Question regarding second dose (just started)

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Raechel

Raechel

Member Since 2015
Phobos started Lantus today (dx a week ago). The vet had us come in to get it since it had to be ordered in last week. By the time our appointment rolled around and the vet gave the insulin, it was noon. I'd like to do dosing at 8:00, which I told her. She said it was no problem to give the dose at noon today and then the second one at 8pm. Just wanted to double-check here with you knowledgeable folks and see what your thoughts/experiences are. Should I really do the dose at 8 or should I be adjusting the time more gradually?
Thanks!
 
No!! Lantus needs to be giving every 12 hours, so now you're kind of stuck waiting until midnight to shoot (you can move shot times 15 minutes per cycle or 30 minutes per day to get back to your chosen time....so that would be 11:45pm tonight)..then 11:30am tomorrow, 11:15pm tomorrow night, etc....

You may want to just start over in the morning and shoot at your chosen 8am

Do you know you can get Lantus at any human pharmacy? How was the insulin from your vet bottled? Lantus only comes in 10ml vials and Solostar pens that are 3ml each....it's not supposed to be "repackaged" if that's what your vet is doing
 
Thank you for the info! That's what I was afraid of - that I would have to wait the full 12hrs. It won't be an issue to skip tonight's dose and just start at 8am? That sounds more reasonable than trying to move it by small increments.

Unfortunately, I learned a lot after the Lantus was prescribed & ordered on Friday. My husband and I were just discussing looking for cheaper ways to get the Lantus - pharmacy or online perhaps. I didn't know until after it was ordered, that the Lantus comes in the pens...that would have made a lot more sense and saved oodles of money, I'm sure. The vet had us get the 10ml vial. It is not repackaged.
 
For humans they say not to refrigerate, that's because they get much larger doses and it's uncomfortable. They also use a vial up much more quickly. However, if you keep the Lantus refrigerated it will last much longer than the recommended 28 days. Just handle it gently, no rolling or mixing, it doesn't need it. And don't store it in the door of the fridge, les temperature swings and jarring.

You can ge an Rx from you vet to be filled at any pharmacy. GoodRx.com will give you comparisons for local pharmacies, just put in your zip code. Since i see you are in Idaho, do you ever go up to Canada? I don't think a Rx is required there and it is much cheaper. Be careful of ordering online in the winter, Lantus should not be frozen!
 
Hi Rachel and Phobos and welcome,
You can certainly wait until tomorrow morning to give the next shot. Then you can set your own 12-hour schedule for the Lantus shots.

Ask any questions you want and someone will be here to help you out. We have all been in your shoes.

Welcome!!

Ella & Rusty
 
Hello and welcome to you and Phobos. No problem waiting skipping tonight's shot and waiting until tomorrow at 8AM to start fresh.
Ann & Tess said:
do you ever go up to Canada? I don't think a Rx is required there and it is much cheaper.
Click to expand...
Ann is right - insulin is cheaper in Canada and does not require a prescription.
 
I noticed you have Hills A/D listed as something you're feeding

The A/D is higher in carbs than we suggest. Is there any particular reason you're feeding A/D?

It's also important to get at least one test during the PM cycle. Most cats go lower at night, so it's the only way to catch them! Even if you can just grab a test "before bed", it'll help figure out what she's doing overnight

We look forward to helping you to help your "extra sweet" Phobos!
 
You're already getting tons of great info here, so I just wanted to say Welcome to Lantus&LevLand! Keep asking questions....Phobos is so lucky to have you!
 
I'll add my welcome too! Feel free to ask questions - there is a lot to learn but everyone will help you master things one step at a time. If you need help with hometesting or shooting, say so. There's a bazillion tips that people will share. Here is one document on Testing & Shooting tips that might be helpful.

Here's another link that may be useful - it can be challenging to find the info you are looking for - this is an index called Where Can I Find?
 
Awesome! You guys are great - thanks so much for the welcomes and information! This seems like a wonderful site; I'm glad I stumbled across it :) I've spent the weekend reading and reading, so I feel like I'm getting a good education, but there's always stuff that comes up that requires the knowledge of folks who have btdt.
I saw a vet tech for today's appointment and I wasn't thrilled. She was very adamant that I should be feeding Hill's W/D or M/D rather than the FF or Friskies. She also was sure there was no issue with doing the second dose at +8 hrs. I didn't think it would be, so asked to clarify and she assured me it was fine.

