2/20 KiKi AMPS 481,+4 = HI ?

Just started Lantus last nite for the first time. After I gave him his 1st shot I noticed his fur was a little wet (he was squirming) so not real sure how much he actually received - so I only put down .5 for last nite shot. This AM he was 481, but now +4 he's higher? Should I retest? How long does the Lantus usually take to begin? Should I have only given him .5 or some such? I don't know what to do ... he's drinking and peeing and sleeping since AM shot

 

Hi Donna

welcome to Lantus Land,,,,while you hang around, read up on the information stickies (with the "star" icon) up above.
Others will be along to assist and help answer your concerns, okey-dokey?

give some of us a sec, catching up on your previous threads in the health forum...

FYI: Kiki's first Health thread
viewtopic.php?f=3&t=6509&p=65205#p65205

 

From Health forum, test results thread

viewtopic.php?f=3&t=6804&p=67923#p67923

 

when do u expect the test results back?

have u looked into getting a ketones box from a pharmacy? usually under $10, if u can, I would suggest picking one up.
EDIT to add: yup , there seems to be a ketones check the other day, Sienne just pointed that out to me!

I'm going to let the more experienced ones guide u with the dosing, ur spreadsheet for vetsulin has a lot of data, which is great

can u tell us what Kiki is currently eating?

 

Hi Donna.

Let me suggest that you list the actual dose you put in the syringe and you put a comment that you think the shot was a fur shot. It's possible that the damp spot was from some insulin on the outside of the needle.

If you can, could you please complete a Profile? In particular, I'd like to know if Kiki has had any health issues, especially a history of ketones. With numbers this high, testing regularly for ketones is important and it looks like you tested recently. The instructions for a Profile are in the Tech Support forum.

I saw from your post on Health that you were waiting for test results. Did you get them back yet? Also, do you happen to know Kiki's ideal weight? Lantus starting dose is often started based on weight.

Just to get you oriented, you will want to read over the notes marked with a star at the top of the Board. These will help you to get oriented to Lantus Land (LL). There's a ton of information there -- everything from our dosing protocol and links to the research articles, how to handle Lantus, a link to the slang directory, posting conventions, etc. One of the most important things to understand is that we encourage testing, especially this early in your use of Lantus. You should be in a data gathering mode. Getting pre-shot tests is important to insure that numbers are in a safe range to shoot -- just like with Vetsulin. However, dosing is not based on pre-shot levels. Instead, dosing is based on nadir. As a result, you will need to get spot checks during both the AM and PM cycles.

Please continue to post regularly. And, please ask questions and let us know how we can help.

 

No history of ketones. He did have some type infection that was cleared up with Clavamox (04/09). But no problems since.
He ate 2 pouches Friskies Fine Cuts with Tuna this AM.
Remaining test results are not expected until early next week. Vet wanted to know exactly what we were dealing with instead of just guessing.
I will try to get another ketone test done -- i have strips
Kiki can be finnicky when it comes to food. If I feed him the same thing more than three times in a row, he will turn his nose up and walk away. So I have a variety on hand at any given time (each can/pouch marked with carb value in marker).

 

It sounds like you're on top of all of the food issues. I'll be curious to see if there are differences between when you are feeding the Friskies (9 carbs) vs. FF which is about half the carbs.

It's going to take a few days to get the depot (aka "shed") built and the Lantus to really start kicking in. I'm sure others will be by later today to say welcome and look at Kiki's SS. There are usually people here 24/7 -- we're an international group -- so if something comes up and you want input, holler!

 

HELP +7 and still HI Now I am really starting to worry -- shouldnt it have atleast gone down even a little by now?
Waiting for vet to return my call --

 

hang in there Donna,

is there anything "off" with Kiki with these hi numbers?

 

How do you mean "off"? He has just been sleeping all day since his AM shot. He seemed perfectly fine before the shot -- just hungry.
Emergency (on-call) vet returned my call -- initially, he was wanting me tp increase to 3.0u tonite. But he is not familiar with Lantus at all, so he is calling Iowa State University to get some additional guidance and will call me back.
Did a temporary job on my profile page and now will do some more reading up on Lantus -- my internet connection sux right now for some reason I could just scream -- its extremely slow to try and post anything

 

I meant anything that looks unusual, if he's eating, napping and alert then this is good, but we dont want to keep him in such hi numbers for too long,
sorry, didnt mean to alarm you, like Sienne mentioned, we'll have others check ur spreadsheet to advise u further.
have u had a chance to read up on Lantus in the stickies up above?

 

Hey Donna, see if u can try to get a ketones test in today ok? Just to make sure nothing is going on there.

