? 06/20 Derek AMPS 331 +4 270... UPDATE... Syringe comments... Question...

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In your previous condo, you had mentioned your girlfriend works semi-normal hours. Would she be able to help out with getting some tests in during the week when you are at work?
 
MollynSkooter said:
In your previous condo, you had mentioned your girlfriend works semi-normal hours. Would she be able to help out with getting some tests in during the week when you are at work?
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MollynSkooter said:
In your previous condo, you had mentioned your girlfriend works semi-normal hours. Would she be able to help out with getting some tests in during the week when you are at work?
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She gets up and leaves for her job about 2 hours after I do... But gets home much later (around 5:30 PM- she works longer hours and a very long commute)... with the exception of the 2 hours after I leave... She's here less than I am.
 
No one got back to me...

Derek's PMPS was 238...

Decided to go with the 3/4 unit (instead of 1 unit).
 
Sorry no one was around, I always work on the theory if in doubt do the conservative thing so good choice.

However, the thing you'll need to get used to with lantus is the depot effect. Unlike other insulins, with lantus and levemir dose is determined by how low the dose is taking the kitty not on what the preshot number is. When you shoot lantus you're shooting into the depot rather than giving a specific dose that will only affect that cycle. A particular cycle is likely to be affected by the doses given in about the previous six cycles. This also means that you need to be as consistent as possible in your dosing so that we know what a particular dose is doing. The reduction advice yesterday was only if you were using an ALPHATRAK meter but I'm a bit torn now as to whether it would be best to treat this one shot as a BCS (big chicken shot) or whether, given your schedule and that he almost earned a reduction according to the SLGS protocol it would be better to keep him at .75 for a few cycles to see how he does. Hopefully someone else will chime in before his AM shot @Wendy&Neko @Sienne and Gabby @julie & punkin (ga)

Re your question about bouncing - when a kitty drops into lower numbers than the kitty has become used to or drops very fast the liver panics and thinks there's a problem so stored sugars are released which send the kitties BG high. The effect of this can last for up to 6 cycles and should be ignored when considering dose adjustments. As the kitty becomes reused to appropriate BG numbers the bouncing gets shorter and less frequent and you hope to have kitty sailing along pretty flat in normal numbers.

Since you're not going to be able to be sure whether Derek has eaten within two hours of shot time this is something that needs to be considered when deciding if it's safe to shoot so remember to mention it if you're posting for advice on whether to shoot otherwise people will assume that the BG you have is not food influenced.

Well done on the condo linking too, you have the etiquette down pat :cat: did you know you can edit your subject line as you go along to? You go into your original post and there's a button on the top right hand side, I think it says something about 'thread' when you click on it there is an option to edit the subject line. That way you can update with new results as you get them and it's easy for others to see immediately if it's looking like you may need help.
 
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Sorry about no one responding. I may have missed it but it's helpful to put something in your subject line to alert people that you have a question. Sometimes, it's easy to overlook the question mark.
 
Vyktors Mum said:
Sorry no one was around, I always work on the theory if in doubt do the conservative thing so good choice.

However, the thing you'll need to get used to with lantus is the depot effect. Unlike other insulins, with lantus and levemir dose is determined by how low the dose is taking the kitty not on what the preshot number is. When you shoot lantus you're shooting into the depot rather than giving a specific dose that will only affect that cycle. A particular cycle is likely to be affected by the doses given in about the previous six cycles. This also means that you need to be as consistent as possible in your dosing so that we know what a particular dose is doing. The reduction advice yesterday was only if you were using an ALPHATRAK meter but I'm a bit torn now as to whether it would be best to treat this one shot as a BCS (big chicken shot) or whether, given your schedule and that he almost earned a reduction according to the SLGS protocol it would be better to keep him at .75 for a few cycles to see how he does. Hopefully someone else will chime in before his AM shot @Wendy&Neko @Sienne and Gabby @julie & punkin (ga)

Re your question about bouncing - when a kitty drops into lower numbers than the kitty has become used to or drops very fast the liver panics and thinks there's a problem so stored sugars are released which send the kitties BG high. The effect of this can last for up to 6 cycles and should be ignored when considering dose adjustments. As the kitty becomes reused to appropriate BG numbers the bouncing gets shorter and less frequent and you hope to have kitty sailing along pretty flat in normal numbers.

