10/26 Monet AMBG 103 NS,+3 103,+4 123,+8 133, +12 197

Hi everyone....is is my first "condo" posting on the Lantus Board...so any comments/advise is very welcomed ;-)
Monet is acting totally normal today....check mark on the 5Ps!

I am during a BG curve today and tomorrow per my Vet's request....so Monet is getting pricked a lot...poor baby.
His last shot was yesterday @7 pm (EST) 1 unit. Just tested and now his BG has risen to 197. Will test again prior to giving shot 2nite @7.

Another member suggested I might want to decrease his insulin down to .5 since the 1 unit appears to be lasting him for almost 24 hours. I just started with the 1 unit dosage on Friday. Would love to hear others thoughts on reducing his dosage.

Also, Today I started gradually changing his food from Hills's M/D to lower carb options from Dr Lisa Pierson's List...so far so good...he is really eating well!

Welcome to Lantus Land!!

Here's the link to your first post on Health. It looks like you got inundated in responses on your first day here!!

I want to encourage you to read the starred, sticky notes at the top of the Board. These will help you to understand the Tight Regulation Protocol, the basics of how this forum operates, and some key concepts about Lantus. In particular, the notion of the insulin depot is important since I suspect the action of the depot is why you think Monet is getting a 24 hour duration from one shot. To briefly summarize,when you inject Lantus, it forms microcrystals that deposit in the fat tissue. These crystals gradually build up and in a similar gradual fashion, dissolve. They help to keep the level of insulin constant and thereby give it at least a 12-hour duration and allow for overlap between doses.

So what does that mean for Monet? Because you started out at a much larger dose, Monet's depot was being formed based on your initial dose of 3 - 4 units. That initial dose was clearly way too high. Even with having skipped doses, I would bet that Monet's depot is not fully depleted. As a result, since you are now giving a 1.0u dose, the depot hasn't yet drained to be consistent with your current dose.

Rather than giving a 1.0u dose once a day, it may make more sense to further reduce Monet's dose to 0.75u or 0.5u so you can shoot twice a day. Lantus works best if given twice a day. If you don't reduce the dose, what I suspect you will see is a low pre-shot number that you're not yet comfortable shooting, you understandably skip, and then shoot at your next shot time because numbers have sprung back up due to the lack of insulin.

Please let us know if you have questions. The people here are very knowledgeable and generous with that knowledge and their time.

Hi Rise and welcome to Lantus Land!!!

I know you're a little nervous about what dose, since you've had a rocky start. We usually recommend new people start at 1 unit and hold it for 5-7 days to "build the depot", but since you started so high, and have had problems because of it, we need to find a dose you can give twice a day.

Since he has had some insulin, there's probably still "some" in his depot, so it's not like you're a "brand new" caretaker.

If you want to try .75 (which I personally think would be a good idea), use some of the afternoon to "learn" where it is on your syringe. Take a used one and draw up some colored water, tea, coffee...something you can really see in the syringe and get used to where you are seeing it so when you're "Live", you'll be in pretty much the same place.

Or you can drop back to .5 (which has it's own line on the syringe) if that's easier and more comfortable for you, but if he needs more than .5 (after staying there for 3-5 days), you'll be needing to go up to .75 anyway, so if you have the time on the weekend, it's a good time to learn where that .75 is on your syringes anyway.

Dose adjustments are done in .25 unit increments so it's a skill you'll probably need to use at some point..even if it's to go down to .25 in the future.

I am NOT trying to tell you to go with the .75...the dose you decide on has to be comfortable for you to shoot! Starting at .5 considering the problems you've already had is also a good decision, since it'll still build back his depot, but it's less likely he'll go into any low numbers..but not impossible for him to go too low on either. There's just no way to know for sure what dose will work best without going too low since you're new to this dance and don't have the data to compare.

Look forward to seeing how Monet does! Good luck to both of you on this new adventure! You've already had some pretty good scares, so let's do it right this time (sorry Monet's vet, but it's just crazy starting at 3 units and then when you get called about a possible hypo, your advice is if he's over 120, shoot, but not to reduce the dose...pure insanity)

Welcome to T.R.
Looks like Monet is already doing fairly well.
Here's a shortcut version of Dr. Lisa's food list.

I think I would go with the lesser dose amount so you can shoot twice a day.
It looks like you could be in microdosing sooner than later.
There are folks here who are giving less than a 1/4 of a unit....

