Unsure about dosing

[Idjit's mom]

Idjit web to the vet last Wednesday for a curve. Vet wanted us to continue 1 U Lantus each am, and test Mondays and Thursdays at +6 hours. Idjit had been eating very well, excreting normally,being frisky again. I continued to research, and kept seeing "test before injection". His +6 yesterday was 82, so I decided to test this am, before injection and meal. It was 139 so I did not inject. Called vet, just got a call back. She said was very surprised at these numbers in only 2 weeks. She said if under 200, no insulin, 200-250: text again in 2 hours, 250+ give insulin. I asked to give the entire 1unit, she wasn't sure there were syringes marked for half units. I told her I thought there were. I intend to test every morning, have to roust old man to hold the cat, Idjit is a 2 person job. I noticed most of you dose every 12 hours, we have been dosing every 24. Vet seems ok with this. Any thoughts? And where do you get syringes that measure half units? Thanks.

 

[Veronica & Babu-chiri]

Hi and Welcome!

Take a big breath I know it's a lot to take in but we'll try and help you.

Latus is designed to be taken only once in people but for cats has to be taken every 12 hours because cat's metabolism is different and faster that ours or dogs, and you need to keep the schedule as consistent as possible, changing the shooting times is not very good with Lantus

You need always to test before shooting to keep your cat safe ( people test themselves before shooting insulin why would it be different for cats ), what we recommend is always test before you shoot and if you can get a test in between shoots.

Some cats get regulated very quickly some can take months, every cat is different

When you are starting and since you really don't know how your cat reacts to insulin yes is safer not to shoot if he's under 200 but that will change as you gather data and start getting to know your cat and his reactions, you can always ask here what to do if this happens

There are syringes with half unit markings, Where are you located? I'm not shure where you can buy them since I'm not in the US, but I've read that a lot of people here get them at walmart, maybe someone else will give you a tip on this.

I don't want to overwhelm you but here's the link to the Lantus forum and some information you can start with
http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

More importantly keep asking as much as you need or want

 

[Idjit's mom]

Thanks very much. I have located half unit syringes and will have them on hand. I called the vet back and her experience is that the lantus is slow acting enough, and allows for more leeway in case pet parents cannot adhere to 12 hour schedule.

 

[JanetNJ]

You can get the syringes with half unit markings at www.adwdiabetes.com

 

[Veronica & Babu-chiri]

Thanks very much. I have located half unit syringes and will have them on hand. I called the vet back and her experience is that the lantus is slow acting enough, and allows for more leeway in case pet parents cannot adhere to 12 hour schedule.

Unfortunately the experience and studies conducted with Lantus have shown that it does require shooting every 12 hours at least in cats for it to work properly and needs as much consistency in the schedule as possible

There are other insulins that are more forgiving and that may allow some flexibility you could consider them if you need flexibility but will need to be shooted every more o less 12 hours too

Thing is all this insulins work different in cats than they do in dogs which is what most vets are used to treat for what I know is true that in dogs you shoot once a day (I think but I don't have much experience in dogs)

 

[Idjit's mom]

Ok, granted that we should shoot 1/2 unit every 12 hours instead of one unit every 24 hours per the Lantus forum. I had called the vet a second time to say I had obtained 1/2 unit syringes. (Unforunately, these are 50 unit and I will need a magnifying glass to see what I'm doing) Vet instructed to shoot 1/2 unit if BG 200-300, 1 unit if BG 300+. No dose if -200. How on earth to figure dose if changing to a12 your schedule? Should I take this to the Lantus forum? Do people here determine, on their own, how much to shoot?

 

[Bunny0210]

Idjit web to the vet last Wednesday for a curve. Vet wanted us to continue 1 U Lantus each am, and test Mondays and Thursdays at +6 hours. Idjit had been eating very well, excreting normally,being frisky again. I continued to research, and kept seeing "test before injection". His +6 yesterday was 82, so I decided to test this am, before injection and meal. It was 139 so I did not inject. Called vet, just got a call back. She said was very surprised at these numbers in only 2 weeks. She said if under 200, no insulin, 200-250: text again in 2 hours, 250+ give insulin. I asked to give the entire 1unit, she wasn't sure there were syringes marked for half units. I told her I thought there were. I intend to test every morning, have to roust old man to hold the cat, Idjit is a 2 person job. I noticed most of you dose every 12 hours, we have been dosing every 24. Vet seems ok with this. Any thoughts? And where do you get syringes that measure half units? Thanks.

