1/12/ Bubba- PMPS 401 +3 359+5 369

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chubbabubba

chubbabubba

Member Since 2012
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Bubba still has slight ketones in his urine, but nothing like before. He is eating well but his numbers have been crazy!
He had one great day when he had a increase on the N, but I feel since its not long lasting we may have created the bounce?
Anyway, N did work for him before in 2010 but as you all said it is harsh and does not last. He will be starting Lantus tonight
and they are starting him at 1unit? Is that the normal starting dose? He is a big boy. The Dr said, tomorrow he would increase him?
Isnt that to soon? I think N really is my vets insulin of choice now that I think of it and I am going to need some help here!

I took off this whole week to watch Bubba. I am not going to lie, Lantus is different then N and I may still need direction (sorry guys even after the sticky notes)

When should I start testing like crazy? Lantus takes a few days to build up right? Would it be a waste to look for the nadir tonight?
Any suggestions would be great on the testing home front and also on the above dose and next day increase so soon?
Also since its a brand new bottle of lantus, do I need to put air into it or draw more then I need ? Is this in case there are bubbles?
 
Re: Bubba is FINALLY starting Lantus tonight!

If you were able to absorb everything in the sticky notes, you'd be the exception rather than the rule. It takes most of us a couple of weeks to get the routine down and begin to understand how Lantus works. If anything, being familiar with N may end up complicating things for you since the approach to dosing is, as you noted, rather different. We're here to help.

There is a formula for calculating initial dose. However, when a cat is switching insulin, consideration is given to the dose of the insulin that's currently being used. We typically recommend that the dose is reduced by 30% when switching to Lantus. Some cats have a marked response to a switch in insulin. That said, it looks like Bubba's current dose of N is 2.5u. Dropping his dose to 1.0u of Lantus, especially if you have been seeing ketones, may not be prudent. (A 30% reduction in your current dose would be approx. 1.75u.) PLEASE, test for ketones as often as you can.

Usually, the starting dose of Lantus is held for 5 - 7 days. With a cat that's switching and throwing ketones, we'd most likely fast track the dose and increase after 2 - 3 days. Increasing after 12-hours is giving the insulin depot no time to stabilize.

It does take a few days for the depot to form. However, getting tests every 3 hours for the first several days, if possible, will give you a chance to see when Lantus onset and nadir are occurring. In addition, monitoring a little more often will help to keep Bubba safe if he dose have a strong response to the insulin switch.

Do NOT inject air into the vial. Do NOT roll or otherwise shake the bottle. N is a suspension and you need to roll the bottle in order to mix the insulin. Lantus is a solution and you do not need to mix it. Lantus is also more fragile than N. This is why you don't want to inject air into the vial. Load the syringe with more insulin than you need, withdraw the syringe, and expel the excess into the sink. Please read over the sticky on the care and use of Lantus. There's also a video in that thread on how to fill a syringe with Lantus.
 
Re: Bubba is FINALLY starting Lantus tonight!

I wouldn't bother to look for a nadir tonight, since it's his first shot of Lantus. I would plan to get a couple of spot checks, though, just in case he is one of those cats who decides to have a good reaction on the first dose.

For what it's worth, I wouldn't start at 1 unit. Bubba is a big boy, and has been on 2.5 units of N, so I would think a good starting dose would be closer to 2 units. What is Bubba's ideal weight? We usually calculate a starting dose at 0.25u per kg of ideal weight (unless the cat is underweight, then we use their actual weight). Is it possible that your vet is just being cautious with the first dose because it is night, since they said they would increase tomorrow? I wouldn't think there is a need for that, and haven't seen others do it that way.

You don't need to put air into the Lantus. Please read our Information and Handling sticky for more information on how to deal with Lantus.
 
Re: Bubba is FINALLY starting Lantus tonight! few quick ques

I agree with Libby and Sienne. I think giving 1 unit tonight and an increase tomorrow morning doesn't make sense.
I would suggest you go with the larger dose that they suggested 2.00 or 1.75, since he has some ketones, and the depot of Lantus may take a few days to develope.
 
Re: Bubba is FINALLY starting Lantus tonight! few quick ques

Thank you guys. Well, since I had to shoot at 7, I gave him the 1 unit. No posts by then and I had to do something :(
Like I said, I dont know why he said 1 unit but perhaps he is being cautious, I dont know. If he tells me to increase tomorrow ( say numbers are high) which lets face it I feel they will be
Would it be safe to go to 1.75 right away it would be his second shot? I am so confused!


I watched the video- Please just correct me If I am wrong-( Please note- using the vial of Lantus- Brand new, first use tonight)

Dont shake, roll etc. BUT before you put the insulin into your needle- if you are giving 1.75 units you inject that amount of air into the vial before drawing out? Didnt she say that in the video? ? Am I not understanding this? So dont inject air back in. ( I didnt) Also if you are drawing out 1.75 units you need to take extra lets say 2 units in this case and put the extra into sink, paper towel? Why is that part done? to avoid bubbles?

If he tells me 2 units in the am lets say, Should I stick to 1.75? I need to get needles at cvs tomorrow that have half units
mine dont. Suggestions?

I am sorry I am so nervous and trying to absorb as much as I can. Now I feel so bad he only got 1 unit. I am sorry if I sound like a crazy person here, but as much as I read it, I feel like a dumb dumb with this insulin.
 
Re: Bubba is FINALLY starting Lantus tonight! few quick ques

It's okay :YMHUG: we're here to help you and guide you, and give you support :YMHUG:

I'm not sure about upping the dose to 1.75 tomorrow morning, now, so I will let others chime in on that.

