3/7 Squallie 52 Do I panic yet?

Okay, I've bought the syringes, I've done the changes in diet, and I've finally got Squallie pretty well back to a good BG level, so I guess I'm out of excuses, lol! I would like to start him on Lantus tomorrow morning. His vet has suggested I start him on 1U, since his BG has come down so much recently. Maybe someone here could please take a look at his SS, just for a "second opinion." Also, am I right in believing I heard not to "roll" Lantus, like I have done in the past with the Vetsuin?

I hate the syringes the pharmacist at Walmart gave me. He was not very pleasant to me, and acted like I was a blithering idiot taking up his valuable time. He was very impatient. He told me the syringes were not marked in 1/2 unit increments, but it sure looks to me like they are (which is good). I specifically told him I wanted 1/2" needles and when I got them home and opened them I found that he sold me the shorter needled syringes-I've never used these, and don't think I like them much from the look of 'em. Will they be difficult to use? Squallie has very thick hair and skin so I'm afraid they may be challenging! I really didn't need anything to make me more nervous than I already am, lol!

ETA: The rubber stoppers on these syringes are all twisted and slanty, too.

 

It looks like you shot 2 units this morning correct? I'm not one to give any advise but maybe my post will bump your question to the top. It's also helpful to put the "?" in the prefix of the title line. Weekends are a little less active on the board but hopefully someone will chime in.

I started with the Walgreens needles and eventually switched because of the reasons you mentioned with the plunger being slanted etc.

 

If you got the relions from wal-mart, yeah, they're not the highest quality, but they're CHEAP. Like less than 1/3 the price of BD's. And ALL relion syringes are marked in 1/2 units, it's clearly printed on their website. Pharm tech obviously doesn't know squat, that doesn't surprise me.
You should be fine with the shorter needles...I actually prefer them because there's virtually no chance of going out the other side of the "tent". Just make sure to insert it all the way and keep it pressed against the skin when depressing the plunger!
ETA: I have had some syringes that had excess friction on the plunger...be careful to distinguish this from not fully piercing the skin! (that hurts!)

 

Hi Lucy! I don't know what dose you should start at but I wanted to day good luck. You and Squallie Bear will be in good hands on this board. @Bobbie And Bubba and @Woodsywife are using Lantus these days so you'll see some familiar names here.

 

Lol, that was the pharmacist, not a tech, and he's been there for years! He should know all about it. He also told me he didn't think they made U40 syringes anymore, I don't think he believed me when I said that was what I had been using. This is why I don't get my Rxs filled at Walmart anymore, lol.

 

Thanks for the heads-up about the "?"

Yes, those syringes look pretty gruesome, don't think I'll be buying Walmart brand again.

 

Thanks, Shane! I've finally gotten his BG back under control again with the Vetsulin (I think it was the 9 Lives I was feeding that made his BG go up, I feel terrible about that, but it said it was only 4% carbs!) but I think we need to make the change just the same. I think it will be better for Mr. Bear, and will make him feel more like himself, because it's ultimately easier on his system.

 

I had 2nd thoughts on the shorter needles. But I actually like them better because you can't go to deep. Smokey has thick fur, I part with a comb. Push needle into the skin push with a little pressure. Haven't had a fur shot since. I did switch to monoject syringes. Wal-Mart didn't even know they had the 1/2u ones. But it's nice to know I can get them in a hurry if I need to.

 

Hey Lucy! Good to see you here! I use the shorter needles from Walmart also and I like them better because I was going all the way through my tent a few times. Haven't had that happen in a while ( anti-jinx) So, you have all ready met some peeps from L & L land and well, just welcome to you and Squallie Bear.!!! Any questions, just yell!

 

PS maybe change your title to ? Dosing Advice Needed for First time. The wise ones will weigh in to help you.

 

Welcome to Lantus! I'm sure Squallie will be just fine, good luck

 

I'm pretty sure with a change from vetsulin you keep the same dose, i.e. If you've been shooting 2 units of vetsulin then you'll start with 2 units of lantus. Pretty sure isn't the same as knowing though so let's see if we can't get @Sienne and Gabby (GA) to confirm @Marje and Gracie might be around too

 

Well, I'm not Sienne or Marje, but I do happen to know a little bit about dosing. LOL!

Since Squallie's dose has been decreasing this past week, I think I'd start with a 1.75u (bid) Lantus dose. We can always suggest adjustments sooner than later if necessary.

