Switch to lantus: Do ss #'s look ok?

Hello All,

I did it. I made the switch to Lantus! Well....I picked up the Lantus. Would you recommend .5 units as a starting dose and are the U40 syringes the right ones for this insulin? I'm going to start this after work today so I can get some decent data. Also, do I feed before the dose as I did with Caninsulin?

Thank you

 

Re: Switch from Caninsulin to Lantus

Hiya Kim,

Yay! Well done!

I'm pretty sure that Lantus is a U100 insulin (check to see if it says 'U100' on the vial), so the U40 Caninsulin syringes will be the wrong sort. It should be possible to get U100 syringes with half-unit markings too. You'll find them pretty tiddly after the Caninsulin syringes!

I think too that you can't put Lantus back into the vial as you might with Caninsulin. So any excess drawn up into the syringe needs to be discarded. (Lantus folks please correct me if I'm wrong!)

As to when to feed, I've no idea and so will leave that to the Lantus folks here (of which there are many!) . Just wanted to let you know about the syringes to give you time to get some for later...

Edited to add:
Kim, here are links to 2 stickies from the Lantus forum. The first here is about handling and storing Lantus, and the second gives info on the 'insulin depot' which is very useful for understanding how Lantus will differ from Caninsulin.
viewtopic.php?f=9&t=151#p873
viewtopic.php?f=9&t=150#p857

Good luck, Kim! Here's hoping this is the beginning of great things for Twice!

Eliz

 

Re: Switch from Caninsulin to Lantus

Hi Kim,
You need U100 syringes for Lantus. They should have orange caps over the needle. They are available with half-unit markings on them which makes dosing easier. You DON'T want to use the U40 syringes with Lantus, because you would be giving two and a half times as much insulin than you think you are giving.

 

Re: Switch from Caninsulin to Lantus

The sequence with Lantus is the same - test, then feed, then give the shot. You don't need to delay after feeding like you might with Caninsulin. Some people give the shot while kitty is eating and distracted.

What dose of caninsulin have you been giving?

 

Re: Switch from Caninsulin to Lantus

Yes, you need to get U100 syringes and try to get them with 1/2 unit marks. Just to let you know, some pharmacies don't even know they have syringes with 1/2 unit marks and will tell you they don't but they do. If you live near a WalMart a lot of us use the Reli On brand.
Lantus takes up to 2 hours to take affect (reach onset), so you have some time to get food in before the insulin starts to lower the BGs. We do test, shoot, feed, but some do test, feed, shoot, but it's all done within 5 minutes.
Good luck with the Lantus. It's a good insulin for cats.

 

Re: Switch from Caninsulin to Lantus

Good luck with the Lantus Chyna was on Caninsulin to start with and I switched to Lantus after a month and a half (and it helped her to remission). Make sure not to roll/mix the Lantus. I kept mine in the original box, then in a mug with a handle on the middle top shelf of my fridge to prevent jostling (don't keep it in the door).

The reading stickies Elizabeth posted should help There are Lantus forums if you're interested found here http://www.felinediabetes.com/FDMB/viewforum.php?f=5. Tight regulation is the busiest and has a stickie for new people to read near the top of the page that will explain how that forum works. I started not knowing which protocol I was going to follow but still posted in tight regulation.

I always fed right after Chyna got her Lantus, since she always gulped it up (she loved the change to wet food so that was a treat) and then had several small meals left out as "catsickles" (frozen portion of cat food mixed with water) or in an autofeeder. On the days she didn't feel like eating then I worried especially when I had to leave for work, so it doesn't hurt to feed before the shot just to make sure they have food on board. I know quite a few people do mini meals for the first few hours (with autofeeders when working) when the nadir is early onset if their cat drops BG quickly and some do mini meals up to nadir but every cat is different and some have very late nadir. I know and remember there is a lot of reading and it's different from the Caninsulin so post with questions if it's overwhelming :shock: Hope you have a great day!

 

Re: Switch from Caninsulin to Lantus

Welcome to FDMB!

The starting dose of Lantus can be based on your cat's ideal weight. However, you also want to take your current dose and other factors, such as any medical issues, into consideration. How much does Twice weigh? Unless your cat is very thin or very "fluffy," this usually calculates out to somewhere in the neighborhood of 1.0u.

I looked at your SS. There is a version of the World SS that has a tab that automatically converts the numbers into the US format, which is what we use here. This is the link to the instructions. You'll see the link to the World template with the automatic conversion under the "Getting & Using the Template" instructions and you want the 2nd template in the instructions. It will make it much easier for you when you're posting unless you want to manually convert the numbers. Likewise, most people will not be familiar with making the conversions so it will be easier to offer assistance if you have a SS that does the conversions automatically.

I'd encourage you to read the starred sticky notes at the top of the Lantus board. There is a wealth of information in those notes that will help to get your started.

• Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal version -- the “Tilly” Protocol developed by the counterpart of this group in Germany, which was also published by Kirsten Roomp & Jacqui Rand, DVM in one of the top vet journals.
• New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
• Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
• Lantus depot: This is an important concept for understanding how Lantus works.
• Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.

A couple of points that differentiate Lantus from Caninsulin.

• Lantus dosing is based on the nadir (lowest point in the cycle) and not on the pre-shot value. Thus, you do not change the dose based on the pre-shot (unless you test and the number is too low to shoot).
• Generally, dose adjustments are made in 0.25u amounts. This is why people were encouraging you to get syringes with half unit markings.
• Lantus is a depot-type of insulin. This allows it to have a long duration and allows for a cumulative effect. It also makes Lantus gentle compared to Caninsulin. Because it is a depot insulin, doses need time to "settle." Unless a dose reduction is indicated, a dose needs consecutive days to see if it is effective. It can take between 5 to 7 days when starting Lantus for the depot to stabilize.

Please let us know if you have questions. The people here are very generous with their time and their information and everyone is here to help.

 

Re: Switch from Caninsulin to Lantus

Thank you everyone. OK, so Twice weighs 12lbs now...lost alot of weight and muscle tone after the predisone. He has been getting 1unit caninsulin in a.m. and 1.5 in p.m.
I got the syringes with the half marks as suggested. Still not sure what dose to start him on tonight? Is it the 1unit?

 

Re: Switch from Caninsulin to Lantus

Now trying to republish Twice's ss with conversions....

 

Re: Switch from Caninsulin to Lantus

I see the conversions (although I'm Canadian so I look at mmol/L and despite being on the boards awhile I still write all mine down as that and understand it best ;-) ) I'm not a dosing expert although going by weight only it looks like it would be a good start as 1u, so hopefully someone can chime in on that. If you want to add something like "switch from caninsulin to lantus: what dose?" into your original subject line it may get more eyes on here for you Just hit edit on your original post and it will let you change the subject line

 

Re: Switch from caninsulin to lantus: what dose?

Thanks for the tip on editing Rachel. I'm supposed to give Twice his meds in 10 minutes, so I think I will go with the 1unit. I have been reading all the sticky's I can get my eyes on, but I'm still unsure about this dosing thing with the Lantus. You dose by the nadir, but what if you can only get one nadir reading in 24 hours? Also, I see that I am to stick with a dose for 5-7 days to give everything time to set up. When do I start this dose by the nadir routine... I have seen the notes on what to dose for different nadir ranges, just not sure when to use this info...

 

Re: Switch from caninsulin to lantus: what dose?

Yes Kim....I'd say 1 unit is a good dose to start with...it's where most of us start unless the kitty is really small.

Just remember to get a pre-shot before giving anything (without feeding for at least 2 hours) and we recommend you don't shoot if the pre-shot is under 200 (at least at first)

You can "stall", don't feed, and retest in 30 minutes if you get a number under 200...and use that time to post so someone can help you through it.

As you get more data on how Twice responds to the Lantus, you'll gradually learn to shoot lower numbers, but for now, keep it at 200 or above unless you have help from someone here.

Getting a +2 or +3 is a good indicator of how active the cycle might be too. A similar number to the pre-shot number and it'll probably be a quiet cycle. A big decrease from the pre-shot number, and it's probably going to be an active cycle requiring more testing.

Get a "before bed" test in too if possible. The sooner you get the data, the sooner you'll be able to really see how Twice is doing.

Good luck to you!! Happy to see you using a better insulin for Twice too!

 

Re: Switch from caninsulin to lantus: what dose?

For now, get as many tests in as you can Kim....We will help you learn how to read the patterns as the week goes by. You want to keep giving the same dose for the 5-7 days UNLESS Twice drops below 50, which earns a reduction of .25

What's your current shooting schedule and work schedule? We may be able to help you adjust it so you can get more tests in

 

Re: Switch from caninsulin to lantus: what dose?

One more "tip" for your Spreadsheet....You need to make it VERY clear that you've changed insulins...You might want to either put CHANGED TO LANTUS in caps in the Remarks and then click on the little paint bucket and choose a color to make it stand out, or you can even add another line and in the PM cycle for tonight, you can put L A N T U S (use one letter in each space) and then start a new line with your PM cycle readings for tonight

So you could have 2 lines for 10/19

One with the AM dose/readings and then in that same line, in the PM cycle put L A N T U S
and then one line under that for 10/19 and just the PM dose..and maybe even L A N T U S in the AM cycle info....it's just important that you somehow make it stand out on your spreadsheet until more people know you've changed over

 

Re: Switch from caninsulin to lantus: what dose?

