Introducing Toonces to the Lantus group

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Janet

Member Since 2014
Toonces' Story

Hi.
The link above is the information for Toonces. I have been filling in her ss. She is on 3.5 units of Lantus. What should I do now? Does the Lantus need to be increased? She was previously on 9 units of prozinc, but as you can see in her story, it didn't work for probably many reasons. Can someone please tell me what I should be doing? The Lantus has brought her down to the 400's...which is better than the prozinc ever did, but still not good.

Janet

I forgot to say, today is her 5th day on lantus.
 
Welcome to Lantus Land Janet and extra sweet Toonces!! (I love that name!)

Since Toonces is a new Lantus user, we hold the same dose for 5-7 days (10-14 cycles) to "fill the depot". After that, increases are made in .25 units (so it's important to have the syringes with 1/2 unit markings since that's the best we can do)

It's totally possible Toonces doesn't need even 3.5units. We usually start at 1 unit and go up slowly to make sure we don't miss a "perfect" dose. Too much insulin can look like too little, so it's hard to say which he might be.

I think since you've come this far, it's probably best to go ahead and continue with the 3.5 for the full 5 days unless he drops below 50 (80 on AlphaTrak) which gets an automatic reduction in dose.....but there are more experienced eyes than mine that might suggest a different dose

If you can run to WalMart, you can get a Relion meter and save yourself a LOT of money on strips. If you're going to continue to use the Alpha (at least for now), would you please edit your Signature line and add that you're using the Alphatrak?

Go back to the User Control Panel, and in the Signature line, put your name and Toonces, the type of insulin you're using, the type of meter (you might want to put this in BOLD or a different color as long as it's the Alphatrak since so many of us use human meters), the type of food you're feeding..and of course the link to your spreadsheet which is already there.

Once again, welcome to the group and ask all the questions you can think of! Read others condo's and you'll learn a lot too!
 
Thanks Chris, I will edit my signature line. It,s hard watching her feeling so bad. Her ps this morning was 486. I checked her at +4 because she was laying flat out by her water dish and she was 566.
 
hi janet! read through your other post - you've had quite a time.

you're in the right spot now, so take a deep breath and know that we'll do our best to help you get Toonces regulated. what a cute name!

when you switched her food to the Wellness, you reduced her carb load significantly, so she *might* need less insulin. It's hard to know when she was at 9u Prozinc. btw, that's one of the 3 best for cats, so it wasn't a bad call to put her on it. But Lantus and Levemir last longer in a cat's body and that helps cats even their blood sugar out even more.

So you're in MIchigan - how many hours away til your next shot? i'm thinking it would be good to have a few more eyes on her situation to look at her dose.
 
ok, perfect. check back here before you shoot.

When did you make the switch to the low carb canned food?



btw, i was buying the "buy 4 packs and get one free" of strips from American Diabetes Wholesale - 250 strips for about $70. I had a Relion Confirm meter - you have to get the meter first and then buy strips that work with the meter. http://www.americandiabeteswholesal...-sensor-blood-glucose-test-strips_4050_54.htm

I also used the Terumo syringes, which are fairly accurate and really glide easily. At the point where you're in need of new syringes, you might consider these. many people here like them. http://www.americandiabeteswholesal...-sensor-blood-glucose-test-strips_4050_54.htm

Many people switch to human meters - even though it seems ridiculous to get a new one when you've got one that works, those strips are so expensive that you recover the cost of a new meter very quickly.
 
oh - and there are plenty of good cheaper meters out there. i'm not saying you have to get a Relion Confirm. But it's one option. Others use other meters as well. It's just the one I know. If you want suggestions on meters, edit the subject line of your FIRST post here and put something about meter advice in it. that'll bring out everyone! :-D

the only ones you wouldn't want are the Freestyle - which is awesome and accurate for people, but somehow in how it works, it doesn't measure cat's high numbers as well. Also there are some meters with "true" in the name that aren't very accurate. in the "New to the Group" sticky there is a link to Consumer Reports on glucometers.
 