 

I went from longer needles to shorter ones and at first I didn't like them but now I do. I buy my syringes from Walmart because I work there and get a discount but I don't use the pharmacy for my meds.

 

What do I do if his BG is 200 or less? Do I stall, like I would with Vetsulin?

 

Have you decided yet whether you are going to use Tight Regulation or Start Low Go Slow (SLGS) method for dosing? The guidelines for what to do when you see a lower preshot number vary depending on which dosing method you chose. There is a Sticky Note on Handling and Shooting Low Numbers for TR, and the instructions for SLGS are in the SLGS sticky note itself. Once you've deciding which dosing method you want to use, it's helpful to put either TR or SLGS in your signature - so we stop asking that question.

Good luck!

 

I don't know which one to use, I don't know which would be best for Squallie. I feel so stupid, asking all these questions, seeing as how he's been on insulin since last June!

 

TR has a higher chance of remission, but requires a bit more testing, faster increases, and lower reduction points. The decision really is yours, depending on your circumstances. But there's nothing to stop you from picking one, trying it for a while, then switching if it doesn't work for you and Squallie.

 

Does Squallie eat any dry food at all? If he does, you have to go with the SLGS method. If he doesn't eat dry and if you want to increase faster, then go with the TR. You need to test more with TR and you do test a lot all ready. I went with TR because I didn't want to pussy foot around (no pun) anymore and wanted to get him regulated as quickly as possible.

 

And don't feel stupid asking questions, Lucy, I am still asking and I have been using Lantus 3 months. Everyone here is so nice and so helpful. And someone is always around, like Wendy, and Tara and Gill and Jill.

 

No dry food at all, it wreaks havoc with his BG. Apparently he is extremely carb-sensitive; any time I have tried to feed him anything around 4% or over, his numbers really sky-rocket. I think I'll probably go with SLGS, I'm too much of a coward to try TR yet!

 

You can always change once you get a feel for it and how he responds.

 

That sounds good to me!

 

Good luck with the change, look forward to seeing Squallies first numbers on Lantus.

 

Sorry to be late to the party! I'm glad Jill was able to stop by.

Since you're not thrilled about Relion syringes, this info is from the sticky re. Syringe & Insulin info:

Many of us purchase our syringes from ADW (American Diabetes Warehouse). They sell strips, syringes, meters, and all sorts of other supplies.

Given the frequency with which you've been testing already, you can easily do TR. There's a sticky note on how to manage TR if you're working/in school that may be helpful as you're trying to decide. There is published research supporting the efficacy of TR. SLGS is an approach that has been used here for quite some time and kitties have done well. It allows for more flexibility. I used TR for the 6.5 years that I managed my cat's diabetes.

Also, it will help to keep in mind that regardless of whether you opt for TR or SLGS, the mindset regarding dosing is very different than with Vetsulin. Lantus is a depot-type of insulin. This means that each dose builds on the previous dose and that you have greater duration between doses. It is also gentler and less potent than many of the shorter acting types of insulin. In other words, it doesn't "yank" numbers down (usually). It also means that dosing is based on the nadir and not on the pre-shot numbers. Doses are held for 3 - 5 days (depending on where the nadir is) in order for the depot to stabilize.-- unless a dose reduction is indicated. Rapid changes in dose usually result in wonky numbers due to the effect of dose changes on the depot.

It will, no doubt, take a while for you to wrap your head around the differences in dosing strategies between Lantus and Vetsulin. It will, however, become second nature. Please let us know if you have questions or can help in any way.

 

Personally I found this one of the most important pieces of information to understand when switching from Vetsulin to Lantus. There is also a Sticky to ready with even more information. You are in good hands here and continue to ask questions. We look forward to seeing Squallie's progess

 

Thank you all so very much for all your help and encouragement! I am so nervous, as we approach shot time - Squallie threw up early this morning, maybe he's nervous, too, lol.

I realized as I fed breakfast this morning that my vet will be monitoring Squallie's SS all week to see how the changeover is going, so I had better go ahead and start with the 1U he recommended (it's weird, I forgot I don't have to wait 30 mins after feeding to give Lantus!). I think this will be low, but we will see; easier to raise the dose than have him go hypo.

Should I start another thread with his numbers for today or should I just go ahead and post them here?

