1/2 Ozzy PMPS 253, +2 192, +3.15 227

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Ok. Thanks! I know you are busy so here's Yesterday's Condo.

I'm trying to walk between SLGS and not rushing the dose, keeping his DKA in mind, and still being aware there could have been a difference in dose between syringes with him getting less now. But I also don't necessarily want to see you increase the dose the day you go back to work tomorrow (note: because today would give him six cycles at this dose and to increase tomorrow would not be rushing it).

What are your thoughts? He's not really at numbers that would have us fast track him so the alternative is to leave him at this dose for seven days under SLGS and make sure you stay on top of the ketone tests.
 
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I just gave him .75U. He wasnt ready to pee for me. Was going to add my condo from yesterday but it is easier to add the links from my laptop and I am still on my phone. Thank you!

I actually don't feel super nervous about going with 1 u because he was doing ok on 1u on vestulin and got some blues and greens, but those greens just went too low too fast. I understand nose dives are not common on lantus. On the TR protocol, he should actually start out around 1.6u so....?? I guess it is too late since we already dosed him this am.

These new syringes suck compared to the old ones. Harder to push out your extra insulin without pushing past your correct dose and having to start over. I can imagine how difficult it can be at lower doses. We will adjust.
 
I'm not nervous about you going with 1u either but I have seen enough to know that sometimes they get New Dose Wonkiness with a new dose and sometimes they drop the first or second cycle before they settle a bit. I was trying to keep that in mind with you returning to work.

We don't really know whether he will get NDW with Lantus. Wish you had one more day at home after today!

BTW, I never liked the Relion syringes. I used Terumos, as did many members, and they were wonderful but they discontinued them. BDs are better than Relions but a lot more expensive. I've heard the CarePoint Vet from ADW are really good but, as with many syringes, get bubbles that you have to learn to deal with. I've linked the ones I would use. I think it's best to use 31g syringes.....less prick for them to feel.
 
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You and me BOTH!!! I really wish I would've trusted my gut and got Lantus last week. I am kicking myself for not!!! So hard to return to work after 18 days off too! I am so sad!!:(

But I go back for Tues-Friday. Maybe we can see how he does this week on .75 and then adjust him up if needed on Thursday am or PM cycle? Doesn't it take a few cycles to sink in? That way I have 5 cycles to monitor before going back to work the following week
 
Ozzy Pawzbourne said:
I just gave him .75U. He wasnt ready to pee for me. Was going to add my condo from yesterday but it is easier to add the links from my laptop and I am still on my phone. Thank you!

I actually don't feel super nervous about going with 1 u because he was doing ok on 1u on vestulin and got some blues and greens, but those greens just went too low too fast. I understand nose dives are not common on lantus. On the TR protocol, he should actually start out around 1.6u so....?? I guess it is too late since we already dosed him this am.

These new syringes suck compared to the old ones. Harder to push out your extra insulin without pushing past your correct dose and having to start over. I can imagine how difficult it can be at lower doses. We will adjust.
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Hi Joanna !!! Posted on ur yesterday thread a bit ago. I too got the Relion syringes in getting ready for Lantus and I already see I do not like them. Going to vet tomorrow to get the U 100 ulticare ....I have loved the working of them in U40 .... just know Elmo and I have you and Ozzy's back...check out our message to you both in yesterday's thread !!!
 
Ozzy Pawzbourne said:
You and me BOTH!!! I really wish I would've trusted my gut and got Lantus last week. I am kicking myself for not!!! So hard to return to work after 18 days off too! I am so sad!!:(

But I go back for Tues-Friday. Maybe we can see how he does this week on .75 and then adjust him up if needed on Thursday am or PM cycle? Doesn't it take a few cycles to sink in? That way I have 5 cycles to monitor before going back to work the following week
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With SLGS, you would need to do a curve and then adjust according to the guidelines.

How about a +2 test today so we can see if he onsets then?
 
Marje and Gracie said:
I'm not nervous about you going with 1u either but I have seen enough to know that sometimes they get New Dose Wonkiness with a new dose and sometimes they drop the first or second cycle before they settle a bit. I was trying to keep that in mind with you returning to work.