Thank you Chris. I made the ss changes. Starting to feel like a pro at that part..lol.
As for my schedule;
4am-wake up, feed dogs, make lunch, get ready for work
5am-get preshot, feed Twice and all the other kitties, give the insulin, leave for work
4pm-Return from work
5pm-get preshot, feed and insulin
I try to get a couple more readings in here +2, +4, ..
9pm-sleep

I work 6-7 days/week. I no longer work the 12hr shift though as I would be gone from the house for 14hrs at a time. Too long for Twice to wait or have any sense of a normal life.

 

Re: Switch from caninsulin to lantus: what dose?

OK...if you just changed your schedule a little, and when you first got up, got your Pre-shot, fed and shot Twice, you could make your lunches, feed the dogs and get ready for work, and get a +1 before heading out the door...that would help tell you if you might want to leave some higher carb food down for Twice in case he's dropping too fast.

(Or you could get up at 3, test/shoot/feed and get a +2 which would be even better, but who wants to get up at 3am?..but you will eventually get to the point where you can "sleep test" too....there are lots of times I have gotten up at un-Godly hours to get a test, put the result on the spreadsheet and gone back to bed and if it weren't for the proof of the spreadsheet, I wouldn't have remembered doing the test...LOL)

Then when you get home at 4, you could repeat the AM routine...test/feed/shoot as you come in the door, and that would give you the opportunity to get some +2's and +5's routinely on the PM cycle...where they tend to go lower anyway

I know we have lots of people who work full time jobs and figure out a way to do it...some may even have to give the shots a little "off" the 12 hour schedule, but hopefully Twice will settle into some good, safe numbers for you soon

 

Re: Switch from caninsulin to lantus: what dose?

Thats great you have moved to Lantus! Make sure you read the links above that Sienne gave and ask questions!

This initial dose should be held for a week to allow the Lantus depot to build up (unless as Chris says, she drops under 50).

Then changes made in 0.25 increments - waiting 3-5 days each time. We can help advise on when and how much if you have questions.

Also make sure you keep the lantus in the fridge, not the door (read siennes link on storing and handling) and it should keep for up to 6 months.

Wendy

 

Re: Switch from caninsulin to lantus: what dose?

Thanks Wendy. I have been reading like mad here. Photocopying as needed for quick reference. Just want to do this right. I stayed home from work today as i wanted to get some more readings on Twice for this change (didn't notice I was down to 10 strips and no pharm open in our area). But should be able to get some decent readings to see how he reacts to this change. I will be keeping his ss up to the minute. I also set up another post about him getting a regrowth on his tongue (reason for pred long term in first place).

 

I got a bunch of numbers today to get an idea of how this insulin will work. Hoping for a couple more tonight.

 

Yeah it's still too early to know how the 1 unit dose is going to work, but with the drop from 261 to 122 in 2 hours means Twice is most likely going to have an active cycle, so it'll be important for you to test tonight...at the very least, I'd get a +5 or +6 (but I'd probably try to get a +4 and +6 and see how he's doing)

If he does happen to drop below 50, you'll want to catch it as soon as possible and bring him up some. If you DO get a number below 50, don't panic! Depending on how low he goes, you want to give a teaspoon or two of the "gravy" off of a Gravy Lovers type of food and retest in 20-30 minutes. (if he goes below 40, you'd want to give a little more gravy...or you can add a couple of drops of Karo or maple syrup into a teaspoon of his regular Low carb food) We would want to get him coming up into safer numbers, but not send him through the roof

After you give the gravy (or low carb food + Karo) use that 20-30 minutes and post and ask for help. You can use the 911 icon in the FIRST post so you'll get eyes on it quicker, but you should have the How to handle low numbers sticky printed out in case it takes a little while for someone to get online to help you.

I do not want to worry you...it's just better to be prepared than it is to panic....there's no way to know what he'll do later in the cycle, but a fast drop like that usually means an active cycle...and an active cycle doesn't necessarily mean a low one.

 

Thank you Chris!

 

I just remembered you don't have a lot of strips...another way you can kind of tell his numbers might be going too low is he'll be really hungry. Most of our kitties will go looking for food when their numbers go lower (I know China is an absolute PEST, so it's a good sign for me to grab a quick test)

If Twice does go below 50, you'll need strips to keep testing until he comes up into the 60's and stays there without having any food for a couple of hours...which brings up the next topic...if at all possible, always try to have a spare box of strips tucked away...the one time you really NEED them is no time to not have them.

 

Ok. At the +2 he had dropped quick so I gave him about a tbls of fancy feast pate as a mini snack. He is now +4- 2.1mmol. I don't have that higher carb gravy food. Should I give some of the m/d kibbles I have left over?

 

Just now gave another tbls of ff pate. I'm down to 3 strips until tomorrow!!! Panicking

 

You can crumble a few of the kibbles on the top of the food. Do you have any karo syrup or honey? Maple syrup?

You only have 3 strips? We will need to use them sparingly then.

 

correction...4 strips, not great still. yes I have corn syrup and honey

 

Gave him about 10 kibbles. He's ravenous

 

OK. You will want to get another test 30 minutes after this last feeding. And post the number, I'll be watching for it.

