4/18 - Sammy (7.5u) first dose lantus - amps 212; +1 182

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Maureen & Sammy

Member Since 2010
Sammy's been diabetic since 2006 and tightly regulated on PZI Vet. Honeymooned and then fell off the wagon. He's on low-glutin FF and had six rotten teeth removed from his little head 12 days ago. He's got a heart condition (but came through the operation beautifully) and the latest tests show his kidneys aren't that great. We are now making the great leap off PZI, having for all intents and purposes licked the last bottle dry. He was at 171 +23 an hour ago after getting 4.4U - way, way more than usual because he was at 309 (at +11) but we've been getting these weird spikes lately. Anyway, I've been told to treat Lantus like PZI that would mean that he would get 2.2U. (I use U100 needles, btw, and use the conversion chart so the doses I've mentioned are U40 doses.) Since I'm terrified I'd appreciate any advise.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Hi Maureen. Welcome to Lantus. You will get lots of advise and support and help here.
Someone will be along very shortly to help you with dosing advice.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Welcome Maureen. Others will be along to get you started, so while you are waiting, you can start by reading the stickies at the top of the main Lantus screen, and put a profile and spreadsheet together which will help everyone to better guide you in the transition.

I am glad to hear that the teeth issue is in the past and you and Sammy both survived the ordeal.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

good morning and welcome to lantus land! sorry to hear sammy fell off the wagon. if you haven't already, please take the time to read through the "stickies" at the top of the page. lantus is different from pzi from the way it's handled to it's use. dosing is based on nadirs with only some consideration given to preshot numbers.

as far as an initial starting dose is concerned, it's hard to comment without seeing the last couple of weeks of pzi numbers. there is a link in the "new to the group?" sticky to instructions for setting up a spreadsheet. a spreadsheet will help us answer your questions.

good luck with the switch!
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Oh, god, I hope I haven't killed him. I figured I couldn't wait any longer so at +24 when he hit 212 I shot him with 7.5U (U100). I'll go struggle trying to a spreadsheet.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Hello

welcome to the Lantus forum.

Sorry can you clarify? You shot 4.4u of the last of your PZI this morning or 7.5u? Will you be home to monitor by spot checking Sammy?
Post if you need help ok?

Jill is one of our very experienced members here, and she likes to see data, so if she says - let's see some numbers, know what I mean? :-D
When you have a chance, set yourself up with a spreadsheet and link it to your signature.
All the info is in the "stickies" up above (the threads with the "star" icon)

Hope to see you posting often, and I too am sorry you have to start back up again on insulin, but you're in good hands here!
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

want to make sure i'm understanding you...
you just shot 7.5u of lantus? was this the first dose of lantus?

do you have any high carb (18%) canned food and karo in the house if you need it to bring up numbers?
please get a +1 and +2 for starters. post the numbers when you get them...
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Maureen,
Did you give Sammy a dose of 7.5u of Lantus using U100?

I just wanted to be clear on exactly what you did.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

I shot the last of the PZI Vet yesterday at 8:17am. Sammy was at 309 so he got 4.4U (U40), which is 11 in U100 terms. At +8 he was at 111. At +11 he was at 107. At +14 he was at 85. At +18 he was at 93. At +23 he was at 171. At +24 he was at 212. That's when I gave him 3U (U40) or 7.5U in U100 terms.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Will you be around this morning to get spotchecks?
can you start with a +1 (thats one after this morning's shot and AMPS)
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Hi Maureen & Sammy, and welcome! My post has crossed with all the replies you just received. The experts are concerned!! The following is what I wrote before I saw the above responses to your post:

You have come to the right place. The dosing experts will want to know how much Sammy weighs and will want to see his chart. So if you can get a spreadsheet and profile up and running, they will be happy. Instructions for setting up a spreadsheet in Google Docs can be found in the Tech Forum. The template we use has already been made and all you have to do is set up a free account in Google Docs and link your Google Docs spreadsheet to your signature. If you keep your spreadsheet up to date, the people here can see how Sammy is doing and make recommendations for dosing.

Stu was also diagnosed in 2006 and was on PZI Vet until last November, when we switched to Lantus. His initial dose was set too high and we had quite an adventure until I found this forum! Lantus works very differently from PZI Vet. It is given every 12 hours and there is very little wiggle room with regard to the timing of the shot (you don't have that hour or two of leeway that you have with PZI Vet). Also the dosing is based on the blood glucose number at nadir (when the number is lowest and the insulin is peaking), not at the pre-shot number. After the initial dose has been decided upon, we follow a modified version of the Tilly Protocol (see the informational "stickies" above). When making dosing changes, we go very slowly, raising or lowering the dose by .25 of a unit, or .5 of a unit (depending on the cat and a bunch of other factors). We then hold the new dose for a number of 12-hour cycles to let it "settle". Lantus like this go-slow approach. It sounds finicky, but it really does produce results.

There are many very knowledgeable people on this board who will give you sound advice with dosing. Someone will be along soon. In the meantime, read as many of the "stickies" at the top of the Lantus forum as you can. It's a lot of info. and Lantus has has steep learning curve, but it's worth it. And, again, welcome!

