1. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    hello all. I am considering the switch from PZI to Lantus. Surprisingly my vet did not give me a hard time. I have read a lot and am still confused and quite frankly scared to death to make the switch so perhaps you can answer some questions for me.
    So Lantus is a U 100 insulin as opposed to Prozinc which has U 40 dosing. I have some experience with U 100 syringes as I use them for micro dosing conversions for the Prozinc. My vet is suggesting I start with 1U ONCE A DAY
    1 U on a U 100 is almost microscopic assuming I am looking at the syringe properly. If so I am almost afraid that I will get the dosing wrong as it is tough to see.
    Does anyone have experience with the Pens? I read up on how to use the pen and it seems dosing would be extremely precise but it also seems you must waste some each dose to see if the pen is working correctly? Am I understanding that right? Although the dose seems much smaller than U 40 insulin, Isn’t that a lot of wasted insulin?
    Also concerned that with a longer acting insulin how will I know when to stop worrying about a hypo episode from a time ( hours after shot) perspective?
    Lastly my vet is recommending I start with 1U only ONCE a day... thoughts?
    I am really frightened that I won’t know her cycle and when during my day I can stop worrying about her dropping to low... is there a “typical” NADIR window? I know ECID but an idea would be helpful.
    Thank you for any advice you can give. I would be lost and wouldn’t have made it this far in my Journey without this site.
     
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  2. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Hi and welcome to lantus. No one can open your spreadsheet. It says item not found. It will help you understand lantus if you read the yellow stickies. Nadir roughly is around +6 but varies from cat to cat and cycle to cycle.

    We use the pens like a vial with syringes. A magnifying glass can help see the small doses. I’ve also known folks that wear two pairs of reading glasses one on top of another.

    You often can get an idea about whether you will have an active cycle by the reading at +2. That being said Max let me know by+2.5 or +3. At the beginning a +1 and +2 is suggested. Max never had a symptomatic hypo. I guided his cycles with food and fed several small meals. It will take a little experimenting to see how Little responds. Lantus is the only insulin I used. Others have used PZI so if you can get your ss to show that will be helpful.
     
    Last edited: May 16, 2019
    AmandaE likes this.
  3. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Once we can see your spreadsheet, we will be able to tell you if 1 unit is a good starting dose. But it would be twice a day, not once. Cats have faster metabolisms than cats so do better on twice a day dosing. As for syringes, you can get u-100 syringes with half unit markings that hold hold a total of 30 units. Cats are sensitive to small changes in dose, so we typically change by 0.25 units at once, the half unit markings help us eyeball that.
     
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  4. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    Hey Girl Hey!

    Welcome! This forum can seem pretty overwhelming but once you start posting daily you’ll get to become more comfortable. I just started Lantus in March after switching from Caninsulin so I’ll try and answer what I can, I’m sure someone who is more experienced will stop by and fill in the gaps :D

    Doses for Lantus are typically chosen based on what dosage that Little was on for Prozinc. I don’t have experience suggesting dosage but Someone with more experience will be by to give you the information you need to get started. I can say that Mowgli started at 1u Lantus as per the vet FWIW.

    For Lantus dosing once a day won’t work, that is because it is a depot style insulin and will only last about 12 hours in your cat. This means that if you only dose once a day that the depot won’t build and Lantus can’t be effective. There is an intro sticky at the top of this forum that can explain how the depot works ;)

    I use the pens and I believe most people on the forum do. That being said we don’t use them with the needle tips that are provided, if you use the needle tips for the pen you do have to waste two units before you dose, and you aren’t able to do half or quarter unit doses.

    Instead the pens can be used as mini vials and you can use a u100 syringe to draw it. That way you don’t need to waste precious insulin! There is info (you guessed it) in the stickies that go over how to draw insulin from a Lantus pen.

    This knowledge comes with time, but since Lantus is a less aggressive insulin that is longer acting, members usually use the +2 BG level to predict how the cycle will go. If your +2 is similar to your pre shot it will probably be a shallow curve, if there is a significant decrease compared to the pre shot you will probably be in for a day of testing.

    There is a breakdown of a typical Lantus cycle in one of the stickies that can give you more of an understanding of what to expect (respecting that ECID). Maybe it would be best to start Little on a day that you know you can monitor / test closely.

    Your vet is wrong about this. If you only give 1 shot a day you won’t build a depot and the insulin won’t be effective.

    Starting a new insulin is stressful, but don’t sweat it, you’ll get there. I don’t think it would be a bad idea to use Lantus for the first day on a day that you can monitor Little closely. If you’re stereotyping Lantus a typical Nadir is at +6, but of course ECID :)

    One thing you’ll have to decide when using Lantus is what dosing protocol that you’d like to follow. There are two choices for Lantus: Start Low Go Slow, and Tight Regulation. Read the stickies about them and see which one will suit your lifestyle. These protocols will determine when it is appropriate to increase or decrease your dosages.

