1/30 Zarley Dose/Schedule Questions

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Zarley's first day on Lantus.

AMPS - 380. I was stunned. Why? Well ever since starting that last bottle of Vetsulin (in late December), his AM and PM PS have been inthe mid to high 400s -- no matter what I tried. I didn't want to start the Lantus overnight, so he's been without Vetsulin for 24-hours and his BG DROPPED.

Tested for ketones yesterday and negative reading thank God (literally).

I wanted to start with 1u, but after my vet completely scared the heck out of me and "guaranteed" this medicine will kill my cat, I decided to start with .50 to see how it affects him - both BG-wise and behavior-wise.

My hands were shaking like crazy this morning, but I did it. He's finally on a new med. I work at home so I'm going to monitor him and test him every three hours (from what I understand it's best to do that for the first few days and then adjust the dosage as needed). Of course any comments or advice welcome.
 
Re: Starting Zarley's first day on Lantus

It is my Bert's first full day on insulin and Lantus.

Good luck and I hope this works better for him than the other stuff did!!
 
Re: Starting Zarley's first day on Lantus

Welcome to Lantus Land Tracy :YMHUG:

Zarley will be so happy with numbers out of those yucky reds.....already!
 
Re: Starting Zarley's first day on Lantus

Good start Tracy


glad ur here with Zarley too!

just a tip, in ur SS, would be a good idea to note the name of the meds Zarley is on, in ur comment box.

will u be around today to gather a couple of spotchecks?
And Zarley is eating wet food now correct?

I'm going to link ur previous threads to make it easier to look back on how u got here....this will be something u will do every morning, when u open your new thread for the day, go back to the previous day and link that thread to the new one. Make sense?

viewtopic.php?f=9&t=4493&p=44032#p44032
viewtopic.php?f=9&t=4389&p=43721#p43721
viewtopic.php?f=19&t=4386&p=42715#p42715


Good luck today!!
 
Re: Starting Zarley's first day on Lantus

((((Tracy))))) You ALWAYS have to be comfortable with what you shoot...that being said, your vet seems like a real d*ck h*ad so I would take what he/she said with a grain of salt. :-Q You're on your way now...no looking back! :thumbup
 
Re: Starting Zarley's first day on Lantus

Updated and corrected: I gave him just under .50 not .25. It was just under that first little line. But half of what I would've otherwise started him on.

He's been on low carb wet food (no rice, wheat or wheat gluten) since his diagnosis a year ago (against the advice of the vet - okay enough about her) and I do have caro syrup just in case.
 
Re: Starting Zarley's first day on Lantus

Ronnie & Luna said:
Good start Tracy


glad ur here with Zarley too!

just a tip, in ur SS, would be a good idea to note the name of the meds Zarley is on, in ur comment box.

will u be around today to gather a couple of spotchecks?
And Zarley is eating wet food now correct?

I'm going to link ur previous threads to make it easier to look back on how u got here....this will be something u will do every morning, when u open your new thread for the day, go back to the previous day and link that thread to the new one. Make sense?

http://felinediabetes.com/FDMB/viewtopi ... 032#p44032
http://felinediabetes.com/FDMB/viewtopi ... 721#p43721
http://felinediabetes.com/FDMB/viewtopi ... 715#p42715

Good luck today!!

Thanks. All my previous stuff before that was wiped out but that's my fault for not visiting the board for almost six months. I don't understand the "the name the meds Zarley is on" comment. He's on Lantus. I think maybe you were asking if he's on other meds maybe? Thankfully, no.
 
Re: Starting Zarley's first day on Lantus

no meds? alright! I thought u meant he is currently on medication...lol thats ok!! Insulin is still a med and an excellent one!!
thats all! :-D
 
Re: Starting Zarley's first day on Lantus

Happy first day on Lantus to you and Zarley!!! :mrgreen:
I was on Vetsulin with my two kitties previously too so I related to what you said. (I think I didn't give any the day before I started with Levemir also...and had similar results! LOL) I am so happy that I finally switched to the longer acting insulin and I think you will be pleasantly surprised too!
Zarley is a handsome boy!! (I love black kitties...)
I look forward to your posts everyday and will be interested in how he does on this....I hated the way Vetsulin would leave them during the cycle and then their PSs were always sans insulin and totally depressing. Not so with Lantus or Lev....so glad you are here! :mrgreen:
(my Raja is OTJ...but Shadow boy is my problem child...still, he is doing so much better nowadays!!)

Oh...and here's the link to your condo from yesterday: viewtopic.php?f=9&t=4389

We link the previous condo in the first post of each day...just so you know...
((Tracy)) I just read your heartbreaking story about Ranger..I am SO sorry.....how tragic ((hugs))
 
Re: Starting Zarley's first day on Lantus

Call it a skinny .5 on your SS that would read: S.50.

This way, you know what it looks like and can repeat it and when you need to adjust you can tweak accordingly.

congrats on your first day! Welcome to LL.

