Help Lantus and Relion meter

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Cathy Huffman

Member Since 2018
My Beans is newly f2f with diabetes he has been ill since having heat stroke after hurricane Irma. One thing then another.

Anyone the vet wants us on alphatrak meter. I have Relion meter at this point. Her orders were .5 if under 360, 1 unit if over once a day to start.

Well from what. I understand Relion's numbers are not the same so I am probably under dosing him. Here are his numbers since I started he has only received the .5 each day.

Friday 1/19/18. - 236
Sat. 1/20/18. - 120
Sun. 1/21/18. - 246
Mon. 1/22/18. - 296
Tues. 1/23/18. - 330
Wed. 1/24/18. - 364 no insulin yet just fed.

Advice please should I be doing the 1 unit instead of the .5 the 120 is probably not accurate. Thank you in advance.
 
Are you using lantus? We don't usually recommend dosing lantus according to the PS number, it works much better with a stable dose. We have methods to figure out what that dose is over time (SLGS is one, check out the board stickies).

A human meter will read lower than a pet one. We don't know by how much, as it's not linear. Do you have other measurements than the preshot value? It helps a lot to know how low a cat goes on a given dose, actually.

It's really hard to say what to do in your case, but 364 on a human meter would probably read quite a bit higher on an AT2.
 
Welcome Cathy and Beans. So glad you are already home testing. This is the most important thing! No need to use alphatrak (AT). Actually, most here use human meters and Relion is one of our favorites. Lantus should be given twice a day (12 hours apart). I'm worried your vet may not be up to speed if she recommended only once / day. There are several sticky notes at the top of the forum to explain Lantus and how it works. You may want to review these and select the best 12 hour schedule for you (i.e. 6AM / 6PM). It is recommended you always test before a shot, but also you will want to get additional tests through the day to see how low Beans is going on the current dose. Lantus dose is based on the lowest number in the cycle (which would typically be +5 / +6, but every cat is different).

The next thing you are going to want to do is create a spreadsheet to share your test results and get feedback on dose. Please see these instructions.

Please ask any questions. Lots of folks here love to help you help your kitty!
 
Cathy, what are you shot times? And when are you doing your testing? Are you only testing before one shot or both?

The best way for preshots and shooting lantus is test/feed/shoot. No need to wait for them to eat before the shot. I can get it all done within 10 minutes with feeding my 3 kitties.
 
Meridith and Zeke said:
Cathy, what are you shot times? And when are you doing your testing? Are you only testing before one shot or both?

The best way for preshots and shooting lantus is test/feed/shoot. No need to wait for them to eat before the shot. I can get it all done within 10 minutes with feeding my 3 kitties.
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We go back tomorrow. She started us off with 1x daily. In all honesty testing has been a bit of a challenge. I just did his foot today. Test pre shot. I will start doing some afters to get more data. I tried the other night but after 6 failures gave up.

I am night owl so I do 1:30 pm I figured that works am or pm. Also guaranteed to be home at those times. But need to know should I give 1 unit now or stick to the .5 of below 360. It is going higher every day on .5
 
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Cathy Huffman said:
We go back tomorrow. She started us off with 1x daily. In all honesty testing has been a bit of a challenge. I just did his foot today. Test pre shot. I will start doing some afters to get more data. I tried the other night but after 6 failures gave up.

I am night owl so I do 1:30 pm I figured that works am or pm. But need to know should I give 1 unit now or stick to the .5 of below 360. It is going higher every day on .5
Click to expand...

What is best for beginning since new to this and no prior insulin is .5 units twice a day. You want to do 2 tests minimum per cycle. The preshot to know if it is safe to give the dose, and a test at 6 hours after the shot to know more of how that dose is doing. Even if the mid-cycle shot isn't when your normally awake, you can set an alarm so you can get the test then go back to bed.
 
Meridith and Zeke said:
What is best for beginning since new to this and no prior insulin is .5 units twice a day. You want to do 2 tests minimum per cycle. The preshot to know if it is safe to give the dose, and a test at 6 hours after the shot to know more of how that dose is doing. Even if the mid-cycle shot isn't when your normally awake, you can set an alarm so you can get the test then go back to bed.
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Getting up is not a problem my senior demanded food every 2 hours.
 