We don't really know whether he will get NDW with Lantus. Wish you had one more day at home after today!

BTW, I never liked the Relion syringes. I used Terumos, as did many members, and they were wonderful but they discontinued them. BDs are better than Relions but a lot more expensive. I've heard the CarePoint Vet from ADW are really good but, as with many syringes, get bubbles that you have to learn to deal with. I've linked the ones I would use. I think it's best to use 31g syringes.....less prick for them to feel.
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Hi from soon to be Lantus users!!! Have a question about Syringes....we have been using 12.7 mm length ulticare and really like them...do any of the U100 come in 1/2 inch ???
 
Beth 73 said:
Hi from soon to be Lantus users!!! Have a question about Syringes....we have been using 12.7 mm length ulticare and really like them...do any of the U100 come in 1/2 inch ???
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Yes, they do. On American Diabetes Wholesale, the Ulticare 0.3cc syringes come in 12mm and 8mm. The 12 mm are 15/32" so al out 1/2".

I preferred short needles (5/16") but it's all about personal preference.
 
Marje and Gracie said:
How about a +2 test today so we can see if he onsets then?
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You got it!

It's too early to do a curve today, right? What times should I test today?

I really really tried to stay up last night to get a +6 because I wanted to see if he would go down during the typical +6 nadir and was getting used to the lantus. If you recall, Ozzy's BG was going back up at +6 for his first 2 cycles. But I friggen passed out around 1:30a. I set my alarm for 3:30A just in case I couldn't stay up and it went off....BUT I didn't hear it, slept right through it.
 
Let's start with +2 and see if he's flat or headed down a bit. If he's not in a rush down, I'd probably do a +5 and a +8/+9 or so. We do need to see what he does later in the cycle and whether he gets any second dips towards the end.

I think it's too soon to do an actual curve for purposes of SLGS. When he starts getting more blue and green numbers, you'll be glad you gave him some pokey breaks at these higher numbers. Yes, data is good but we can fill in gaps without overpoking when he's higher.

You should also take advantage of sleeping when he's high. A before bed test is fine as long as he's in these yellow numbers and not dropping a lot from PMPS.
 
Beth 73 said:
Hi Joanna !!! Posted on ur yesterday thread a bit ago. I too got the Relion syringes in getting ready for Lantus and I already see I do not like them. Going to vet tomorrow to get the U 100 ulticare ....I have loved the working of them in U40 .... just know Elmo and I have you and Ozzy's back...check out our message to you both in yesterday's thread !!!
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Thanks Beth! I got your note on yesterday's condo and replied.

My vet too had the U 100 ulticare but they didn't have the half unit markings. Hope yours does. You should go in and look at their syringes yourself. When I called over the phone, they said they did have them but after 3 wrong boxes of syringes later, they realized they did not. :facepalm: I got a script and headed over to Walmart.

I really liked the U40 syringes a LOT. They were so easy to use. We will have to get use to these new ones. I see a lot of wasted insulin and syringes in my future from pushing out insulin past the correct dose and having to dump and start over. I've already done this 2 times out of 3 cycles. And I haven't even had Hubby try yet... he's going to be pissed at them! He has less patience than me!
 
Jo

I know this is your last day off but while you have the time, it would be good to go back through the last few days of condos and be sure you've read everything. Sometimes we cross post and you might not realize that links have been left for you to look at (e.g. Did you see Dosing with Calipers?).

We try to not throw a lot at you at once but there is so much to learn and a lot of valuable links as you ca see from the "Where Can I Find" post that I also linked. I'm not saying you need to read all of those; you don't but it gives you a sense of the tip of the iceberg of the amount of info available.
 
