New! And appropriate syringes

Discussion in 'Lantus / Levemir / Biosimilars' started by April & Quincy, Sep 13, 2019.

  1. April & Quincy

    April & Quincy Member

    Joined:
    Sep 6, 2019
    Good morning everyone! After lots of help on another part of the forum I am finally here! A little background...
    Quincy will start insulin next week; we have the insulin demonstration next Thursday. I have given two BG checks so far and will do more this week and next week before our appointment. I have some questions.

    Do the following syringes look okay?

    https://www.amazon.com/BD-Ultra-Fin...7JP/ref=sr_1_4?crid=3H93NJOFOZ1WZ&keywords=31 gauge 6mm insulin syringes&qid=1568389853&s=gateway&sprefix=31 gauge 6mm,aps,156&sr=8-4

    Or what can people recommend? Idjit's Mom recommended the following: SureComfort U-100 Insulin Syringes Half Unit 31G 3/10cc 5/16" 100/bx
    Monoject Ultra Comfort U-100 Insulin Syringes 30G 3/10cc 5/16" 100/bx 1/2 unit.

    What are the main numbers I'm looking for?

    I also wanted to ask about timing for shots and meals but I can wait until this stuff is answered!! Thank you all for your help!

    Oh, and the reason I posted here is because he will be starting Basaglar!
     
    Last edited: Sep 13, 2019
    Reason for edit: added something
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  2. Camille and Cyclone

    Camille and Cyclone Well-Known Member

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    Dec 29, 2009
  3. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Welcome! I love it when new members are getting fully prepared (great job on the SS!) but just curious why you are waiting on starting insulin? The longer he is at higher numbers, the more glucose toxicity sets in and the more insulin it takes to bring the numbers down.

    The BDs are fine as long as you make sure they have half-unit markings. You might want to check prices at American Diabetes Wholesale. It’s where many members buy their syringes. The basic thing you need to look for is that they are U100, 3/10cc with half unit markings. The gauge is up to you but most use 31g as it’s a tiny needle and less discomfort for kitty. The needle length is also personal preference. Some prefer short needles (I did) and some prefer long. You have to be careful with long so you don’t pierce through the skin on both sides and give a fur shot.

    Don’t be surprised if you start with one type and switch. I tried 3 types before I found one that I loved....which was then discontinued.

    Here are some Testing and Shooting Tips to help you get started.

    Do you mean for syringes? If so, see above. Or do you mean for BG?

    We are happy to answer your questions so go ahead and ask away. We are glad you found us! And do you mind if we get your name, please? We are like family here and it’s nice to be able to put your name with your sweet Quincy’s.
     
  4. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
  5. Figaro's Liz

    Figaro's Liz Member

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    Jun 18, 2019
    Hello there!

    I use those BD syringes (that's what my vet prescribed originally so I stuck with them), but if I were ordering on Amazon I would use this listing instead as the listing you linked has some iffy reviews:
    https://www.amazon.com/Ultra-Fine-Half-Insulin-Syringes-100ct/dp/B07F7QHV81

    They are fine but I can't say I personally love the BDs--the first batch I got were inconsistently marked on the barrel which was really frustrating--but I haven't tried others yet so can't compare. I've considered trying the Monojects which I have seen recommended a few times before.

    As others have said, the 1/2 unit markings are important. :)
     
  6. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    Hi! My name is April! Thank you for asking! I can definitely see you're like family and I hope I can join! :) Yes, I am waiting to start the insulin because due to my schedule and vet's I couldn't get in until then. :( The reason I've been waiting since May is because I'm a teacher and didn't have a job over the summer so no income. Believe me, it wasn't an easy decision but here we are and ready to start!

    I think I'll start with the shorter needles but Idjit's Mom recommended the WalMart syringes so I'm gonna check into those tomorrow! I bought syringes with the insulin but I think they're not as good as the one's on here, you know with the 3/10cc and half unit markings.

    For numbers I meant syringes so thank you for your answer. I still don't get what 3/10cc means but I can always look that up on my own!

    I have been surfing the forums and reading a ton on this particular Basaglar forum so it's been helpful! Thank you!!
     