 

Let's slow down a bit. Even if you shot 3.0u, it may not do what you want. Lantus is not a short or intermediate (like Vetsulin) acting insulin. It's long acting. You have to build a blood level or depot of the drug which takes a few days. (See both the dosing protocol and the note on depot or shed.) You may see some action with an initial dose but more often, it will take a few days to get the shed established before the Lantus starts working and/or we need to look at whether the dose needs to be raised. One of the hardest issues to overcome with Lantus is patience. It just does not drop numbers quickly like the shorter acting insulins. However, you have better coverage of the 12 hour cycle and it's much gentler once it starats to work.

It's also possible that Kiki was started on too low of a dose. The starting dose can be based on weight - 0.25u per kg of ideal weight. This is why I asked if you knew Kiki's ideal weight.

Other considerations are whether there is an infection present that may be elevating numbers. Likewise, if your cat needs a dental, this could influence numbers.

Some of the very experienced members will be on the Board later today. They generally stop by all new members' condos. As long as there is no emergent health issue, let's wait to see what they have to say.

 

Vet called again - he suggested 1.0 - 2.0u based on KiKi's weight. Also suggested that I up the dosage to either 1.5 or 2.0 tonite. Any feelings or advice on that? He sounded somewhat surprised that KiKi had been pretty much diet controlled from 09/09 til this last episode.
As far as *ideal* weight -- He''s been right around 7 lbs his entire adult life.
Vet had looked at his teeth, but never mentioned any problem with them ....
Right now, he seems alert and purrs when I stroke him, so he must not feel too out-of-sorts.
Still waiting for him to have to pee tho.
I will try and sit tight for now.
I DO have 4 Clavamox 62.5mg. still foil-wrapped. Would it HURT anything to give him that? It cleared up whatever the problem was last year

**Update: Ketones Negative** Played for about 5 - 10 minutes then demanded more food -- only ate about 1/4 c @ around 4pm. Groomed himself and now sleeping again.

 

hello and welcome to the group!
i'm not sure how your vet came up with a 1 - 2 unit starting dose for kiki based on weight.
if 7 pounds is kiki's ideal weight,
7lbs = 3.2kg
3.2kg x 0.25u = 0.8 unit

lantus works differently than some of the other insulins. lantus has a cumulative effect. in other words, you're not going to see immediate results. it's going to take a few days to see the effect of this 1u dose. i looked at kiki's vetsulin ss. normally, we take prior insulin doses into account when determining a good starting dose for lantus, but because of the dose hopping on vetsulin i can't get a clear picture of what any one dose was doing. if it were me, i would hold the 1u dose and check for ketones everyday. there is the option to raise the dose after 24 -48 hours if kiki is experiencing high flat numbers or if she's prone to ketones. please read through the tight regulation protocol linked in my signature... and breathe.

 

Giving an antibiotic without knowing which bacteria, if any infection, is present can contribute to antibiotic resistance. One of the vets who occasionally posts on the Health board, Dr. Lisa Pierson, has commented on this at length. Apparently, it is a very hot topic on the veterinary professional discussion boards. The example that is frequently given is with urinary track infections. It's best to get a sterile urine sample by cytocentsis (needle draw) and a culture and sensitivity (where they grow the bacteria) so that the proper drug can be prescribed. Otherwise, you have no idea if the antibiotic will work.

I think it's just in recent years that vets are becoming aware that cats can be diet controlled.

It looks like Jill has posted right before me. She's one of the very experienced people here. If she's suggesting to hold the dose for a bit, it's a good recommendation.

 

I just saw ur ketones check update - very good! Keep checking this everyday, as Jill suggested...

by the way, with Lantus, you should stop food after +10 in both cycles (AM & PM) .....best time to give last meal serving would be between +8 and +9.5...giving food after +10 often times will give you a food spike at your preshot BG test, pretty much the BG number will be influenced by food intake, so it will be higher than usual... so if you can try to steer away from that, maybe start today. No food after +10.

Many here use timed feeders like this one, especially while you're away or overnite while you sleep....This one in the link, The PetSafe 5 , is very popular and works well with wet food: http://www.petsmart.com/product/index.j ... Id=2751315

 

Re: 2/20 KiKi AMPS 481, +4 = hi

Will remember not to feed after +10
I have thrown away the clavamox.
Vet did the cytocentsis (needle draw)-- just wish we didnt have to wait thru the weekend to get the results.
I will continue to test for Ketones as well
I will keep the dosage the same for the time being -- I feel more comfortable doing that anyhow.
Thanks

**UPDATE** PMPS was still too high to register on meter. +4 is 540 ... thats a good sign, right?

 

I'm late, but I wanted to say welcome to Lantus Land! I hope to see you posting here every day.