Toonces has eaten wellness chic/herring for the past 3 years (I learned the hard way how bad dry food was three years ago when my male cat Trooper had to have emergency surgery for a plugged urinary tube).

Unfortunatly, when the vet diagnosed her her with diabetes two months ago, he insisted she had to be taken off of Wellness, which he had never heard of and be put on Hill WD. When I read here that Wellness is lower carb than Hills, I swiched her back to Wellness two days after she was put on Lantus.

So, she,s been on Lantus for 5 days and back on Wellness for 3days.
 
Hi Janet and Tounces and welcome!

I have been a few days ahead of you in this journey and I can tell you this forum is overwhelming with support for you both. I am simply on day 1 of doubling scooters Lev so I have no advice but I am sure you will feel the same as I do about the support.

It is so sad when they lay near the water. I totally understand. That is the reason I took my other sugarcat Jack to the Vet. He was telling me. Crossing my fingers and praying the Lantus works for you both!

Linda
 
I probably will switch meters in the future..right now my brain cannot handle the switch. I think I,ll continue paying the high price for the strips until I see some progress with Toonces.
 
Hi Janet,

Welcome to you and Toonces. You are definitely in the right place. There are a lot of people on this board with a LOT of experience and tons of knowledge, and they will jump right in and help. You can generally find someone to answer a question at any hour of the day. I highly recommend that you read all the stickies, and follow the advice you are given. The people here literally saved my kitty's life. I am not smart enough to give advice - I just want to give moral support and encouragement because I benefited, and continue to benefit from this board. Good luck with Toonces. I know you will have her feeling better soon! :-D
 
it's fine to keep using the AT as long as you want. You probably want to put it in your signature line in nice big letters so nobody giving you advice misses it.

the start to this Feline Diabetes dance is overwhelming. there's a steep learning curve in the first couple of weeks, but it gets infinitely better and before you know it, it becomes relatively routine. just keep plugging and asking questions for now and it really will get easier.
 
Hi Tricia and Cinco,
I just read Cinco's story. Wow, what a wonderful person you are to take in a stray kitty and do so much for him. I also read his SS...gives me hope for Toonces.
Janet
 
Welcome to Lantus Land, Toonces and Janet :-D You're off to a great start just being here and asking questions, and hometesting ;-) Have a great night!
 
janet, just having another thought. punkin started out with Prozinc and then the vet switched him after a while to Lantus. What I didn't know and what the vet didn't think to tell me, was that you use a different syringe for Lantus than you do for Prozinc.

Did you change syringes when you made the switch? You should be using a syringe now that is labeled for u-100 insulin. Is that what yours are?
 
Welcome to Lantus Land!

If it has been 5 days/10 cycles since you started Lantus and since Toonces is back on low carb food, it sounds like you're in a good place to start Tight Regulation.
REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

  • Kitty should be monitored closely the first three days when starting Lantus or Levemir. Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9. More monitoring may be needed.
  • It will be necessary to test kitty's blood glucose levels multiple times per day.
  • Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
  • Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
  • Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
  • Feed a high quality low carb canned or raw food diet.
  • Feed small meals throughout the day. Some kitties adapt well to free feeding.
Click to expand...

According to this dosing protocol, you give the initial dose of Lantus 5 - 7 days to stabilize and to allow the insulin depot to form. Once you're past the initial period, it's time to increase the dose.
"General" Guidelines:

  • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
  • Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
  • Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    If your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    When your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

So, based on the protocol, you may want to increase Toonces dose by 0.5u to 4.0u.

A couple of points. Lantus is different than Prozinc. You do not adjust the dose based on the pre-shot numbers. Doses are changed based on the lowest number in the cycle -- the nadir. Lantus is a depot-type of insulin. It is long-acting and one advantage is that there is overlap between the doses.
 
Hi Janet and Toonces

Glad you found us!!! Welcome to Lantus Land. You can see we have a very warm and close knit family here anxious to help and offer all the support you need.

