Portia's AMPS was 239

Hi everyone,
I gave Portia her first insulin shot today but her AMPS was only 239. Is that dangerously close to the no shot limit for a beginner? We started tapering her pred since yesterday so Im not sure if that contributing her low BG. Her BG curve on tuesday (with no insulin) was between 275-350. Im confused. ANy thoughts

Rita

 

Re: How long does lantus last in the fridge?

Hi Rita, and welcome here.

The 28 days quoted is if you leave it outside of the fridge. If you keep it on the fridge shelf (not the door) and away from warm foods, you should be able to get a lot longer out of a vial. I've heard of people here getting 5-6 months. Here's a pointer to the sticky note on handling and storing Lantus.

 

Re: How long does lantus last in the fridge?

hi rita! just wanted to say welcome to Lantus Land. Keep asking questions and we'll help you learn what you need to know to take care of Portia. The page Wendy sent you to has lots of good info. It's good to learn how to take care of it properly because it is expensive - and you do want it to last as long as possible. Lots of people get several months out of it.

You can also explore the option of Solostar pens when you buy it next. Some pharmacies will sell one pen at a time - it takes some calling around and asking. Look at the video on how to draw up your insulin from either of those while preserving them as best as possible.

If you haven't looked yet at the yellow starred "New to the Group" sticky at the top of the Lantus TR page, that's a great place to start. At the end of that page there is an excellent information post on pancreatitis. I see in your sig line that Portia's had some trouble with it. Perhaps there is something helpful in the post.

Ask away.

 

Re: How long does lantus last in the fridge?

Hi Rita

Two people here just got about 5 months out of their vials of Lantus. You almost certainly should get more than a month from yours with proper care.

BTW welcome to Lantus Land! Tight regulation will give Portia the best chance for OTJ. We can help walk you through the whole process one step at a time. Any questions just ask away.

You may "relax" things later on down the road, but this is certainly the best place to get started.

 

Protocol for beginners

Hi all,
Thank you all so much for your response. I changed the subject since technically Im asking different questions in this message.
Im really feeling a little overwhelmed by this whole thing and Im not even sure where to begin. Her resting glucose is between 275-350mg/dL at home. So my vet has prescribed 1unit of Lantus BID. Im going to start giving her insulin tomorrow and this is what Ive gathered so far.

1. Test before giving insulin (the no shot limit for beginners is 200mg/dL right?)
2. Feed her (she will usually eat about 1.5oz of canned food at a time).
3. Shoot insulin right after.
4. Since this is the first time, monitor every 3 hours for 12 hours and record values.
5. At no point should the value fall below 50 mg/dL

Is that all I have to do tomorrow?

Do I also have to test all night? or just once before I go to bed?
From the second day, I only test at nadir (5-7 hrs post insulin).

I think I need to take one day at a time otherwise I go crazy.

Please let me know if I have the protocol right. I will also look at the links.
Thank you all for your time

 

Re: Protocol for beginners

Definitely! We're here for you, you can do it! :thumbup

To change the question, go to the first post in this thread and edit the subject: "Protocol for beginners" then all can see it at a glance.

 

Re: How long does lantus last in the fridge?

You've got it pretty right Rita!!

Make sure you don't feed for 2 hours prior to pre-shot tests. You don't want those 2 numbers "food influenced". If you feed during the cycle, that's fine but take up the food for those 2 hours

The only thing I'd add is that yes, it's not necessary to do a curve every day (a full curve is every 2 hours for a complete 12 hour cycle..mini-curve is every 3 hours), but the more tests you can get in, the better off you're going to be in learning how Portia responds to both insulin and food.

I'm not saying you have to do a curve every day, but if possible, getting a +2 or +3 each cycle and a mid-cycle test (somewhere between +5 and +8) on both cycles (or a before bed test at night so you have an idea of if you want to set an alarm to get up and test later in the wee hours)

There are also the "forgotten" tests, like +1, +10 and +11...as you go forward, just get "spot checks" at different times during the cycles. There's really no such thing as too much data

Good luck to you and extra sweet Portia! It looks like you've got a good basic understanding of the protocol. Ask questions and read others posts. You'll learn a lot by just reading others questions and answers!

 

Re: How long does lantus last in the fridge?

Welcome to Lantus Land!! I gather you're Rita. What's your kitty's name?

You are so right about this entire endeavor being completely overwhelming at the beginning. Give yourself about 2 weeks and you will have the routine down and it will seem far more manageable! We've all been in your shoes so we really do understand just how much this can make your brain hurt!!

On this Board, we use 150 as the post and ask for help number. (Health uses a higher "no shoot" number.) With Lantus, the mantra is "Shoot low to stay low." however, we don't expect that you will begin to shoot low numbers your first couple of weeks.

It's important to do your best to get at least 4 tests per day -- your two pre-shot tests and at least one test during both the AM and PM cycles if your schedule permits. I'm a bit of a testaholic and I like data so I will always encourage you to get more rather than less tests but you need to balance testing with a reasonable lifestyle. Basically, the more data you collect, the more quickly you will be able to get a handle on your kitty's patterns. Getting a mini-curve (testing every 3 hours) will help you to see when Lantus onset begins and where your kitty's nadir falls. This first week may be atypical since it will take 5 - 7 days for the insulin depot to form.

