Waiting on Lantus, currently using Humulin N

Hi folks, my Clyde, 8yrs old, weighs 18lbs, on a all protein diet[Friskies classic/fancy feast classic] eats twice a day[approx 6oz] is currently on Humulin N. He is injected every 12 hrs, 4 1/2 units. The Humulin is not working out, I have noticed lately increased drinking. I've read on the site about how Humlin N just does not work well for cats, hence, my purchasing Lantus[from Canada]. I talked to my Vet, he felt he always had no problems w/ Humulin but had no problem with me switching to Lantus. He feels Clyde should get a total blood workup, but, I'm getting the feeling he is not "up to date" concerning Feline Diabetes. He stated I should start Clyde on 2 units/twice a day. His last visit to the vet 2 weeks ago 6 hrs after he ate was 266. A few days ago I began to try to home test, an hour after he ate was 480. I'm having a tough time trying to home test, I think I'll give Clyde a break till I get the Lantus, he's not cooperating at the moment. Any advise would help a newbie Lantus user.

Ritchie... as I was told...you are in the best place you never wanted to be. I'm rather new and have gotten a lot of help from wonderful caring people who live and breathe FD. Someone with more experience than me will be along shortly. Just wanted to welcome you and Clyde.

It's great you are hometesting...it does get easier the more you do it. I reward Ollie everytime I test. Even when I didn't get a successful one he still got a treat. You'll get the hang of it before you know it. Recording the results on a spreadsheet gives an overview that allows the experienced ones to be able to guide you with getting Clyde regulated. Good luck and keep posting.

Thank you Patsy. The spread sheet is my next step.'Only how do I begin? Clyde & his brother & sister have me up, like clock work at 3:30'-'4:00 am,'ready for breakfast. I'm out the door by 5:00am. Do I try testing him before he eats? My wife gets up later,'at 6, but I know she will not even try to test him, she's very squeamish. I return home around 4:30pm. What kind of testing schedule should I set up,'now that you know my schedule?

Hi Richie!! I'm glad you made it over here to LantusLand!! Getting a spreadsheet set up is your top priority!! It's the only way people here can help you with dosing decisions. It doesn't take long to do, though sometimes Google docs is temperamental. There's a link in the stickies at the top of the forum about setting up a spreadsheet. It's very important that you test before giving insulin. All of us here usually test/shoot/feed, altogether. It's easiest to set the food down in front of Clyde, test him while he's eating, and then shoot while he's eating. He'll be so preoccupied by his food that he won't even pay attention to what you're doing. I'm hoping your wife will trytrytry to get over her aversion to trying to test. It's the simplist thing in the world. Have her test herself so she realizes it's no big thing. If you're using a lancet device, you'll have a different setting for the cat compared to yourself, though. When I check my BG, I set the lancet device to the second shallowish level while Champ's level is the second to the deepest. Even though it's their little ears, it needs a big poke. It might even go all the way through, but that's okay. Clyde will get used to it all. Just make sure you put a cotton ball behind the ear so you don't poke your finger. I also get up at 4:00, but I have the luxury of working at home so testing is easier for me. It's important when using Lantus that you do the test/feed/shoot as described above, but you'll also want to try to test a couple times, but at least once, during his cycle. I like to get a +2 because if this number is lower than his preshot number, I know I'm going to need to keep an eye on his numbers during the rest of the cycle because he could go low. If nothing else, a midcycle test is rather important. This is where your wife comes in if she's at home during the day. If she's not at home, maybe you could come home at lunch. Some people aren't able to test during the day....you do what you can, but as much as you can. At night, again I get a +2 and usually a +4. ALWAYS test before you go to bed. I'm sure you don't want to wake up and find Clyde dived overnight and you didn't know he was headed in that direction!! Testing becomes a big nonissue the more you do it. Champ purrs right through it. He doesn't even need a treat anymore for me to test him. I just tap him on his back and he lies down for me. I've even tested him when he was sleeping. He opens one eye and then promptly closed it and went back to sleep as I tested. With Lantus, dose increases and decreases are based on the lowest point in the cycle (called the nadir), not on the preshot numbers, which is why it's important to test throughout the cycle. Not all cats nadir at +6. Champ used to nadir right around +4. Now I'm getting his lowest numbers toward the end of his cycle (I'm still perplexed about that!). In order to know when he nadirs, you'll need to do a curve (testing every two hours for one 12-hour cycle) to see how his numbers flow. Of course, you'll do all this after you start the Lantus and his "shed" has built up (you'll learn about the shed in the stickies at the top of the forum).