Thanks Sienne and Chris for your advise. Will definitely reduce to .75 and play around with a syringe with coffee in it so I can get use to where the sweet spot is....that was such a great tip !

I have been reading all the stickys on this board's index to try and gain as much knowledge as I can about lantus, nutrition, home monitoring etc.

You guys have already helped me understand so much in the short time since I discovered this site. It scares me to think where Monet would be right now if it wasn't for this group of AMAZING people !

Thanks Rhiannon for your comments and the link 2 the short list of food choices!

Need advise....once again...just tested Monet prior 2 pm shot and got reading of 159. Was planning on reducing shot to .75 2nite....but since it has gone down from the 4:00pm test of 197 not sure what to do?

Not sure what you mean Rise

Your spreadsheet says Monet is at 197 at +10 so his shot wouldn't be for 2 more hours

BUT, if you want to change your shot schedule, now's the time to do it. If you want to be on a 7am/7pm schedule, you can or you can pick a time tonight that works for you to be able to always get a pre-test, and if at all possible, a test somewhere in the middle of each cycle

Chris, sMonet got his shot at 7:00 this morning ...I was a bit late 2nite testing and I guess my ss is not correct (I will try and correct it) It has been 13 hrs since his shot... His BG 15 minutes ago was 159 so I am just unsure as to give it or not. Members had adviced earlier 2day that I go to a .75 or .5 dose. Sorry my previous post was confusing.

OK...since you didn't shoot this morning, go ahead and shoot now..I take it that it's 8pm'ish for you.

Give the dose you feel most comfortable shooting for the next 3-5 days. .5 is fine, as is .75...we have to start somewhere. If it's easiest on you, start low and we'll gradually work our way up. It might mean Monet is at higher numbers for a few days, but high numbers don't kill like low ones do

Tomorrow, at 8am, you'll want to test, feed, shoot...all within about 10 minutes unless he's under 200. We usually drop to 150 here in Lantus Land, but you're still so new and have so little data, I think it's probably best if you DO get a number under 200, you "Stall", DON'T feed, and post and ask for help.

If you haven't already done it, read the Sticky on How to handle Low Numbers

This one, you should have printed out and someplace safe...Just in case you're in an emergency situation and nobody is available to help, the board is down for some reason, you lose your internet service or electricity. How to treat Hypo's..They can kill

Now on the spreadsheet...No matter what the ACTUAL time is, when you give the shot, that's the number that goes in the Pre-shot column, and the 12 hour clock starts for that cycle.

If you "stall", you can put the numbers you get at +12 (and on, like +12.5, +13) into the "remarks" column...and when you DO make the decision to shoot/not shoot, that's the number you put into the AMPS and PMPS column

If you don't shoot for some reason, you still put the number in, but in the U column you put NS, or No shot

Don't worry..we'll get you there!

Thanks Chris I will go and inject right now....thanks a ton!

Tomorrow, at 8am, you'll want to test, feed, shoot...all within about 10 minutes unless he's under 200. We usually drop to 150 here in Lantus Land, but you're still so new and have so little data, I think it's probably best if you DO get a number under 200, you "Stall", DON'T feed, and post and ask for help.

Click to expand...

Monet's BG @ 5am (EST) was 174 ( PMBG 174 +4 - hope that is correct way to type it) ...now at 7:50am his BG Is 116 pre-feeding & shot)(AMBG 116)
so by looking at all of the protocol info what I think is correct is to feed some hc wet food now and NO SHOT ???
He does not seem to be feeling good this AM .... Just laying around a bit too much for his normal routine.
Thanks !

Update....I went and got Monet's (&Picasso's) food out and Monet came ready to eat ! He was not running like usual but walking just fine. I am feeding him some med.HC wet food right now and he is eating well/ normal. Looks like no shot this AM or less I hear different from u guys.

We use 150 as a "post and ask for help" number when you're still new at managing your cat's diabetes. I would not feed HC food unless numbers are below 50.

If you have flexibility with your schedule (especially tomorrow), I would urge you to think about stalling. However, if you fed HC food, that may not be a particularly good option since you will have inflated Monet's numbers. (When you stall, you don't want to feed -- although there are occasional exceptions if numbers are very low at shot time).

You may want to start a new thread (we call them "condos") for today. We open one condo, per cat, per day.

Thanks Sienne for your response. I did not feed Monet his normal amount yet and what I did feed him was the Hill's w/d which is higher in carbs than the m/d and the ff classic chicken feast which I had been feeding him.

I will start a new condo as you suggested and copy some of this post in the body.