Oh and stupid vet - Lantus won't kill a cat! Sheesh! just look at all the OTJ lantus kitties - I believe there is about 100 since 2008 to present. Tell that to the vet and smoke it.... :o

tee hee - I see I posted here and just posted on your yesterday thread....well that's ok - go give it a read and just know - that everything will be alright!
 
Re: Starting Zarley's first day on Lantus

He started at 380 PS. He's at 220 at +3. Is that bad or what is expected, or .....? I'm used to the 6-hour nadir of Vetsulin so I'm concerned.

Wanting to be on the safe side, plus him acting like he's starving, I just gave him some (regular) tuna.
 
Re: Starting Zarley's first day on Lantus

did u test him just now to see where he's at? Can u grab a test to see where he is at?

and forget everything u went thru on vetsulin, Lantus is much gentler and managable.
 
Re: Starting Zarley's first day on Lantus

Tracy....he is doing great! You can get other tests today, right?
ECID and my Shadow nadirs at about +8 so you will have to test ...maybe at +6 and +8 and then the PMPS...
right? Some kitties are early nadirs too....so you just have to keep checking on him.
It is very hard to forget everything you have been used to with Vetsulin...you will find that the drops are more like a curve rather than the ski slopes!! Lantus is a slow acting insulin and should be with him even past the PMPS...maybe a bit of an overlap. Your data will show what he is doing with it.

You are doing great! This is a happy day!
 
Re: Starting Zarley's first day on Lantus

oh ok!! Cool!

yea Lantus kitties don't always have a nadir at +6, mine took a couple of months before he figured that out...I'd have a +3 nadir, then +4 on another cycle, and so on...some kitties will nadir way past that point like Pat mentioned.

So this is why spotchecks at times u are home to monitor are important. ;-)
 
Re: Starting Zarley's first day on Lantus

Ronnie & Luna said:
oh ok!! Cool!

yea Lantus kitties don't always have a nadir at +6, mine took a couple of months before he figured that out...I'd have a +3 nadir, then +4 on another cycle, and so on...some kitties will nadir way past that point like Pat mentioned.

So this is why spotchecks at times u are home to monitor are important. ;-)

Oh no! So he'll have to be spot checked every few hours forever? I thought it was for the first few days and then periodically after that. How do I ever leave the house not knowing if he'll go into hypo?
 
Re: Starting Zarley's first day on Lantus

Hands shaking or not, you did great!

A quick piece of administrivia. The subject lines for a condo, once you start shooting, should read: date - Cat's name - AMPS - #, and any other test info. So for today, your subject line would read: 1/20 Zarley AMPS-380, +3-220. You could also add "First day on Lantus" or whatever. Also, if you need help at any point during the day, you need to edit the subject line of your initial post to ask for help, note if you have a question, etc. It will also help if you post a reply note if you have a concern since a new post is the only way to bump your condo up to the top of the message board.

Hillary is right about consistency. You want to keep shooting the amount that you shot this morning. For cats just starting on Lantus, the dose is held for at least 5 days to allow a level of insulin to be built up. We refer to this as a "shed." You may actually see more of a response today than within the next few days since some of the Lantus is going to the shed and won't be immediately available for Zarley's body to use. Doses are not changed based on PS numbers. Dose changes are based on the nadir in the cycle which is why spot checks and/or curves are so important with Lantus. Changes are generally made in 0.25 increments. If you have a question about whether it is safe to shoot a PS number, please post and ask. You need to have data to support shooting a lower than expected number but almost everyone gets nervous with lower numbers the first couple of times. For the next couple of weeks, you will need to be gathering data so you know how Zarley is responding to Lantus. (And I'm very jealous that you work from home and can do this!!) You will need to do spot checks - maybe not forever -- unless you're like Ronnie and me (we're a bit testaholic). But, you will need at least PS tests and one other test per cycle, and sometimes more if you need to closely monitor.

Please don't hesitate to ask questions, visit other condos, and read spreadsheets. It's a great way to learn.
 
Re: Starting Zarley's first day on Lantus

^ ^ Thank you!

Yes luckly Zarley is easy to test (my other cat? no way if I needed to). I don't mind testing even AM and PM in the future but every three hours? I'd never leave the house.
 
Re: Starting Zarley's first day on Lantus

not so much every 3 hours...there will be times, you will be testing every 15 minutes thou! Can ya dig it? It's a lot of fun.

Really just depends what Zarley is doing with his numbers that will determine your availability to be around to monitor. You will be asked "are you home to monitor" when you get those magic numbers...When this happens, there will be folks here to guide you along, to give you options based on your data collected.
So it's important to update your numbers on your SS and/or in your daily thread if you're around.

dont panic ok? Life goes on and some people here still make it to the movies. Even I left my house once to go see a movie. And that was a rare treat for me.
If I can do it - you can!
:-D
 
Re: 1/30 Zarley AMPS-380, +3-220

Zarley's pattern will show soon enough...just try to get the tests today...and then tonight...a +4 or
like before you go to bed...or when you can....then you will see the time of nadir.
Let's just look at what you end up with today, k?
It is just to get an idea...you will see that it is going to be ok... :-D

If you want to alternate....if you are off tomorrow or whenever, you can get alternating hours from
what you have data on from today. So tomorrow might be a +4 and +7...see?
After PMPS, you might want a +1 and a +3 or before bedtime...does that make sense?
 