Cathy Huffman said:
Vet has us on one shot right now will ask about 2 shots on our next visit tomorrow. So I will Test before each shot. For sure.
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Humans are normally once a day on Lantus but cats have a faster metabolism so they need 2x a day. Also, you really need to go for the mid-cycle tests too or you will never know how well the dose is doing and can not adjust the dosing safely.
 
Very few of us even go to the vets for dosing advice etc now that we have gained the knowledge from this board and the help of those here that have so much more experience then most of our vets have. I haven't been to our vet for Zeke's diabetes specifically since June of last year. I can safely adjust his dosing and I monitor with home testing to insure he is safe. No need to go to the vet for it unless I need bloodwork done or a new prescription.

For Lantus, there is two protocols that are proven to work. You want to read over and study them both and decide which one will work best for you. It is really important that you follow them exactly and not try to modify them. I learned that because I tried adjusting how we did it for Zeke and we probably lost months of progress when we could have had him regulated much sooner. The types are TR for tight regulation and SLGS for start low go slow. They are on the stickies at the top of this board but will post the links here too.
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol-tr.1581/
 
Cathy Huffman said:
In all honesty testing has been a bit of a challenge. I just did his foot today. Test pre shot. I will start doing some afters to get more data. I tried the other night but after 6 failures gave up.
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Testing will get easier. Most people stick to the ears, both cat and human end up figuring out how to make it work. Patience! Everything takes practice. There are videos that can help you adjust your testing technique, not sure if you've watched any. And if you bump into any specific problem with the testing, do ask, and we'll be happy to share our tips and tricks!
 
Cathy Huffman said:
We go back tomorrow. She started us off with 1x daily. In all honesty testing has been a bit of a challenge. I just did his foot today. Test pre shot. I will start doing some afters to get more data. I tried the other night but after 6 failures gave up.

I am night owl so I do 1:30 pm I figured that works am or pm. But need to know should I give 1 unit now or stick to the .5 of below 360. It is going higher every day on .5
Click to expand...

THe problem is that with only 1 test a day, we can't know if Bean is going much lower at some other time of the day. Bean should also be on this shot 2 times a day, which will definitely lower her BG. Your vet sounds a little inexperienced with treating diabetes. I say this, because even the most conservative and old fashioned vets prescribe Lantus shots to be given 2 times a day.
So what you need to do before even considering an increase, is to start giving Bean 2 shots of Lantus a day, 12 hours apart. For example, I give TiTi her morning shot at 7:15am and and her evening shot at 7:15 pm.
Also you do need to test Bean before giving her the Lantus shots, because you need to be sure her BG hasn't dropped so low that it is dangerous to give her any more insulin.
Is it possible for you to test, at least 3 times a day, before the morning shot, before the evening shot, and one check inbetween the morning and evening shots?

Oh, and welcome!
 
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Yep, testing definitely gets easier. Zeke still lets me know most the time he doesn't like it, but he will sit still for the testing cause he wants his bite of chicken. He has also let us know that he needs a test too. And considering most those times his bg was dropping faster then normal, if he starts acting like he wants tested, we test. Even when it isn't his normal test time.
 
Stephanie & Quintus said:
Testing will get easier. Most people stick to the ears, both cat and human end up figuring out how to make it work. Patience! Everything takes practice. There are videos that can help you adjust your testing technique, not sure if you've watched any. And if you bump into any specific problem with the testing, do ask, and we'll be happy to share our tips and tricks!
Click to expand...
 
He folds his ear down and I lose my drop or jerks his head away and shakes it. I will try using my finger nail on ear next. But he didn't seem to mind the foot too much.
 
Hi I was old my answers aren't showing up.
So will reply here. I test before shot. We are on 1x a day but we see the vet tomorrow and will ask to go to twice. The vet said She knows of no proof it works any better then the cheapest human insulin N I think other vet ordered. If she does not approve 2x a day we will just have to do it anyway starting at the .5 because once is not working. He may still have an infection going. He had shots a few weeks prior to starting insulin. He seems down today not social like yesterday.
 