I can't wait until you get your Lantus!!! It's going to make a huge difference!! Champ had been started on 3 units twice a day, but when I found this board I reduced him to 1 unit twice a day and started over from scratch. Champ's a big cat, too, at 18 pounds. I think starting at 1 unit is a good idea because you're pretty certain not to miss his perfect dose. You'll increase his dose by only 0.25u at a time. Make sure to read all the stickies at the top of this forum about being new and read the protocol over and over. It might be a good idea to print it all out and take it to work with you so you can give it a read on your breaks (if you have any!).

Ask any and all questions. There are a ton of people here who will be more than happy to walk you right through this and give you all the help you could want. Sienne, Jill, and Libby are three of our most experienced people who spend a lot of their free time helping all of us. They've been at this for years and their advice is always spot on...you can't go wrong following their advice. There are a lot of other experienced people who will be glad to help, too, but to list all the names would take forever!!

Good luck, Richie!!! We post a new condo every day here and link the previous day's condo so all our info can be tracked easily. If you need help, just ask away!

Hi Richie - so glad you posted over here this morning. You've got a few days waiting for the Lantus to come in which can be a great time to get things set up. I'm going to reference some Sticky's here to read and re-read as many times as you can over the next few days. Don't worry if you just "don't get it" at the beginning, it happens to everyone and as long as you communicate through this board, day or night, there will be someone to help.

How to Create Your Own Spreadsheet
Tight Regulation Protocol:
Insulin Depot/Storage Shed
How to Treat Hypoglycemia
Hypoglycemia Toolbox

Also, as you become familiar with these documents, you'll soon learn that most of the advice you get here, is based on these and that "I just don't get it feeling", will start to become an "I'm empowered feeling" because you'll be in charge of Clyde's disease.

Just a double check to also make sure you have your needed supplies:

• Hypo Toolbox (from the Sticky above)
  U-100 syringes (most of us use 31 gauge, 1/2ml, 5/16", short needle - there are variations to gauge, needle, etc. that are perfectly fine, so if you have something slightly different, just post and someone will advise if that syringe will work.
  Alcohol pads
  Lancents
  Meter
  Supply of Testing Strips
  TREATS (I boil chicken and break it into little pieces, other's buy freeze dried...lots of choices, no carb is key!)
  And probably most important - CONFIDENCE - you can do this ;-)

Your home work list is big, I know, but take it step by step.

Your last question was in reference to a testing schedule that works with your schedule and the initial dose is still up in the air. Please send some info regarding the following and we'll keep moving forward. Remember, testing is the key to making this all work and most of the advise you get will be around the feasibility and frequency of your testing!

• We know Clyde weighs 18lbs. Is this a "good weight" for him or is he overweight. If the latter - what is his ideal weight?
  Do you work a typical Monday - Friday?
  You said you leave the house at 5AM and return at 4:30PM every work day, is that correct?
  What is the likelihood of your wife being able to learn to do this? If you think it's possible, what is her schedule (by day and time).
  Is there anyone else that could test during the day if needed?
  Did anyone ever reach out to you near Freehold that could teach you to test?

That should be a great start. Again - welcome - you are doing all of the right things and have come "home", so let's dig in and work to get old Clyde on track to feeling better!

Welcome to Lantus Land!

If 18 lbs is close to Clyde's ideal weight, 2.0u is a good starting dose of Lantus. In addition to the weight-based formula (initial dose = 0.25 x ideal weight in kilograms), you need to take your dose of N into account.

I would encourage you to not wait to get started with home testing. You can still be using N and test -- in fact, it's probably a good idea given that N is a much harsher insulin. My cat did not do well on it either and I was glad to switch. The sooner both you and Clyde get comfortable with testing the easier it will become. Most of our cats know that treats or food are associated with a test and it's pretty amazing how well motivated these guys can be when food/treats are involved! Freeze dried treats are very popular. My cats like the Wellness jerky-style treats.

