? 06/02 Maggie AMPS 384, +2 294, +4 202, +6 214, +9 274, PMPS 315 /2nd day on Lantus

[hellen_maggie]

Hi everyone!
We finally managed to switch Maggie to Lantus and we are currently on day 2(4th dose).

I already feel so much relief! We are seeing a big difference compared to the daily rollercoaster and the scary drops we had with Caninsulin. Maggie seems more stable today, drinking significantly less water and urinating less frequently than before. I know our numbers are still too high, but i am hopeful that we will see more improvement as the depot builds up in the coming days. We are feeding small meals at +2 and +5 (amps & pmps) and we are doing a very gradual transition to a low carb air-dried food to keep her stomach happy (we tried hard switching to wet food, but her stomach simply couldn΄t handle it no matter what we tried. The air dried option seems to be the golden mean for her digestion so far).

Since we have zero experience with Lantus, i would love to hear your thoughts or any tips you might have for these first few days. Are we finally on the right track?

One last thing: Since Lantus is something new for us, the fear of dropping during the night is keeping us awake. Any reassurance or advice on how to handle the overnight shift safely would mean the world to us.


Thank you all for your support and help!





Started caninsulin about a month ago, results are not good enough
? - Plan to switch from Caninsulin to Lantus. Any advice on dosing?

 

[Allie & Gen]

Congratulations on the switch. I'm very hopeful that this will make a huge difference for Maggie.

I think the key at this point is patience, though I know that's hard. Her body needs time to adjust to the change. I haven't had the experience of switching insulins before, so I don't have that kind of specific insight, but any change in dosage takes some time to show results.

The good news about the slowness of Lantus is that you're also much less likely to see huge drops out of nowhere, though! You're likely to be able to see a plunge coming. I don't know how her shot schedule matches up with your sleep schedule, but hopefully you have at least a couple of hours post-shot to see how she's trending?

The longer she's on Lantus, the better sense you'll get of how she responds, what patterns her cycles tend to follow, etc. You're in a data-gathering place right now, and predictions are difficult. If something unexpected happens, though, we'll be here! Tagging @Wendy&Neko and @Mary & Jude for better insight on the insulin switching specifics.

 

[Mary & Jude]

Hi Hellen! Welcome to the Lantus forum!!

We switched from Vetsulin to Lantus and saw much better numbers; I think you're going to like it better, too.

If you haven't already done so, you'll want to start reading the information posted at the top of the Lantus board to familiarize yourself with some basics of the insulin. This post is especially helpful as it outlines the two dosing methods that most of us on the forum use. These dosing methods guide us in making dose increases/decreases based on kitty's bg numbers.

You mention the fear of dropping at night being a concern; this is often a concern for caregivers. In the beginning, while you are gathering data with the bg tests and learning how Maggie handles the insulin, you'll begin to better understand how she is metabolizing her insulin. Lantus typically follows a curve: onset is typically around +2, when the bg begins to drop, until the nadir, after which the bg begins to rise. And I put emphasis on the word typical here as many factors can affect the curve and make it look more belled at times as opposed to flat. (I'll also add here that some kitties can experience a double nadir, which comes at the end of a cycle and is a bit higher than the first nadir.) What I always look for with Jude is how he responds to the insulin at the +2 point: if he is considerably higher from preshot to +2, then his cycle is likely to not be too active; if he has a significant drop after the shot (rule of thumb: 20%), then I know we're in for a more active cycle, and I am going to need to monitor and test more frequently to ensure he does not get into dangerously low numbers. So, you're doing well right now to monitor as frequently as possible. Don't leave any huge gaps in your monitoring right now (try to get a curve at least once a week--shooting for one bg test every 3 hours for 24-hours or one bg test every 2 hours for 12 hours) because gaps in testing could mean that you're running the risk of the bg dropping in that gap. Build your data, and get to know how Maggie handles her insulin.

Feel free to ask questions. FD has a significant learning curve; we've all had to get up that curve (and are still learning!), and we're happy to help you as you're doing the same.

 

[hellen_maggie]

Congratulations on the switch. I'm very hopeful that this will make a huge difference for Maggie.

I think the key at this point is patience, though I know that's hard. Her body needs time to adjust to the change. I haven't had the experience of switching insulins before, so I don't have that kind of specific insight, but any change in dosage takes some time to show results.