Cathy Huffman said:
Hi I was old my answers aren't showing up.
So will reply here. I test before shot. We are on 1x a day but we see the vet tomorrow and will ask to go to twice. The vet said She knows of no proof it works any better then the cheapest human insulin N I think other vet ordered. If she does not approve 2x a day we will just have to do it anyway starting at the .5 because once is not working. He may still have an infection going. He had shots a few weeks prior to starting insulin. He seems down today not social like yesterday.
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Since the numbers have been staying higher, I would recommend checking his ketones. You can easily do this yourself with strips that you can find for a couple dollars at walmart. For us, we can just hold a ladle under his booty after he starts peeing to catch a little urine to test. Others have used a little bit of crumpled up cling wrap. If you don't think you can get a test done, then have your vet check for ketones tomorrow when you go.
 
Meridith and Zeke said:
Since the numbers have been staying higher, I would recommend checking his ketones. You can easily do this yourself with strips that you can find for a couple dollars at walmart. For us, we can just hold a ladle under his booty after he starts peeing to catch a little urine to test. Others have used a little bit of crumpled up cling wrap. If you don't think you can get a test done, then have your vet check for ketones tomorrow when you go.
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My boy is having an issue so he steps into potty box with front feet and pees on his bedding (arthritis or diabetes related?) so getting urine won't be a problem.
 
Cathy Huffman said:
My boy is having an issue so he steps into potty box with front feet and pees on his bedding (arthritis or diabetes related?) so getting urine won't be a problem.
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Maybe arthritis related, but don't think diabetes related. Usually things like that are more associated with UTI's.
 
Hi and welcome. Please read you yellow sticky on lantus. It explains a basic 12 hour cycle and how dosing is based on the lowest point in the cycle, the nadir. I don’t think you will ever get Beans regulated the way you are doing it. Lantus starts to wear off from the nadir to the next shot especially at first. Most cats that become a food regulated diabetic and OTJ, off insulin, do so in the first six months after diagnosis.

Please set up a spreadsheet. All you need is a google account. We heed to see all results to help you. We are very data based around here.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
Cathy Huffman said:
Hi I was old my answers aren't showing up.
So will reply here. I test before shot. We are on 1x a day but we see the vet tomorrow and will ask to go to twice. The vet said She knows of no proof it works any better then the cheapest human insulin N I think other vet ordered. If she does not approve 2x a day we will just have to do it anyway starting at the .5 because once is not working. He may still have an infection going. He had shots a few weeks prior to starting insulin. He seems down today not social like yesterday.
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WEll, he needs insulin, and if that infection is still going on, that's going to make him feel crummy. I'm thinking you might be able to teach your vet, kindly and surreptitiously, of course.
Actually there is a big difference between n and Lantus, and I'll call out the experts to fill you in. @Wendy&Neko @Gill & George @Tricia Cinco(GA) & Harvey
 
Kathy and TiTi said:
WEll, he needs insulin, and if that infection is still going on, that's going to make him feel crummy. I'm thinking you might be able to teach your vet, kindly and surreptitiously, of course.
Actually there is a big difference between n and Lantus, and I'll call out the experts to fill you in. @Wendy&Neko @Gill & George @Tricia Cinco(GA) & Harvey
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Yes I did not like the other vet mine was out sick. He also did not weigh him bit took thee weight from a year ago from his chart 17 lbs. To decide his insulin dose. I did not give it to him. Beans has been through A lot and is below 12 lbs. The last 4.5 months starting with heat stroke, UTI and upper respiratory infections and an ALT OF 1000 so liver issues I almost lost him back at the end of October.
 
I did an 8 hour read after shot got a 54 did a second and got 63. I did get help with chart but n sure how to work it. His preshot test was 364. He received .5 of Lantus. I just need to know if I need to worry about tonight's sugar level. Now at 10 hours has had 1.5 cans of FF and a bath.
 