If you are having difficulty with the spreadsheet link, you might try this link instead. (Google's been a bit temperamental lately.)

There's an overwhelming amount of information in the starred, sticky notes at the top of the board. Please ask questions! The people here are very generous with their time and knowledge and very willing to lend a hand. Again, welcome to the Lantus board.

Hi guys .. Well looks like everyone here has given you all the info you need and soon Clyde will be on his way to feeling better! This is a great board and there is ALWAYS someone around willing to answer a question or just walk you through the first scary steps .. Have a great day guys!

Jess, my eyes are tearing up typing this, knowing that Clydey has some awesome support. The "welcome home" really hit me. Clydes weight originally started at around 22lbs. I blame his dry food diet in the past. Since he & his brother & sister have been on a WET diet for the past 4 months, Clyde & Casper have both lost weight & look great. Our Vet says Clydey looks great, coat,eyes, everything checks out. I think what kick started this Diabetes was not only his weight, but our vet prescribed a Steriod drops for his eyes, he immediately became as the vet put it "Transient Diabetes". He was then put on glyperide pills, which did bring his BG levels back down. But 8 months later, I began to notice his constant drinking, sure enough, his BG was in the high 400's. Thats when the vet decided to put him on Humulin N. His feeling now because Clydes levels arent under control, he feels there is more going on. I don't believe that. That's when I decided to join this awesome message board. As far as my schedule, there really is no way I or my wife could get home midday for testing, unless we are off. Weekends are probably the only time I can check him. Whe you say +2 or +4, you mean hrs after feeding? So far I haven't seen any unusual behavior with Clyde, he's seems happy & purring, & has a BIG appetite. I'm going to TRY & test him when he is eating later. I'll keep you posted.

Hi Richie, welcome to Lantus Land. I think you will be very happy withe the switch to Lantus.

You are starting out ahead of the game since you are already home testing and have clyde eating canned foods. If this was at your vet's suggestion he may be more up to date than you thin. At least he didn't fight you on switching to Lantus so he is also open to new things.

Reducing the dose when starting a new insulin is not a bad idea, then you can slowly work up to what Clyde needs, as Patty said by .25 units every few days. But you have got to give Lantus time to work and not try to up the dose too fast. Lantus builds up a reserve, a depot or shed, in the body that slowly releases. This is how it works for such a long time, other insulins are in and out of the body quickly resulting in spikes in the BG. Each time the dose is changed the shed needs to re-establish itself, this usually takes about 3 days. By going up slowly you have a much better chance of finding exactly the right dose. If you go too fast and miss it, often too much insulin can also rise BG numbers, so you keep increasing and increasing.

Another blood workup is not a bad idea either, things can change quickly. But don't rely on the vet's tests for BG. Stress often raises a cat's BG and they get very stressed at the vet so the numbers aren't reliable. As to when to test, always try to test before eating! When you got that 480 an hour after eating you were seeing a food spike. Especially before the shot (preshot test) you want it to be a fasting test or a clean test, with no food influence. If possible all food should betaken away for 2 hours before preshot. This test is to be sure that Clyde's BG is not too low to safely give insulin and is important. It is not what dosing is based on, however. That comes from the midcycle tests.

Once you get the hang of it test, feed, shoot takes less than 10 minutes. A lot of us find that the distraction of food makes giving the shot really easy and out cats sit and purr during tests because they know treats are coming. You wife can do it too. My husband was squeamish too, but he handles it like a pro now. This from the guy who nearly passed out in the ER when I gouged my thumb!

i hope we are answering a lot of your questions. There is a ton of info at the top of the board in the "stickies", again you are lucky to have a chance to get up to speed before you start, rather than having to play catchup

I just saw your latest post. Many here work and can't test during the day. They get by w/ tests at night and do more on the weekends. We do what we can. :YMHUG:

Richie, your schedule is your schedule and after all, someone has to make the green to buy all these insulin supplies right? ;-) ;-) Just knowing what you have to work with will help others to guide in the right direction. Many people can't test during the day of a work week and make it work out just fine! Clyde is so lucky to have you and soon, you're going to be on top of everything - take one day at a time and ask away.

