3/17 Tommy +5.5 336, +7.5 322,+10.5 410, +11.5 432

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Lauren&Tommy (GA)

Lauren&Tommy (GA)

Member Since 2010
Ok, first things first, you all are wonderful people with how much you care and take the time to respond. Let me answer the questions you have asked and then i have some questions i would like to ask also.
Tommy came with the property i was building a house on some 14yrs ago. He was approx 2yrs old then. He remained an outside kitty for many of those years until he had one too many an encounter with a raccoon and my husband and i decided that was enough. He needed to be inside to heal from the wound to his leg so we took that as a sign to try and make him and indoor kitty.. That didn't take long. Fast forward, He has never had dental cleaning done. When i took him in for his UTI, the vet checked him over and found that one of his teeth was infected. He started Tommy on antibiotics for the UTI also hoping that would take care of the infection on the tooth. He suggested we get the UTI under control and then address the tooth if it was still bad. I have not taken him back to have the tooth looked at. I will do that.
A urine culture was done to pinpoint what kind of antibiotic to combat the problem but the culture came back negative. His ketones have consistently come back negative as well.
Tommy drinks a lot of water and his P's are mostly always very big.
Let me start by letting you know how i take care of Tommy, maybe i'm doing something wrong.
I feed in the a.m.--test--then shoot
I saw in an earlier post that you should test--feed--then shoot.
The reason i was doing this was Tommy was having a hard time sitting still if he wasn't fed first.
Let me know if i definitely need to test before feeding

Ok, now with my questions:
The vial of lantus i have is still almost half full and it cost about $110. If in fact it has lost its potency, i will be wasting about $50. by throwing it out. Why would anyone use a vial if you end up throwing away most of it? I understand it's human insulin and they use more than do animals, but i just don't understand using a vial for my Tommy if i'm going to throw out 1/2 a vial every time. I cannot afford that.
Do i need a prescription from my Vet for the solostar pens and if so how to i go about getting that done and here as soon as possible. Does my vet have to call, fax, e-mail the pharmacy or company i choose, or how does it work?
Libby and Lucy, are you saying that if i'm up at 3am i should go ahead and test? Is that what you are referring to by spot testing.. I've done a couple of 12hr curves to find the nadir and many tests throughout the day on other occasions.
When i receive the new lantus, should i start over with a lower dose since it will be more potent..? Please advise. I know i've asked a whole lot of questions.
I will continue with the 4u 2x a day until i can get more lantus and i will reduce his food intake to the appropriate amt.
Thank you all for caring so much.. It's nice to know i'm not alone on this journey.
If you have any more questions or i have missed something.. please let me know.
Have a wonderful day all!!!
 
Re: More answers and Questions on Tommy

Hello all, another thing since my post this morning i have called in a prescription for a solostar lantus pen. My husband was in town and i found a good price for one pen at costco. he is bringing it home with him..
Now to my question. I have lowered Tommys food intake and he is currently getting 4u 2x a day.. Should i lower the amt of insulin given the vial i had been using has more than likely lost it's potency and the pen will be fresh.. I don't want to give too much at first.
Also, i still use the same needles i was using with the vial and i can dose out 1/2 units if needed correct?
Sorry for all the questions, just want to get it right.
Thanks.
I also know that directions are not always what they should be so i'm gonna ask ahead of time. Keep the insulin refrigerated, upright, don't shake or drop.
Does it need to be rolled or mixed in any way ? and do i have to throw it out after a month if i don't use it all.. I know there are some conflicting lengths of time one should use the insulin. I am having to throw out almost a half a vial of lantus, because it has gone bad..
 
Re: More answers and Questions on Tommy

Hi, someone else may come by & suggest differently.. but since your pen will be more potent, if it were my kitty - I would shoot the regular dose & monitor closely. Will you be home? Get a +1, +2, etc. the +2 is a good indication of where the cycle is going (if there is more than a 50 point drop from the preshot #, then it can be an active cycle) yes, you do still use the same u100 syringes to give the injection.
As far as the handling of Lantus...

PROPER HANDLING OF LANTUS and LEVEMIR


Lantus and Levemir should be inspected visually prior to administration and should be used only if it appears clear and colorless.
Never shake or roll your vial, cartridge, or pen.
In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
Be careful your refrigerator is not so cold that the insulin freezes. Do NOT use Lantus or Levemir if it has been frozen.
Never reuse syringes. You'll run the risk of contaminating the whole vial/cartridge/pen.
Do not inject air into vial and especially not cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.
If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It can contaminate the insulin vial with silicon (this is probably what makes "floaties", it forms a white precipitate). Better to waste a drop than ruin whole vial, cartridge, or pen.
Pre-filling Syringes with Lantus (see page 3) is NOT recommended.
Lantus and Levemir should not be diluted or mixed with any other insulins or liquids.
 