    Don’t be afraid to ask questions everyone here is helpful and very supportive. A lot of people post here though so make sure if you have a question that you label your title with the “?” prefix so that it gets more attention :)

    Good luck with Lantus! I’m sure Little will do great on it!!
     
  5. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    Thank you all so very much.!!!! Geez. I am overwhelmed. I assume I would start with the tight regulation as don’t quite understand the other. I did read the stickies and am still unclear as to how to go about dosing and changes. Not sure why you guys can’t see my SS as the prozinc forum has no issues. Do I need to provide access to this group somehow? I knew the vet was wrong about the once a day...lol. That’s why I am here. This board has never steered me wrong. If any one can advise on how to get my SS to be visible I would greatly appreciate it. With regard to the pens.. if not using the pen needles then why not just use a vial and draw the regular way?
     
    AmandaE likes this.
  6. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    Tight Regulation is a good choice and it has a lot of scientific backing!

    The SS could have to do with your permissions although I don’t know what would be different between the two groups. Maybe the settings have changed due to a glitch with google?

    Once a day LOL - take a hike vet! (Except also thanks for your help ;))

    In my mind the pens are the better option. This is because you have 5 mini vials in your arsenal that you can use in case one gets contaminated or frozen by mistake. They also aren’t breakable (double plus)

    It is so overwhelming when you’re starting with Lantus but just read and re-read the stickies. It will start to sink in :D
     
  7. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    I’ve read and will again... I feel like a moron. I guess I just don’t get the “depot” idea. If insulin is be stored and released ... wouldn’t that dictate a lot of dose dropping the longer you use it?
     
  8. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    LOL Moron!? Give yourself a break!!

    It is a bit of a confusing concept and I myself am just starting to grasp it. Basically when you inject Little with insulin it changes from a liquid to a solid under his skin. Then Little’s body starts to dissolve that solid into his body. If you are giving 1u Little is only building a 1u Lantus depot. It builds gradually while littles body learns to use it. This means that you need to hold a dose for a few cycles to allow the depot to build.

    This is the explanation that I’ve kind of understood but maybe a more experienced member can explain it a little better.

    The only reason that there is a lot of dose dropping is if 1u is too much for Little to use which is reflected by low BG levels. We hope that that will happen for you so Little can hopefully achieve remission!!
     
  9. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    I went over to the Prozinc forum, and couldn’t read the spreadsheet over there either, not surprising, it’s tied to you, not the forum. Did anyone over there actually look at it? Anyhow, I did notice you say you got lime green on 2.5 and were thinking of going back to 2 units. Not sure what numbers you were getting on 2 units of Prozinc, it it’d be closer to a good starting dose here. We take the dose of the existing insulin into consideration.
     
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  10. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    Really? All the prozinc peeps seem to be able to see it without issue. I will have to Investigate tomorrow while working from home. Not that computer savvy so hopefully I can figure it out. She was doing blues on 2.6 for about a week then the mysterious hypo yesterday. Hence I may consider switching to Lantus as no dose has kept her really stable and it’s been 7 months. :arghh: I am terrified to switch and clinically she is doing great... the numbers however not constant. She’ll do great for a while and then crash...
     
  11. Sybil and Zoe

    Sybil and Zoe Member

    Joined:
    Oct 16, 2018
    I can see Little's spread sheet, though it pops open on 2018 and I have to switch it to 2019.
     
  12. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    Thank you Sybil. If you can tell me how to fix that I’d be very grateful. I love it to open in 2019. Wonder why you can see it and no one else can...
     
  13. Sybil and Zoe

    Sybil and Zoe Member

    Joined:
    Oct 16, 2018
    LOL I'm too new to this as well, I wonder if you can open your spread sheet and drag the 2019 tab in front of the 2018. I use a mac and I know they operate differntly than a pc.
     
  14. AmandaE

    AmandaE Well-Known Member

    Joined:
    Mar 18, 2019
    Lisa, I can see your spreadsheet too. I can’t open it in google docs because it says the URL doesn’t exist but I can open it on my browser if I choose to open it in a new tab... how strange.
     
  15. Ti-Mousse

    Ti-Mousse Well-Known Member

    Joined:
    Dec 2, 2018
    Welcome to you and Little ! I think there's a lot that has been said! Don't forget to post for questions or updates on Little's progress!
    BTW I can see your SS also! It opens up in 2018 but we just have to click on 2019 and all the info is there! You're not the only one like that; when you have time, just redo your link to the 2019 SS!
     