 

Amps 326, 1U Lantus

 

Hey Lucy, just change your title to the 3.6 Squallie AM 326. Anytime you had another test number you can update it. Good luck!!

 

Thanks, Bobbie!

 

Don't be upset if he doesn't drop down today, Lucy, it takes a few shots to build the depot.

Welcome to the club

 

Thanks! I didn't realize how difficult it is to draw up just one unit in a U100 syringe, lol! It took me three tries to get it close to right, and by the time I got all the air out, I think it was a little short. So begins the learning curve!

 

Okay, another stupid question. I guess I'm going to try TR (that seems to be what my vet recommended, as well, without actually calling it TR). How often should I test him? The sticky said +3, +6, +9, etc, is it okay to test at +2 , +4,, etc, instead?

 

Absolutely, I test on the even numbers too. Mainly because I like to get a +2 to see how active the cycle will be. Did you read Being Data Ready? That link is very helpful. Scroll down a little bit.
http://www.felinediabetes.com/FDMB/...regulation-shooting-handling-low-numbers.147/

 

Thanks!

 

+2.5 174

 

1 unit may have been a good choice!

 

+4 108

 

Is he dropping too much too soon? Should I be worried?

 

+5 129

 

Squallie had a good drop at +2.5 but seems to have levelled out nicely. It will take a few days for the Lantus depot to properly build and for you to determine when the nadir time will be. Looking good so far.

 

Wow! Lucy what a great start on Lantus!! Surf safely Squallie!

 

Thank you! I'm sorry if I seem a little paranoid, I just don't really know what to expect, and I want to make sure SquallieBear stays safe!

 

No worries! We have all been there, Lucy and you keep asking questions, they help you and others viewing.

 

Never apologize!! You are only being concerned and caring especially with just changing insulins!! Now ME....I am the poster child for paranoid!! I think, rethink and rethink everything...every number ...every bounce...every sneeze, just everything!!

 

We all do! It's part of the dance

 

Okay, bad time for this to happen but I am running low on test strips. I will be getting more tomorrow. Which times, besides the AMPS and PMPS, are the most vital for me to be testing? I have 5 strips to see me through till tomorrow afternoon. I DO have my Alphatrak for backup if I need to use it.

 

Glad you have the Alpha to fall back on. Is his SS up to date time wise for today?

 

Yes, it is, now.

 

It's never a good time to run out of strips but yay for the AT back up! Based on the very limited info we have so far I would recommend +3 to get you started after PMPS tonight that test will tell you whether you need any more for the PM cycle or not - Squallie may bounce.

 

I just tested him with the Alphatrak to make sure he is safe and it was 271.

 

It looks like he nadired all ready. I was going to say PM and +2 but +3 works too. He's looking good, Lucy!

 

He didn't eat much lunch today, has basically just slept all day. The low numbers today shouldn't be unfamiliar to him, he's been going very low on Vetsulin the past several days.

 

Hopefully he gets his appy back. Sending appy vines to him.

 

Well, drat it, I just discovered him noshing away on a civvie's leftover lunch! He is due for his shot at 9:00, but he'll have food in his system at PMPS. What do I do? This day started out with me thinking the change-over wasn't going to be as bad as I was afraid it might be, but now, for entirely different reasons, it's turning into a mess!!!

 

Because you have been testing through the day you know he was already on his way up and he's going to have a safe number to shoot so no problem this time. I would just add a note in the comments section that his PMPS may be food influenced.

You're doing great - stop stressing

 

Oh my gosh - so hard not to stress out! I'm in tears right now. And I'm trying to get in touch with my son at work to see if he will bring me some Relion strips when he gets off work at 2:00AM.

 

Awwwwwww a good sook is great for getting the toxins and stress out so highly recommended from time to time but really everything is fine. You have the AT so you're not going to get caught out if he does happen to go low it will just make sorting out the spreadsheet a little more interesting. Also I'm betting you won't let yourself run so low on strips again so lesson learned and all is well.

Give Squallie a big cuddle to remind yourself why this is all worthwhile

 

Thank you, feeling really stupid and low right now. I should have checked on my strips, but I had just bought them recently and didn't realize I had used so many, I guess.

 

Lucy, you've got this! Stop stressing. Sending you hugs It's all going to be okay.

