Yoshi 9/1 AMPS 369 +5 333 PMPS 369

Stressedcatmom

Member Since 2017
The vet gave me 29G 1/2 needle U-100 insulin syringes. Is that what you guys use? One unit is tiny. These syringes are smaller than the ones I was given on Prozinc.

Regarding his dental, I do plan to get the cleaning when I go to my moms house for thanksgiving as her vet is way cheaper. I teach and school is starting and I just dont think with new insulin and not knowing how it will affect him is a good idea.

Also, someone asked about the antibiodic. He was given a broad spectrum antibiodic shot. The vet says it stays in his system 2 weeks.

Working on updating the spreadsheet but my signature is updated.

+5 is 333. I can't figure out how to edit my subject line

http://www.felinediabetes.com/FDMB/threads/new-and-need-help.218809/
 
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Those should work, although Yoshi might be more comfortable with a smaller needle-- I use 31G 5/16". Do yours have half-unit markings? As tiny as the 1U is (and it definitely is!), we change doses by 0.25U, so the half-unit lines really come in handy.
 
It sounds like your vet gave Yoshi a shot of Convenia. We typically do not recommend it's use. The problem with a long acting antibiotic is that if your cat is allergic to it you have a HUGE problem -- once it's been dosed, there's no way to get it out of your cat's system. Along with many vets (mine included), we don't encourage its use. The other medication many of us avoid is meloxicam (Metacam). It's a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain. The problem in this case is that the FDA issued a black box warning regarding it's use in cats due to it causing acute kidney failure. Given that diabetes is hard on the kidneys, many of us refuse to use it as to many vets. I have big notes on my kitty's chart at the vet's office regarding not giving either Convenia or meloxicam.

The depot. There are any number of "depot" drugs that are used both in humans and in this case, cats. Lantus is slightly acidic compared to the normal pH of a cat's body. As a result, a small amount of each shot forms microcrystals that are deposited in the fat issue. Over time, these crystals dissolve which is what gives Lantus is longer duration than other types of insulin (Levemir being the other exception although the principle is the same but the mechanism is different). It's also why you need to give any new dose a few days to stabilize since the depot needs that time to catch up.

I hope this makes it less confusing. There's also a sticky note that has more information on the depot.
 
It sounds like your vet gave Yoshi a shot of Convenia. We typically do not recommend it's use. The problem with a long acting antibiotic is that if your cat is allergic to it you have a HUGE problem -- once it's been dosed, there's no way to get it out of your cat's system. Along with many vets (mine included), we don't encourage its use. The other medication many of us avoid is meloxicam (Metacam). It's a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain. The problem in this case is that the FDA issued a black box warning regarding it's use in cats due to it causing acute kidney failure. Given that diabetes is hard on the kidneys, many of us refuse to use it as to many vets. I have big notes on my kitty's chart at the vet's office regarding not giving either Convenia or meloxicam.

The depot. There are any number of "depot" drugs that are used both in humans and in this case, cats. Lantus is slightly acidic compared to the normal pH of a cat's body. As a result, a small amount of each shot forms microcrystals that are deposited in the fat issue. Over time, these crystals dissolve which is what gives Lantus is longer duration than other types of insulin (Levemir being the other exception although the principle is the same but the mechanism is different). It's also why you need to give any new dose a few days to stabilize since the depot needs that time to catch up.

I hope this makes it less confusing. There's also a sticky note that has more information on the depot.
Thank you for the explanation! So does the depot last a cycle?

I just gave him his evening test. I’m a little discouraged because the insulin doesn’t seem to be working as well as I thought it would be? We just started yesterday, but when we were on prozinc I saw noticeable changes within days.

And you were right she did give him that antibiotic. I am having the best weekend ever :(
 
Thank you for the explanation! So does the depot last a cycle?

I just gave him his evening test. I’m a little discouraged because the insulin doesn’t seem to be working as well as I thought it would be? We just started yesterday, but when we were on prozinc I saw noticeable changes within days.
 
It takes roughly 5 - 7 days for the depot to become established. This being the case, don't expect to see much of an effect until the depot is formed.

Once it is formed, a dose "proves" itself in roughly 3 days You don't want to change doses in less than 3 days/6 cycles since back-to-back changes can result in wonky numbers. The exception is with dose reductions although this is a more complex situation.

Given the above, the depot isn't a one day phenomenon. When you change the dose -- either increase or decrease -- you don't necessarily see an immediate response.
 
It takes roughly 5 - 7 days for the depot to become established. This being the case, don't expect to see much of an effect until the depot is formed.

Once it is formed, a dose "proves" itself in roughly 3 days You don't want to change doses in less than 3 days/6 cycles since back-to-back changes can result in wonky numbers. The exception is with dose reductions although this is a more complex situation.

Does this mean that all of the insulin he’s been getting will release from the depot and he will go hypo? I miss prozinc. I feel much more comfortable with it. I don’t know if it would be a good idea to switch at this point.

Given the above, the depot isn't a one day phenomenon. When you change the dose -- either increase or decrease -- you don't necessarily see an immediate response.
 
Does this mean that all of the insulin he’s been getting will release from the depot and he will go hypo?

No....this is a very simple explanation, but it may help you understand it better.

The first shot, only a small amount goes into the bloodstream and the rest goes "in the depot" and slowly releases into the bloodstream....it doesn't "release" fast enough for the entire amount to get into the bloodstream

The next shot, same thing...a small amount goes to work and the rest goes "in the depot"...but now the depot has a little more in it, so the amount that's "released" over the cycle is a little more.

As you keep shooting, the depot eventually becomes "full" and releases the amount in relationship to the dose....so it's kind of like timed release in that sense.

Not until the depot is full will it be able to "release" the full dose amount (but it doesn't release it all at once)
 
Here's a more involved explanation:

The depot is basically a subcutaneous (below the skin) "spare tank" of insulin, which has yet to be used by the body.

Because no insulin injection is immediately 100% absorbed by the body, the yet to be used insulin stays under the skin. As needed, the body starts drawing on this "reserve"

When you first start insulin therapy with an "L" insulin, it can take up to 7 days (14 cycles) to see the full effect of that starting dose because only a small amount of each shot goes to work "quickly"....the rest is stored in the "depot" and gradually released

The larger your insulin dose, the larger the insulin depot in your subcutaneous fat tissue. If you skip a dose (or are late) the depot will drain and you have to "fill it up" again to get the optimum effect from the dose you're giving...with a small depot, this effect is greater than if you have a large depot

In Lantus:

After injected into the subcutaneous tissue, the acidic solution is neutralized by your body to a neutral pH. Because Lantus is not soluble (does not dissolve) at a neutral pH, it precipitates out into a form that's not soluble in subcutaneous fat, and there forms a relatively insoluble depot. From that depot of precipitated Lantus, small amounts slowly move back into solution over time and then to the bloodstream.
 
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