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Hi Cathy and Beans, and welcome to Lantus & Levemir Land, the nicest place you never wanted to be.

Have you tested again since the 63?

It's great that you're home testing. That's the best way to keep Beans safe. I know it seems hard at first, but it's really important, and with practise, both you and Beans will get used to it. Here is a post that has some great tips to help make it easier. My favorite tips are: 1) Always give a diabetic-friendly treat when you test. Even if you don't get any blood, or don't get enough to get a reading. You want Beans to associate testing with something good. Diabetic-friendly treats include bites-sized pieces of plain, boiled chicken or freeze-dried meats you can buy at most pet stores. 2) If you're testing the ear, warm it first. Many of us use a small sock filled with uncooked rice. You warm in it the microwave approximately 30 seconds (test it on your wrist, like a baby's formula). Hold it against the ear for several seconds to warm it, then put it behind the ear to brace it as you poke. There are more tips in the post.

As others have mentioned, Lantus is a depot insulin. If you don't give the same dose twice a day, twelve hours apart, the depot can't fill and you will get numbers all over the place. It sounds like your vet is not very familiar with Lantus, but actually it is currently considered to be one of the best insulins for cats because it is gentler than the "in and out" insulins. Her dose advice sounds like she is more familiar with one of them.

We are not vets here, but many of us have years of experience with feline diabetes, some of us with more than one cat. We live it 24/7, 365. Most vets don't have a great deal of experience with it, and less with folks that actually want to home test. To be fair, a vet has to learn about many different diseases and conditions in multiple species, so unless they specialize, they are unlikely to be super knowledgeable about any one disease. I had my cats treated at UC Davis Veterinary Medical Teaching Hospital, the #1 rated vet school in the country, and I was told by a third year student there that they got exactly 5 hours of training on diabetes, and that covered both cats and dogs!

Cathy Huffman said:
the vet wants us on alphatrak meter.
Click to expand...
Many vets say that. However, the strips are ridiculously expensive, and you have to order them online. With a human meter you can buy strips at Walmart or a drug store for much less. The readings are different, but as long as you stick to the same kind of meter, you are getting accurate results. Our guidelines are based on using a human meter here, because most cannot afford an AT.

Here is a post we put together to help new members get comfortable with our forum. It should answer many questions you have. It includes instructions for setting up the spreadsheet and linking it to your signature block. The signature block is very important, as the info it contains will prevent people from asking you the same questions over and over, like "how much does Beans weigh? How old is he? What other conditions does he have? Other meds? Where do you live (useful to know your time zone)? etc.

Read the stickies at the top of the L&L page, and ask lots of questions. We love to help.
 
Tricia Cinco(GA) & Harvey said:
Hi Cathy and Beans, and welcome to Lantus & Levemir Land, the nicest place you never wanted to be.

Have you tested again since the 63?

It's great that you're home testing. That's the best way to keep Beans safe. I know it seems hard at first, but it's really important, and with practise, both you and Beans will get used to it. Here is a post that has some great tips to help make it easier. My favorite tips are: 1) Always give a diabetic-friendly treat when you test. Even if you don't get any blood, or don't get enough to get a reading. You want Beans to associate testing with something good. Diabetic-friendly treats include bites-sized pieces of plain, boiled chicken or freeze-dried meats you can buy at most pet stores. 2) If you're testing the ear, warm it first. Many of us use a small sock filled with uncooked rice. You warm in it the microwave approximately 30 seconds (test it on your wrist, like a baby's formula). Hold it against the ear for several seconds to warm it, then put it behind the ear to brace it as you poke. There are more tips in the post.

As others have mentioned, Lantus is a depot insulin. If you don't give the same dose twice a day, twelve hours apart, the depot can't fill and you will get numbers all over the place. It sounds like your vet is not very familiar with Lantus, but actually it is currently considered to be one of the best insulins for cats because it is gentler than the "in and out" insulins. Her dose advice sounds like she is more familiar with one of them.