  16. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    Thank you Lyane Ummm yeah... how do I do that? I’m technologically challenged. Lol
     
  17. SpotsMom

    SpotsMom Member

    Joined:
    Feb 10, 2018
  18. SpotsMom

    SpotsMom Member

    Joined:
    Feb 10, 2018
    Well the browser is so smart it’s not even showing the whole thing when I paste it lol. I took a picture of what I see....
     

    Attached Files:

  19. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    Hummm...it opened fine for me. I'm PC with browser. It doesn't matter what forum you're on, the ssheet is in google. Anyone anywhere with the link can see it.

    To open to the 2019 tab, grab the 2019 tab and drag it to the far left... :) Viola...
     
  20. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    It's not a link redo - she just needs to drag the 2019 tab to the far left. Whatever is far left is what opens...link to the ssheet always remains the same.
     
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  21. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    When I click on the spreadsheet in your signature it says file not found.
     
  22. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    I might have narrowed down the problem. The spreadsheet opens fine on my desktop Mac, but not the iPad. Tagging our SS guru @Marje and Gracie to see if she can figure it out.

    As for dose, I think you could try a 2.25 units to give yourself a little bit of cushion, but only if you are doing the switch when you have a couple days you can monitor closely. Some cats have a stronger reaction to a switch in insulin.
     
  23. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    Welcome to the forum!

    I’d just try and relink it first. Go back through the “publish to the web” step, copy that link, open your signature block in FDMB, highlight “LITTLES SPREADSHEET”, click on the hyperlink icon in the tool bar, delete what’s there now, paste the copied link, click insert.

    I’m traveling and can’t see the SS from my iPhone or iPad. If the above doesn’t work, I won’t be able to troubleshoot until Tues.
     
  24. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    Just did. Thank you. I feel dumb but it usually is the simplest thing that stymies me!!
     
    Marje and Gracie likes this.
  25. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    Can anyone see my SS now?
     
  26. Sybil and Zoe

    Sybil and Zoe Member

    Joined:
    Oct 16, 2018
    I see it, but it still opened at 2018 even though I see you moved the 2019 tab . Most should figure out just to click on the 2019 tab.;)
     
    Krystina & Nelli likes this.
  27. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    That's weird - I've never seen this happen before. It SHOULD open to the far left tab but it's still opening to 2018 even tho I too can see 2019. I click on it and see everything fine too. Before you close it down, click on that 2019 tab making it 'active'. I have NO idea if that's it or not but if it works, we'll know, if it doesn't, we'll still be confuzzled...but we'll know too. :) Tag me when you do it please as I don't check in daily.
     
  28. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I’m still getting file not found on my iPad. I’ll check on my Mac.

    Okay, I can get to it from my Mac but not my iPhone or iPad. It brings up the 2018 ss but at the bottom I clicked on 2019 and was able to see it. It's good that you saw a green nadir. I'd hold this dose and see what happens. @Wendy&Neko your guess was right.
     
    Last edited: May 17, 2019
  29. Krystina & Nelli

    Krystina & Nelli Well-Known Member

    Joined:
    Jul 4, 2018
    :) ... WELCOME :bighug:
     
  30. Krystina & Nelli

    Krystina & Nelli Well-Known Member

    Joined:
    Jul 4, 2018
    No
    Not me... not on iPad or google pixel o_O
     
  31. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    It opened on my iPad to the 2019 tab. On my iPhone, it took me to my google sheets app before it opened which is odd. There are still two links in the signature block SS last night so if you can please follow my instructions in post 2$ above, it will likely fix the issue.
     
  32. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    Omg! This tech is beyond me. Now when I open it opens right to 2019 where as before even I had to click the tab. Beyond my pay grade for sure. Thank you all for checking up. I am scared to switch and it’s good to know I’ll have experienced eyes helping even if you have to jump through hoops to see the info. :bighug::bighug:
     
  33. Lisa and little

    Lisa and little Member

    Joined:
    Sep 24, 2018
    I am not sure what you are saying I should try. I am afraid of losing all my info I will study in detail tomorrow and hopefully fix it without accidentally deleting from the PZI group which I am still using until I get my script.
     
  34. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    So weird. It won’t open on my iPad. I get the same message. File not found.
     
  35. Marje and Gracie

    Marje and Gracie Well-Known Member

    Joined:
    May 30, 2010
    If you can give me editing rights, I’ll fix it for you. I’ve never lost a SS or data yet :). There is no difference in how the PZI forum can see it and we can see it; it’s more likely based on the devices used.

    I’ll send you a private message so check your inbox, Upper right corner of page.
     
    Last edited: May 18, 2019

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