It takes 30 minutes for the number to show up in his BG on the meter.

And you'll probably need to feed another tsp or two then, but depending on the number you see, you might need to add a half dozen drops of honey to it.

If he's ravenous, that is good. It's a sign he realizes his blood sugar is low, like a human will grab for a candy bar or coke when they go low. You just don't want him to eat too much too soon and not keep it down. "Scarf and barf" is what we call that. ;-)

You can go ahead and give him another tsp of FF now with 3 or 4 drops of honey on it.

 

Oh, and one thing you can practice in between tests and feeding? You'll need to see if you can eyeball .75u in the syringe. You can practice with water with a used syringe.

Dropping below 50 means he will be needing less insulin going forward.

You did a great job catching that quick drop at +2 and testing again at +4, by the way.

 

Carl, it's 9:30 now and he's eating the wet food with a few drops of syrup. Do I test at 10pm, or now since I first fed him a bit at 9pm? Also, he's still hungry...I;m holding more food back though. Otherwise he seems coordinated.

 

Wait until 10, I would say. The two feedings should have brought him up by then.

If you see any weird behavior, test prior to that. We're trying to balance safe and "only 4 strips". I know you haven't done "this" before, but I have, lots of times. If you see anything weird, post as soon as you can. You're doing great!

 

Are you alone? Is there anyone who could make a quick run to get strips and/or HC gravy food?

 

Not alone, but an hour and forty five minutes to the nearest city center. We are in the middle of a very small farming area.

 

OK, then we'll work with what we have.

Definitely will want strips first thing in the morning though. If needed, we'll use all 4 tonight, and hold off on morning insulin until you can get some strips to test before that shot.

 

I promise to NEVER be this low on strips again. I can't believe I blew through 100 already. I feel just horrible.

 

Nah, don't feel horrible. You aren't the first person this has happened to. ;-) Kitties seem to plot these things!

 

This is just a recap (in US numbers) in case anyone else drops by...

PMPS ~ 261 1u
+2 ~ 122
+4 ~ 38 Fed 2 tsps LC
+4.5 fed 10 dry kibbles, and 1 tsp LC with few drops of karo

 

Thanks for checking in Carl!! I had a feeling this might happen!

Slow down and breathe Kim...38 is low, but I'm glad you caught it early!

We don't generally like using dry to bring up the numbers because it does take longer to break down and bring the numbers up..and then it takes longer to clear the bloodstream, which is why we say to keep that Hypo kit stocked up at all times.....stick to the low carb food and a couple of drops of honey or syrup but don't give him too much...we might want him to keep eating for awhile

Will watch for the test coming up at 10

 

I swear I will be better prepared from now on.
2.4mmol

 

OK...up to 43 so you want to go ahead and give him another teaspoon or 2 of low carb food, plus another several drops of Karo/syrup

Retest in an hour unless something tells you to retest sooner..we have to save those strips

 

OK, to me, that is a 43.

You will want to feed him 2-3 more tsps of LC with 5 or 6 drops of karo/honey mixed in, and let him munch. And test again in 30 60 minutes. Usually it's 30 minutes, but we're conserving strips and feeding a little more than "normal".

This is what we call "later, rinse, repeat". You want him up to 100 or higher in the next hour or two. So you're looking for a 5.6 or so.


You doing okay?

 

I thank you both so much Carl and Chris. I am so scared. Twice seems to be content enough right now. I'm trying to not be a wreck, because he is so sensitive to my feelings. He's sticking close by and gobbling up that food and syrup

 

Is it karo syrup you are using? If so, that's perfect. It's better than honey to bring up the numbers.


You're very welcome Kim. Great job putting the 911 Icon up. It caught my eye as I was checking the board. Try not to be a wreck. You're fine, and so is he.

 

Yeah Kim...You're doing great!

I haven't been on the board near as long as Carl has, but I've read a lot of posts and helped quite a few people through their low numbers. Carl's one of the best here so I'm glad he checked in and that you'd put the 911 up.

You can probably go ahead and take it down now. You have our attention and at least one of us will stay with you until we know Twice is OK for the night

If you get concerned again, put the 911 back up though. We want you to feel safe going through this...and believe it or not, the next time it'll be easier...and the time after that even easier

 

Yes I am giving karo syrup (corn syrup). You both have such supportive and kind words. I can't tell you how much it means to me.

 

Just checking in on you to say you're in awesome hands with Carl and Chris, and you're doing great! I know it's scary, I've been there, I think we all have! I wish you were closer so I could give you some strips, I grew up on a farm so totally get the isolated from stores thing. Our kitties like to keep us on our toes :shock: They also like night time pajama parties and fuds with syrup ;-) Keep up the great work

 

Thank you Rachel. You made me smile!