Re: More answers and Questions on Tommy

Hiya! Glad you were able to go with Costco for the pens... it really is much easier to buy them one at a time!

To address one of your early questions... we test/feed/shoot because food can increase BG levels. While that may not be a big deal when Tommy is in higher numbers, when you're shooting lower numbers, you really need to know if the number is a true number or a number influenced by food, as the food will wear off quickly. It is okay to feed a low carb treat at test time... we use pure bites chicken (get the dog treats, not the cat ones... much cheaper!), protreats raw naturals chicken treats (also a dog treat) or cat-man-do bonito flakes. Willie gets a little snack, but I don't have to worry about affecting his BG#s.
 
Re: More answers and Questions on Tommy

There are syringes with half unit markings that most of us use...
do your syringes have half unit marks?
if not, we can get you a link for where to buy them...they make the microdosing worlds easier.

celi & binks
 
Re: More answers and Questions on Tommy

Yes i do have the syringes with 1/2u markings. I've been using reli on 29g u-100 since the beginning.. It sure does make it easier.
I have a bit of a quandary though. My husband just brought home the solostar pen and i was reading the warnings on the packaging and it states on more than one occasion to by no means refrigerate.. someone please give me some confirmation on this. Every thing i have read has said to refrigerate.. if that's the case, do i wait until i give Tommy his first shot with it tonight or do i put it in the fridge now before I use it for the first time..
Did anyone have any other input as to whether or not i should continue to give 4u 2x a day or scale down 1/2 u or so given it's fresh..
Thanks again everyone for all the help..
 
Re: More answers and Questions on Tommy

Yes, refrigerate the pen. Humans use it up faster & that may be the reason it states do not. I have posted the instructions above, please refrigerate & you do not have to wait to use it for tonight. Again, you can use the same syringes. I offered my input on tonight's dose, but I'm not an advisor. Will you be home to monitor?
 
Re: More answers and Questions on Tommy

wow, i'm glad you asked that. Here's the lantus site: http://www.lantus.com/currently-on-lantus/storage.aspx

Once you’ve opened your vial of LANTUS®, or your LANTUS® SoloSTAR® pen, it can be used for 28 days. Keep LANTUS® insulin away from heat or light. Don’t leave LANTUS® in a hot car in direct sun, or in a freezing car overnight. If LANTUS® gets too hot or freezes, it will have to be thrown away.

Vials of insulin can be refrigerated or kept at room temperature (no greater than 86°F) for 28 days after first use. The LANTUS® SoloSTAR® pen should not be refrigerated once opened, but should be kept at room temperature (below 86°F) and must be thrown away after 28 days.
Click to expand...

i didn't know there was a difference between the vial and the pen in terms of storage.

what are other people doing?
 
Re: More answers and Questions on Tommy

Nicole & Baby said:
Yes, refrigerate the pen. Humans use it up faster & that may be the reason it states do not. I have posted the instructions above, please refrigerate & you do not have to wait to use it for tonight. Again, you can use the same syringes. I offered my input on tonight's dose, but I'm not an advisor. Will you be home to monitor?
Click to expand...

I'm sorry Nicole, i saw your earlier post and i appreciate the input, i just wanted some confirmation on whether or not to keep the same dose that's all.
I will be home to monitor, most definitely.
As far as refrigeration, i saw that also, but after i read the warnings on the package, i had to be sure.
The post that julie1220 just left, led me to the lantus site and specifically states DO NOT REFRIGERATE AFTER OPENING.
I consider myself to be a pretty logical person. Is the reason you and most everyone else on the forum refrigerates is because it will last longer. I know that cold insulin does not feel too good on humans correct? I have had no problems giving Tommy the vial that stayed in the fridge. Actually i let it warm up in the syringe for just a few minutes before i shoot anyway..
Thanks for all the input. I will keep you all up to date. Wish us luck.
 
Re: More answers and Questions on Tommy

nicole, i must've been posting at the same time as you.

what would be a logical reason not to refrigerate the lantus in that pen when it's identical to the lantus in the vial? i'm thinking - pardon my cynicism, that either they expect humans to have it used up in one month, in which case it doesn't need to last longer. OR, they want you to buy it every month.

could there be any REAL chemical reason for not refrigerating the pen when the vial needs to be refrigerated?

I also warm up the syringe in my fingers for a few minutes before injecting it.

btw, I'd put DOSING Q in your subject line if you want one of the dosing experts to come comment. they're usually on around this time of day.
 