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  7. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    Thank you! All these recommendations are very helpful! I'll start with the Walmart ones and then take these recs!
     
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  8. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Hi April, welcome to the family.
     
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  9. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    Welcome April and Quincy!!

    It looks like you already got a lot of great advice from the main health forum! One other tip I might offer is to keep your eyes on the supply closet in case anyone is selling Basaglar (and other diabetic supplies) for a cheaper price, or even giving it away for free. There aren't any right now, but you never know in the future! Additionally you had mentioned that in the summers you don't have a lot of cash flow. There is a program called Diabetic Cats in Need (DCIN) that helps low income individuals afford insulin, if Quincy doesn't get into remission before the summer you might want to consider reaching out to see if you qualify so that you don't have to stop Quincy's treatment for a couple of months.

    Looking forward to getting to know the two of you as Quincy starts treatment, fingers crossed that he has a short journey to get OTJ (Off the juice ;))
     
  10. Figaro's Liz

    Figaro's Liz Member

    Joined:
    Jun 18, 2019
    3/10cc is the total volume of the syringe. A cc is a cubic centimeter, which is equivalent to a milliliter.
    3/10cc is quite small! Only 3/10 of a milliliter!

    Which reminds me, when choosing syringes for Basaglar or Lantus it is important to use U-100 syringes (NOT U-40 syringes). We measure insulin in units. U-100 means that there are 100 units of insulin per milliliter.

    Some other types of insulin need to be measured with U-40 syringes (only 40 units of insulin per milliliter, so more dilute than U-100). Some insulins marketed for pets are U-40, so just be careful when shopping around for syringes.
     
  11. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    All syringes are notoriously inaccurate so know that before you switch. It’s the reason I developed Dosing with Calipers. It’s not required to use calipers but it sure helps with dosing consistency and you can use the BDs if you like them other than the inaccuracies.

    I see Liz responded to your question of 3/10cc so I won’t be redundant.

    Do you have the insulin already? If you do, I’d really suggest you get started with it and we can help you with a starting dose...we do it all the time. There are specific methods we use here that determine the starting dose. We often find that vets either start the dose too high or increase too fast.

    There are different resources to help you learn how to shoot....YouTube is full of them but I’d get him started, IMHO, especially with the weekend ahead for you to monitor him.

    Edited to add:

    I read through your first thread and thought I’d provide you with a couple of resources regarding foods.
    The first discusses the typical nutrient analysis and why you don’t want to use the guaranteed analysis numbers found on cat food labels. The second is an excellent discussion on percent calories from carbs to feed. I found with my Gracie that she did much better with the 6-10% range of foods than 1-3%.

    Calculating % calories from carbs
    Feeding Lowest/Zero Carb vs Higher Lower Carb Foods
     
    Last edited: Sep 13, 2019
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  12. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    Thank you!
     
  13. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    Thank you so much! And yesssssss, I hope he's OTJ soon! But I feel like he's had this for quite some time so I'm not sure... :(
     
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  14. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    I do have the insulin but TBH, I'm nervous about starting without talking to the vet but let me think about it...Also, even though our appt is next Thursday I wouldn't start it until the weekend so I could monitor him.

    I learned about food info back in May but i'm still learning more! I learned how to calculate dry matter and moisture content, etc. I started giving a little Fancy Feast Tuna Flaked last night and both cats LOVED it but I'm obviously being slow with adding it to the DM. I will definitely read the resources!
     
  15. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Are you not able to monitor this weekend if you got started?

    First goal is regulation. We all come here wanting remission but it’s best to have regulation as your goal. Then we can see what is possible :) However, this is the very reason I hate to see you wait any longer on giving insulin. I know I’m giving you lots of things to read but probably the most important is this info on glucose toxicity.

    You are very, very lucky that he did not develop diabetic ketoacidosis. It’s always a threat when FD is untreated and if the kitty gets any type of infection at all (dental, urinary tract which is common in FDs, etc).

    Having said that, it’s important when you start insulin that you are available to do some monitoring even though it usually takes several days before the depot fills and the BG moves and that’s if the dose is correct from the get-go.
     