 

Don't make me blush! Seriously, you're welcome. I will point out though that this isn't the very first time you've had to deal with an unexpected low number. It looks like you had to feed low numbers twice while using Caninsulin. And both times, Twice seemed to respond well to the food.

Lantus is just a different beast, and the nadir is usually later. But Twice should be getting close to that point now.

The goal here is to bump up the numbers using LC and karo, test an hour later, and hopefully see him rise the next couple of tests. 80, 100, or even higher.

He's "made his point". He says "1u is too much", the 38 means his dose gets reduced. He's likely the "bounce" due to the low number, so don't be surprised if you see a high number later tonight or tomorrow morning. It's expected, and no big deal. Bounces happen, and then they go away.

 

Keep on smiling Reducie already :mrgreen: . I've noticed a lot of cats on here seem to prefer to have their beans stay up all night with them to pay attention and feed them good fuds :lol: What meter are you using? I noticed you're a fellow Canadian and was just curious, I ended up with Accu chek and got strips much cheaper off ebay to have a supply in the cuboard They were mucho expensive at the pharmacy but I did have to buy from there a few times when supply was too low for my liking :? And I just saw the avatar, what a pretty kitty Twice is :smile:

 

Carl-thank you for the heads up on his numbers. As I wont get the strips until about 9am and his dose is usually at 5am, I'm guessing I should skip the morning one entirely?
On the Caninsulin he shot up and down so fast I didn't have time to get too panicky. I also had a lot more supplies on hand

Rachel- I'm using the Bayer Contour meter and they give you a free meter every time you buy 100 strips. The strips apparently vary in price depending on where you live, which I think is bogus. But I'm in an area where they are more affordable I am told. $90/100.

 

Twice was just checking out the computer screen. Being very nosy. He thinks Chyna is a very pretty torti girl. But asked me why Bob is sticking his tongue out at him?? lol

 

Since you're probably going to run out of strips tonight, then yes, you'd want to skip the shot in the morning.

You never want to shoot without getting a pre-shot number

 

Haha, thanks, I'm biased but well I think Chyna is pretty too . Ouch, that is pricey. Mine were around $80 for 100 strips, but like you said it depends on where you are, the different pharmacies in my city were different prices from eachother :roll: I got 150 strips on ebay for around $50 once including shipping, just had to keep checking and watch for good deals with decent expiry dates/pricing/shipping cost. And it may not be a concern for you, I'm just babbling on tonight, aren't I, lol.

Definitely skip your morning shot if you can't test ;-)

 

Ha, tell Twice it took me about 25 tries to get that one pic of Bob with his tongue out. I swear he was doing on purpose, like he timed my shutter speed. He kept sticking it out after eating, and I was going for the "action shot" of the tongue in clear view. Next time, I'll try giving him peanut butter or something to slow it down. :lol:

 

OK, I get to use my favorite "Hypo-watch PJ Party" line....

It's about time to play "poke the kitty"! :lol:

Let's see a higher number, Twice.

 

Oh, Carl you just totally cracked me up :lol: Love your dessert quote too. I'm not the only one with multiple shots of the exact same pose within seconds of the last picture?? ohmygod_smile Yes, come on up a bit Twice ;-)

 

Hi Kim, I'm another Canadian just saying "hello". Quite the night tonight. Good to see you are going down in dose already. Without test strips, I'd skip Twice's shot in the morning.

For the Bayer Contour (which is my back up meter), I've found the best price in a store is a London Drugs. They will ship to you for a decent shipping price and I've occasionally seen sales with the price $10 lower. Some people here also buy from a reputable seller on eBay. I'm lucky that I'm close enough to the border than I can get some cheaper Walmart ones with some cross border shopping. One thing you might want to consider is putting together a "hypo" kit with some gravy foods and a spare package of test strips. Then you know you've always got what you need on hand.

 

Thanks Chris. And it would be way to far off his schedule to do a shot later on. I called in to take another day off tomorrow and I'm hitting the city for test strips (plus a pkg for the hypo kit), as well as the hc food. I rechecked the list and should have everything else I need here. Just gotta put it in a nice box in the cupboard and we are set.

Rachel, that is an awesome price and I am definately going to check ebay out!

Carl-That's awesome! lol. I have a dog you would get great pics of. He drops his mouth open in most pictures...looks confused..lol

3.2mmol or 57.6

 

Hmm, hoped it would be higher.

OK, another 2-3 tsps of LC with karo topping?

Do you have a curfew? I mean, at what point does this start to eat into sleep time?

 

Whew..well at least he's headed in the right direction and is above 50...Trust us...at some point he's probably going to bounce, so if you see a 300 (or even higher) tomorrow, don't worry about it

Feed him some more low carb, a few more drops of Karo and retest in an hour

That's going to be your last strip though, right?

Good thing you can call in and take tomorrow off...you're not going to be getting much sleep tonight....Welcome to your first PJ party!!