Oh, btw, Phobos isn't eating as much as he should (which I still haven't figured out how much that is), and when he does eat it's only a bit at each sitting. Is this going to be a problem with the insulin? Like, I can only get him to eat 1/8-1/4 of a (5.5 oz) can at one time, and usually not when I want him to. The vet tech today said it's not a problem, but the vet on Friday said he really needed to eat 1/2 a can before the insulin shot. How does one figure out how much food a cat should be eating in a day? The vet on Friday said he should be eating 1 can/day. The tech today said 378 cal. at his current weight, which would be 2 1/2 - 3 cans for the w/d & m/d. And the cat food cans say 1 oz. food/ lb of cat weight, which would be almost 14 oz. Sorry, I'm new to using canned foods.

Phobos was given the a/d on Friday because it is higher calorie and he was barely eating. I'm weaning him off of it, though, as he seems to be eating more. I knew it was higher carb than we want, but didn't think it was really high so I figured it would be okay for awhile.
 
With Lantus, the insulin onset is gradual and gentle, so it is OK for the cat to graze, rather than finish a set amount of food. That said, are there any issues with vomiting, diarrhea, or food refusal or is it just that Phobos likes to graze? Grazing is fine. The other 3 problems can cause issues with glucose management.

And Lantus works best with the same dose, close to 12 hours apart. Shooting early may act like a dose increase; shooting late may act like a dose decrease. due to changing amounts of dose overlap effects (the depot or shed, ie leftover insulin which is still being released). You might get away with it once or twice, and then you might have problems. Its not worth the risk.
 
it's pretty important to stick to a 12 hr schedule unless there is a compelling reason and someone with experience helps you look at the ss and decide if it's safe or not. Most everyone shoots every 12 hrs all the time. As BJM said, when you shoot early, you are increasing the overlap between the previous shot wearing off and the beginning of the next shot's action (onset). That has the same effect as a dose increase.

As far as eating, grazing is fine and can help even out blood sugar. For some cats eating in the second half of the cycle, if it's a larger quantity, can act like a brake on the insulin's action. it's strongest in the first half of the cycle. But a cat who truly grazes, just nibbling all day long, it's perfectly ok. What you might want to try is picking up his food at +8 or so and then setting it back down again at +12 when you're ready to shoot.
 
Ann & Tess said:
Just handle it gently, no rolling or mixing, it doesn't need it.
Click to expand...
Just read this and clicked the link about storage/handling of Lantus. My vet told me to gently roll the bottle before every injection! I've been doing this every time, and it's totally wrong?!? (Sorry, not to thread hijack, I'm just flabbergasted.)
 
Older insulins were a mixture of different particles and required the gentle rolling to distribute the particles evenly. Lantus is not like that. Educate them at the vet's office, please!
 
That's what people did with insulins that were suspensions. You probably haven't harmed it - just stop doing that and move forward. :D there is a video on how to draw up your dose on the link about handling and storing your insulin. Might be worth watching if you haven't done so.

it's ok to ask questions on someone else's threads - no worries.
 
My vet told me that too. Fortunately, someone here put me on to the link before I actually did it. I know it's required for some insulins - I guess they think it's a standard instruction for all of them.
 
Thanks, again.

Our 3 cats have never had set meal times and with the dry food, they'd eat some and then come back throughout the day to pick. Now, switching to canned and insulin (for 1), we're having to change their routine. It's slow going, but I'll keep working on it. I don't leave food down at night, mostly because I just don't know how long canned food should sit out. Right now, I'm just giving about a Tbsp or 2 at a time, which is all they'll come close to eating at one time, and repeating throughout the day when they seem interested.

Since Phobos got sick about a week and a half ago, he's been refusing food on & off. Seems like it's in relation to how constipated he is. We're treating with Lactulose 2x/day and he seems to be slowly getting better. Friday, he ate about 3/4 can A/D + about 1 oz. FF; Saturday just about a whole can of A/D; Sunday refused food until evening, but then ate almost 1/2 a can A/D (was having constipation issues); today 1/2 can A/D and about 2-3 Tbsp. Friskies.

I'm glad I read & was told about not rolling the insulin, too, as the tech did that today.
 
We have people who work full time jobs and leave wet food out all day

Adding extra water helps to keep it from drying out so much

You can also make "food-cicles" by adding water to canned food and putting it into ice cube or muffin trays and freezing them. As they defrost, they return to smelling like food so it's a way to "leave some out for later"...but occasionally we'll have a cat that'll eat them frozen too!...lol
 
I leave canned food out all day. Most of my cats graze, which allows the food to come in slowly and the burden on the pancreas to be spread out, rather than needing to push out more insulin than it can produce (in the case of the diabetic Gracie).
 
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