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Lantus Pen Question

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Emma47, Aug 15, 2019.

  1. Emma47

    Emma47 Member

    Joined:
    Aug 7, 2019
    Hi everyone! Harry has been on Lantus for exactly a week at 1 unit twice a day. We’ve been dealing with some other issues such as the returning UTIs and he is having a really hard time passing bowel movements (we’ve tried basically everything so everyday I’m checking to see if there’s any gifts in the litterbox) So it’s been a week and we now think he’s ready for a little increase. I was advised to only increase by .25 so that means the pen won’t be able to give me that exact amount so I will be going back to the U-100 needles. I had some questions about how to do it because I read that you DONT want to inject any air into the pen but I’m worried that I’m not gonna pull the exact amount on the first try and I don’t want to contaminate the pen. I’m planning on starting him on 1.25 units tomorrow so any advice would be wonderful! Thank you so much:)
     
  2. Emmy

    Emmy Member

    Joined:
    Dec 3, 2016
    I have used both Lantus and now Levemir pens by inserting a disposable U100 31 gauge syringe (either Carepoint or now Relion) with half unit markings and withdrawing Mabel's 1.5 units. I never actually delivered insulin through the pen itself. I couldn't see how that would work. I've always used syringes with the pen. I decrease or increase her 1.5 a quarter or a half unit as needed using the half unit markings on the syringe according to her blood sugar readings. It's been accurate enough, I guess. She's still with me after 4 years. I think the blood sugar readings are essential. I don't know how anybody could give insulin without those. I have found learning her behavior is also almost as important as blood sugar readings and getting the insulin amount accurate. As time goes by with the illness I'm convinced Mabel is really tuned into how she's doing. When she's not feeling too great she rests, sleeps. When she's feeling tip top she's in the windows or playing with a toy or playing with Ady. I put extra water in her wet food to keep her well hydrated. She gets Dr. Elsey's Clean Protein dry food, too, because she's always liked her kibble. Anyway, I've gone beyond your question. Sorry. Hope any of this helps. Emmy, Mabel, Ady P.S. By the way, could Harry be dehydrated? I really don't know if getting used to the Lantus or other issues could cause constipation. But the first thing I'd do is provide hydration by adding water to wet food (canned pates--no gravy or sauces). You have a lot on your plate right now, I know. It's really challenging especially at first. If you are looking for info on nutrition a good source is Dr. Lisa Pierson's website catinfo.org. She emphasizes the importance of wet food, under 10% carb! Food charts on her site. Our mainstay is just Friskies pates or Fancy Feast pates. If he's really dehydrated he could need the vet tech to give him extra fluids. But I would think the vet would have seen that.
     
    Last edited: Aug 15, 2019
    Reason for edit: Add
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  3. Emmy

    Emmy Member

    Joined:
    Dec 3, 2016
    By the way, Emma, Mabel used to have a problem with constipation. I actually started my cats on wet food, in addition to dry food, in order to help Mabel poop. It did work. She has never been as much constipated as she was before she she starting getting more moisture regularly. As a diabetic, she gets extra thirsty as blood sugar rises, too, and she drinks extra water then, as well. She doesn't deliver "presents" as you put it daily, but she does go every other day or at most early the third day. I guess every cat is different.
     
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  4. Emma47

    Emma47 Member

    Joined:
    Aug 7, 2019
    Thank you:) Harry gets lots of water in his wet food and drinks frequently throughout the day, so hydration doesn’t seem to be the issue. He had an enema three days and then didn’t poop the next day so we called the vet and he said to come in if he didn’t go the next day. Well the following day I woke up to vomit and a tiny BM in the liter box, the constipation could of caused him to barf while he was trying to get a BM out or it could of been that he had eaten a lot the following night and then preceded to go on a little walk with us even though we told him he needed to rest. We then found another decent sized BM in his outside litter box, so that had us feeling good. So far nothing today thought :/ We’ve tried extra water, Pumpkin, Miralax so hopefully he gives us a BM soon. So you said you use U-40 needles? That’s frustrating cause we bought U-100 and then he was on the pen which required $40 dollar pen needles and now I have to buy u-40?!? Ugh so expensive! Thank you for answering and providing some insight. We appreciate it:)
     
  5. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
    Hey there ! Correction: for Lantus , you use U 100 syringes NOT U 40.

    When you draw up your dose , draw about .25 to .50 more than you need. Then once the syringe has been removed , you can flick the barrel to get the bubble to the top and then express out any excess in the air like you see on doctor shows.

    You are correct about not wanting to express any extra back into the pen as the lubricant inside each syringe can contaminate the insulin.

    There is a really good stickie on insulin-care at the top of the Lantus forum.
     