Re: More answers and Questions on Tommy

When the Lantus pens were developed, it was an innovation in that it allowed people who were diabetic to travel without necessitating that their insulin be refrigerated at all times. It is not required that you refrigerate the pen. It will, however, prolong the lifespan of your insulin. FWIW, the 5-pack of pens i bought a month ago has a pharmacy label indicating the the pens, both until opened and once in use, be kept refrigerated. I suspect that if you were to go back and forth between leaving the pens out and refrigerating them that the wide variation in temperature could affect the stability of the insulin. As a rule, we encourage keeping your Lantus refrigerated.

The manufacturer recommends discarding unused Lantus after 28 days -- whether a vial or the pens. Many people here get longer than 28 days use from their insulin. Many of us will swap out old Lantus for new around the 28 day mark. If you're getting a good response, keep using your pen. The reason we encourage you to use the pens is because it's a smaller quantity and if you do need to discard, you're not losing half of a vial.

I've never reduced my dose when I've started a new pen. You should monitor carefully especially if you think your Lantus has lost potency. However, if your Lantus was toasty, it will take some time to rebuild the shed with the better/newer insulin.

Also, the pen doesn't need to be kept upright. It can be kept on it's side. The pens operate on a negative pressure system so there's no air in there and the insulin won't slosh around the way it does in a vial. You might want to keep it in a crisper drawer vs. the door. The temperature is the least constant on the door.

Spot checks are any tests other than your AMPS and PMPS. I think Libby was suggesting that if you happen to get up at night to use the bathroom, grab a test. If you decide you want a midnight snack, get a test. Routinely get a test before you go to sleep. The PM tests can be important because many cats run lower numbers at night. Also, if you get no tests at night, you are missing half of your data.

You might want to reduce Tommy's food gradually. He will be mightily annoyed if you put him on a strict diet very quickly.
 
Dosing For Tommy

Good evening all. I was just getting ready to give Tommy his dose this evening with the new solostar pen. I tested and his number is 326.. It was 439 just an hour ago.. I will hold off for a few to see if anyone can give some advice on whether i should still shoot the 4U or go lower. I will be home to monitor throughout the night if any one is wondering.
Thanks
 
Re: More answers and Questions on Tommy

Hi, we normally do not adjust a dose based on a new pen, vial, etc. 326 is definitely a # you want to shoot, you should feel comfortable whatever you end up doing. Again, I would get a +1 & +2 to see where you are at & monitor.
 
Re: More answers and Questions on Tommy

You're seeing a dropping number and you're being wise to ask if you should shoot. There are a couple of fundamental questions -- do you have extra strips, high carb food (or syrup) and can you test this evening?

If you are going to shoot what amounts to the lowest number you've seen in a while, you really need to be able to monitor. Even if you were to shoot a reduced dose, there's a chance that the shed may still make up the difference this cycle and numbers could still drop. You've got to have the needed supplies and be willing to test and possibly lose some sleep.
 
Re: More answers and Questions on Tommy

A housekeeping item:

You will get more help if you change your subject line. We do keep to a convention of the date, your cat's name, the AMPS#, and +hours/BG#. If we spot a lower than usual number, people will stop by. Likewise, if you indicate you have a question or need help, people will stop by.

If you hadn't dropped me a PM, from your subject line, I wouldn't have known you had additional questions. (It's a lot to absorb.)
 
Re: More answers and Questions on Tommy

thank you for responding so quickly nicole, I was going to give him shot no matter what, i just didnt' know with the number being so much lower than just an hour ago if i should lower the amt. i did give him the 4U and i will monitor this evening. Just picking your brain here. Any idea what would make for such wonky numbers today 468-+6 was397, +9was 417,+11 was 439, +12 326.
Have a wonderful evening everyone..
 
Re: More answers and Questions on Tommy

Hi, sure thing.. as I had said earlier I am not an advisor.. make sure you get a +1 & we will see where Tommy is at ;-)
I will be up & around tonight to check on you two & others are here too. As far as strips & your High Carb/Medium Carb kit.. do you have that stocked too?
You are doing great..
 
Re: More answers and Questions on Tommy

willing to lose sleep yes, I can set many alarm on my phone, yes i have many test strips right now, my question is how many times to i need to test this evening and when can i go to sleep without worrying about too low of a number.. What should be the "safe" cut off for having to test?
 
Re: More answers and Questions on Tommy

We don't really have "cut off" #s to my knowledge.. I may stand corrected though.. others are much more knowledgable than me. We want to see where the cycle goes.. did Tommy eat when you gave his injection this evening? You will want to get a +1, +2 & then we/others can evaluate on testing tonight. We generally base testing on the #s we see, the lower #s require more testing.
 