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  16. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    I'm supposed to go out of town this weekend but I haven't fully decided.

    Yes, I am very lucky. Believe me, I know. That's why I want to start monitoring next weekend and once I leave the vet on Thursday, be able to let you all know what the vet told me I should start with and get all of your opinions. I can also monitor him all weekend.
     
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  17. April & Quincy

    April & Quincy Member

    Joined:
    Sep 6, 2019
    I also know I'll need to shoot every 12 hours. I am wondering about feeding schedule with this. I feed him right now before I go to work at 7am, again at 430 when I get home, and then at 9 when I go to bed. Obviously no feeding time is 12 hours apart. Do I need to feed him after the shot?

    Also, on my other thread, I talked a lot about poking through his ear with my lancet. If I can get some tests in this weekend, if I don't go out of town or can have my boyfriend do the tests, I am worried his whole ear will be pierced through!! :(
     
  18. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    If you look at the Testing and Shooting Tips, it will, hopefully, help you not poke through his ear all the way. There is a learning curve.

    With the longer term insulins, most of us usually test and then feed and shoot at the same time so the kitty has it’s face in the plate while shooting the insulin. While every cat is different (ECID), we usually suggest you don’t feed much after mid cycle because it slows the effects of the insulin like slamming on the brakes of a car. If he’s really hungry, a few low carb treats like freeze dried chicken or even boiled chicken pieces can do the trick without effecting the insulin. We recommend that, unless he’s low, you don’t feed two hours prior to shot time so that it doesn’t falsely elevate numbers for when you shoot.

    Many feed minimeals to work with the insulin. That might or might not be necessary with him but it probably is an advantage to feed a few smaller portions over several hours. I do this even with my non diabetic cats; they are fed 4-6 small meals a day.
     
  19. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Welcome to the group April and Quincy! Yes, there's lot's to learn here - much more than your vet will be able to tell you. Some vets don't care much for the information we've learned here on the forum. My first vet (yes, sometimes it takes several to find one you like) rolled his eyes and said something like 'don't go listening to everyone on the internet'...yep, right. I've found over the nearly two years that I've treated Luci for her diabetes that the knowledge of the people here on this forum far, far exceed what any vet that I've met with even has the tiniest fraction of information by comparison.

    I don't argue...I just say something like... well, ok. I'll get back to you, etc. etc. And then I go home to the forum and my spreadsheets - Luci is doing very well without help from the vets that I've met...

    We'll be looking for your posts :)
     
  20. April & Quincy

    April & Quincy Member

    Joined:
    Sep 6, 2019
    Okay I'm going to need to read that a few more times!! I'm on the phone so it's kind of hard to digest. But wow, info on overload! So I guess I'll have to look at feeding times...

    Also here is the syringes I bought before I had all of the info on here. Thoughts?
     

    Attached Files:

  21. April & Quincy

    April & Quincy Member

    Joined:
    Sep 6, 2019
    Yes, while I love my vet, you all seem very, very knowledgeable and I think I'll stick with you. :) :) I can't even tell you how appreciative I am to have found this site and for all of you even talking to me because I have no one else to turn to I am very worried and anxious about my lovely baby. Great advice about the vet by the way. I think I'll probably be the same way w my vet. Thank you very much!
     
  22. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Can’t tell if they have half unit markings just from that pic and I’m not familiar with that brand but that part doesn’t matter. :)
     
  23. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    They are half unit, yes!
     
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  24. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    Do those look okay for now even though they're not 3/10cc?
     
  25. Figaro's Liz

    Figaro's Liz Member

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    Jun 18, 2019
    3/10 = 0.3. So they are in fact 3/10cc, just marked differently :)
     
  26. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    Haha wow. Whoops! Thank you!
     
  27. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    So a few more BG checks were given this weekend. He got into the 200's at one point but I tested him roughly two hours after eating so maybe that's why?

    I also used lancets that aren't the "automatic" ones, if that makes sense? I had to prick his ear a few times to get blood but at least I didn't pierce it all the way through this time! Practice, practice, practice...

