? Dose Advice ~ Seems to be headed in right direction, just need confirmation

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DonnaBee

DonnaBee

Member Since 2017
Today we are starting Lantus after having tried Novolin. Trying to go slow so started at .5. Vet prescribed 1 and 1/2 units, but this is her first time to prescribe Lantus, so am following the suggestions of experience here. The numbers today began at AMPS 404, +3 433, +6 443. Since I began at .5, how long should I wait to increase to 1 unit. Is tomorrow morning ok, or should I wait longer? Appetite is good, had two 3 oz. cans of food for morning shot, and has had 1/2 can through the day so far. Activity level is about the same as usual. I don't have the spreadsheet started yet, but am working on it.
 
Hello,
welcome to the Lantus Land!

There are Sticky info Notes at the top of this Forum - take a look at the SLGL and the TR - two dosing methods used here.

I have question: your Signature block lists 6.6 lb as the current weight, is it correct? Both lovely guys in the avatar pic look a bit larger.. :)The initial dose in based on weight but since are not new to the injections I'd add "dose advise please" to your current subject line, and I'd add the question mark to it as prefix - more eyes to catch this way. You may need to start higher.
 
Hi there and welcome to Lantus Land! Glad you are working on the SS. I linked the instructions below. If you have any trouble setting it up, please yell and someone can assist you.

The instructions are Here

How much novolin were your giving before the switch to Lantus. Also is Pumpkin a male or female?

Below is how to determine the starting dose or Tight Regulation

STARTING DOSE:
The weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
  • the formula is 0.25 unit per kg of the cat's ideal weight
  • if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
  • if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration

Is 6.6 an ideal weight for Pumpkin? If so, he/she could have started at .75 of a unit. The depot takes 5-7 cycles to fill in and stabilize but, if he/she continues in these higher numbers I think I would take the dose to .75 unit as long as you can monitor and start counting the cycles from there.

Here is a picture of what .75 unit looks like.

upload_2017-8-15_15-18-18.png


 
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Hello and welcome. I am glad you are home testing. I look forward to seeing the spreadsheet values. What dose did you get to on Novolin? Typically we'll take that value into consideration rather than starting back at the beginning since Pumpkin has been on insulin for a while already.
 
Hi, Thanks for the welcome! Pumpkin is a female, and the tortie on the right in the picture. It was taken way before she became diabetic. Both her and her sister in the picture we're quite fluffy. The sister has a thyroid problem now and is a bit thinner too. Pumpkin's ideal weight was around 12 pounds, so she has lost about half her weight this past year and is so bony despite eating like a horse. Before 6/26/17 she was on Vetsulin. After that date she had been given Novolin 4 units 2x/day. I guess I should've started a bit higher dose, but after reading on here, I wanted tread lightly. Her +9 reading is 535. On Novolin and Vetsulin, her numbers never really dipped down past the mid 200's.
 
Sorry we mistook her for a boy. :oops: Previous Pumpkins here have been boys, though it was a pet name for my girl too.

How high a dose did Pumpkin get to on Vetsulin? I am just worried that if she needs a larger dose, it'll take a while to get there and you'll be leaving her in higher numbers longer. My Neko was on Caninsulin/Vetsulin to start. We got up to 5 units of Caninsulin and I made the mistake of going back to 1 unit on Lantus. So I wasted several months getting her back up in dose and we even ended up higher than 5 units of Lantus.
 
No worries, I've never thought of Pumpkin for a boys name :)

On Vetsulin, she was at 1 unit. Oh my, I hope I haven't messed up :(

I've got the spreadsheet started. Thanks!
 
Bobbie And Bubba said:
Hi there and welcome to Lantus Land! Glad you are working on the SS. I linked the instructions below. If you have any trouble setting it up, please yell and someone can assist you.

The instructions are Here

How much novolin were your giving before the switch to Lantus. Also is Pumpkin a male or female?

Below is how to determine the starting dose or Tight Regulation

STARTING DOSE:
The weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
  • the formula is 0.25 unit per kg of the cat's ideal weight
  • if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
  • if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration

Is 6.6 an ideal weight for Pumpkin? If so, he/she could have started at .75 of a unit. The depot takes 5-7 cycles to fill in and stabilize but, if he/she continues in these higher numbers I think I would take the dose to .75 unit as long as you can monitor and start counting the cycles from there.

Here is a picture of what .75 unit looks like.

View attachment 30358
Click to expand...
Oh my gosh, how on earth do you get .75? I have a hard time just getting half marks. Wish the plunger and lines were different colors.
 
Great progress on the spreadsheet. :) If you have any information from Novolin, even the last couple of weeks, it'll help us figure out where the starting dose on Lantus needs to change.

DonnaBee said:
Oh my gosh, how on earth do you get .75? I have a hard time just getting half marks. Wish the plunger and lines were different colors.
Click to expand...
Eyeballing and good eyes (readers or magnifying glasses :p) with a good overhead light.
 
Wendy&Neko said:
Great progress on the spreadsheet. :) If you have any information from Novolin, even the last couple of weeks, it'll help us figure out where the starting dose on Lantus needs to change.


Eyeballing and good eyes (readers or magnifying glasses :p) with a good overhead light.
Click to expand...
Ok, I'll see if I've got the old Novolin numbers handy.