The good news about the slowness of Lantus is that you're also much less likely to see huge drops out of nowhere, though! You're likely to be able to see a plunge coming. I don't know how her shot schedule matches up with your sleep schedule, but hopefully you have at least a couple of hours post-shot to see how she's trending?

The longer she's on Lantus, the better sense you'll get of how she responds, what patterns her cycles tend to follow, etc. You're in a data-gathering place right now, and predictions are difficult. If something unexpected happens, though, we'll be here! Tagging @Wendy&Neko and @Mary & Jude for better insight on the insulin switching specifics.

Thank you so much for the reassurance, Allie! It really helps to hear that Lantus is more predictable than Caninsulin.
To answer your question, our injection schedule is at 06:30 AM and 18:30 PM. My plan for the night cycle is to always test her at +3 (21:30 PM). Since I have to work during the day, I’m trying to figure out a safe routine so I can get some sleep and be able to function at my job.
I am looking for a general rule of thumb to follow. I’ve heard some people say that if the +3 reading is higher than or equal to the PMPS, it’s usually a safe cycle to go to sleep. Is this a reliable rule for Lantus, especially during these first few days?
At what point should I consider staying up for a +4 or +5 test? I want to have a guideline in my mind so I can manage my anxiety and get some rest. Thank you for tagging the others, I really appreciate the help!

 

[hellen_maggie]

Hi Hellen! Welcome to the Lantus forum!!

We switched from Vetsulin to Lantus and saw much better numbers; I think you're going to like it better, too.

If you haven't already done so, you'll want to start reading the information posted at the top of the Lantus board to familiarize yourself with some basics of the insulin. This post is especially helpful as it outlines the two dosing methods that most of us on the forum use. These dosing methods guide us in making dose increases/decreases based on kitty's bg numbers.

You mention the fear of dropping at night being a concern; this is often a concern for caregivers. In the beginning, while you are gathering data with the bg tests and learning how Maggie handles the insulin you'll begin to better understand how she is metabolizing her insulin. Lantus typically follows a curve: onset is typically around +2, when the bg begins to drop, until the nadir, after which the bg begins to rise. And I put emphasis on the word typical here as many factors can affect the curve and make it look more belled at times as opposed to flat. (I'll also add here that some kitties can experience a double nadir, which comes at the end of a cycle and is a bit higher than the first nadir.) What I always look for with Jude is how he responds to the insulin at the +2 point: if he is considerably higher from preshot to +2, then his cycle is likely to not be too active; if he has a significant drop after the shot (rule of thumb: 20%), then I know we're in for a more active cycle, and I am going to need to monitor and test more frequently to ensure he does not get into dangerously low numbers. So, you're doing well right now to monitor as frequently as possible. Don't leave any huge gaps in your monitoring right now (try to get a curve at least once a week--shooting for one bg test every 3 hours for 24-hours or one bg test every 2 hours for 12 hours) because gaps in testing could mean that you're running the risk of the bg dropping in that gap. Build your data, and get to know how Maggie handles her insulin.

Feel free to ask questions. FD has a significant learning curve; we've all had to get up that curve (and are still learning!), and we're happy to help you as you're doing the same.

Hi Mary and thank you so much for the warm welcome and for all the helpful information! It’s truly reassuring to hear positive experiences about switching from Vetsulin to Lantus, and I really hope we’ll see consistently better numbers with Maggie as well!

Nighttime drops is something that worries me a lot, but what you explained about the +2 and how you “read” the cycle is extremely helpful. I hadn’t thought of it that way, and I’ll definitely start paying closer attention to the preshot–to–+2 difference to better understand whether we’re heading into an active cycle.

I’m already trying to test as frequently as possible, and I’ll make sure not to leave large gaps, especially during this period while we’re still learning how Maggie responds to Lantus. The weekly curve is also part of my plan, so we can build the best possible data to help my baby!

Thank you again for the encouragement and support. This community is truly invaluable, and it means a lot to know you’re not alone in all of this. I’ll definitely be back with questions as we move forward

 

[Mary & Jude]

I will also add this. My experience with FD is that it's kind of like caring for a baby--at the beginning of diagnosis, you'll have some sleepless nights, but overtime, things can get easier, and you'll, hopefully, get to a point of consistency and regulation. At the beginning of Jude's diagnosis, I was very stressed out by managing the sleepless nights with a full time job, but looking back now, what I wish I knew then was that things would get better and easier overtime.