BIG [[[HUGS]]] TO YOU GUYS FROM CLYDE & I. THANK YOU. Ann, I was the one who changed my cat's diet after reading Dr.Piersons article on dry food. I mentioned it to my vet & there wasn't really a reaction, cept a "ok". He kinda poo poo'ed the Lantus, saying "you can try it, but there's going to be no difference, and most people go back to Humulin because the Lantus is too expensive". Clyde & I will be the judge of that. Oh, one thing I am noticing, in the litter box where Clyde is Urinating, I noticed the litter clumps are how would I explain it, "sticky", maybe. Is this normal for a Diabetic kitty?

Clyde's urine is "sticky" because his blood glucose (BG) levels are still high. When BG is above renal threshold (somewhere around 220 but this varies with every cat), there is glucose in the urine. Hence, it is sticky. It is also what makes urinary track infections an issue with unregulated diabetes.

Hmmm.... So according to your vet the choice is a less expensive insulin that really doesn't work well with cats or one that has the best track record for getting cats into remission/tight regulation. Show of hands -- who would vote for Lantus? If your vet also treats dogs, his use of N makes sense. It is a good insulin for dogs. For cats, not so much.

hi richie!

welcome to lantus land!

i've heard other people comment on sticky urine - i think that says that sugar is in it. that means there is more sugar than his kidneys can process. not a good thing, but you'll be able to get him under control before long.

i agree with sienne about starting with 2 units. he's been diabetic for a while, is a big cat, and because he's been on another insulin that changes the equation. cats completely new to insulin usually start at 1unit.

one reason for going ahead and starting testing now is that it takes a couple of weeks for a cat's ears to grow more capillaries. when you first start testing you won't get blood every time. it can be REALLY frustrating! it isn't too long before you get blood every time, but in the meantime, everyone here has a bag of tricks they've tried. if you have trouble, just say so and we'll inundate you with ideas.

some basics - make a little rice sock - cotton sock, 1/3 cup raw rice, tie a knot and microwave til comfy warm. hold it on the ear for a little bit. a warm ear bleeds better. you're aiming for the outside 1/4" of the ear from the tip along the outside to that little folded/doubled spot. massaging sometimes helps if clyde will tolerate it. when you've poked, you can kinda "open" the poked spot a little and it might bleed better, or rub around it. if it smears off on you, you can test it off of you. goofy, i know, but it works. put on some neosporin with pain relief (i like the ointment) at night and it will heal by morning. make sure you apply pressure after you've tested so it doesn't bruise.

read the other condos (posts) today from other new folks and you'll learn a lot.

we've all been in your shoes. i think most of us have had vets that don't really understand feline diabetes, but people here do it 24/7. since i registered in february i've seen 29 cats go off of insulin. that steroid use very likely pushed clyde into this. i trusted my gut and while i'm still at the same vet's practice, basically i tell him what i'm doing and what i need him to do - and i come here for diabetes help for punkin. he has thrived with it, and unfortunately, my vet made so many mistakes it's a miracle punkin survived it. you're in the right spot now. we'll teach you so that you can help clyde get healthy again.

in the meantime, good job on the food, get hometesting, get a spreadsheet set up (it lets us see at a glance how his body is responding to the insulin) and keep asking questions!

Good morning Richie and sweet Clyde!

May I suggest that you DO continue to test at least the basics of AMPS/PMPS and what you can do between? When I was waiting on our Lantus to arrive, I thought the same way first. BUT I decided I wanted those days results too so did continue. Now that we're on Lantus, I have a track record of Humulin N's responses as well as the Lantus response. This sure helps me see the differences the Lantus has made and I know it will make a difference to the vet - who's just now learning about Lantus because of 'stubborn' me. I also hope it will help those like you that arrive with the same 'Humulin N' vet issues to actually SEE what happens. As I've said before, KT's still not regulated - his body is scared of those low numbers but we'll eventually get it thru that it's OK as long as we keep working at it!

