18/12 Hercules AMPS 311, +2 378, first day and worried

[Hercule's mum]

Today is Hercules first day on Lantus. Had difficulty dosing 0.75. I will have to invest on calipers if we stay in this low dose.

So we went, from high to higher so far.....I guess I should have expected....From reading, I understand that it will take a few days to build a depot.... but with his BG up he is getting ravenous and ready to chew my leg.... Will it be like this for 3 days? Is it healthy to keep him high for days?

I am sure the answer is no, but do people dose with prozinc and Lantus during transition?

 

[Butters & Lyla]

Welcome!
For continuity and ease of access to information about Hercules, here is your last thread: https://www.felinediabetes.com/FDMB...o-is-switching-to-lantus.240155/#post-2701366

Switching insulins is not easy. You're correct, the Lantus depot needs to build. When I switched Butters from Caninsulin to Lantus, it felt like we were starting from scratch.

Do you check Hercules for ketones? Test more frequently when his numbers are high. This is very important.
I can't hard to say whether his numbers will be like this for three days. I will sometimes give Butters a little extra food when her numbers are high because she also gets ravenous and I know her body isn't using the food efficiently.

Here is a link for the "how-to" on dosing with calipers: https://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/
I highly recommend it. Bit of a learning curve at first, but then you can be sure Hercules is getting a consistent amount of insulin with each shot.

 

[JaxBenji]

I also use calipers like Lyla - I love mine - they are good for any size dose since the lines on syringes aren't always lined up - on my syringes, I've seen the lines off as much as a quarter to half unit. If you are in the US, I use these 6in ones from Harbor Freight (the 4in version is also popular with people on the board...it was out of stock when I got mine but I like the longer "handle" of my 6in ones).

There is also this fine dosing sticky with pictures - scroll down to the bottom to see magnified pictures.

Like you need another sticky to read but have you read the dosing method sticky at the top of the board? On Tight Regulation, you'd hold initial dose for 5-7 days and on Start Low Go Slow, you hold for 7 days - as you said, this helps build the depot. Some of the more experienced folks may advise to increase sooner but I personally would get input from them before doing so. Assuming you want to follow one of the dosing methods used here, you'll also want to pick one to follow (and you can always switch if it doesn't fit your lifestyle).

do people dose with prozinc and Lantus during transition?

I'm not an expert but I do know this is not safe. It can be hard to see the higher numbers but it's my understanding cats can handle the higher numbers much better than humans. You'll get the numbers down with the right lantus dose. People here try to hand out patience pants so far not one pair has been in my size

 

[Hercule's mum]

Thank you both. So his BG dropped a tad at +6.

I have heard about active and non-active cycles..... I assumed not much was going to happen today, and +2 and +4 confirmed this, but now with +6 I am wondering.... just normal variation, or do I need to get ready for PJ party tonight?

 

[Wendy&Neko]

do I need to get ready for PJ party tonight?

Nope, not tonight. The +2 test is a good one to get (for most cats, not mine ) on Lantus. For non contrarian cats, how the +2 relates to the preshot can give you a heads up how the cycle will look. If the +2 is higher than preshot, it'll be a quiet cycle, a good one for sleeping. If the +2 is about the same as the preshot, it'll be a "typical" Lantus cycle with some downward movement. If it's quite a bit lower than preshot, it's likely going to be a more active cycle, requiring extra monitoring.

 

[Sienne and Gabby (GA)]

Just one observation... You could have started Hercules at the same dose of Lantus as you were giving with Prozinc. Cats can have a marked response for a cycle or two when switching insulins, but not always. The TR protocol suggests reducing the dose if switching between Lantus and Levemir since they are both depot insulins.

At this point, stick with your 0.75u dose. You're seeing a little bit of movement. It may help to know that Lantus is gentle -- it doesn't "yank" numbers down. As the overall numbers come down, you'll see Lantus flattening the curve and you'll be getting better numbers. If it's not obvious, patience is something we have all had to cultivate when using a depot insulin.