How Do The Pens Work?

It's very likely I missed it on this site, but how do you use a syringe & needle with a pen? Do you unscrew the cap off the pen and stick the needle in a rubber thing (like you would a vial)?

Do you just unwrap the syringe, stick it in the rubber part of the pen/cartridge, then draw back however many units you want? Is it more complicated than that? I need to get this insulin in my cat ASAP.

BTW, I'm incapable of watching videos right now (long story).

 

The information you're looking for is on the LANTUS & LEVEMIR - SYRINGE & INSULIN INFO: HANDLING, DRAWING, & FINE DOSES sticky. You use the pen like a vial by taking the cap off the pen and inserting the needle into the rubber stopper at the end. You just insert the needle and draw up what you need. Just don't push back any extra insulin back into the pen, you can contaminate the insulin. If you draw up extra, just slowly squirt it out into the air.

 

Thanks. That's what I was looking at before I posted, but I thought there was more to using the pen than that. So if I know how to use administer medicine from a vial (not necessarily insulin) with a needle, under the skin, then the pen works the same way?

 

Yes, that's correct.......the reason we buy the pens is because it works out cheaper and we all just insert the needle into the end, draw the insulin out and put it in the fridge until next time. It's also less waste if you're not using too much insulin as the vials are larger and will likely expire before all the insulin is used up. The pens if unused last a long time since each one is sealed.

 

So where is the 2 unit marking on the syringe exactly?

 

Here's a 1 unit mark on a 'half unit marked' syringe. The half unit marks are shorter and thinner on this syringe. The next line down is 1.5 units, the next bold line is 2 units.



Here's just another picture of the rubber seal - it looks white in this pic but it's usually gray or red. This is an empty levemir cartridge but Lantus is the same, just a different color.

 

You might want to remove the 911 from your thread, we use that prefix when a kitty is in serious and immediate danger...

 

Hope you managed to give the shot though!

 

Thanks everyone. The darn vet clinic acted like I could wait a little while to give the insulin, then they said I needed to give it ASAP. It's a very long story but basically I'm now on my own giving insulin.

So they told me to give 2 units of Lantus (blood glucose was between 400-490 this AM) but said I don't need to monitor anything. Is that right? The cat needs her insulin ASAP and now I'm afraid to give it.

I should mention that she's on a canned only diet.

 

You should give it when you're able to …..it needs to be given as close to every 12 hours as possible, so you need to decide on a schedule that works for you (not your vet)

High numbers take time to do damage....it's the low ones that kill quickly.

How much does your cat weigh? Most cats start at about 1U...2U is a pretty high starting dose.

Your vet is also wrong about not needing to monitor anything. Home testing saves lives. Cats have the unique ability for their pancreas to heal and the only way you'll know how your cat is responding is by testing at home.

Always test before shooting....then if at all possible, get at least 1 test 5-7 hours after the AM shot and at least a "before bed" test on the PM cycle

 

My cat is now just under 9 lbs. Should I ignore the vet and go with 1U, to be safe? I can't get a home testing meter until tomorrow, late morning maybe. Isn't it better to give less than to give more?

 

The starting dose for a 9lb cat would be 1U

Yes, it's safer to give less, especially if you don't have a meter so you can test

The dose is based on how LOW it takes them, not how high the blood glucose is before the shot (we call it the Pre-Shot)

 

So, if I give 1U, then is it highly unlikely I need to worry about hypoglycemia? Especially since I don't have a meter.

 

I can't say that...we have cats that only need .1, .25...even only 1 drop of insulin, but it's a lot safer than 2U

We have other cats on over 50 units.....it's not something we can predict....that's why testing is so important

If you have syringes with half unit markings, you could start with .5

 

Well... I went ahead and gave .5 units. I'm so exhausted that if I had to take her to the ER tonight, I'd probably have a mental breakdown.

 

Home testing will save you not only money, but a lot of worry too. Being able to quickly check your cat's BG anytime you want to saves you a lot of unnecessary worry!!

 

Trying to be pragmatic, you're probably reasonably safe with that 0.5 dose right now ( = this night). Don't forget, however, that Lantus potency "builds up" (shot by shot, so by tomorrow already), so you want to start testing as soon as you can (like... tomorrow? today, if it's already today?).

Sleep is important too! Testing is a routine that might keep you from going to bed at times, but it also lets you sleep soundly knowing that your cat is in safe numbers and has a good BG regulation.

Can you order/lay your hands on a meter? Human meter is fine, get a cheap one where the strips don't cost much.