Since you're not going to be able to be sure whether Derek has eaten within two hours of shot time this is something that needs to be considered when deciding if it's safe to shoot so remember to mention it if you're posting for advice on whether to shoot otherwise people will assume that the BG you have is not food influenced.

Well done on the condo linking too, you have the etiquette down pat :cat: did you know you can edit your subject line as you go along to? You go into your original post and there's a button on the top right hand side, I think it says something about 'thread' when you click on it there is an option to edit the subject line. That way you can update with new results as you get them and it's easy for others to see immediately if it's looking like you may need help.
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Thanks...

Derek's AMPS was 280 (2:26 am)... gave 3/4 unit... or close to it... eyeballing it here :(... back to bed for a couple of hours :)
 
I find it very helpful to make up a sample syringe of the dose I want using coloured water (you could also use cold tea). I spend a bit of time making that one up and getting it just right and then use the sample to compare to the dose I'm drawing. It helps to keep it consistent and makes it much quicker to draw up the dose I want when I'm shooting.
 
purrdydolly said:
I find it very helpful to make up a sample syringe of the dose I want using coloured water (you could also use cold tea). I spend a bit of time making that one up and getting it just right and then use the sample to compare to the dose I'm drawing. It helps to keep it consistent and makes it much quicker to draw up the dose I want when I'm shooting.
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That's a great suggestion! Thanks! I'm going to do that...

I think part of the problem is with the Relion syringes I use. The marking are very inconsistent- at the needle end- some have very line marking (these seem fine), some with thicker markings- with the thicker marking closest to the needle end. Sometimes the marking are so thick they almost touch! On some it looks like there's less space between the first mark and first 1/2 unit mark than there is between that first 1/2 unit mark and the next full unit mark. I've been finding maybe 12 or so of these in a box off 100. I've not been using these. Makes me wonder how accurate the other ones are. Have you noticed anything like that?
 
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Sienne and Gabby said:
What you're describing is a common problem with most syringes. Many of us use 4" digital calipers to make sure our dosing is consistent.
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How does that work?

You would think that someone would design a better syringe- like one half the diameter with finer/more accurate 1/4 unit markings! :banghead:
 
Most humans don't give such small doses and the syringes are primarily meant for humans. The best syringes are no longer being made (Terumo). Many of us have switched to the BD Ultra Fine syringes, which you can buy for a good price at ADW:
http://www.adwdiabetes.com/product/bd-ultra-fine-insulin-syringes_6941_1.htm
There is a "dose ruler" that you can download from the German Lantus group that is designed to be used with the BD Ultra Fine syringe referenced above: http://www.diabetes-katzen.net/insulinruler.pdf
When you print this ruler out, make sure to set your printer for A-4 size paper (the standard European letter-size). Otherwise the proportions will be wrong and the dose won't be correct.
You may eventually find that calipers are the way to go, but in the meantime, this dose ruler and the BD syringes it works with are a pretty good substitute.
In general: there are very few "perfect" syringes!!

Best of luck,

Ella & Rusty
 
Ella & Rusty & Stu(GA) said:
Most humans don't give such small doses and the syringes are primarily meant for humans. The best syringes are no longer being made (Terumo). Many of us have switched to the BD Ultra Fine syringes, which you can buy for a good price at ADW:
http://www.adwdiabetes.com/product/bd-ultra-fine-insulin-syringes_6941_1.htm
There is a "dose ruler" that you can download from the German Lantus group that is designed to be used with the BD Ultra Fine syringe referenced above: http://www.diabetes-katzen.net/insulinruler.pdf
When you print this ruler out, make sure to set your printer for A-4 size paper (the standard European letter-size). Otherwise the proportions will be wrong and the dose won't be correct.
You may eventually find that calipers are the way to go, but in the meantime, this dose ruler and the BD syringes it works with are a pretty good substitute.
In general: there are very few "perfect" syringes!!

