10/9 - Lantus - Flash - PMPS - 99

Discussion in 'Lantus / Levemir / Biosimilars' started by Flash's human, Oct 9, 2019.

  1. Flash's human

    Flash's human Member

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    Mar 19, 2019
    Yesterday's post: http://www.felinediabetes.com/FDMB/threads/10-8-lantus-flash-pmps-356.220208/
    While he approached 100 today, I don't feel giving him insulin makes much sense. He had a little watery vomit this morning, but I attribute that to more of a hair ball since he started cleaning himself more now as he feels better, and it really was a small amount. I probably will still give him 3 UI tonight if his glucose is elevated as I expect w/no insulin given this morning. Do people sometimes just give 1 UI if the number is this low or is that still somewhat dangerous since I'm not around to watch his reaction today?
     
  2. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Bumping you up for dosing advice. Don't worry, together with you, we'll find a good dose for Flash.
     
  3. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
    Keeping you bumped up. :bighug:
     
  4. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
  5. Sonia & Leo

    Sonia & Leo Well-Known Member

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    May 24, 2018
  6. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Hey there, I think since you are not going to be around to monitor, skipping sounds like a good idea. I trust he’s never been DKA? If he had then we would rethink things.

    ETA: sorry I saw this late and I assume you skipped. Had you been home to monitor, I would have said to shoot. We wait to get great lower numbers to shoot ( above 50). Lantus isn’t good at pulling high numbers down , but is good at keeping lower numbers flat. You’ll get your chance again to shoot a green that you can monitor.
     
    Last edited: Oct 9, 2019
  7. Flash's human

    Flash's human Member

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    Mar 19, 2019
    I did ask my vet about that, his ketones fortunately have never been at a level where DKA was a concern. Ok, so if I work from home on Thursday where I could monitor him, you are saying I would be safe in giving him say 1 UI of insulin if he's at least between 50-100? And, if he drops below the 50 I just have to be ready w/an item to give him that has high blood sugar? I'm starting to question if he should really get 2 UI at night, 3 may be too much now w/dry food removed from his diet.
     
  8. Flash's human

    Flash's human Member

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    Mar 19, 2019
  9. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    They're already being used on some cats here. It's called the Freestyle Libre

    While it sounds good to just scan and go, it's really not a substitute for blood glucose testing on the ear though.....and we've had several complaints about it's use. It's supposed to stay on for 2 weeks but rarely does (more often just stays on a few days)….it's expensive to use, especially if you have to put a new one on every few days when the cat knocks it off, and we've had cats that had horrible reactions to the glue that's used as well as getting hurt when they tried to remove the sensor.

    Maybe someday they'll figure something out that works better in our sugarcats though.

    If you do a search for "Libre", you'll probably find several posts about it's use here
     
  10. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    I hope you'll be able to give him his insulin tonight...Lantus loves consistency...consistent dosage, consistent time, etc. If you change the dose it can cause the BG numbers you'll get to be all kinds of wonky...I still don't see which protocol you're following??? I presume SLGS? The slower of the two?
     
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  11. Flash's human

    Flash's human Member

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    Mar 19, 2019
    Yes, SLGS
     
  12. Flash's human

    Flash's human Member

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    Mar 19, 2019
    very interesting, i work with a diabetic who has a system like this. For this to work on a pet, I figured a kind of chip would have to be implanted, otherwise it would be too easy to knock off.
     
  13. Sue and Luci

    Sue and Luci Well-Known Member

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    Nov 3, 2017
    If you could put that on your signature it would be very helpful. Thanks!
     
  14. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    It looks like even the 3 unit dose may be too much. I'll let more experienced people weight in on that.
    @Chris & China (GA) @Wendy&Neko @MrWorfMen's Mom

    It is very important to get some mid-cycle readings. Lantus dosing is based on the lowest point of the cycle.
     
  15. Flash's human

    Flash's human Member

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    Mar 19, 2019
    ok, that will happen tomorrow during the day.
     
  16. Flash's human

    Flash's human Member

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    Mar 19, 2019
    done.
     
    Sue and Luci likes this.
  17. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    For now until you have more data to know how he responds to shooting lower numbers , I would stick with not shooting anything under 150. I got ahead of myself this morning when I talked about shooting a green number. Even though he was diagnosed May 2018, it looks like you just started testing the end of September.

    Ideally, you want to get to a dose that you can shoot twice a day, so his present dose could be too high. I’m not sure where he is since the dose had been changed up frequently.

    With SLGS you will hold a dose for 7 days before increasing. You would give a reduction if he goes under 90.

    I’m thinking it might be a good idea to shoot 2 units tonight and hold that dose for 7 days unless he earns a reduction. It will take about 4-6 cycles for the depot to fill and know if that is a good dose. If he needs a higher dose after 7 days, the increase would only be .25 of a unit. We raise and decrease in increments of .25 so you do t go over the best dose

    He will likely be higher tonight from skipping this AM. Let’s see what 2 units can do and go from there.Or Maybe some of the others that were tagged will weigh in.
     
    Last edited: Oct 9, 2019
  18. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    I agree....3U looks like it may be too much (but with the 4 and 5U depot in play, that adds another wrinkle into it)

    I think going down to 2U and getting as many tests as you can in is the best plan going forward. If you absolutely can't get mid-cycle tests on the AM cycle due to work, it's really important to get at least 1-2 tests on the PM cycle. (Welcome to the wonderful world of sleep deprivation known as Feline Diabetes! ;))

    If he drops below 90 again on the 2U dose, we may need to go even lower.
     
  19. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    I agree with Bobbie and Chris. I'd try the 2u dose and get mid cycle tests as often as possible to see how that plays out so you can hopefully shoot consistently day and night.
     
  20. Flash's human

    Flash's human Member

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    Mar 19, 2019
    485 PMPS, gave him 2 UI as requested, will see what tomorrow brings...
     
  21. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Good luck with the new dose. I hope you can get a test in before you go to bed tonight.
     

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