No, you do not inject air back into the vial. It actually read that in the fine print of the Lantus instructions way back when I first started posting. And, I used to do, but I was told to not inject air back into the vial, and you never want to inject air into the pens or cartridges as they are vacuum sealed and can pop if you put extra pressure into them.

Can you go get the syringes with the 1/2 unit marks on them, tonight? And make sure your stores of supplies are loaded up.
 
Re: Bubba is FINALLY starting Lantus tonight! few quick ques

I just feel so badly right now :( Its just so darn confusing when you have different advise and thinking what the heck do I do?
I feel so bad he only has 1u of Lantus and now I messed it up for his am shot? ( shed) as you guys normally wait 2-3 days?
This whole thing has really gotten me down over the last month. I worry so much that my darn hair is falling out in clumps!
Bald and broke but hopefully he will get better. :)

Like I said, I think N is his drug of choice so I really need direction. Bubba has been my problem child since day 1 and I always tell him
I wont give up Chubby , you dont either :) Really they may be coming to take me away in the white jacket any day now!
So, my brain is shot and I swear I dont mean to ask and ask questions over and over. Like I said its like my head needs to be re-trained now from N

I will go tonight for the needles again- I have them just not with half marks
So I am asking for u-100 3/10 cc right? What needle size and guage?

Thanks
 
Re: Bubba is FINALLY starting Lantus tonight! few quick ques

if Bubba was mine, I would raise the dose tomorrow. Just pretend that the 1 unit tonight was a partial fur shot, or kind of a "booster" shot to get him through tonight, with his real official start tomorrow morning. ;-)

My suggestion was 2 units, Sienne suggested 1.75. Pick one of those and go with it.
 
Re: Bubba is FINALLY starting Lantus tonight! few quick ques

Ok.... I am going to throw in a few 3+ tests tonight. I will update as we go, and start at 1.75 in the morning dose.
Thanks, sometimes I just need a kick in the booty. Bubba said he will have his bags packed and be at your house in the am
cause I am driving him nuts! :lol:

PS. Got it NO AIR BACK IN VIAL !!! But I do draw out more then I use, dispose of rest before injecting. (Noted))) :)
 
Re: Bubba is FINALLY starting Lantus tonight! few quick ques

No worries. Frankly, the 2.0u will be easier to dose but either 1.75u or the 2.0u will be fine. This is one shot out of many. We've all given fur shots, had to skip or miss a shot, etc.

As for syringes: U100 3/10cc syringes with half unit markings are the best to use for fine dosing. BD, Monoject, GNP (through Hocks), Terumo, 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). The thinner the needle, the less your cat will notice. People with longer hair cats seem to prefer the longer needles.

What we don't want is for you to worry yourself sick over Bubba. It will be doubly hard for you to take care of Bubba if you feel lousy. This forum is a tremendous source of support and knowledge. You're not in this alone.
 
Re: Bubba is FINALLY starting Lantus tonight! few quick ques

Thank you all so much! I am a worry wart with this guy no doubt. I am very nervous with the Lantus journey but know that Bubba will be better off in the long run. He acted very bad on the N .( health wise and acted better when he was coming off of it)
I know there will be ups and downs ahead and I am ready for them. I am so thankful to all of you that are here to help Bubba and I.
Really! Ok, will post numbers in a bit. If 2 sounds good for tomorrow, then so be it!!! 2 it will be.

I should assume that in a few days , lets say ( wed) that I am now looking at his true numbers?
Just stick with me guys :) I will regain my sense soon. I feel a bit safer that he is on the Lantus now
No worries, I will continue to chase Bubba down for ketones at least once per day. I always have N on hand as well. ( hopefully no need)

Ok, deep breathe...........Let the journey start! Check back on his ss, new numbers posted later.
I will continue to do the 3+ for this week as much as I could . Need to get a real idea before going back to work.
 
Re: Bubba is FINALLY starting Lantus tonight! few quick ques

A +3 sounds good.

If you have a concern about Bubba's numbers, the quickest way to get everyone's attention is to edit your subject line. Go to your first post in the thread, click on the "Edit" button above the text box, make the change, and then click on "Submit."

It will also help us if you post Bubba's numbers as you get them in your subject line. There are several of us who scan the board to make sure there's not a problem brewing with any of our kitties. Being able to see your numbers helps a great deal (and saves time since we don't have to open everyone's thread -- aka "condo"). The convention we use is:
Cat's name....today's date....AMPS-#, +time-#​
 
Re: Bubba 1/12/12 PMPS 401 +3 359

Jackie

You are doing just fine! Don't worry....we all go through those first anxious days and weeks until we settle into a pattern. You and Bubba will, too.

Here's a post I did on Testing and Shooting Tips that might help you a little.

We are more than happy to help. I'm glad you got him on lantus.
 
Re: 1/12/12 Bubba- PMPS 401 +3 359+5 369

Then I won't annoy you by pointing out it's now 2013!! (I think that's why I leave off the year.)

I also think it's perfectly safe for you to go to sleep.
 
Re: 1/12/13 Bubba- PMPS 401 +3 359+5 369

LOL!!!!!!!!!!!!!!! ohmygod_smile

Thanks for pointing that out! See, I told you guys I am going a bit stir crazy.
Yes, I dont think I am going to see much other then the numbers going up tonight.
Tomorrow is the BIG day. In the morning we are moving up to 2u based on his weight, and previous dose.
Oh boy...bites nails :)
 
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