Re: 1/30 Zarley AMPS-380, +3-220, +3-315

+ 6 is 315 :sad:

I thought it was a mistake and tested him again 15 minutes later. Same range.

So nadir was +4? What did I do wrong?

Zarley is used to having a little bit of food (always wet and always low or no carb) throughout the day (otherwise he will meow, non stop). Before his diagnosis, he was a "free feeder" with dry food. I work at home but it's for an outside company that requires me to be on the phone all day. Meowing in the background (or kids, music, etc) isn't tolerated (our calls are recorded) so the only thing between the +4 and the +6 was a few bites of tuna.

I DO think I understand about the initial testing frequency now though. As soon as I see his numbers go lower than they have, testing every 15 is a good idea to see HOW low he goes (and to make sure he doesn't go into hypo) until the numbers start to rise again.
 
Re: 1/30 Zarley AMPS-380, +3-220, +3-315

Actually, you will only test every 15 if you are in a VERY low situation, like 30s 40s 50s even, and then just to see that the number is going up to avert a hypo. When they are in lower numbers we feed them to bring them up a bit. Then as a reward for all that testing, they get a dose reduction (usually).

In my world, I know Morris nadirs at +8, so I usually don't test him until around then or, if I suspect something or he tells me he needs it (yes, they do after awhile) I will test before then. And I usually get in a before bed check just to be safe because my eyes won't be on him. But then we have the other side of the coin, the testaholics. If you want to, you can join them...and you may join them just for awhile until you learn your own baby's pattern.

I went to the movies yesterday myself, first time in about 10 years, but it wasn't because of Morris' diabetes. I usually do just about whatever I want, but always with thoughts of him in the background...it just becomes habit after awhile. Don't worry too much....this is fun!!!
 
Re: 1/30 Zarley AMPS-380, +3-220, +6-315 +9 410

Well, we're already higher than when we started this morning and not even +12 yet. nailbite_smile

I know you're supposed to stick with the same dosage the first few days. Do I do that or try the "recommended" 1u tomorrow (tonight, I'm okay with giving him the same dosage I gave him this morning - at least I know it won't take him anywhere close to hypo).

Also, I gave him his first shot way too late this morning (so late that there's no way I could do much testing after the PM shot). I don't know what I was thinking. Is it okay to give him the PM shot a little earlier tonight (an hour before he's due) since his numbers are high anyway?

Thanks for everyone's help today. I couldn't have made (sane-ly) it without you.
 
Re: 1/30 Zarley AMPS-380, +3-220, +6-315 +9 410

Tracy0504 said:
Well, we're already higher than when we started this morning and not even +12 yet. nailbite_smile

I know you're supposed to stick with the same dosage the first few days. Do I do that or try the "recommended" 1u tomorrow (tonight, I'm okay with giving him the same dosage I gave him this morning - at least I know it won't take him anywhere close to hypo).

Also, I gave him his first shot way too late this morning (so late that there's no way I could do much testing after the PM shot). I don't know what I was thinking. Is it okay to give him the PM shot a little earlier tonight (an hour before he's due) since his numbers are high anyway?

Thanks for everyone's help today. I couldn't have made (sane-ly) it without you.


so u have a couple of questions, when do u raise the dose?
and
you need to make up some time?

what schedule do u want to keep? examples: 6am/6pm, 7am/7pm and so forth
what time did u shoot at this morning?

EDIT: u can always add "DOSE/Schedule Questions" in ur FIRST post SUBJECT line to get eyes on it, ok? Just hit edit on first post, and adjust your SUBJECT line
 
Re: 1/30 Zarley AMPS-380, +3-220, +6-315 +9 410

Well I'm not so much asking when I should raise the dose. I'm asking if since this is my first day and .50 didn't do much, can I just raise it to the 1 or do I need to wait several days.

I shot at 10:30 this morning (EST).

I'd rather do 9am/9pm.

If he was at 400 at +9, I hate to see what +12 will show.

I feel like I failed today.

I guess I'll just raise the dose tomorrow morning and again monitor every three hours. I don't know what else to do.

Today: AMPS-380
+3-220
+6-315
+9 410
 
Re: 1/30 Zarley AMPS-380, +3-220, +6-315 +9 410

no failing here...ur here aren't u?
ur doing the BEST thing for Zarley!! cat_pet_icon

we'll get u some eyes for ur dose question ok?
:YMHUG:
 
Well, he was 460 at +11 so since I need to change his schedule a bit, that's when he got his next shot (again at .5). I'll test again in a few hours and then "we" need to sleep. I won't change any dosages until I visit this board again tomorrow.

Thanks again everyone
 
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