Re: More answers and Questions on Tommy

Nicole is correct -- there's not a hard or fast number that says you're done testing for the night. Take a look at this post that will lay out the process of handling low numbers. There's no way to know whether Tommy's numbers will drop into the lower ranges but getting the +1 and +2 will give you a clue. Generally, your +1 should reflect a food spike. Your +2 should be about the same as your PMPS. If they are lower, it's an indication of a busy cycle. (You can look at Gabby's SS from tonight. Her +1 and +2 were dropping and I'm busy testing.)
 
Re: More answers and Questions on Tommy

yes Tommy ate this evening.. should i feed him more throughout the night since i'm going to be up? He doesn't have food through the evening/early morning hours.. He gets fed around 8am or so
 
Re: More answers and Questions on Tommy

A lot of us feed at shot time, then at +1, +2, +3 to prevent a fast drop & help the kitty surf a smooth cycle.
When will your +1 test be (I ask so we can check on you & Tommy)
Also, can you edit your original post subject line to read: 3/16 Tommy PMPS 326
Then when you get his +1 it will read 3/16 Tommy PMPS 326 +1 (insert the BG reading you get here)
It will make it easier to see.
Do you update your SS real time or go back & do that later? Just wondering :-D

**Edited to Add
Example of a typical curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
 
Re: More answers and Questions on Tommy

Not every cat get's meals at +1, +2, and +3. Some people spread the food out over the first half of the cycle (e.g., pre-shot, +2, +4, and +6 or pre-shot, +3 and +5). It all depends on your cat. The smaller meals are easier on a healing pancreas as opposed to giving half of the day's food at each pre-shot time -- unless your cat will graze throughout the day.

Those of us with cats who have a tendency to drop fast early in the cycle front load the first few hours with food. It helps to offset the fast drop.
 
Re: 3/16 Tommy pmps 326, +1 424

hello all, i've done the +1 already.. and yes at least within the hour i post to his ss.. so i guess you could say it's as close to real time as possible. i'll be testing the +2 here in about a half and hour..
Sleep well everyone..
 
Re: 3/16 Tommy pmps 326, +1 424

Great job on editing your subject line (thank you!)
Just as an FYI, I am not going to sleep anytime soon.. I will hang out with you & see what Tommy does with his #s.. since you have your new insulin ;-)
You are doing great.
 
Re: 3/16 Tommy pmps 326, +1 424, +2 433

+2 not what we were hoping for I'm sure.. i'm going to test again in a couple of hours.. unless i should test again in one hour. i'll wait for more advice. His ears seem to be taking it just fine right now and with the meter i use i need to gather a very very small amt of blood to test so it really takes no time at all.
 
Re: 3/16 Tommy pmps 326, +1 424, +2 433

This is good.. to see some data for the PM cycles :-D
With this +2, I would be inclined to get a +4 & +6 to see how the cycle is going (if the +2 would have been a significant drop we would have encouraged you to get a +3 at least) lets see if others chime in & have an idea for when you should best test tonight.
 
Re: 3/16 Tommy pmps 326, +1 424, +2 433

I'm wondering if that PMPS was a wonky test. Just something to consider -- if you get a test that seems inconsistent, re-test. Sometimes, there's not enough blood for an accurate test but there's just enough that you don't get an error reading. I've also gotten a weird test when there was too much blood. Unless you want to do an overnight curve, this is basically a save-a-strip night.
 
Re: 3/16 Tommy pmps 326, +1 424, +2 433, +5 461

Yes you see right. Numbers definitely not what we had hoped for this evening. Don't think i have to worry about going too low right now.
I'll take more data tomorrow and keep you all up to date. Thanks for staying up with me :-D
 
Re: 3/16 Tommy pmps 326, +1 424, +2 433, +5 461

Sure no problem ;-)
I hope tomorrow's #s are better & Tommy comes on down to some healthy, healing #s.
Great job tonight/this morning :lol:
 
Re: 3/17 Tommy Amps 444, +2.5 373,+3.5 353

Off to a much better start today i would say! :smile: Have a great day all, I will keep you posted.
 
Re: 3/17 Tommy Amps 444, +2.5 373,+3.5 353, +5.5 336

Thinking of you today & so very happy to see 300s instead of 400s ;-)
I see that you made yesterday's condo today's by changing the date, I wanted to share or suggest something because it is helpful for others to keep up with Tommy in Lantus land, or the thread becomes to long to follow if one has to scroll through 2 or 3 days of posts.

We open a daily condo (thread) one per day per cat. So for tomorrow you can:
1. Begin a New Topic: 3/18 Tommy AMPS ##
And in the body of the thread you can link the prior day's condo by copying the link & selecting the URL & pasting it. Does that make sense? It would look like this:
Yesterday

I LOVE Tommy's pic :thumbup

I hope Tommy continues to come on down for you & you both can catch up on some sleep too :-D
 
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