 

[hellen_maggie]

I will also add this. My experience with FD is that it's kind of like caring for a baby--at the beginning of diagnosis, you'll have some sleepless nights, but overtime, things can get easier, and you'll, hopefully, get to a point of consistency and regulation. At the beginning of Jude's diagnosis, I was very stressed out by managing the sleepless nights with a full time job, but looking back now, what I wish I knew then was that things would get better and easier overtime.

Thank you so much! I truly believe and hope that we will manage to get her regulated so that we can both be happier and less stressed. For now, we just got our +3 reading and it looks like we are heading for a quiet night full of cuddles, something we both really need! Thank you again for everything Mary

 

[tiffmaxee]

Welcome. Not all cats onset (when Lantus kicks in) at +2. Max was more like +2.5 or even +3 unless he started lower probably due to carry over from the previous cycle and he was onset earlier. When possible it’s a good idea to get a +1 at the beginning to see how much of a food bump you get. At first it’s good to pick up food 2 hours before shots. Are you giving shots 12 hours apart? I’m not understanding 18:30 p.m.

 

[Allie & Gen]

Welcome. Not all cats onset (when Lantus kicks in) at +2. Max was more like +2.5 or even +3 unless he started lower probably due to carry over from the previous cycle and he was onset earlier. When possible it’s a good idea to get a +1 at the beginning to see how much of a food bump you get. At first it’s good to pick up food 2 hours before shots. Are you giving shots 12 hours apart? I’m not understanding 18:30 p.m.

She's using 24-hour time. 18:30 is 6:30PM (12 + 6 = 18).

 

[hellen_maggie]

Welcome. Not all cats onset (when Lantus kicks in) at +2. Max was more like +2.5 or even +3 unless he started lower probably due to carry over from the previous cycle and he was onset earlier. When possible it’s a good idea to get a +1 at the beginning to see how much of a food bump you get. At first it’s good to pick up food 2 hours before shots. Are you giving shots 12 hours apart? I’m not understanding 18:30 p.m.

Hi Elise! Thank you for the advice. To clarify, yes, I give the shots exactly 12 hours apart: at 6:30 AM and 6:30 PM.
Regarding food, I never give her any food 2 hours before the shot. Her meals are strictly scheduled right after the pre-shot test, at +2 and at +5. She doesn't eat anything else outside of these times.
I will try to get a +1 measurement when possible to see the food bump, thanks for telling me!!!

 

[tiffmaxee]

Hi Elise! Thank you for the advice. To clarify, yes, I give the shots exactly 12 hours apart: at 6:30 AM and 6:30 PM.
Regarding food, I never give her any food 2 hours before the shot. Her meals are strictly scheduled right after the pre-shot test, at +2 and at +5. She doesn't eat anything else outside of these times.
I will try to get a +1 measurement when possible to see the food bump, thanks for telling me!!!

Thanks for this. I was just confuse since you used two different ways of reporting the time. Since you are not feeding less than 2 hours before shots the +1 is not really needed unless the amps or pmps is a lot lower than usual.

 

[Wendy&Neko]

Do you have an automated feeder for Maggie? Once you've figure out when she typically has her lowest numbers (nadir) you can program a feeder to make sure she has fresh food then.

Over time, as Maggie's body learns how to use the Lantus, you will start to see patterns in her blood sugar numbers. These patterns are typically across a few cycles. Knowing those patterns will help you know when you have to get a later test and night, and when you don't.

Since you are still feeding dry food, you have to follow the Start Low Go Slow dosing method, but there are still some tips in this document that can help when you have to go to work or sleep: Is Tight Regulation Possible with a Full Time Job? Yes!

 

[hellen_maggie]

Do you have an automated feeder for Maggie? Once you've figure out when she typically has her lowest numbers (nadir) you can program a feeder to make sure she has fresh food then.

Over time, as Maggie's body learns how to use the Lantus, you will start to see patterns in her blood sugar numbers. These patterns are typically across a few cycles. Knowing those patterns will help you know when you have to get a later test and night, and when you don't.

Since you are still feeding dry food, you have to follow the Start Low Go Slow dosing method, but there are still some tips in this document that can help when you have to go to work or sleep: Is Tight Regulation Possible with a Full Time Job? Yes!

Hi Wendy! I actually already have an automated feeder. At first, Maggie was a bit afraid of it, but thankfully she is slowly starting to accept it. So I hope that once I learn when her nadir typically occurs, I can program a meal around that time. Thank you so much for your tips!