    I'm still trying to figure out how I'll do meals now with insulin injections about to happen so I was thinking I'd give him a mini meal after his second injection since the first one will be given at breakfast time. Still pretty stressed about giving him insulin injections. While he was eating this weekend, I grabbed the fur/skin where I believe I'll be giving him the injection and it feels so tight between his collar bones! I hope I can do it right.
     
  28. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    Hey April!

    Definitely food will boost Quincy’s numbers!

    Re: the lancets - a lot of us do the same thing here... I do. I way prefer to just use the lancet rather than the lancet with the combination of the injector pen because it gives me more control. You’re right. Practice makes perfect! You’ll get there for sure! Typically we recommend starting with the 28 gauge Lancets because theyre slightly larger so it makes it easier to get blood while you're still learning. You can get a smaller lancet (ex 31 gauge) once Quincy has grown new capillaries and bleeds better for you :)

    Re: Insulin injections and feeding - I’m sure you’ve already heard this but your injections should be 12hrs apart. This is because Lantus typically has a 12 hour duration in cats. If you inject earlier than 12 hours apart it acts like a dose increase and can put your cat in danger of a hypo event, likewise, if you inject later than 12hrs apart it acts like a dose decrease. You want to be as consistent as possible so your dose depot remains stable and can do it's job. As of right now my cats are free fed so I can't really advise on strategies for feeding multiple smaller meals throughout the day but, I thought I would show you my daily schedule with Mowgli to give you an idea of a scenario that has worked for me :)

    5:50am: Get up and take Mowgli's BG reading
    5:55am: Prepare Mowgli's food [typically 1 can of LC Fancy Feast if BGs are kind of high (black, red, pink,yell,ow) or 3/4 can of LC Friskies if he has a lower BG (Blue, high green)]and prepare his insulin dose - if his BG was high enough to shoot that day. (I am not able to check in on him during the day so if he is in mid-low dark green values I would skip the shot or give a reduced dose)
    6:00am: Put Mowgli's food down and while he is eating give him his insulin shot. It's easier to give while they're eating since they're distracted

    ~~~~~~WORKING~~~~~~

    5:50pm: Take Mowgli's BG
    5:55pm: Prepare Mowgli's food, same as in the morning, and prepare his insulin dose if he is in safe enough numbers to give his dose
    6:00pm: Put Mowgli's food down and while he is eating give him his insulin shot.
    7/8:00pm: Take a reading to see if Mowgli has had an easy or aggressive onset (onset = when the insulin starts to kick in)
    Before Bed: Take a reading to make sure Mowgli is in safe enough numbers so that I don't have to worry about getting tests through the night

    Many members use a timed feeder to give multiple small meals throughout the day... I believe the "Petsafe 5" is a popular model.

    Shooting is tough in the beginning so be kind to yourself, it is likely you'll make mistakes along the way but you will get there, HERE is a link to some tips on giving injections and you can also find some other tips and diagrams on where to inject along with some more how to tips HERE. There are also many videos on youtube which can help give you some ideas on shooting

    Hope this helps! Good luck!!
     
  29. Figaro's Liz

    Figaro's Liz Member

    Joined:
    Jun 18, 2019
    I second Amanda's suggestion of watching youtube videos for technique on giving a cat injections! Watch as many as you can... seeing multiple people do the technique helped me a lot. Much of the time the cat doesn't even feel the needle! Pulling up firmly on the skin will help too, so that the skin is taut and the needly doesn't "tug" as much when inserted.
     
  30. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    Thanks for this! I'm not sure how to quote each section BUT for lancets:

    LANCETS: I bought 26 gauge I believe? They were sold out or something of 28 and the next size was 31 so I just got 26. I know I'll get there!

    FEEDING: I do know Basaglar are 12 hours apart as well. Your schedule looks similar to mine because I'll be at work all day in the middle as well. I think I'll only take one reading after the insulin at night - perhaps around 8pm or 9pm when I feed him his final meal. I will also follow what all of you have said based on numbers before shooting so I know not to shoot or shoot half.

    Thanks, I will watch those videos! I've already watched a few on youtube but I'll keep doing it!
     
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  31. April & Quincy

    April & Quincy Member

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    Sep 6, 2019
    Thank you! Great advice, I want him to feel as little as possible!
     

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