Or a pair of young eyes...my son just helped me get where I needed to be for this PM shot. :D

Thanks!
 
Marvin's Mom - Nat said:
Do you have the syringe with the half unit markings? They help with those .25 and .75 doses. I didn't know about them till I came here :)
Click to expand...
Yes, it does help. Can't imagine trying to measure without the half marks :nailbiting:, guess I just need a learning curve to get it right. But I do think someone could make a million creating a syringe just for Lantus cats :smuggrin:
 
Bobbie And Bubba said:
Hi there and welcome to Lantus Land! Glad you are working on the SS. I linked the instructions below. If you have any trouble setting it up, please yell and someone can assist you.

The instructions are Here

How much novolin were your giving before the switch to Lantus. Also is Pumpkin a male or female?

Below is how to determine the starting dose or Tight Regulation

STARTING DOSE:
The weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
  • the formula is 0.25 unit per kg of the cat's ideal weight
  • if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
  • if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration

Is 6.6 an ideal weight for Pumpkin? If so, he/she could have started at .75 of a unit. The depot takes 5-7 cycles to fill in and stabilize but, if he/she continues in these higher numbers I think I would take the dose to .75 unit as long as you can monitor and start counting the cycles from there.

Here is a picture of what .75 unit looks like.

View attachment 30358
Click to expand...
Thanks Bobbie! I upped the dose to .75 for the PM shot and her +3 came down more than it did with the .5 dose for the morning. Think I will continue at that dose for the rest of the cycle and see what to do from there. Pumpkin's ideal weight would be around 11 pounds.
 
After 3 days, would it be protocol to increase the dose by .25 if BG numbers are still high? Or should I give it a week to see if it lowers more?
 
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When you are first starting with Lantus, you hold the initial dose a little longer than you do once the depot has had a chance to be established. In other words, you wait 5 - 7 days before increasing. However, if numbers are high, sometimes we fast track the dose.

 
Hi Donna, since Pumkin was on 4U of novolin before you switch, you may want to think about fast track until you are closer to the dose she had before, so that you don't have to start from the beginning on lantus. Just saying, if you are around to monitor it may be good so you aren't back tracking all the way.
 
Marvin's Mom - Nat said:
Hi Donna, since Pumkin was on 4U of novolin before you switch, you may want to think about fast track until you are closer to the dose she had before, so that you don't have to start from the beginning on lantus. Just saying, if you are around to monitor it may be good so you aren't back tracking all the way.
Click to expand...
Hi Nat, If I do fast track, would I start that with tomorrow morning's shot? Is there a link on how to fast track? Thanks!
 
There really isn't a "guide" for fast tracking. Do you have any test data from your Novolin days? That would be helpful but it's not a problem if you don't.

Nat does make a good point that it does look like you started a a lower dose than you needed to. Usually, when a cat switches from another insulin to Lantus, there isn't a need to drop the dose as much as you did. Usually, you can make a unit-to-unit change from Novolin to Lantus.

That said, I'd probably stick with your current dose tonight and because Pumpkin's numbers are consistently above 300, increase by 0.5u at AMPS tomorrow. I'm tagging @Wendy&Neko since she's been following, as well.

 
I agree with Sienne. You are doing a good job getting some test data so we can really see what is happening. But if you don't see a yellow before tomorrow morning, I would go up to 1.25 units.
 
Sienne and Gabby (GA) said:
There really isn't a "guide" for fast tracking. Do you have any test data from your Novolin days? That would be helpful but it's not a problem if you don't.

Nat does make a good point that it does look like you started a a lower dose than you needed to. Usually, when a cat switches from another insulin to Lantus, there isn't a need to drop the dose as much as you did. Usually, you can make a unit-to-unit change from Novolin to Lantus.

That said, I'd probably stick with your current dose tonight and because Pumpkin's numbers are consistently above 300, increase by 0.5u at AMPS tomorrow. I'm tagging @Wendy&Neko since she's been following, as well.
Click to expand...
I've updated my Novolin numbers. Pretty sure we won't see any yellow tonight, so
I will up her dose in the morning. Thank you all, I will post updates tomorrow!
 
One of the frustrating things about depot insulins is that it can take several cycles, as many as six, to see what a dose can do. When it's working well, it can get you nice flat cycles, so it's worth the wait. Let's see what the next few cycles brings.

I don't think it's a bounce, unless she dropped fast sometime today. Kitties can do all sorts of weird patterns, including sometimes going high before they go low. Not much you can do but wait. Lantus teaches you patience, never my strong suit. :p
 
Wendy&Neko said:
One of the frustrating things about depot insulins is that it can take several cycles, as many as six, to see what a dose can do. When it's working well, it can get you nice flat cycles, so it's worth the wait. Let's see what the next few cycles brings.

I don't think it's a bounce, unless she dropped fast sometime today. Kitties can do all sorts of weird patterns, including sometimes going high before they go low. Not much you can do but wait. Lantus teaches you patience, never my strong suit. :p
Click to expand...
Ok, thank you! Of course I picked today to be off schedule and not test her as usual. Back on schedule now, so will see how it goes. I'll have to work on my patience...I think I've got panic down really well. :D
 
Her numbers are headed downward, but not there yet. Will continue at 1.5 units. Thanks for the help here, it's been invaluable!
 
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