10yo male just diagnosed with BG of 385

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To clarify on putting air into a pen or a vial

Vial - yes ok to put air in. You need to even out the pressure for the insulin you withdraw.
Pen - no do not put air in. The pens already have a positive pressure in them. It helps for humans that use the pen needle tips and the dial a dose feature and actually "pushes" the insulin out of the pen.
 
Thank you for the clarification!

I do have a question, I have Jack's spreadsheet updated in my signature. Since this is my first time, if his numbers do not go over 250 when I do my +12 reading and ready to dose again, should I do the 0.5u again or should I lower it to 0.25u? I don't know what to do and I am due to dose within the next 10 minutes. Please help. Thank you!!!
 
Lantus dose adjustments are based on the nadir - the lowest glucose level between shots. It should go no lower than 50 mg/dL in cats diabetic for less than 1 year.

We want you to post here if your pre-shot test is < 200 mg/dL so we can guide you safely. To shoot under 200 mg/dL requires knowing how low the glucose is going first, to make sure if is safe for the cat.
 
Since this is your very first day giving Jack insulin, and you already got a BG of 67 at +4, this 0.5U dose may be too high. Lantus is a depot insulin, so the dose you give in one cycle does not all go to work immediately. Once the depot builds up, you will start to see the full effects of the dose you are giving. This usually takes 3-5 days.

With that steep drop from 309 at AMPS to 67 at +4, I'm concerned this 0.5U dose may be too much for Jack, especially with the cumulative nature of the dose.

Are you able to monitor this evening? Testing at +2 would be a great idea. If Jack is a lot lower at that time, you may need to monitor through the night to keep Jack safe.

If it drops too low, you need to give some higher carb food to raise the numbers up. If that happens, go back to your very first post, click on edit,change the post icon to the 911 icon, and submit the change. Then, add a new reply to your post and let people know what is going on.

It's only the very first post where the heading and posting icon change and show up on the board. Otherwise, it's buried way down in the psot, and those of us that scan the board may easily miss that you have a urgent need. If there is no one on here on the Feline Health forum, please post a new topic with a 911 icon over in the Lantus TR group. Lots of experienced people and west coast people there, up much later than us east coast folks. There would be someone there to help you.
 
I did dose .5u, but I think it was a little skinny of a dose, as I thought there was an air bubble in it and when I twisted the syringe a little more came out then what I thought, it is really hard to see those lines with that small of a dose. I need to find a magnifying glass. :)

I will be up through or around his +7 tonight as I have to do some work from home tonight. I will be posting his +2 numbers in about 10-15 minutes when I take them so they are a true +2.

Thank you again for all of your help!!! Truly appreciate it!!!!
 
I posted his +2 and they are higher than when I dosed him. I wonder if he barely got any insulin because of my mistake. I will be up to test him, what should I look for if he keeps rising? Even without insulin previously he has not been over 361 since I adjusted his food, or is this normal, since his body his adjusting to receiving insulin? Here are his previous numbers prior to starting insulin:

Initial at DR. office 12/30 11:30am 385
Follow up at DR. office 1/3 3:30pm 300

The rest are home readings

1/4 12:11pm 260
1/5 9:02am 268
.....4:37pm 361
.....7:13pm ketone negative urine test
1/6 9:01am 121
.....6:13pm 271
1/7 12:09am 235
.....8:15am 326
.....12:32pm 273
.....11:52pm 263
1/8 8:57am 311
.....1:47pm 274
.....10:22pm 311
1/9 6:22am 309
.....6:47pm 289
.....11:15pm 286
.....11:22pm ketone negative urine test
1/10 6:28am 306
.....6:42pm 311
1/11 12:10am 294
.....8:15am 309.....this is the morning I started the insulin

I would appreciate your advice, thank you!
 
When our kitties are diagnosed, we don't know how long their BGs has been high. But their liver had adjusted to those numbers so when we give insulin, and the BG comes down quickly or lower than what it deems as normal, it reacts by dumping counterregulatory hormones and glucagon into the bloodstream bringing the BG back up to where it feels is normal. We call this bouncing. All cats do it. Bounces can last for up to six cycles...but don't always.

I think he's bouncing and you might see the numbers go higher than you've seen. Don't panic and whatever you do, don't dose on the preshot and a bouncy number. So if you see him really high at AMPS tomorrow, don't raise the dose :-D

If you want to get a before bed test, that's fine.

Questions? :-D
 
I would stick with the 0.5 unit dose for now.

Dose adjustments are based on the lowest number between shots (nadir).
You want that no lower than 50 mg/dL.

In about 5 days, this first dose level of Lantus will have stabilized. Then you review the next tests in the +5 to +7 hour period after the shot to evaluate the dose and if it needs adjustment.
 
Thank you very much!!! I appreciate your comments. I will keep an eye out and I won't dose tonight. :) I will continue where I am at to allow for everything to level off. Thank you all again for all of your advice, support and talking off the ledge. :)
 
His numbers increased through the night so I am assuming that I didn't get any insulin in him last night. He is coming down this morning after his first dose and his +2 so I will continue to monitor. I went back to injecting in the scruff. Just a little further down because I feel more comfortable there. I tried flank last night and didn't feel as comfortable. I will move up and down the scruff and back for now until I feel better about giving the shots.
 
Remember, Lantus builds up. Keep a close watch in the +5 to +7 hours after the shot.
 
Unless you can be home to monitor and test and intervene if he goes to an unsafe level, I would not shoot. You just don't have the data to show it is safe.

He may need you to dose even smaller - 0.25 - which we eyeball on the syringe - or you may be fortunate and he may be able to get off the insulin.

Or, try this: feed him and test 2 to 3 hours later. If it does not spike the glucose, he may be producing some insulin on his own.

Glucose levels between 50 to 130 are normal for the diet-controlled diabetic cat and may not require insulin.
 
I did feed him and tested him an hour later and he was at 220. I dosed him at 0.25u but I think I got a fur shot. :( I will need to keep an eye out and see if he continues to raise. :( I struggle with the 0.25u ones trying to figure out if I have enough in there.
 
Been there, done that.

Hang in there.

A trick for the 0.25 - practice with a used syringe and some colored liquid. Carefully squeeze out equal sized drops. Count the number. Repeat until you can get the same number of equal sized drops each time.
 
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