should have started this morning, but since I could not monitor properly and I have no clue how it will work with Levemir, I chose to wait...

 

You're welcome! You know, I haven't read that sticky in years until today.