 

In somewhat more technical terms, what Stephanie was referring to by Lantus "building up" is a property that makes Lantus and Levemir different from other types of insulin. Lantus forms a "depot." Every time you give a shot, Lantus forms micro-crystals that are deposited in fat tissue. The crystals dissolve slowly, which gives Lantus its duration -- it last longer than most other insulin so that eventually, you won't get wide swing between your shot times. In addition, not all of the insulin dissolves by the next shot. Some of the insulin is stored, which is what the depot is all about. It also means that the effects of Lantus are cumulative. You don't generally see an instantaneous response to an increase or decrease in dose.

I suspect a lot of this sounds like gibberish. There is a sticky note at the top of the board that discusses the depot. As you get more familiar with how Lantus works and this doesn't seem quite so overwhelming, it will begin to make much more sense. I'd encourage you to look over the sticky notes. They contain a huge amount of information. Please don't hesitate to ask questions. The members here are very generous with their time and knowledge. We've all been in that place where tearing out our hair seems far easier than managing our cat's diabetes. it really does get a lot easier -- the learning curve can be pretty steep though.

And please get a meter. A human meter is fine. Walmart's Relion brand is inexpensive (as are the strips, which are what ends up being more costly over time). Testing your cat is the best way to keep your kitty safe and out of the ER. Many vets, for a reason I can't quite fathom, will tell you your cat will hate you if you test. If you look at Gabby's spreadsheet or Chris' China's spreadsheet (they are attached in our signatures), you'll see that some of us test(ed) a lot. Our cats didn't hate us. Of course, they got a low carb treat every time they got tested and they associated testing both with treats and with feeling better. You will also want to set up a spreadsheet to keep track of your data. The instructions for setting up a spreadsheet are here.

 

HaHa..........check out Davidson's SS.........he gets a ton of treats to go with the gazillion tests, but he's wonderful and all I need to do is ask him if he wants a "test" and he goes to the office, jumps on my desk, purrs, waits for his ear prick and then dare that I don't give him a treat!! He sticks his head down by the drawer and drools every where until he gets one. Not sure who's trained who, but it works like a charm! Just remember to switch ears and prick areas and it will be so natural in due time.

 

Thank you everyone for the help, I really appreciate it.

I did get the meter this AM. It's a Relion Confirm. I gave 0.5U at 10:30 am without testing first because I was still trying to learn how to use the meter and everything involved with it. I did a test at 2:15 pm and the results were 376 mg/dL.

So I've been reading here off/on throughout the day and am slowly learning things. But, I'm still confused as to when I should test. Is it right before I give an injection and then 4 hrs and 8 hrs later? Then repeat?

And how much should I give for the PM dose? I don't know that I feel comfortable with 2U, but I still don't fully understand how insulin and diabetes work. Based on what I've been reading, it looks like I should either give 0.5U or 1U. Is the amount I give always supposed to be the same for the first week, or am I supposed to adjust it based on the test results? Because the vet said to give 2U every 12 hrs for two weeks without testing. That seems messed up.

Unfortunately, some of my family members are not happy that I've been sitting in front of the computer so long. Apparently I have chores that need to be done.

 

Congatulate me, I'm pretty sure I messed up the injection. I think the needle went all the way through the skin to the other side (if that makes sense) and the insulin came out in her fur. There was a yucky odor near the injection site, so I don't think any went in. I've given many injections before (subq, Adequan) so I'm not sure what happened here.
I'm really upset because she really needs the insulin.

 

So, first of all, congrats on getting the meter! Your first mission is going to be to get comfortable with the testing, for you and for her. So right now it doesn't matter all that much when you test her, I'd say, until you're comfy doing it.

Once you're comfy, aim to test before each shot (order: test-feed-shoot) and get one extra reading somewhere in the middle of each cycle. For the night cycle, unless you're a night bird, aim to get a reading before going to bed. If you get up more than an hour before shot time, you can also get a reading then (it'll be a +11 or a +10, for exemple).

One thing that will be really useful will be to set up a spreadsheet to input your readings: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ -- if you need help, give a shout, and we'll find somebody to help you (I can if I'm around, but there are many other people who can give a hand). Once it's done do take a minute to set up your signature here http://www.felinediabetes.com/FDMB/account/signature

Don't beat yourself up about the fur shot. It happens to everyone. She does need insulin, yes, but in the grand scheme of things one missed shot is not going to change the face of the world. Once you have a few tests in and get the spreadsheet up and running we'll be able to see more clearly what to do with her dose.

In case you hadn't seen it, here's our hometesting tips and tricks file: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Are any other family members willing to give a hand with testing, if they don't like you on the computer researching? never know!!