Marje and Gracie said:
I think it's too soon to do an actual curve for purposes of SLGS. When he starts getting more blue and green numbers, you'll be glad you gave him some pokey breaks at these higher numbers. Yes, data is good but we can fill in gaps without overpoking when he's higher.
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I am sure he will appreciate the pokey breaks, too. My poor kitty's ears look awful! :blackeye: See...I am a former vestulin user and it seems I have a little PTSD from how erratic vestulin was. I was always worried Ozzy was going to drop too low and wanted to see how long it would last in him (which was never very long). I have to adjust my thinking and fears and realize lantus acts different and is more gentle. I'll get there!
Marje and Gracie said:
You should also take advantage of sleeping when he's high. A before bed test is fine as long as he's in these yellow numbers and not dropping a lot from PMPS.
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What +? time should I check before bed to know if he's going to be ok for the night so I don't worry? +2?
 
Got Ozzy to give me a pee test. The result looked mostly negative but somewhat in between negative and trace. What's going on with these stupid strips! Could he really be fluctuating from negative to trace and back and forth? Really need to get the blood meter. I did test myself yesterday and it looked negative.
 
BTW....Sorry to off topic rant- but how STUPID is it that the Rose Parade is today and not yesterday which was the actual first day of the new year. I know it's today the holiday is recognized ...Blah blah blah....it's just stupid. I have seen the Rose Parade for decades and never once remember it not being on the 1st of January.
 
Marje and Gracie said:
Jo

I know this is your last day off but while you have the time, it would be good to go back through the last few days of condos and be sure you've read everything. Sometimes we cross post and you might not realize that links have been left for you to look at (e.g. Did you see Dosing with Calipers?).

We try to not throw a lot at you at once but there is so much to learn and a lot of valuable links as you ca see from the "Where Can I Find" post that I also linked. I'm not saying you need to read all of those; you don't but it gives you a sense of the tip of the iceberg of the amount of info available.
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Thank you. I did read over all of yesterday's post...I'm admittedly a little addicted to this site now....Hubby's like- what's happened to you!!?

I bookmarked the "Where Can I Find__?" thread because there is a lot of info on it that I haven't had time to get through. Also will read the dosing with calipers thread today. I did see it yesterday but didn't get a chance to read it as I was going through stickies all day and spocking other people's SSs.
 
Ugh.....not getting my notifications again. Sorry.

At night, it's always best to get a +2 so you can tell if he's going to come down. based on where he is arm+2, you can decide if you need to test sooner or later. If he's flat or down a bit but not much, then whoever goes to bed last can test as long as it's within a couple hours. If he's down a lot, you'll need to test sooner.

At some point, you might need to set an alarm and take turns getting up to grab a test. I always kept everything on the nightstand including a small flashlight I could hold in my mouth. Since Gracie always slept next to me, it was easy to quickly grab a test.

I wouldn't think he'd fluctuate between negative and trace that much. Could it be lighting?

Glad to see that +2. I think you can go until +4.
 
Marje and Gracie said:
I wouldn't think he'd fluctuate between negative and trace that much. Could it be lighting?
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I'm not sure if it's the lighting or not...those test strips are annoying because there is such a subtle difference between negative and trace and you only have 15 seconds to figure out which one it is.... I will just keep testing. Looking for the meter online now and strips. Trying to see which meter takes the least expensive strips.

Will test again at +4
 
Ozzy Pawzbourne said:
I'm not sure if it's the lighting or not...those test strips are annoying because there is such a subtle difference between negative and trace and you only have 15 seconds to figure out which one it is.... I will just keep testing. Looking for the meter online now and strips. Trying to see which meter takes the least expensive strips.

Will test again at +4
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Actually, I also had a hard time telling sometimes and would just retest. I could always insert a large spoon under her bottom as she squatted and get a spoonful of urine so retesting with another strip was easy. It hunk when the strips are new, they seem to be a bit more sensitive to the 15 secs as I noticed they would change fast.
 
Ozzy Pawzbourne said:
BTW....Sorry to off topic rant- but how STUPID is it that the Rose Parade is today and not yesterday which was the actual first day of the new year. I know it's today the holiday is recognized ...Blah blah blah....it's just stupid. I have seen the Rose Parade for decades and never once remember it not being on the 1st of January.
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:woot::D:p:joyful::eek::smuggrin::woot:
 
@Marje and Gracie
AMPS =293
+2 =239
+4 = 228

Still high and flat...hoping his will come down into some blues here soon.