Big hugs and lots of headbutts,

Sorry, i had a whole long response written, went to get you a link and my browser froze. grr_red Well, at least you vet will let you do what you know is best for Clyde. We've heard all the stories here, vets telling owners that they have to do it his way or no insulin rx, telling them their cat will die, even threatening to have the cat put down.

Back to it, The "sticky" clumps in the LB are a sign of glucose spilling into the urine. That can be tested w/ urine test strips, but BG testing is more accurate. One urine test you shoud be doing is ketone testing, especially if Clyde has been high for a while. You can get the test strips from any pharmacy. Ketones are an indicator of a serious problem, diabetic ketoacidosis. It needs to be caught and treated early. It is best to get the test strip ditectly in the urine stream, but w/ cats that is very difficult. Tess let me do it, ONCE. Since then her butt has been firmly planted on the litter. :roll: Peeps resort to all sorts of tricks long handled ladles, plastic film over some of the litter, replacing the litter with something non-absorbent like aquarium gravel. I finally resorted to the Breeze LB system, non absorbent pellets and a catch tray underneath.

I know you've already ordered the Lantus, did you get a vial or the pens? In the long run the pens are a better value, but cost more initially. W/ the pens you get half again as much insulin, 15ml., and it is in 5 containers . Once opened a Lantus vial has a shelf life of 28 days. It can last longer if handled properly, but no guarantees. Each pen is a separate container so the countdown only starts as each is opened. You will have far less waste.

The other thing is the syringes. We still use syringes w/ the pens, not the needles designed to be used w/ them. Lantus is a u100 insulin and needs u100 syringes. I'm not sure but i think Humulin is u40. Lantus has 100 units of insulin per 1ml of fluid, u40 insulins have 40 units of insulin per 1ml of fluid. Just make sure you have the right syringes. If you haven't gotten u100 syringes yet try to get ones w/ half unit markings. They make it much easier to draw the tiny doses we use. Usually when we increase or decrease doses it is in .25 unit increments. A lot of us like the Monoject syringes. Here is a link to where they can be ordered. [url+ADW]http://www.americandiabeteswholesale.com/product/monoject-ultra-comfort-insulin-syringes_2552.htm?source=SiteSearch[/url] It doesn't specify on the web page that they are half unit marked, but they are.

Ann, I did order the pens, & boy am I getting antsy waiting for them to arrive. I ordered them from Northwest Pharmacy in Canada, but I see they were dispensed from a European Pharmacy. What is the treatment for Ketones in the urine? Now you have me worried. I'm going to try, operative word try, to get a reading when I get home while he's eating. How should I react to; A,high number, or B, low number?

Ann & Tess said:

....... I'm not sure but i think Humulin is u40. Lantus has 100 units of insulin per 1ml of fluid, u40 insulins have 40 units of insulin per 1ml of fluid. Just make sure you have the right syringes. .......

Click to expand...

Humulin N is also u100 so the same syringe lines work for both, no conversion needed.

Hi again Richie! So now knowing more info, I'm going to give you the "what I would do if I were you" scenario. Before that....I want to make extra sure you know where this advice is coming from, it's strengths and it's limitations. I am a nurse by trade and have been treating diabetics for years, critically ill diabetics. I have a diabetic cat that I have only been treating for 2 months. There are soooo many similarities, but equally as many differences. There are some gals on this board (Sienne, Jill, Libby, just to name a few) that could run circles around 99% of the vets out there when it comes to the right thing to do with feline diabetes and these girls have been treating diabetic cats for years and helping people treat their cats for years....so please, if something I say here doesn't make sense, or if there's a "why" to it - please ask, and if one of these ladies says something differently than I...give it tons of weight. I'm an organized person by nature and so goes my mind....For me, getting a schedule down was key and if I can offer you a bit of assistance in telling you what I do....hopefully it will ease this transition for you. Ultimately, Clyde is your little guy and you will make decisions everyday that are different than someone else - which is A-OK - it's a learning process and everyone's lives are different.
FOR NOW:
1. Get your spreadsheet together and while you're waiting on Lantus, test Clyde when ever you can so that the two of you can get a routine down and you can get a hang of it.
2. Get used to posting each day and updating your spreadsheet each day with those tests.
3. Continue on Humulin while you're waiting and ALWAYS test before each shot. As long as you're seeing those high numbers, shoot away.
4. Read the Stickies over and over.
5. Get your self an autofeeder (this will make more sense when you read on). This is the one I use, it works fine, nothing great, nothing terrible...just fits the bill. Pet Feeder