Best of luck,

Ella & Rusty
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Thanks for this!

I'd like to get and try these.

Wouldn't these require a different prescription (than 3/29G)? If so- mt vet may have a issue with this (not sure). Is there a way around this?

Why the dose ruler? Can't the markings on the syringe be used? Seems that the difference is gauge and length of the needle...? Wouldn't the unit markings stay the same?

Trying to understand (can be a bit slow at times) :(

Thanks again!
 
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I don't think there should be an issue with the Rx for the syringes.

The syringes you need to be using are described in the New to the Group sticky.
U100 3/10cc syringes with half unit markings are the best to use for fine dosing. BD, Monoject, GNP, and ReliOn are some of the brands available with half unit markings. Needle gauge and length is your preference They come in ½ inch or 5/16 inch needle lengths. Needle gauges 29, 30 or 31 (31 being the thinnest).
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I'm not sure what you mean by a "3/29G" syringe. I'm assuming you're using a 29 gauge syringe. (I use a 31 gauge -- it's a thinner needle.)
 
JohnZ said:
Wouldn't these require a different prescription (than 3/29G)? If so- mt vet may have a issue with this (not sure). Is there a way around this?

Why the dose ruler? Can't the markings on the syringe be used? Seems that the difference is gauge and length of the needle...? Wouldn't the unit markings stay the same?
Click to expand...

Some states require a prescription for syringes. If yours does, ADW will tell you and all you have to do is get your vet's office to call in the prescription (I don't think this should cause any problems with the vet if what you want to order is a different gauge than he/she prescribed; the higher the gauge, the thinner the needle, and therefore much more comfortable for the cat). Once you have ordered from ADW, for subsequent orders you simply have to state on the online order form that the vet's prescription is on file. The gauge of the needle and the length may not have a lot to do with the dose (I'm not sure about this), but the diameter of the barrel of the syringe, the thickness of the barrel, and whether or not there is a "dead air" spot at the needle end of the syringe body have a lot to do with measuring. That is why the "dose ruler" would only work with that specific BG syringe.
If a syringe has half-unit markings, the barrel will be skinnier so that the markings are spaced further apart (and therefore easier to read when drawing up the dose).

As Sienne remarks, most of us use a U-100, 3/10 mL cc syringe, 31 gauge, 8mm length of needle (5/16'') with half-unit markings. (the 3/10 mL capacity is for doses of 30 Units or less, and these syringes are easier to read than the 1/2 mL or the 1 mL, where the markings are much closer together in all brands.)

Hope this helps. The major problem with all brands of syringes is that the "zero" line usually does not line up with the plastic disk at the needle end of the syringe. This throws off all subsequent markings on the barrel of the syringe. And, just like cats, Every Syringe Is Different (ESID)!
 
Here is a post that you might want to bookmark to help find things on the Lantus/Lev group. In the second half of the initial post you'll find a link to a post on "dosing with calipers" that explains what Sienne was referring to. Unfortunately, syringe markings are horribly inconsistent. If you take 10 from your box and compare where the printed unit line markings are, they will not doubt have a lot of variation. Many cats are very sensitive to small dose changes. Using calipers is one way to work around the syringe marking inconsistencies.

The paper ruler that Ella referred to is something you could make for any brand. The most important thing with dosing is that you want to be consistent - so your 0.75u doesn't need to look like anyone else's, just be consistent for you from one shot to the next. I also saw someone recently suggested making a sample syringe like Serryn (Vyktor's Mum) suggested, only she suggested using a piece of masking tape to note where you want the dose to be. Both are good ideas.
 
Thank you all for your information. Now I have a good understanding (and need to make some changes).

This place is fantastic. It's amazing how much I've learned here!

Sorry I didn't reply sooner- insane last few days.

Thanks again! :cat:
 
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