And where are our manners!! We didn't even offer her a cup of coffee!!

 

Hi Wendy. Thanks for checking in on us. Thanks for the tips and the store info. I see you're from BC. Me too until 3 years ago. Kamloops

Carl- ok, just fed and syruped him again. I am usually in bed at 9pm, but I called into work and asked for a holiday tomorrow. I wouldn't be able to sleep tonight anyhow. You guys must all be getting sleepy tho!

Chris- I needed that coffee! Can't remember the last time I ever had a PJ Party, but I'm grateful it is with all of you! I have 2 strips left. I think they must have been stuck together earlier today because I originally thought I had WAY less than I ended up having (used most this am tho as I took the day off to monitor his new insulin). I need to work on my planning skills...

 

I was thinking you now have two strips left? Good. Next one is an hour from now. If he isn't up to 100 by then, I would feed the same thing with karo, and test again in an hour. Let's see where he's at then.

Not sleepy here yet. I'm off tomorrow anyway.


Oh, here's a fresh picture of the Bobster... I took this last night while I was watching the baseball game, and Bob apparently wasn't...

 

He ate his snack, slower this time. Not so frenzied. Had a small play with my pen and now watching something very interesting out the window (apparently). He is quite active.

Carl- He is so cute! Is he a manx, or just hiding his tail? Looks like he's toasting his belly by a fireplace..lol.

 

RECAP -

PMPS ~ 261 1u
+2 ~ 122
+4 ~ 38 Fed 2 tsps LC
+4.5 fed 10 dry kibbles, and 1 tsp LC with few drops of karo
+5 ~ 43 Fed 2 tsp LC w/ karo
+6 ~ 57 Fed 2 tsp LC w/ karo


Kim, not sure if you fed 2 or 3 tsps each time...

 

I hope you see some higher numbers soon, I'm glad you can have tomorrow off and that he is feeling playful Aaaand I totally want to give Bob tummy kisses. cat_pet_icon

I don't know which exact strips you use, but the bayer contour ones I just checked out on ebay were pretty decent priced. I have a little too much experience shopping on ebay.ca :lol:

I have to work in the early ish morning so I'd better go catch some zzzzz's. I have a kitty waiting next to the bed and it's past my bedtime so I hope you all have a good night and that Twice decides to surf at safe numbers

 

Goodnight Rachel and Chyna. Thanks for being with us.

Carl-I gave him 2 tsps with the syrup each time.

 

Kim,
We always thought he was "part manx". His litter of 5 were all gray and white, three had tails, but two didn't. He has maybe one vertebrae under a puff of fur.

They were feral/barn kittens found a few days old with no momma and covered with fire ants. Bob and one sister, Lillian, ended up staying with us. Lilly had a normal tail. Bob still has scars on his nose from when he was bitten by the ants. He's 14 years old.

 

Well thank goodness for sticky strips!! At least it gives you one extra in case he doesn't come way up by the next test.

I'm always up until at least midnight to get China's +6 at night..I sleep better having that number, especially since I shot a 68 tonight and she likes to occasionally throw me a curve ball. If I get a number I'm concerned with, I'll set my alarm to make sure I'm up to get another test. Once you've been doing this dance awhile, you'll get to the point where you can "ghost test"...You'll wake up, poke, test and enter the number into your spreadsheet and only have the proof on your meter and your spreadsheet that you did it...LOL

Since you have Carl and Wendy to sit with you, I think I'm going to go find some soup. I'm fighting the flu and had meant to check back with you earlier since I'd told you to get those tests due to the drop at +2, but laid down for "a minute" and snoozed off.

This message board is wonderful though, and like I promised, when you post that 911, you'll usually get someone's attention pretty quick...I'm so thankful Carl was browsing the forums!

May check back in later, but if not, will see you tomorrow (later today) and see how Twice is doing...I'm pretty sure he's on his way up now, and I know that at least one of us will stay with you until you feel comfortable going to bed. That's a promise we make to someone...we don't leave unless we have secured someone to take over for us and continue holding your hand.

You did GREAT tonight Kim!! Give yourself a little pat on the back and know that you did what you needed to do, and have gained a lot of knowledge in a short time.

 

OK, good. It's just good to keep track for "future reference" so you can see what works for him. When you buy the H/C food, you would use that instead. It's good because you can sometimes just give the tsps of gravy, which is where the carbs are supposed to be for the most part. That boosts the numbers without filling the belly in case you have to do this every 30 minutes for several hours.

 

Oh those poor kittens! So glad you found them. Bob looks like he could stand up to a fire ant now! We actually have had a real issue here with stray kitties and lots of litters. We are in a community of about 50 people and the thinking is very old fashioned when it comes to animal care. So Terry and I are in the process of catching, spaying/neutering, and releasing. I wish we could find homes for all of them, or any of them really, but until then we feed them, built shelters, and are hoping they can live a decent life without having anymore babies. I know you can't save the world. And there will always be more. But you do what you can for who and what you can.

