? What is the Recommended Amount of Insulin?

Discussion in 'Lantus / Levemir / Biosimilars' started by Casey Warner, Jun 4, 2018.

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  1. Casey Warner

    Casey Warner Member

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    Jun 4, 2018
    My vet prescribed 2U of Lantus and I was told I didn't need to do hometesting. I was also told to bring the cat back in two weeks for a test. I didn't feel comfortable with that amount so I did .5U since at the time I didn't have a glucometer. After I got one, I was going to do 1U, but messed up that injection. The morning after, the AMPS was 89 on an empty stomach and I wasn't sure what I was supposed to do, so I didn't give an injection. In retrospect, I think maybe that was wrong, I don't know.

    The cat, Brownie has been switched to wet food only (Friskies) since the DX. So I'm not sure if the vet was going on the fact that I used to feed dry food. I didn't even think to say something about that. It's a lot for me to learn and remember in such a short time.

    So now I'm not sure how much insulin to give. 0.5U or 1U. Is there a way to determine this?

    I can probably do that curve thing I keep reading about. I would need someone to tell me what I'm supposed to do.

    I cannot create a Google account. I keep getting hung up where it asks for a phone number. Is there a way around that? I was able to download the spreadsheet template, but it has some formatting issues and is in the LibreOffice format (ODS). I will try to attach it to this post and hope it works.
     

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  2. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    You can try using a fake phone number. Use your correct area code and try 123-4567 or 123-5555. Is there a reason you won't use your phone number?

    Google Drive is not supported on some tablets. And the ss can only be set up from a pc, but you can view and have limited formatting on a smartphone.

    I use my Kindle fire for everyday access to everything, fdmb, banks, email, internet, games, shopping etc. but it doesn't allow Google drive. I can view everyone ss but that's it. To enter my data into my ss I use my phone and I can make some changes to ss but its small to work on. For major edits and to enter comments I have to use the pc. It's just easier to see the whole page.
     
  3. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Welcome to the group!

    If you are following SLGS, then you do want to start at 0.5u and it sounds like that was a wise decision on your part. Many cats that are transitioned from dry to canned food see an immediate change in their blood glucose (BG) values.

    You didn't make a mistake with regard to skipping a shot. Many of us have routinely been able to shoot low numbers BUT we have a good deal of test data that we've accumulated before shooting low. For someone who is this new to managing their cat's diabetes, with SLGS, we suggest that if you have a pre-shot number that is under 150, post and ask for help. We can walk you through the options. (They are outlined on the SLGS sticky note.) We know how scarey low numbers can be so it's helpful to have someone with experience to help guide you until it becomes second nature.

    Again, if you look at the sticky, if your cat has been switched to a low carb, canned food diet, the starting dose with SLGS is 0.5u. However, your pre-shot number was below 90, so you may want to consider reducing the dose to 0.25u. (90 is the point at which you reduce the dose if you're using SLGS as your dosing method.)

    A curve is taking BG readings every 2 hours for a 12 hour period. However, it takes 5 - 7 days for Lantus to develop a depot. (There's a sticky note on this topic.) You might want to wait a bit before getting a curve. I would, however, suggest that you get a few tests each AM and PM cycle in addition to your pre-shot tests.

    I would suggest following Paula's suggestions re. getting a spreadsheet working. The formatting, as you noted, isn't following what we use. Not everyone here has Excel which is why we rely on Google for spreadsheets.

     
  4. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    You did the right thing getting a meter. It may be hard to accept but many vets know very little about feline diabetes, a meter and testing are essential for determining how much insulin you inject. Would your vet recommend this to his own children?
    It looks for now like Brownie's numbers are still low and not out of control. I don't use Lantus so I can't comment on the amounts but soon other members will give you better advice on that. Whatever your vet tells you remember the meter is just a tool and testing alone won't alter Brownie's health. Welcome to the best place on Earth you could be right now. :)
     
  5. Casey Warner

    Casey Warner Member

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    Jun 4, 2018
    Thanks for the help.

    My vet hasn't been helpful, so I'm basically doing this on my own. There's been improvement though. Brownie is starting to feel like eating on her own. I still have to syringe feed her to make sure she gets all her kcals. She also isn't as dehydrated and peeing as much. Although it's impossible to know if any of that is related to the insulin or because I've been giving her a low dose of potassium gluconate. Acording to the CRF/CKD group, her potassium levels were dangerously low. Then I read that diabetes/insulin can potentially lower it even further. So I took it upon myself to start supplementation. I'm erring on the side of caution and only giving 1 mEq twice daily.

    In regards to the Google spreadsheet, everytime I enter my phone number, Google gives me an error. I tried a different browser and got the same problem. If the problem continues, I 'll see if I can use my cousin's Google account.

    I've attached the most recent spreadsheet.
     

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  6. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I would be extremely careful about giving potassium. Potassium and sodium levels are critical for life. The normal range values give you a very small window for accuracy. I would not give potassium without knowing my cat's blood level of this electrolyte and without input from my vet. If you are not feeling like your vet is knowledgeable or attentive, perhaps it's worth considering finding a new vet. I'm hesitant to suggest this but we can't advise you with respect to issues like potassium levels -- they are too critical and require more expertise than anyone except a vet can assist with.

    I was able to open your spreadsheet on my computer at work -- a PC. It won't open on my Mac. I believe Paula suggested using a different phone number -- use someone else's (it's not like Google is going to call you!) or make up a number. You can also Google your problem (e.g., phone number for new google account) -- it looks like this is an issue if you are setting up your account on a cell phone. If you are able to use a computer to establish the account, you won't be required to give a phone #.
     
  7. Casey Warner

    Casey Warner Member

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    Jun 4, 2018
    Thanks.

    Her potassium levels dropped over the course of a week. They were 3.7 (3.5 - 5.8 is normal) and a week later it was 3.0 The people over on the CKD forums suggested giving potassium. I'm well educated in CKD, but I have already sent an email to my vet about it.

    Google does require a phone number on a PC. During the signup process (on a PC), it asks to verify me by providing a cell number. I put in my number and it gives an error (This phone number format is not recognized. Please check the country and number). I believe they send a text message or call for verification. I do not have another number to use at this time. I asked a few people I know if I could use their number and then remove it from my account, but they said no. They felt it is a security risk. My cousin said that years ago, Google did not require a phone number during setup, but that's changed.
     
    Last edited: Jun 5, 2018
  8. Steph & Quintus & L & O

    Steph & Quintus & L & O Well-Known Member

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    Dec 9, 2017
    How were you inputing the number? you don't have to write your real number here, just put 999 etc in. Maybe it's a question of special characters you added or didn't add, or a 0 before the area code, or something like that? Or any chance you put in a non-number somewhere, or an extra space? Sounds like there is something in the way you enter the number that makes the form validation choke on it.
     
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