Poor Kitty has been over the 200s every single day for last month. :blackeye:
 
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Sorry, missed your comment above and just did a +6 on him because I wanted to see if he would nadir around +6 (since I understand this seems to be the typical time for Lantus).

AMPS =293
+2 =239
+4 = 228
+6=247.

So he has shown twice now that he is nadir'ing around +4. Same as he was when on vestulin. Maybe this will change as his 'depot fills up'.

Kind of wish I would've started him on 1U and had the chance to monitor him on this dose. If I stick with the .75U for the rest of the week, he'll likely run high for another entire week instead of maybe having the opportunity to spend some good time in blue. It will be interesting to see how the next few days go. I already do like that the lantus hasn't made him do any nose dives. Just fine tuning dose from here I guess.
 
Yes, he’s just not getting duration yet. Sometimes as the depot fills and the cumulative nature of the insulin occurs, the numbers improve. He is likely still going to need an increase.

It’s your decision when you want to increase his dose if you are worried about the numbers and him staying there with the DKA past. I’d just be concerned about increasing when you are going back to work and will not be able to monitor him.

Sometimes it’s very clear at what dose to start them when they are moving from Vetsulin, Novolin N, etc but since he had seen some lower greens, it is better to start a tad lower and increase then have him throw you a number below 50 right off the bat.

I would get a test later in the cycle....perhaps +10.
 
Marje and Gracie said:
Yes, he’s just not getting duration yet. Sometimes as the depot fills and the cumulative nature of the insulin occurs, the numbers improve. He is likely still going to need an increase.

It’s your decision when you want to increase his dose if you are worried about the numbers and him staying there with the DKA past. I’d just be concerned about increasing when you are going back to work and will not be able to monitor him.

Sometimes it’s very clear at what dose to start them when they are moving from Vetsulin, Novolin N, etc but since he had seen some lower greens, it is better to start a tad lower and increase then have him throw you a number below 50 right off the bat.

I would get a test later in the cycle....perhaps +10.
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Ok, will post back at +10 Boy has he been a little sleepy snuggle bug today.

I am going to have to put my patience pants on here and just try to wait it out a few days to see if we should increase him. He still hasn't been on this dose let alone this insulin very long for things to truly 'kick in' and I don't want to rock the boat. Also, we are in the process of forcing the schedule back, too so a lot of factors going on here.

I should dose at 8pm tonight, right?
 
Yes, you could shoot at 8 tonight, 7:30 tomorrow morning, 7:30 tomorrow night, and 7 Wed morning. How's that sound?

The patience pants are the hardest part. Mine always fit too tightly ;)
 
If I get a +10, do I need to do a +11.5. Or can I go ahead then and just feed and shoot?

I read your thread and watched your videos on dosing with calipers. Seems very scientific! I'm not sure I understood the part on how you tell how many actual mm are in a unit? You have to test multiple syringes in a box? Like used ones or new ones? Can you explain this part more? I got the part about how to use the calipers but measuring out the units was based on figuring out what a true unit is based on discrepancies with syringes.
 
Ozzy Pawzbourne said:
If I get a +10, do I need to do a +11.5. Or can I go ahead then and just feed and shoot?

I read your thread and watched your videos on dosing with calipers. Seems very scientific! I'm not sure I understood the part on how you tell how many actual mm are in a unit? You have to test multiple syringes in a box? Like used ones or new ones? Can you explain this part more? I got the part about how to use the calipers but measuring out the units was based on figuring out what a true unit is based on discrepancies with syringes.
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Yes, if you do a +10, you'll need a test before you shoot. You can test just before you shoot so it's closer to 2 hours. I just want to see if he dips.

On dosing with Calipers, yes, you would need to look at several syringes to find a few where the zero line is exactly the top of the needle side of the syringe so if you pushed the plunger to the top (needle side) then the needle side of the plunger should match up perfectly with the needle side of the zero line. Then use the Calipers to measure the millimeters from the needle side of the zero line to the needle side of 1u. Then divide by ten as there are 10-0.1u in 1u. If your millimeter measurement is 1.4 mm, then each 0.1 mm dose is .14 mm. That allows you to dose pretty finally and you can just do the math if you are increasing by 0.25u. Make sense?
 