I'm babbling.

 

Forgive me for popping in but I think if you don't have strips, you need to get the numbers way up. The karo will wear off and so I'd be giving him HC food/gravy and abort this cycle. You can add the karo too the HC food but I'd be afraid with just using LC, the karo will wear off and he won't be high enough to stay there.

The goal is to not worry about how high you get him tonight.....just get him up there.

 

That's awesome that you and Terry do that! We used to do a lot of wildlife rehab. And just about every cat I've ever had has been some sort of "misfit" or castaway.

 

Thanks again Chris. Go get yourself healed up. I really appreciate all of everyone's support tonight.
Carl- That's smart about the gravy. I can see how Twice is starting to fill up a bit. So next time (heaven forbid) I will make sure to have the gravy stuff.

 

Marje...she didn't have any High carb...we were kind of hoping he'd be higher by now, especially with the lack of strips.

She's going shopping in the morning...aren't you Kim?

Goodnight Kim...and you really are doing fine....and there will be a "next time"....but each time it will get easier for you...we promise

 

Wildlife rehab would be an experience! Yes, I find that the most lovable bunch is the misfit bunch. You find out you needed them as much as they needed you.

Hi Marje. I was sadly ill prepared and have no hc food left in the house. I am correcting my deficiency first thing in the morning. Not going to let this happen again without the proper items at hand.

 

Sorry...I read that you gave him gravy so thought it was HC. :roll: my bad.

 

Poke time!

 

8.8mmol- 158.4

 

There's the bump we have been waiting for!

OK, give me a minute to put together your "options"... but you can feed him if he's hungry.

 

OK, you have one test strip left.

AMPS is only 5 hours away.

There's a good chance he'll stay this high or go even higher at this point. Nothing wrong with that. This is the food he's consumed and more than likely, a "bounce" from going as low as he did.

If you want to shoot at AMPS -
You can leave out a bit of dry food so that if he gets hungry, he can snack on it while you are sleeping.
Then you could get a few hours sleep, get up for his AMPS test, use your last strip, and feed him.
If you do give him a shot, you would want to reduce the dose to .75u. Do your syringes have half unit marks so you can eyeball .75u?
After giving the shot and feeding, go to town and pick up strips and HC and anything else you need. Maybe a couple cups of coffee?
And when you get home, test him.

If you don't feel comfortable leaving out food and going to bed -
You could test him in another hour. If his number is higher, then you can go to bed, leave out dry.
But then you would most likely want to skip the shot in the AM because you wouldn't be able to test him.
If, in an hour, the number is lower, you'd have to repeat what you've been doing....LC and karo. But you wouldn't be able to get more tests until you go get some strips.

What do you feel is the best way to go?

 

Wendy, Marje, Chris, or anyone else....

If I missed an option or two, please post them?


Also, Kim,
Now that you've had your "trial by fire", please think about posting in the Lantus Tight Regulation forum. Everyone there is familiar with the insulin. The biggest benefit to posting there is that there is usually someone there 24/7. You are sure to catch experienced eyes when you need them.

 

I honestly don't know enough to know what is best to do. I know that from his past two drops, he has continued to rise...but that doesn't really mean alot this early in the game. His attitude during the whole thing tonight was good (but cats are good at hiding stuff). So my gut feeling says he will contimue to rise, but my brain says that is not necessarily the case. I could stay up and feed him again in one hour, I will be up anyways. I could watch him for any changes.
I guess I am wondering what skipping a dose will do to this whole process. I would love to take more time off work until I am more comfortable with everything, but that is not likely an option. So if skipping a dose sets him back as opposed to giving the .75 in the am, I would rather do the latter. I do know I can stay up and set the alarm to monitor him visually. What would you suggest is the wisest course? I realize there is no right answer (due to my negligence), but am I wrong to think he should get his morning amps and shot?

I will def post in the tight reg forum!

 

Personally, I think not skipping the shot is the best way to go. He hasn't been on Lantus long enough for a "skip" to cause a huge setback or anything. But as long as you can keep insulin working in him 24 hours a day, that's what you would like to do.

It's likely that you'll see a higher number at AMPS. But if you skip in the AM, then it's likely he'd continue to go higher all day until tomorrow night's shot.

If you feel more comfortable staying up and keeping an eye on him, I can certainly understand that, Kim. But given one strip, and two options, I'd probably save the strip for the morning test. If you stay up and continue to feed him, he's not likely to drop in numbers at all. But that would mean no sleep for you, which is not a great thing.