You've been given a lot of info today and the first month of the journey is overwhelming as it is. So I'll just extend our welcome and encourage you to ask as many questions as you can think of. There's usually someone here almost 24/7 so any time you need help, don't be bashful.
 
Julie, yes the vet switched me to u100 31guage 5/16" syringes. I really dislike the 5/16 needle. I have to put my ear right down on Toonces when I give her the shot so I can hear it going through the skin...with the 1/2 inch u40s I never had that problem..I could feel them break the skin.

Caryl, that's how she got her name...she was a stray kitten that showed up at my parent'ts house 15 years ago. When I got in the car to leave my parent's house, she jumped in the car and put her paws on the steering wheel. She looks just like the cat from Saturday Night Live and so I named her Toonces and took her home. :-D
 
Sienne..should I increase to 4units tomorrow? I guess I'm just waiting for someone to tell me what to do next.
 
Janet

Yes....unless she comes way down tonight, please increase her dose to 4u tomorrow morning in accordance to this part of the protocol:

Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Click to expand...
 
Hi Janet and Toonces and welcome to Lantus Land,

You've gotten lots of good information, so I'm just going to say that you have come to the right place. Is Toonces a long-haired kitty? If so, it may help when giving the shots (with any length needle) to pull up on her hair. You will see skin easily. Pulling up the hair also pulls the skin into the "tent", so all you have to do is shoot under the "tent", parallel to her body. Rusty is a Maine Coon mix and has very long hair. I had real problems at first finding skin (Stu, my previous diabetic kitty was a short-hair). After learning the pulling-up some hair technique, it became much easier. (Which is not to say that I don't give any "fur shots", but that seems to be my particular problem!) In any event, I use the Terumo 31-gauge syringes with 3/8-inch (9mm) needles and have never had a problem. You can buy them at American Diabetes Wholesale: http://www.americandiabeteswholesal...ro-insulin-syringe_5891.htm?source=SiteSearch.

If you are going to order syringes from ADW, you might as well at the same time order a "back-up" meter, which, for reasons of cost, may soon become your "regular" meter. ADW sells the Arkray GlucoCard 01. This is the same meter as the Walmart Relion Confirm (the Confirm is Walmart's store-branding of the Arkray GlucoCard 01). You can buy the Arkray in a kit that includes various numbers of strips, depending on which kit you buy. Here is a link to the kit with 100 strips:
http://www.americandiabeteswholesal...d-01-blood-glucose-monitoring-kit_4044_53.htm
For future reference, ADW also has a deal where you can buy 5 boxes of strips for the Arkray GlucoCard 01 for the price of 4.

Welcome to Lantus Land!!

Ella & Rusty
 
Hi Janet and sweet Toonces..you have found the right place to get help.

The advise you are already receiving is so good and since I am pretty new to the board I do not have much advise to offer.
What I would like to give you is encouragement.

I originally posted a similar cry for help like you did about 1 month ago and just today my Kitty - Monet- is off insulin (OTJ - off the juice)!!! Please listen to what members here tell you because they saved Monet's life !!!

My vet put Monet on 4 units of Lantus 2 times per day and I came close to losing him because the dosage was way higher that it should have been. Thank God I found this site when I did and the first thing I was told was that I needed to reduce the insulin down to 1 unit ASAP. Actually, if I had found this board prior to starting Monet on Insulin, I might could have controlled his BG levels through diet alone. The low carb wet food makes a huge difference ! Make sure you read the link that others have already given you to the food

I just wanted to reach out to you and let you know it will be OK and you can do this !!!

BTW....I am an AlphaTrak 2 user too ;-)

Here is link to my original post for help : viewtopic.php?f=28&t=106821&p=1132372#p1132372
 
Janet said:
Toonces has eaten wellness chic/herring for the past 3 years (I learned the hard way how bad dry food was three years ago when my male cat Trooper had to have emergency surgery for a plugged urinary tube).

