When starting insulin: how close do I watch her?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Skunky's Mom, Aug 7, 2014.

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  1. Skunky's Mom

    Skunky's Mom Member

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    Aug 2, 2014
    Hi all. I'm planning to start my Funky Skunky on Lantus either Friday night or Saturday morning (when it arrives).

    I was wondering - how closely do I need to watch her, and when is the most dangerous time? I read that Lantus tends to build up in the system, so when does a hypo become the greatest risk? How many days in?
    And how many hours after a Lantus shot does the nadir tend to be? I don't want a hypo, but I also don't want to sit around the house all day all weekend long unless I need to. I'd like to go to church and to the pool sometime over the weekend (summer's almost gone and we have a lot of fun to do ;-)

    I work from home on Mondays so I'll have plenty of time to watch her then, but will be a bit scared going to work on Tuesday!

    I'm pretty sure I'm going to start her on 1/2 unit ,twice a day. My vet knows nothing about these insulins so I'm on my own (except for you guys!). I checked her BG twice a few days ago and it was 339 then 337. I'm going to check again when I get home. She's been on canned food but only a few days ago did I specifically buy the lowest carb Friskies.

    PS - and I may start another thread. I am buying the Lantus from someone. I know to check it for clarity. Should I try to give some to myself first to make sure nothing is wrong with it? I figure. . . if it's got something wrong with it better to go in my 180 lb body than her 14 lb body.
     
  2. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Starting dose calculation:
    What is the current weight?
    What is the ideal weight?
    Take the lower weight.
    Convert it to kilograms if in pounds ( divide by 2.2)
    Multiply by 0.25.
    Round down to the nearest 0.25. You may have to eyeball that if it is 0.25 or 0.75.

    Nadir = lowest glucose between shots. For Lantus, usually between +5 and +7 hours after the shot.

    The initial dose needs to be kept the same for 5 to 7 days on the Tight Regulation protocol. As each day goes by, you will see the nadir stabilize a bit more. You want that value to be above 50 mg/dL on a human glucometer. Depending on how your cat reacts to Lantus and if you are changing the food at all, you may or may not see numbers that are concerning. Each Cat Is Different (ECID).
     
  3. Skunky's Mom

    Skunky's Mom Member

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    Aug 2, 2014
    Thanks!

    I don't know what her ideal weight should be. She's a rather petite cat and mega fat at 14 pounds. Maybe. . . 9? 11? No idea!
     
  4. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    Ask your vet next time you can.
     
  5. Tisha's_Person

    Tisha's_Person Member

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    Aug 3, 2014
    I am new to this too, so I'm not an expert, but our cat has been on Lantus for about 3 weeks now. She started at one unit, and the transition was much easier than I expected. I was scared when I started, then terrified when I read all of the things that could go wrong. But overall, it has been really fairly smooth sailing. She seemed to feel a lot better within a day or two. 1/2 unit is a pretty low dose, so I think it should be relatively safe. We started on a Saturday morning, then went to church as usual on Sunday without incident. Your cat may react differently, but I just wanted to reassure that it might be easier than you thought, and the most likely outcome with that small dose is that it will start doing what's it's supposed to do (lower sugar) without overdoing it.

    Oh, and my cat has survived me being a terrible kitty mama thus far. She is currently eating dry food sitting right next to me and I have no idea what her BG level is because I couldn't get an accurate reading. But I know that she's not in any distress because despite my lack of skills, I know my cat and I can tell she feels pretty good, in part because she is irritated that I'm typing and not paying attention to her. You know your cat. You will know when something is wrong.
     
  6. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    You can use the Secondary Monitoring Tools in my signature link while you work on home blood glucose testing, particularly urine ketone and glucose testing, monitoring for dehydration, and water drunk. Those form the basis for an older, less precise, protocol in adjusting insulin doses.
     
  7. Tisha's_Person

    Tisha's_Person Member

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    Aug 3, 2014
    Is there a thread somewhere on ketone testing? I'm not sure I understand how to do that with litter/breeze cat pads.
     
  8. BJM

    BJM Well-Known Member

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    Oct 6, 2010
    1) Get Ketodiastix or generic equivalent at the pharmacy in diabetic supplies, or ask the pharmacist if they are behind the counter.

    2) Read the package instructions on what you need (fresh specimen, not one dripped into a used pad or tray).

    3) Cats often eliminate about 15-20 minutes after eating

    4) A long-handled serving spoon may work to catch the urine, or tongs may be used to hold the test strip in the stream.

    Keep in mind that urine collects over several hours, so it only tells you what was happening, not what is happening.
     
  9. KPassa

    KPassa Well-Known Member

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    Oct 23, 2012
  10. Aleven

    Aleven Member

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    Jul 14, 2014
    I wouldn't suggest testing the lantus on yourself. The worst thing that can happen to it is that it will lose effectiveness, which you will notice when you test your cat's bg and see that there's no difference from the insulin, in which case you'll know it's lost its punch. I don't know if half a unit can induce hypoglycemia in a non-diabetic person, but it doesn't seem worth experimenting with. You need to take care of yourself so you can take care of your lil guy.

    Have you started posting on the Lantus Tight Regulation forum? I really suggest it. It's very active and everyone is extremely helpful. There's a bit of a learning curve with what the lingo means - AMPS and PMPS mean morning pre-shot reading and evening pre-shot reading respectively, and so on - but you'll figure it out. And everyone there will have lots of suggestions about the best times to test BG when starting insulin. I'm pretty new to this myself but what I've been told is to get a +1 and +2 when starting insulin - (meaning one hour and two hours after the shot) - if there's a sudden dip in BG that lets you know your cat is having an "active" cycle and you'll have to keep a close eye on her. And also a +6 or so, so you know about how low it's going to get at that dose.

    By the way, if this gives you hope, my cat was diagnosed May 22nd of this year and thanks to the Lantus Tight Regulation Protocol and this forum she's now five days away from being declared officially in remission. (I haven't given insulin for nine days and her BG is that of a "normal" cat.)

    Hope this helps.
     
  11. Skunky's Mom

    Skunky's Mom Member

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    Aug 2, 2014
    Thanks Aleven! Great info.

    I gave her her first shot at 1140. Haven't tested again so far, because what I heard is Lantus takes a long time. But I have checked on her. I'll to the +2 test in about 20 minutes (after reading this) and will be interested to see if there are any changes.
    I think I read Lantus takes a while to build up in the system, so they say keep it at the same dose for a week. I may be starting too low but that's better than too high.

    And hooray about your kittie being almost in remission that's awesome!
     
  12. Skunky's Mom

    Skunky's Mom Member

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    Aug 2, 2014
    I think we're going to hit up PetSmart today to get some treats!

    Everybody talks about "freeze dried" which I assume is NOT jerky. I'm thinking Bonito flakes.

    thanks all!

    I couldn't even believe how easy the shot was. She didn't even notice. Though I had a bit of trouble using the syringe in the pen at first, not knowing what I was doing! - I guess you need to hold the plunger down b/c it was drawing in air. I think I've got it now. And I've decided to go buy 1/2 unit marking syringes b/c estimating is too hard!
     
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