 

[Bunny0210]

Idjit web to the vet last Wednesday for a curve. Vet wanted us to continue 1 U Lantus each am, and test Mondays and Thursdays at +6 hours. Idjit had been eating very well, excreting normally,being frisky again. I continued to research, and kept seeing "test before injection". His +6 yesterday was 82, so I decided to test this am, before injection and meal. It was 139 so I did not inject. Called vet, just got a call back. She said was very surprised at these numbers in only 2 weeks. She said if under 200, no insulin, 200-250: text again in 2 hours, 250+ give insulin. I asked to give the entire 1unit, she wasn't sure there were syringes marked for half units. I told her I thought there were. I intend to test every morning, have to roust old man to hold the cat, Idjit is a 2 person job. I noticed most of you dose every 12 hours, we have been dosing every 24. Vet seems ok with this. Any thoughts? And where do you get syringes that measure half units? Thanks.

 

[Kris & Teasel]

Ok, granted that we should shoot 1/2 unit every 12 hours instead of one unit every 24 hours per the Lantus forum. I had called the vet a second time to say I had obtained 1/2 unit syringes. (Unforunately, these are 50 unit and I will need a magnifying glass to see what I'm doing) Vet instructed to shoot 1/2 unit if BG 200-300, 1 unit if BG 300+. No dose if -200. How on earth to figure dose if changing to a12 your schedule? Should I take this to the Lantus forum? Do people here determine, on their own, how much to shoot?

Lantus works best with a consistent dose given twice a day. At a given dose the depot will fill to a size appropriate for that dose. Using a sliding scale to dose as per your vet’s advice prevent proper filling of the depot and can lead to erratic BG levels.

Yes, do take this to the Lantus forum. There are very specific sets of dosing guidelines described there in the yellow stickies. The forum is large and there are very knowledgeable and experienced people to help you.

 

[Veronica & Babu-chiri]

Ok, granted that we should shoot 1/2 unit every 12 hours instead of one unit every 24 hours per the Lantus forum. I had called the vet a second time to say I had obtained 1/2 unit syringes. (Unforunately, these are 50 unit and I will need a magnifying glass to see what I'm doing) Vet instructed to shoot 1/2 unit if BG 200-300, 1 unit if BG 300+. No dose if -200. How on earth to figure dose if changing to a12 your schedule? Should I take this to the Lantus forum? Do people here determine, on their own, how much to shoot?

For Lantus we usually follow one of two protocols Tight regulation (TR) or Start Low Go Slow(SLGS), I suggest you take a look at each of them ( I'm adding the links below ) and decide which one suits you best, the protocol will give you the guidelines on what the requisites are, how to start, when and how to adjust the dose and when to shoot, when to skip and when you have a doubt you can always ask in the Lantus forum for suggestions.

By SLGS protocol (which I think is the more conservative one, the TR is a little bit more aggressive but is up to you which one you want to follow) :
Starting Dose:

• 1u BID if kitty is not on a wet/canned low carb diet
• 0.5u BID if kitty has been switched to a wet/canned low carb diet
• If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
• Generally, shots are to be given 12 hours apart.

At the beginning as Kris mentioned on Lantus you would start on half a unit every 12 hours and keep this dose for at least a week unless he goes under 90 at any time, or your cat won’t eat or you suspect hypoglycemia


Link for Tight regulation (TR)

Link for Start Low Go Slow(SLGS)

I will also suggest you take a look at this link where you can start getting an idea on all the Lantus stuff

http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/

 

[Veronica & Babu-chiri]

I had called the vet a second time to say I had obtained 1/2 unit syringes. (Unforunately, these are 50 unit and I will need a magnifying glass to see what I'm doing)

Regarding the syringes just make sure your syringes are for U-100 (from the sticky in the lantus forum http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/)

• U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus or Levemir from vials, cartridges, and pens. BD Ultra-Fine, CarePoint Vet, Monoject, GNP,UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings. Needle gauge and length is your preference Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)

 

[Idjit's mom]

Lantus works best with a consistent dose given twice a day. At a given dose the depot will fill to a size appropriate for that dose. Using a sliding scale to dose as per your vet’s advice prevent proper filling of the depot and can lead to erratic BG levels.

Yes, do take this to the Lantus forum. There are very specific sets of dosing guidelines described there in the yellow stickies. The forum is large and there are very knowledgeable and experienced people to help you.

I'm sorry I don't understand your comment "using a sliding scale to dose as per vet's advice......." Are you saying using the sliding scale is a bad idea , would it or could it prevent filling the depot and could lead to erratic levels? I am going to research this depot.

 

[Kris & Teasel]

I'm sorry I don't understand your comment "using a sliding scale to dose as per vet's advice......." Are you saying using the sliding scale is a bad idea , would it or could it prevent filling the depot and could lead to erratic levels? I am going to research this depot.

Yes, a sliding scale isn't recommended for the dosing methods described in the Lantus guidelines of TR and SLGS.
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-what-is-the-insulin-depot.150/

 

[JanetNJ]

I'm sorry I don't understand your comment "using a sliding scale to dose as per vet's advice......." Are you saying using the sliding scale is a bad idea , would it or could it prevent filling the depot and could lead to erratic levels? I am going to research this depot.

Sliding scales are better for in and out insulin like vetsulin