CONSISTENT SCHEDULING (based on the knowledge that you leave at 5AM and return at 4:30PM M-F)
Shooting M-F: ***Lantus is shot on a 12/12 schedule - THIS IS KEY......soooo....
Your shooting times will be 4:45AM and 4:45PM (there is a 15 minute window. It is based off the previous shot. For example: If you shot at 4:45AM, you could shoot at 4:30PM or 5:00PM). Remember....12 hours is key.
Testing M-F: You will ALWAYS test before your morning shot (AMPS) and your evening shot (PMPS). For Lantus, especially when you're new, don't shoot under 200. To put a "time" to it, let's say 4:40AM and 4:40PM (you'll soon figure how long this will take you).
Testing at night M-F: This is a time for you to gather data, so the more you can get in, the better; especially early in the process. I always test my cat at +2 and +3 (2 hours after the PMPS) because this is when I can generally "see what's beginning to happen". Please note - this is my cat and Clyde may very well be different. The only way you're going to be able to figure it out is to test at different times throughout that night cycle (and weekends of course, which we'll address in a bit). I continue to test until bedtime, at different hours, sometimes 2 apart, sometimes 1 and I often set my alarm in the middle of the night at different times so I can see what's happening through a true 12 hour cycle - if you can do this great, if not - no sweat, we'll gather more on the weekend.
Feeding M-F Since your not home to test during the day, the safe bet is to make sure that Clyde has an access to food when the insulin begins to peak. Since we don't know just yet what Clyde s peak looks like, we'll guesstimate based on what's "usually" seen (this average number is +6...which is 6 hours after AMPS). If I left free food down when I went to work, my always starving cat would eat the whole enchilada in one sitting....so this is where auto-feeder comes in to play. If Clyde just grazes, you may not need this step. For this purpose, I'm going to assume he's a chow hound and that an auto-feeder will be used. Sounds like you have a handle on how much to feed Clyde during the day, we just need to take that number and divide it out through the course of the day. Since I don't have "your exact amount", let's just use 10 ounces per day for example's sake. What you would do is take that 10 ounces and divide it by 2, so 5 ounces will be fed during the morning, and 5 ounces would be fed during the evening. During the day, I would further take that 5 ounces and split it up into multiple meals, all based on when you shoot, when you leave home, when your wife leaves home and what Clyde's peak is (you'll also hear the term nadir). Food usually passes through their system in 1-2 hours. So....in a perfect world, you would feed him 1.25 ounces at 4:45AM when you gave the shot, 1.25 ounces at 6:45 AM when your wife was leaving, set the auto-feeder to feed another 1.25 ounces at 8:45AM and the second auto-feeder bowl to feed at 10:45AM. For me this is about safety and what I do with my cat during the days when I'm not home. For me, it assures that if his sugar were to drop into a dangerous level, he'd have some food there to gobble up to help raise it.
WEEKENDS The only thing that is really going to be different here is your ability to test more consistently. I would recommend that once per weekend you run what's called a "curve". It's a more formal way to data collect. Pick 1 of the 12 hour cycles that occurs and test every 2 hours through that cycle. So if you chose Saturday morning as your Curve Cycle: your AMPS would be 4:45AM, +2 @ 6:45AM, +4 @ 8:45, etc...all the way to +10 @ 2:24PM. Then...we'll really be able to see what he does through the day!

