5/21 amps183 pmps162 and +3 399!

Discussion in 'Lantus / Levemir / Biosimilars' started by Margie and Jackson, May 21, 2019.

  1. Margie and Jackson

    Margie and Jackson Member

    Joined:
    Apr 26, 2019
    let me know if you have any advice here. I got a new pen, which I believe functioned as a dose increase. The blue numbers are new for us, but why so high tonight? Do you think the dose is too high?
     
  2. Julie and Honey

    Julie and Honey Well-Known Member

    Joined:
    Dec 22, 2018
    Hi there!

    I know you are new and adopted Jackson recently so I wanted to ask a couple of things about insulin dose.

    Signature says 1.25 units every 12 hours, but spreadsheet says 2.25 every 12 hours?

    From spreadsheet looks like you may have started at 2.5 twice a day, which is a high dose to start ( unless was already on insulin before you started tracking?)

    If cat gets a lower blood glucose number then their body is used to, sugar can spike because their liver will secrete stored sugar (their liver thinks something is not right and tries to compensate). Once their body is used to lower numbers they will adjust. This does not indicate a need to increase insulin.

    Also it is possible numbers will be high on too high a dose because if dose is too high and then their sugar drops too low, liver will continue pumping stored sugar to try and “save” them from going too low.

    It is possible may need a decrease in dose to start over and find the right dose for Jackson.

    Also saw the Purina DM. There are 3 kinds of Purina DM, which kind is Jackson eating currently?

    The dry is about 18% carb which is too high carb for diabetic cats.
    The wet “selects” which are 10% carb and a little higher than we like.
    The wet regular type (not selects) is about 6% and that one is fine to keep him on if this is the one he eats.

    Also other low carb wet options that may be less expensive are available. Here is a list, you want to look at the 3rd column at carb content and find something under 10% carbs. You will see foods listed that are much higher than 10%, these are mainly to show what to stay away from. Purina DM wets are on page 61, dry is not on there but it has 18% carb. Purina advertises this dry as “low carb” and it is lower than some dry which can be much higher, but 18% is still too high if you want to have a good chance at getting the diabetes under control.

    https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

    Diabetic cats should be eating food with less than 10% carbs to help get their sugar down. If Jackson is on the dry, would be good to get him on a lower carb food, but the transition needs to be gradual because switching from high carb to low-carb food will drop their blood sugar quite a bit and insulin would very likely need to be reduced as well.
     
  3. Margie and Jackson

    Margie and Jackson Member

    Joined:
    Apr 26, 2019
    Thanks for your thorough response! First, an embarrassing admission about the insulin dose discrepancy between my (former) signature and my spreadsheet. I was given two different syringes by the humane society. One package was .5 cc one was 1 cc. When I started using the 1 cc syringes I didn’t notice that each black line was now two units, not one. I inadvertently doubled Jackson’s dose. I subsequently reduced it to his previous dose, since he tested low. I thought his need for insulin had decreased. He was on 2 units for a month at the shelter and my vet said he could go up to 2.5. I went down to 2.25 when I saw numbers in the 100s.

    Jackson is on dm regular. He got a bout of pancreatitis when I tried to switch him to Tiki cat, so the vet told me to keep him on dm for at least a month.

    I take it that you think he may just need more time and he will adjust to having lower blood sugar levels. I think if his blood sugar was tanking enough to need less insulin that he’d go lower than 140s?
     
  4. Julie and Honey

    Julie and Honey Well-Known Member

    Joined:
    Dec 22, 2018
    The correct syringes for Lantus are u100, 3/10 cc (.3 cc) with 1/2 unit markings.

    Syringes with .5 or 1cc are different. I am concerned if you are using these other syringes you may not be dosing what you think you are.

    Here are the ones I have for Lantus ( u100, 3/10 cc) See pic. I put a mark next to 1 unit line to show, it is not much.

    Let’s figure out how much the cat is actually getting, then we can help you figure what is the best dose.