His +11.5 will be shot time so I won't be able to make it to 2 hrs if we are trying to stay on the 8pm schedule for tonight. Actually his PMPS test will be around 7:45pm if we want to feed him before his shot so that will be at + 11 hrs 15 mins...1 hr and 15 mins after his +10 test. But that's ok.

I have been feeding Ozzy and Figgie every 3 hrs or so. They both have seemed to gain weight in the past few weeks!! :woot: This is good for Fig because he was always skinny his whole life. It is actually nice to pet him without his spine feeling prominent. But not for Ozzy- we actually want him to loose a little more weight. I am not looking to diet him till his DM is more regulated for fear of ketones, but I really don't want him to gain more weight. I was always making sure he was eating at +1.5 because of the low drops on vestulin. How often should we feed them now?
 
Ozzy Pawzbourne said:
His +11.5 will be shot time so I won't be able to make it to 2 hrs if we are trying to stay on the 8pm schedule for tonight. Actually his PMPS test will be around 7:45pm if we want to feed him before his shot so that will be at + 11 hrs 15 mins...1 hr and 15 mins after his +10 test. But that's ok.

I have been feeding Ozzy and Figgie every 3 hrs or so. They both have seemed to gain weight in the past few weeks!! :woot: This is good for Fig because he was always skinny his whole life. It is actually nice to pet him without his spine feeling prominent. But not for Ozzy- we actually want him to loose a little more weight. I am not looking to diet him till his DM is more regulated for fear of ketones, but I really don't want him to gain more weight. I was always making sure he was eating at +1.5 because of the low drops on vestulin. How often should we feed them now?
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Oops....my bad. Yes, you are right that since you are shooting early, you'll be at +11.5 but I'd still test.

It's fine to feed them several small meals. He needs to eat before he onsets but most feed with the shot. As he starts to work the insulin, he might need specific feedings but for now, I wouldn't worry about changes to his schedule.
 
AMPS =293
+2 =239
+4 = 228
+6=247
+10=257

Wonder if he dropped lower in the last 3 hours or stayed the same. Testing again in 1 hour prior to feeding/shot. Will post back then.
 
ok PMPS at +11 hrs 15 mins =253

Eating his wuerva chicken and turkey with rad cat raw mixed in with water now.

Shoot in 10 mins.

Not a bad preshot #.
 
Ozzy Pawzbourne said:
ok PMPS at +11 hrs 15 mins =253

Eating his wuerva chicken and turkey with rad cat raw mixed in with water now.

Shoot in 10 mins.

Not a bad preshot #.
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Excellent. That could be the second Lantus dip....maybe.

Lantus is known for giving a second little dip at the end of the cycle. I'd let him go until +2.

Great if you can get another ketone test!
 
PMPS= 253
+2= 192

Ya- a blue!!! :)

Not sure I am going to make it to do a +4 but probably can do a +3. They are eating some homemade chicken mixed with rad cat raw now so the +3 would be with less than 2 hours food prior.
 
@Marje and Gracie Do you think we should be concerned about his +2 dip for the night? I think this is his biggest 2 hr dip so far. Seeing that he has been pretty flat so far on Lantus, I don't think he will go super low. Doubt he will even get below 160 tonight. What do you think?
 
Reading some other treads and someone commented that usually when a curve is flat it means the dose is too high. Do you think this might be the case with Ozzy? I was thinking he would probably need a dose increase. He did get into the blues before on vestulin on lower doses.
 
No, I don't think his dose is too high. He didn't get into green numbers at a dose lower than 1u.

Patience, Grasshopper :):):);) Actually, almost everyone, including me, wonders if the dose is too high at some point but in the 6.5 years I've been on this board, there have only been a few cats that were overdosed and that's when the vet started them at a ridiculously high dose and then increased it by a unit every week.

He's getting into blue faster and more than Gracie did on lantus at the beginning. In fact, her numbers seemed higher on insulin than off until I got to a fitting dose for her.

Hope you get a good night's rest. I will check in as soon as I get up in the morning.

Nite nite!
 
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