I test and when Gabby's face is in her food, she gets her injection. She's very food motivated and doesn't even notice that she's getting a shot.

Drops below 50 indicate that your cat gets a dose reduction. Kitties also can get a dose reduction is they are in largely normal (green) numbers for a week. Everyone panics when they see numbers below 50. If you think numbers are dropping, please post. We'll walk you through how to manage the numbers. There's also information on Shooting and Handling Low Numbers in the sticky note above. There is a huge volume of information in all of the sticky notes. I'd encourage you to read them and to print out the note I linked. If the Board goes down or your computer isn't working, you'll have the instructions that you'll need.

Please let us know if you have questions. The people here are very generous with their time and their knowledge. We're all here to lend a hand! And again, welcome.

 

Re: How long does lantus last in the fridge?

Hello Rita and Portia and welcome to LL
You are in the best place for Portia. You will get the best advice and support here. It really is a big family.
And I know it's hard to believe now but you really will begin to understand and absorb all this information.
It is sooooo overwhelming at first, but we are all her with one agenda...to help you and Portia
So take a deep breath...everything will be ok!!

 

Protocol for beginners

Hey all,
Thank you all for the detailed messages and the support. I really appreciate it. This is perfect. Couple of questions (and I apologize in advance for asking too many questions)
1. When you say pull food 2 hours before food, does that mean I can feed her 2 hours before and just make sure she doesnt eat after that till just before I shoot? The reason I ask is because Portia eats around 6am and I was planning to work with her schedule and let her eat at 6 and then give her the insulin at 8. Will that work?

2. How often for the first week should I be doing glucose curves (either the short one or every 2 hrs). Portia's ears dont bleed well at all so Im trying not to poke her often till her ear "learns" to bleed.

3. I plan on doing 4 reading every day as suggested so the previous question is specifically about the curves.

4. I will post her glucose reading tomorrow and I would appreciate any input.
Thank you all for the warm welcome and all the suggestions. I will be reading all the posts and stickies tomorrow. Thank you again so much for all your help and Im sorry if Im asking the same questions again.
Thanks
Rita

 

Re: How long does lantus last in the fridge?

Most of us do not feed our kitties after nadir. Feeding late in the cycle may end up inflating numbers since there's less insulin available to offset the effect of food. However, some kitties are used to grazing. You do not want to feed 2 hours prior to shot time. If you do feed at +10, it should be a small amount. Since Lantus onset isn't until roughly 2 hours after you shoot, you do not have to feel well in advance of giving a shot.

I would get a couple of mini-curves. In actuality, getting random spot checks will yield more information than always testing at the same time. Think about getting tests before you leave the house, when you get home, before bed, etc. This will help to fill in the blank spaces on your SS.

Reading other people's threads (we call them "condos") is also very helpful. You will see the discussions and questions you haven't even thought of yet will be answered.

 

Re: How long does lantus last in the fridge?

don't worry about asking questions. we've all been in your shoes and had all of those questions too. you'll find that many people post every day and often your questions will be answered fairly quickly. sienne is right - you'll learn a ton by reading other people's posts.

taking it one day at a time is a great plan. the learning curve is steep, but within a couple of weeks you'll feel like you're starting to get it.

btw, as you poke portia's ears she'll grow capillaries. so your pokes are not in vain!! has anyone mentioned neosporin with pain relief to you? it's great for numbing the owie. you can slather it on at night and the ear will heal overnight. then wipe it mostly off before you test so the ointment doesn't goo up your strip.

 

Hi everyone,
I think I made a mistake with my last post so Im reposting:

I gave Portia her first insulin shot today but her AMPS was only 239. Is that dangerously close to the no shot limit for a beginner? We started tapering her pred since yesterday so Im not sure if that contributing her low BG. Her BG curve on tuesday (with no insulin) was between 275-350. Im confused. ANy thoughts

Rita

 

The 239 is fine. How about getting a test at +2?

You might want to start a new thread (aka "condo") for today. Unlike on the Health board, we open one condo per cat per day. We also link our condo from the previous day to the new, daily condo so it's easy to backtrack. We also use a specific format for subject lines:

date kitty's name AMPS-#, +time=#​

So for today, your subject line would read:

11/8 Portia AMPS-239​

Did anyone happen to mention that using a human glucometer is just as accurate as the Alpha Track and it will save you a huge amount of money? The Alpha Track strips are very expensive and you can't get them anywhere except from a vet or online. Most of us use a human meter.

 

Most of us test/feed/shoot..all within about 10 minutes. If you usually get up and feed at 6, you might want to go ahead and test then, then feed/shoot. At 8am, you can get a +2 test (which is a really good test to get since it can tell you if you're going to have an "active" cycle or a normal one). If the +2 is a lot lower than the Pre-shot, you're going to probably have an active cycle and will want to get more tests in