LANTUS ARRIVES: First...YIPPEE, YIPPEE!!
Now it's decision time...how much and when to begin. You said Clyde weighs 18 lbs. If you use the formula in the Tight Protocol....2 Units is just about the perfect dose. But there are some considerations. The three biggies I see are as follows: He's been on another insulin, we don't know how he reacts to Lantus, and we don't know what day your going to start. Here's where you have to take what everyone says, and make the best decision based on you, what's good for Clyde, your tolerance and your risk. The main goal for me is safety first, so know that my recommendation is based on that. I do not have years of experience of diabetic cats and Lantus, In such scenarios, I tread very lightly and always err on the side of caution. The guiding and deciding factors for me is this: Your are not home during the week to test - this creates a huge unknown (because #1, we do not yet have data, and #2, we don't know how Clyde will respond). So although 2 units may be the ideal dose, based on his weight, there are too many unknowns for me to call it ideal dose to start. I would say 100% go for it if you knew you could monitor him as he adjusted and as data was collected. But unfortunately we do not have that luxury....so.....if he were mine, I would start lower...and my preference would be to start on a Friday when you know you are going to be around the weekend - Remember, the protocol says to monitor closely for the first 3 days and know that the first dose can take up to 5-7 days to see the effect. Because of both of the pieces of info....
If the Lantus came in and Monday AM was your start, I would probably start as low as 1 Unit because it's a long week of unknowns. If you were closer to Friday, I may consider 1.5. If he's sick and really needs to get going....suddenly 2 units makes sense because lower blood sugars become more of a priority. Again....this is where you have to decide what works for you and for him based on the information given.

TO RECAP
M-F: Test at 4:40AM and 4:40PM and as often at night as possible
Shoot at 4:45AM and 4:45PM (as long as bg is over 200)
Feed at 4:45AM, 6:45AM, 8:45AM, 10:45AM and 4:45PM (split the night too if preferred)
Weekends: Test at 4:40AM and 4:40PM, a curve on either Saturday or Sunday
Shoot at 4:45AM and 4:45PM (as long as bg is over 200)
Feed at 4:45AM, 6:45AM, 8:45AM, 10:45AM and 4:45PM (split the night too if preferred)


If everything I've said up to this point resonates and you still don't feel like you know what dose to start with...ask the opinion of others. Make sure you give them the important points so that they can advise you responsibly.

I hope that this gives you some clarity as to how to begin and what will work for you guys. I'd be remiss if I didn't reiterate again that there are people here with a lot more cat/insulin experience than I, so keep your eyes peeled for their advice - it's priceless.

Welcome, Richie and Clyde! We started on Humulin too and Zener was doing terrible. He immediately felt better when we switched to Lantus. You're in the right place to get help and support.
Liz

Richie & Clyde said:

Hi folks, my Clyde, 8yrs old, weighs 18lbs, on a all protein diet[Friskies classic/fancy feast classic] eats twice a day[approx 6oz] is currently on Humulin N. He is injected every 12 hrs, 4 1/2 units. The Humulin is not working out, I have noticed lately increased drinking. I've read on the site about how Humlin N just does not work well for cats, hence, my purchasing Lantus[from Canada]. I talked to my Vet, he felt he always had no problems w/ Humulin but had no problem with me switching to Lantus. He feels Clyde should get a total blood workup, but, I'm getting the feeling he is not "up to date" concerning Feline Diabetes. He stated I should start Clyde on 2 units/twice a day. His last visit to the vet 2 weeks ago 6 hrs after he ate was 266. A few days ago I began to try to home test, an hour after he ate was 480. I'm having a tough time trying to home test, I think I'll give Clyde a break till I get the Lantus, he's not cooperating at the moment. Any advise would help a newbie Lantus user.

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hello and welcome to the group!
you've already been given a whole lot of information to digest, but i wanted to comment on a couple of things.

if clyde hasn't had a complete blood workup recently, having one done probably isn't a bad idea. a blood work may turn up an underlying health issue... a reason why his current insulin isn't working. if there is something else going on it'll need to be addressed before you'll see better results no matter what insulin clyde is on.

imho, giving clyde a break from hometesting until you receive the lantus you ordered is a mistake for a couple of reasons:

shooting 4.5u of N blindly can be downright dangerous. i'd not only want to know what the preshot number was before shooting, but i'd also try to get some random spot checks done whenever possible to figure out how low the current dose is taking clyde.

when a cat has been on another insulin before switching to lantus consideration should be given to the data collected on the previous insulin when determining an initial starting dose of lantus. i find it extremely difficult to suggest a lantus starting dose when kitty is coming from another insulin without data and i've been doing this for awhile. that's where continuing with hometesting while on on N could be important.

here's a link to Hometesting Links and Tips. the more you hometest the easier it will become for both you and clyde.

hope to see you posting often!