    @Bobbie And Bubba, @Sienne and Gabby (GA) do you know someone we can tag that knows more about the syringes and how it affects dosing? Or if you do, please advise. Thanks!

    upload_2019-5-22_19-15-3.jpeg
     
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  5. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    See if this link helps.

    The markings on a 1cc syringe would be very tiny. I'm not sure you'd be able to reliably give a 2.25u dose on a 1cc syringe.

    @Jill & Alex (GA)
     
  6. Margie and Jackson

    Margie and Jackson Member

    Joined:
    Apr 26, 2019
    This is almost the variety I recently bought and am now using. Mine don’t have half unit marks. I’ll look for them on chewy or amazon. I did check the other syringes with the vet, and she said they were u-100 so ok, but it wasn’t a good idea to use them. I packaged them up and plan to donate them back to the shelter.
     
  7. Margie and Jackson

    Margie and Jackson Member

    Joined:
    Apr 26, 2019
    Yeah. What I did was I picked a spot just below the unit measure bar on the syringe, with no daylight between the stopper and bar, and stopped. I was aiming for consistency.
     
  8. Margie and Jackson

    Margie and Jackson Member

    Joined:
    Apr 26, 2019
    I think some fluctuation in blood sugar is due to buying a new Lantus pen. I have no idea why that would cause this problem, but nothing else has changed.... unless he’s getting an infection.
     
  9. Margie and Jackson

    Margie and Jackson Member

    Joined:
    Apr 26, 2019
    That link is helpful
     
  10. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Depending on where you're located, you will likely need a prescription for syringes. I'm not sure you can get syringes on Amazon. You can get insulin syringes at Walmart (Relion syringes). I used to order mine through ADW - American Diabetes Warehouse. They carry several varieties of insulin syringes with half unit increments.
     
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  11. Julie and Honey

    Julie and Honey Well-Known Member

    Joined:
    Dec 22, 2018
    ADW also has decent prices on Monoject. You can sometimes find coupons to offset shipping. Here is a good one for Lantus with half unit markings for more precise doses.

    https://www.adwdiabetes.com/product...100-syringes-30g-3-10cc-5-16in-100ct-1-2-unit

    Saw your spreadsheet is Alphatrack meter? If you order any Alphatrack supplies at ADW, anything else in the order, ie. Syringes are free because all Alphatrack products have free shipping...not sure if you plan to keep using that meter or not though. Just thought I’d mention the shipping part.
     
    Last edited: May 22, 2019
    Reason for edit: Add
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  12. Margie and Jackson

    Margie and Jackson Member

    Joined:
    Apr 26, 2019
    Btw, I edited his spreadsheet to reflect the ACTUAL amount of insulin,rather than what I intended to give him **headsmack**
     
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  13. Margie and Jackson

    Margie and Jackson Member

    Joined:
    Apr 26, 2019
    I can totally just order them and get them delivered to my door! That’s what I did, in fact.
     
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  14. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    That's great!! You're lucky. I've lived in 2 states and needed prescriptions for syringes in both.
     
  15. Julie and Honey

    Julie and Honey Well-Known Member

    Joined:
    Dec 22, 2018
    I am wondering about the dose now. Did they just tell you to start at that dose when you got him, or did they already have him on that dose, and if so, had someone been monitoring his sugar levels on that dose before you adopted him? Reason I ask is that is a high dose to start on and may or may not be the best dose for Jackson.

    If he’s on the regular canned DM that is good, it is the lower carb DM.
     
  16. Julie and Honey

    Julie and Honey Well-Known Member

    Joined:
    Dec 22, 2018
    Also, his stance could be diabetic neuropathy on back legs? Did they tell you anything about that?

    You should try the Zobaline for cats....it's tasteless and the pills crush easily to add to food. This should help with neuropathy as will getting his sugar under control. Good to treat it so it does not continue to get worse.

    It's available on Amazon or from Lifelink
     

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