Help with starting Lantus

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Hi guys, I was hoping that I could get some help starting on Lantus. We have been an Vetsulin since I came to this board and discovered that my vet had very wrongly put Tigger on Humulin R. I should be receiving Lantus this afternoon, (thanks Leslie!) and needed help with dosing. I haven't found a new vet yet, and I refuse to call the old one for their input.
 
Hang in there.....I know others will be by to help!! I am still a newbie so can't give advice on what dose to start with but WELCOME TO LL (Lantus Land) :YMHUG:

You are in good hands here.
 
Hi!
I remember you! Hard to forget an R kitty :) He's getting quite a reaction from the Vetsulin. The drops are too steep to be beneficial, and he's going to be feeling badly from them. Yesterday he dropped over 450 pts in 4 hours, that makes kitties feel icky, but it also causes the liver to get involved and start protecting the body from the rapid drop, which in turn causes those really ugly numbers in the 500-600 region. In other words, those high numbers are not from his diabetes, they are from the reaction to the insulin.

I think I would like to see you start on a nice 1/2u dose when the Lantus gets there. He needs a break from all the up and down, and I am very concerned with his response to vetsulin. Great job getting all those numbers, way to jump in!
 
BY THE WAY... please tell me you have U100 syringes.. Are you the one whose vet issued U40 syringes with U100 insulin? Lantus is U100 and you must use U100 syringes with it. If you don't have them, run to the pharmacy and get them. If they can't sell you a whole box, you may be able to pick up an emergency bag of 10. If you have a choice, ask for the ones with 1/2u markings on them.
 
Carolyn was the wonderful one who helped me decide on a dose to start with. :mrgreen:
 
I don't have U100 syringes yet, but I will be getting them today. The grandma of a friend of mine passed away and they are giving me a bunch of syringes, and if they are not the right ones then I will be buying some. Should I start him on the Lantus tonight? Or wait until the morning when I will be awake to monitor and see how he does? Also, before this diagnosis, all of my kitties were free feeders. They are all very upset about only getting 2 meals a day. Could I leave wet food out all day for them to graze, or is that not acceptable for the diabetic kitty?
 
Hi Mandy and welcome to LL.

A couple of questions...

From your SS, it looks like you were giving either 1.0 or 1.5u of Vetsulin, right?
Do you happen to know Tigger's ideal weight? One way to estimate starting dose is by ideal weight. Usually, this works out to somewhere in the neighborhood of 1.0u.

If you've not already had a chance, you may want to take a look at the dosing protocol that we use as well as all the the "stickies" - the permanent notes/announcements that are starred at the top of the Board.

I'm wondering if you vet gave R as a bolus insulin to help reduce a high blood glucose (BG) level or if it was a mistake. Oh well... If you post in Health and indicate your city, people may be able to recommend a new vet, since it sounds like you're in the market for one!

Whatever you learned about Vetsulin, try to forget it. Lantus is very different. You will need to test at AMPS and PMPS but dosing is not based on pre-shot data. Rather, it's based on nadir. The good news is that you've been getting mid-cycle data already! You will need to get spot checks during the PM cycle, as well. Many cats have lower numbers in the evenings so by not testing during the evening cycle, you're missing half of your data. Another big difference between the two kinds of insulin is that we don't change doses the way you do with Vetsulin. Doses are held for at least 3 days -- more at the outset. Dose changes are typically made in the amount of 0.25u. Gradual changes in dose insure that the optimal amount of insulin is not skipped over.

Do you have u100 syringes in half unit increments? If not, having syringes that are in 0.5u doses will make your dosing life much easier.

Please ask questions, visit other threads (we call them condos), and read our spreadsheets.

Two meals a day is not mandatory. Most of us give a slightly bigger meal at shot time but also give snacks or mini-meals throughout the day. Having low carb, canned food available for free feeding is fine -- unless you have a ginormous cat that needs to lose a few pounds!
 
I leave the wet food out all day for all 4 of my cats. As long as it is low carb it is fine for TIgger to graze. Actually it is good that they have little meals throughout the day. I keep my house cool enough that having the wet food out for too long does not pose any problems. I feed at the AM and PM shot times, so there is always food out.
 
I think that is what I will start doing with the food. I'm not sure what his ideal weight would be. he has lost a lot, and is about 8 pounds right now, he definately needs to gain a few back. I've never seen that dosing page before, when I have a little time this afternoon I will sit and read it all.
 
Cindy - thanks for the links.

Mandy - geez! What a few days you've had. I would have been ready to kill my vet and would have been calling the licensing board about the on-call person. I'm so glad Tigger is ok. BTW, if you haven't switched meters, strips for the Contour are pretty reasonable on Amazon. I use a Contour, as well.

Based on his current weight, Tigger's starting dose would be around 1.0u. If you're more comfortable shooting less, that's fine too. I'd like to suggest that you wait for some of our experienced users to stop by and make a recommendation regarding starting dose. How much time do you have until your PM shot?
 
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