We are not vets here, but many of us have years of experience with feline diabetes, some of us with more than one cat. We live it 24/7, 365. Most vets don't have a great deal of experience with it, and less with folks that actually want to home test. To be fair, a vet has to learn about many different diseases and conditions in multiple species, so unless they specialize, they are unlikely to be super knowledgeable about any one disease. I had my cats treated at UC Davis Veterinary Medical Teaching Hospital, the #1 rated vet school in the country, and I was told by a third year student there that they got exactly 5 hours of training on diabetes, and that covered both cats and dogs!


Many vets say that. However, the strips are ridiculously expensive, and you have to order them online. With a human meter you can buy strips at Walmart or a drug store for much less. The readings are different, but as long as you stick to the same kind of meter, you are getting accurate results. Our guidelines are based on using a human meter here, because most cannot afford an AT.

Here is a post we put together to help new members get comfortable with our forum. It should answer many questions you have. It includes instructions for setting up the spreadsheet and linking it to your signature block. The signature block is very important, as the info it contains will prevent people from asking you the same questions over and over, like "how much does Beans weigh? How old is he? What other conditions does he have? Other meds? Where do you live (useful to know your time zone)? etc.

Read the stickies at the top of the L&L page, and ask lots of questions. We love to help.
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Yes. I am not sure that was real. I tested again at 14 hours and he is back up to 343. He is feeling warm and not happy with mama. We are due at the vet in 5 hours so I am going to try and get a few hours sleep.
 
I know you can't open it I checked. This is numbers. These are pre shot with no food. Except the 14+ was receiving .5 Lantus once a day.

Friday 1/19/18. 236
Sat. 1/20/18. 120
Sun. 1/21/18. 246
Mon. 1/22/18 296
Tues. 1/23/18 330
Wed. 1/24/18 364
14+ after shot 343 with food

Then at vet today it was 533 on my monitor and 619 on vets alphatrak vet increased insulin to twice a day .5 any advise.
 
Cathy Huffman said:
I know you can't open it I checked. This is numbers. These are pre shot with no food. Except the 14+ was receiving .5 Lantus once a day.

Friday 1/19/18. 236
Sat. 1/20/18. 120
Sun. 1/21/18. 246
Mon. 1/22/18 296
Tues. 1/23/18 330
Wed. 1/24/18 364
14+ after shot 343 with food

Then at vet today it was 533 on my monitor and 619 on vets alphatrak vet increased insulin to twice a day .5 any advise.
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Hi. I can't give dose advise, but since you've just agreed with your vet to start at 0.5u, give it a chance. Stick as close to 12 hours apart twice per day as you can. Remove food access 2 hours before each shot. Get at least a +2 or +3 so you can see onset and get indication of how cycle will go. Try to get +6/+7 so you can see the nadir/ low. Any tests confuse you, post here for help. Now that you'll be doing it twice daily, the depot will have a chance to build up. You'll do fine!:bighug:
See if @Chris & China or @Marje and Gracie can fix your ss.
 
Myagi and Heidi said:
Hi. I can't give dose advise, but since you've just agreed with your vet to start at 0.5u, give it a chance. Stick as close to 12 hours apart twice per day as you can. Remove food access 2 hours before each shot. Get at least a +2 or +3 so you can see onset and get indication of how cycle will go. Try to get +6/+7 so you can see the nadir/ low. Any tests confuse you, post here for help. Now that you'll be doing it twice daily, the depot will have a chance to build up. You'll do fine!:bighug:
See if @Chris & China or @Marje and Gracie can fix your ss.
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Marje and Gracie said:
If you can send me a private message, I’ll be glad to get the spreadsheet sorted out for you. To send me a message, click on “Marje and Gracie” to the left and then “start a conversation”.
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I was just concerned whether I should go to .25 twice a day or do .5 ? Slept less then 3 hours so h
Going to take a nap before next test/ feed/shot
 
Cathy Huffman said:
A new friend set it up for me but just don't seem to have it where I can share it.
Click to expand...

Go to the top right corner of your spreadsheet where it says "Share" and click there.

A new box will open up....on the bottom right it will say "Advanced"....click there

Choose "anyone with the link" and then click "Done"
 
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