 

Sounds like it's time for chocolate, or an adult beverage or whatever your pleasure is, you sure have earned it. It's hard when you feel like you're not in control it makes you feel like you're letting them down but you're not. You're doing a wonderful job for Squallie. You really should be patting yourself on the back

For me I always order more strips when I'm down to not less than two full boxes, sometimes you can really whip through them when they're having a run. I know some others keep an emergency box stashed - you just have to remember to keep swapping that one with the fresh ones you buy so it doesn't get out of date. But as I said, in your situation not so bad, you have the AT so it's not a safety issue and you have had a lot on your mind with the insulin change over so I think you should give yourself a break on this one

 

Listen to Vyktor's Mom. You are doing an awesome job!

 

Chocolate is definitely needed for you right now. You are doing great and Squallie is in nice safe numbers.

 

PMPS 224, possibly food-influenced. Is it okay to still give him his 1 unit tonight?

 

Squallie was already on his way up before he got into the other kitties food so you should be fine to shoot. You still have AT strips if you run out of the relion so you are good to go

 

I saw your other thread but am going to answer here. Just fyi, because this is such a busy page and in order to keep info on each cat together, we do one post per cat per day. You can just edit the subject line to ask any new questions.

Yes, I think you're fine to shoot.

 

Okay thanks, and thanks for the heads-up re: posts.

 

you're welcome! In the other groups on the message boards people start new threads all the time, but that's something we do here to keep things manageable.

 

Thank you!

 

That makes a lot of sense!

 

3/7/16
AMPS 201
1 unit given

Sorry if I was supposed to start this in a new thread and link it to this one, I don't know how to do that.

 

Your doing great--
Dre tends to nadir early .... However (there is always a however) LOL--since he has been flattening out with lower numbers I assume nothing
BUT I know his typical patterns... you will find them as you get the data and it will all come together.... Portillos chocolate cake can do wonders for stress

 

Good Morning Lucy! Is Squallie eating better for you? That's a nice AMPS. Here's how to link this to a new page. Highlight the browser and copy it (Ctrl C). Then go to the Lantus Forum and click on New Thread. Then start one with today's date and Squallie and AMPS number. In the body of the new thread ( Ctrl V) and the link will be there.

 

Good Morning, nice start for Squallie this morning. Hope you have a calmer day.

 

+3 52

Do I panic yet?

 

Start steering with LC food and retest in 20 mins.

 

No need to panic, but I'd test again in 15-20 minutes. Looks like Squallie is earning a reduction today.

 

Is Squallie eating for you? If he won't eat LC give him a tsp of HC gravy

 

Regular food or hi-carb stuff?

 

He has eaten everything in sight this morning, and been very active and full of himself.

 

LC until he's under 50.

 

Start with LC and in 20 mins if the number is going down and not up, give HC

 

You can take the 911 down. We got you.

 

Okay, gave him 1/2 can of Sheba, it's one of his "guilty pleasures" and will retest in 20. Thanks for the fast response, everyone, I'm still a little panicky since I don't yet really know how he will respond on Lantus!

 

I'm kicking myself for not testing him at +2, I should have known something was up when he cleaned up everyone else's leftover breakfast.

 

Did you get another test yet?

 

Have you tested him again? What are his numbers now?

 

59 now

 

great! test again in 30 minutes. no more food for right now

 

That's good! Keep coming up Squallie!

 

Tested him with the AT, too, for reference, since I'm down to one Relion strip. He was 115 on the AT.

 

Will do!

 

I am worried because I need to leave at 2:00 today for physical therapy,. I can't cancel it or they will cancel my surgery for the 1st. No one else will be home to monitor him while I'm gone today.

 

Since you need to leave, you can give him some high carb food if you need to "prop him up" while you are out. It's not something we would normally do if you are home and can monitor a surf, but when you can't keep tabs on things, sometimes you have to take certain measures to keep a kitty safe.

How long will you be gone?

 

so 2.00 would be +**?
If you get a minute could you update your ss? thanks

 

Sorry. 2:00 would be +5.

 

I have to leave in about an hour and I will be gone probably about two hours.

 

Test right before you leave and prop him with some HC food if you need too.

 

Agreed with Bobbie.
In your shoes, I would make sure to test again before out the door, and if he's anything but rising, leave some MC or HC down. Since he came up so nicely with LC, he'll probably surf for the rest of the cycle, but sometimes there's a double dip or even late nadir with Lantus.

 

Should I be worried enough to cancel my PT?