Unfortunatly, when the vet diagnosed her her with diabetes two months ago, he insisted she had to be taken off of Wellness, which he had never heard of and be put on Hill WD. When I read here that Wellness is lower carb than Hills, I swiched her back to Wellness two days after she was put on Lantus.

So, she,s been on Lantus for 5 days and back on Wellness for 3days.
Click to expand...

i think where our confusion is on how many days Toonce has been on Lantus. If she's been on for 5 days you could increase tonight. the spreadsheet only shows today as day 3.

So if she's on 5 days, go ahead and increase tonight.

Keep asking away! we all have been in your shoes and we get how confusing it can be.
 
I misread or missed that she has been on lantus five days. I would suggest you modify her SS by inserting two more lines above 1/10 to show when she started lantus and the dose she started at even if you weren't testing. That gives us a better picture especially if, in the case of moi, "we" somewhere missed the five days ;-) ;-)
 
I'm sorry for the miscommunication, my fault, I listed her first two days in my original post and thought you wanted me to start a spreadsheet from that point forward..I will go correct that now.

I will start her on 4 units tomorrow.Her shot is at 9:15 am est. I have an appointment at 10:00 but I plan on being home by 11:00 to test her.

Whenever I increased her on prozinc I had to do a full day curve starting at 2 hours after the shot and every 2 hours after that until her next shot. Is that how I should do it with Lantus or do I still just do the amps and +5 and + 7 ?
 
actually, if you're techy enough, any of the previous data you have would be awesome to insert into the spreadsheet. even if it's not 100% complete, or you have to estimate dates, that helps us tremendously. Any chance of getting the data from the vet on the curves that were done?

Was there any point where you saw, or the vet got tests, that showed numbers under 300ish?

we tend to go from one test to the next to decide when to test next, so it's hard to say for sure now what you'll need to do tomorrow. the TR guidelines say

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
Click to expand...

You're past the first 3 days now. Once we see a clear curve with a nadir (low point) then it will be easier to answer that. I was able to test punkin at +3 and then decide from that point when he had to be checked next. He tended to drop slowly so the +3 gave me a "pointer" that told me where he was going next.

you don't have to do a full curve. you should have no trouble with going to your appt unless you see a low preshot in the morning. many people test until the nadir and then once they can expect what their cat will do, don't test again til the pmps.
 
toonces' spreadsheet is up to date now.

Ella...thank you for the tip on pulling the fur up for a shot..she is short haired but it seemed to work .
 
Julie, the first day on the spreadsheet wed jan 8 is the curve from the vets office. He started her on 3 units of Lantus and told me to give her 3 units that night and then increase her to 4 units on the next day, Thursday jan 9. I only increased her by 1/2 unit because that's what I read here.

He basically told me to keep doing curves and increasing each week until I got results. He admitted that he was pretty unfamiliar with Lantus and always thought it would be cost prohibitive for his patients. I gave him the printout from this site about Lantus lasting 6 months if kept in the fridge and he was very receptive to the idea. I am so glad I found this site because I would have been lost.

Janet
 
Janet said:
Julie, yes the vet switched me to u100 31guage 5/16" syringes. I really dislike the 5/16 needle. I have to put my ear right down on Toonces when I give her the shot so I can hear it going through the skin...with the 1/2 inch u40s I never had that problem..I could feel them break the skin.

Caryl, that's how she got her name...she was a stray kitten that showed up at my parent'ts house 15 years ago. When I got in the car to leave my parent's house, she jumped in the car and put her paws on the steering wheel. She looks just like the cat from Saturday Night Live and so I named her Toonces and took her home. :-D
Click to expand...

One of my all time favorite skits...i wish i could post videos lets see...

Toonces The Driving Cat
 
even the data from Prozinc would be helpful, if it's possible to get that in the ss as well.

not trying to make things difficult, but those bits can tell us things.
 
Thanks very much, Janet for adding that data. Very helpful! I'm sure I would never have remembered there were a couple more days worth of data.
 
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