Just wanted to say Welcome! Lots of others have great advice so I won't add more to your already overwhelmed self now. These people are GREAT. They will help get Clyde regulated and feeling much better. The difference in Smokey in just the past month has been amazing- I'm sorry that you're here but glad you found us!

Ok folks, with much resistance from Clyde, I tested as he was eating[he wasn't happy as too what I was doing] I got a good sample, Meter read 581. I'm kinda in a little panic right now, HELP! Should I give my Vet a call tomorrow first thing, he's closed now. Plus I have to leave in about another 2hrs for an engagement. Clyde looks fine & is acting his normal self. Purring away.

If the vet's closed, there's not much you can do. It's possible that there's a food spike. I tend to test (give a treat), feed and while Gabby is eating, give her her shot. With Humulin, you need to feed first. With Lantus, you don't.

What I would suggest, however, is that if you don't have them, pick up some Ketostix. If numbers are this high, you want to make sure there are no urinary ketones. You put the stick in your cat's urine stream (or you can try to use a cup or ladle to catch fresh urine, dip the stick and wait the amount of time specified in the instructions (usually about 15 sec.) You then match the color on the strip to the color code on the container. Trace or no ketones are the acceptable readings. Otherwise, it's a trip to the vet/ER.

I did shoot him first, then fed him, so maybe I was seeing a spike. I got that number just as he finished eating. I couldn't get it before, he was totally uncooperative. I didn't want to force him into testing, but was able to get it right after he ate by holding him on my counter & feeding him some cooked chicken pieces.

pick up the ketostix and try to get a sample to test. just to make clear what sienne was saying - the trip to the ER/vet is if you test for ketones and you see more than a trace or no ketones. she's not saying to take him for the high number. we have seen other cats get HI on their meters, which is over 600.

it is helpful to add water to their food. i add about 50% water to punkin's. it helps to flush out their system.

in general, unless a cat has some compelling reason to need to eat, we try to avoid feeding within 2 hours of testing and the shot. i think i also mentioned above that feeding past the peak of the insulin will result in higher numbers. if you could try getting the food in the first few hours after the shot that might help clyde's numbers.

the fact that he looks normal and is purring is really significant. we give a "whole cat report" on our kitties because their numbers aren't the only important factor. they are more than blood sugar! having him feel good is wonderful!

Yeaaaa, the Lantus has arrived. I followed everyone's advise & gave Clyde 1 unit at 5:00pm EST, [Vet perscribed 2], will try & test him +6? Again try is the operative word, we are working on it. Deb gave me some good tips!!!! I'm going to eye a watchful eye on him for the rest of the night.

Good luck! You might want to think about starting a new post topic tomorrow so people can see what's going on now without having to scroll through this whole one. Remember that Lantus will take a while to start working!!! Woohoo for joining the Lantus train!

Welcome to Lantus Land!

was the 581 your preshot reading?

I would get some tests tonight whenever you can. You don't have to wait until +6. Then start working on your spreadsheet. :mrgreen: We'll be watching closely to see how Clyde responds in the next couple of cycles. If his numbers stay this high, then we might suggest going up in dose fairly quickly at the beginning. The goal is to get his numbers down as quickly as we can safely do so. Keep posting daily, ok?

Aren't presents in the mail great?

Ditto on what Libby said. Let us know how we can help.

Sienne and Gabby said:

Aren't presents in the mail great?

Ditto on what Libby said. Let us know how we can help.

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ok, Just checked Clydey, +4, 411. At 5:00pm I had given him 1 unit.

Richie:

Just to lend us a hand, we change the subject line to list out our test data. This is a quick way for people to scan the board and see if someone needs help. We have a convention for our subject lines: date, cat's name, pre-shot test, +hour-BG#. So for Clyde, today's subject line would read:


Also, when you have a chance, can you complete a Profile on Clyde? It will give us important background information.

And, getting your spreadsheet up and running will be very helpful.