 

I think you got it pretty well covered Carl

The only thing I'd add is IF you have the strip in the morning at AMPS time, you do not want to shoot if he's under 200 (but I doubt if there's much chance of that)...the kibble you gave him earlier has had time to get into his bloodstream too and probably helped bring that number up...along with a lot of sugar in the form of Karo

Kim, since you've just started the Lantus, skipping the shot isn't going to do any damage. You'd just start over counting days at the dose (but you're going to be doing that anyway because you're shooting a new dose) but if you have the strip at AMPS time, I agree that if he's over 200, you should give the .75 and head to the store as soon as you can and then test when you get home.

Twice has been high for quite some time..another 12 hours or more isn't going to make any difference in the grand scheme of things. We'd rather he was too high for a day, than too low for a minute...as you've learned tonight.

I think I'd leave a little kibble out just in case, and go on to bed....set your alarm to check on him later if it makes you feel more comfortable.

 

Thank you Carl. For everything tonight. You are a wonderful, supportive man and Bob's a very lucky kitty to have you. I like the idea of giving the last test in the morning so I can keep him on a schedule. That data may come in handy for the future. I will continue feeding and watching him tonight and set an alarm to catch some quick zzz's in between. I'm good with that.

Have a great sleep tonight! You really deserve it!

 

Thanks for the extra info Chris. Now get back to bed and get over that flu! lol

 

You sure you're good? Like Chris mentioned earlier, once somebody jumps in to help, we're here till you tell us we're done.

You did wonderfully tonight with all of this, Kim. Chris mentioned a couple of times "next time this happens....".
Well, I won't tell you it won't happen again. But I will tell you it never happened with me while Bob was on insulin. I didn't use the same insulin, or the TR protocol. But I never had to stay up all night with Bob in low numbers. So yes, at some point, you're going to see a number under 50. But next time, it won't cause you as much stress. You'll see how Twice responds to food, and you'll be able to deal with lower numbers more easily. And a month from now, it'll be you doing what me and Chris and everyone else did tonight. It'll be some new member seeing a 40 or below for the first time, and you'll be able to walk them through it.

 

I promise I'm good. Thanks to everyone's efforts and support tonight. I honestly don't know what I would have gone through mentally if I had never found this place. It is truly amazing what people will do for each other and for their love of animals. I am proud to be a member here and I am truly excited that the experiences I am going through with learning all of this, will help me to help others. This place and its people are a blessing.
Goodnight and sweet dreams to you all.

 

OK, try to get some sleep tonight. I'll check back tomorrow for Twice's next adventure. ;-)

 

Hi Kim, Wendy gave me a helpful tip, and that is to buy strips from eBay.
I've bought from this guy and he was great: http://www.ebay.ca/itm/Bayer-Contou...875?pt=LH_DefaultDomain_2&hash=item3cd734a34b
Currently he has listed 300 strips for $108.

 

Wonderful info! I'm going to check it out right now.
Update on Twice. He got up to pick at his food all night, so needless to say, he is full and not eating this morning. Because of this I have not given him his insulin as I can't be positive when he last ate. I think it was after the 3am check...but not sure...I was pretty out of it. I know it was between alarms, just not which alarms. His bg is 22.9.

 

At that high (412), I would go ahead and give the .75 Kim

He's got enough food in him to last awhile I'm sure...and if you did leave kibble down and he nibbled on it, that's going to keep his BG up (but if you haven't taken it up yet, you need to go ahead and get it.) You can always leave some LC food down before you leave to go shopping....he's shown he'll eat if his numbers do happen to drop

 

Welcome Kim & Twice! Just read this post, and wanted to say, Good Job and with limited supplies!

It is so true that you will never feel alone - you had wonderful people with you last night.

Hope tonight is not as exciting for you :lol:

Jane

 

Since you're now officially on Lantus, come on over to the Lantus Board today. Of course you may continue to post in Health if you like, but on the Lantus board, you'll get the advice of many of us who've been using it for awhile

Each day, you do one post, and edit the Subject line along the way (we call the posts "condo's")

You'd start today's with 10/21 Twice AMPS 412 in the subject line, and as you get more tests, you'd add that info by editing that first subject line again. In the body of the condo, we want to hear the WCR (Whole Cat Report)

How's he feeling? Appetite good? 5 P's in place? (Purring, preening, playing, peeing, pooping) as well as any questions you have. Add the ? icon to that first post if you do have a question in your condo that day and it'll help everyone know you have a question.

Great job last night and I hope you can get a nap in today. I'm sure you need it!!

 

Chris I am now 1.5 hours behind scheduled shot. Still give?

 

Ok. Gave it. Realized after I sent msg that yours came at 6am

 

Hi Kim! I didn't want to jump in last night since you were dealing with low numbers, but I just had to say hello since I think you're geographically the closest Canuck I've seen here yet - I'm in Winnipeg but I'm from Roblin originally (just the other side of the SK/MB border straight east of Yorkton). So hello and welcome! You did great with the low numbers last night. I know someone suggested you could start to post in Lantus Tight Regulation so hopefully I'll see you over there

 

Hi Amy! Thanks for the welcome. It's nice to be able to connect to so many great people.