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  6. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

    Joined:
    Jun 15, 2015
  7. Emmy

    Emmy Member

    Joined:
    Dec 3, 2016
    Yes, I use U-100 syringes. I have corrected that mistake in my post! Sorry, sorry. For Lantus and Levemir, human insulins, the U-100 syringe is required. It's the pet insulins like Prozinc that require you to use U-40. Just making this clear for anyone else:
    A U-100 insulin has 100 units of active insulin in each mL of liquid. You can think of it as being 100 pieces of insulin in each mL of liquid.
    A U-40 insulin has 40 units of insulin in each milliliter (mL) of liquid.

    I never used pen needles. I draw insulin through the rubber seal in the pen by poking the syringe through and drawing out, as if it were a vial. I do this because we can use a whole pen but vials have so much insulin in them it would get too old before we could use it all up.

    Regarding BMs, Mabel does not have one every day. Her regular schedule is every two or three days. This is normal for her. She is primarily eating really high quality food--Dr. Elsey's Clean Protein. She gets some Orijen Fit n Trim as treats, which is higher fiber and also anywhere from 14 to 17 per cent carbs. And this isn't great for the diabetes but she likes to alternate. And with the moisture she gets it keeps her regular. Changes in food can also have an impact. I've read not to introduce a change sharply but to provide a transition any time you can.

    Every cat is different, as they say. I hope Harry is doing better soon.
     
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  8. Emmy

    Emmy Member

    Joined:
    Dec 3, 2016
    YES, thank you for spotting my mistake! Of course, I use U-100 with Levemir. I corrected that above and wrote another note. Emmy
     
  9. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Emma, let us know if you need help setting up your spreadsheet. There are folks on here in the later parts of the day (not me unfortunately, as I get up early for work)... but there are many helpers for getting your SS set up if you need help. It would be really great to see Mabel's blood glucose numbers - particularly before the insulin injections - we call it AMPS and PMPS (am pre-shot and pm pre-shot)...and then during the day so we can see how low the insulin is taking Mabel.

    There are others here with the constipation issues so they may be more helpful in helping you with that issue.

    I hope Mabel gets things moving - it'll surely help her to feel better :)
     
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  10. Emmy

    Emmy Member

    Joined:
    Dec 3, 2016

    Mabel is not constipated. She has regular BMs now. She used to have more difficulty with it way before she became insulin dependent for the diabetes. I introduced wet food and extra water in it and that really helped her.

    We're getting a pretty wide spread on her numbers these days. It's complicated because the duration of the Levemir varies. I take her blood sugar every twelve, but I do not inject every twelve hours because sometimes she can have a perfect reading at 12 hours, in the (human) within 50-100 or just above. The Lev can last as long as 17 hours. The duration hinges on external variables, the obvious one being food, but I think there are others, as well, including exercise, stress, whether there's any slight infection. If anything, I'd love to have a very knowledgeable skilled vet take care of her teeth. She is 14. The highest readings I get now are in the 300-350 range, and this is using a human meter that can read as much as 40 points higher than another meter. I usually figure it as 20 points higher, a median between meters. Mabel actually seems to feel fine in the 150-200 range, but I aim for somewhere between 100-150. I am no longer trying to get her into remission. She was in remission for one year, but I don't think that's going to be possible again. I'm always on the lookout for it, but I'd be surprised if it happened. She puts out a lot of urine because she takes in a lot of moisture in wet food plus water and also drinking water. She does sometimes vomit small patches of liquid. Sometimes it has some fur in it but she's short hair and I don't really think that's why. The little bit vomiting is sporadic (not even weekly) and does not affect her appetite. I'm not clear on what is the cause of the vomiting. I think there can be so many causes for it that even with a total workup I might not learn why. So, I monitor her pretty closely as you see. I work at home most of the time so I can. And my approach to caring for her now is making sure her quality of life is good. If you have any responses to any of this I would appreciate them. Warm wishes for kitty wellness to you, Emmy
     
  11. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Harry has been on Lantus for exactly a week at 1 unit twice a day. We’ve been dealing with some other issues such as the returning UTIs and he is having a really hard time passing bowel movements (

    Who's Harry?
     
  12. Emmy

    Emmy Member

    Joined:
    Dec 3, 2016
    Are you asking how to find the post about Harry? First post here written by Emma47.

    I apologize if I confused this thread by getting Mabel involved. I began by just making a comparison when I was replying to Emma47 about Harry. Then in your prior post you addressed to Emma and then made a reference to Mabel, so I answered your post about Mabel. I guess I should have started my own post under health concerns. Live and learn. Emmy
     
  13. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Yes, I'm confused completely now....old age? :p
     

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