Ella & Stu
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

ok. thank you for the explanation. since this is his first dose of lantus and a high one at that, please get those early spot checks and we'll go from there. the +2 should be about the same as the preshot number.

the insulins are different strengths. for example, if he was doing well on 4u of a U40 insulin, we would probably recommend a starting dose of lantus somewhere right around 4 units (in a U100 syringe).

looks like you'll need to monitor carefully today. do you have high carb canned (18%) and karo on hand if needed?
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

do you have high carb canned (18%) and karo on hand if needed?
see you at +1...
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Yes, I have Karo at hand. No, I do not have any high-carb food in the house. I specifically ask the vet if I should start like it was the beginning with 1U and he specifically said no treat as PZI. The vet btw is about as fancy as you can get. A slew of highly networked specialists.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Maureen & Sammy said:
Yes, I have Karo at hand. No, I do not have any high-carb food in the house. I specifically ask the vet if I should start like it was the beginning with 1U and he specifically no treat as PZI. The vet btw is about as fancy as you can get. A slew of highly networked specialists.
i agree with your vet. i wouldn't have recommended starting over at 1u bid either. however, using lantus and pzi are very different. you do not roll or shake the vial/pen/cartridge before using. dose adjustments are made according to nadir. sliding scales are not used with lantus. consistent dosing is the key to success with lantus.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Maureen & Sammy said:
If I do have to give him Karo how many cc's do I give him?
is sammy carb sensitive? some cats are, some aren't. depending on the numbers... initially, i'd start out with a few drops (possibly mixed in a little bit of food) to see what kind of bump it gives. if it's not enough, you'd have to increase the amount. your meter will guide you.

since you have a head's up and can monitor carefully today, we should be able to manage the curve without any problems.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

a little dip. i'd feed a teaspoon of lc here... no more than that. we don't want him getting full in case we need him to eat later.
see you at +2.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

I don't know if he's carb-sensitive. I've always managed with human food like beef if he was going a little low. He only had karo once in his life and that was on April 7 after the operation when the vet panicked. Should I go out and buy food or stay with him?
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

LC is low carb, MC medium carb and HC for high carb,,,you prob should get stocked up on HC and MC varieties when you can, this is something we like to encourage for you to keep in your hypo tool kit along with the Karo.

If you're close to a store and can get back quickly then yes, I would go, or send someone to go for you.
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

there's time to get some fancy feast grilled flavors in the house. they're usually around 18% carbs.
i have NO idea how this will all shake out today. he may drop or this may turn into a non-event. often times it does. i'm hoping for the latter considering this is the first dose of lantus, but monitoring is the only way we'll know for sure. better to be safe than sorry...


lc = low carb wet food
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

Ah, yes, I used to have that in a segregated part of the pantry as backup but not for a while
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

lc means "low carb" food. (mc= medium card; hc= high carb). Low carb (what we feed under normal circumstances) is anything below 9-10% carbs on Janet's and Binky's food charts (see the link to this in the sticky "New to the Group"). Medium carb is from about 10% to 14%; high carb is above 15% and any of the foods with "gravy" is high carb. MC can be "made" by adding high-carb gravy to low carb food, or a little Karo to low carb food.
Hope this helps a little!

Ella
 
Re: Dosing Advice Sought, Moving from PZI Vet to Lantus

this might be a good time to go to the store. :smile:

Welcome to Lantus Land!
 
maureen, i took the liberty of changing the subject line to reflect the dose and current numbers so others will be alerted to your situation.
hope you don't mind...
 
If it will take too much time to make a grocery store/Fancy Feast (FF) run, don't worry about it. A few drops of Karo or other syrupy stuff mixed into regular LC food will do the job.

And, welcome to Lantus Land. Sorry about the "exciting" introduction!
 
I know the feeling, I've been thinking there must be another FDMB person very near me. Last week I could not find the regular FF flavors that my cats like (chicken and turkey giblets) anywhere, and at my grocery store there was none of our backup, Friskies turkey, either. The first PetSmart I went to had 1 can of chicken feast and 4 cans of turkey. They checked in back and there were none. Went to another PetSmart later in the week, I got a case of chopped grill and a few cans of each of the others. Between two grocery stores I got I think 12 cans of each FF and a couple cans of Friskies. The two nearest grocery stores are often out of those flavors. What's up with that? Two of my cats like premium food and I have that, but one won't eat the good stuff at all so I have to have FF and Friskies.
 
ok. squeeze some of the gravy out of one of those cans of high carb food and let him have about a teaspoon. all we want to do is give him something to slow the drop without filling him up. i'd retest in 30 minutes to see if we've accomplished our immediate goal.
see you then...
 
lol! of course he wants the high carb food! hold off on it for now. we don't want to fill him up at this point.
how are you fixed for strips? have a lot on hand?
 
Sammy weighs about 16 lbs. He has consistently weighed 16 lbs since the diabetes. His mother was a Maine Coon cat. His putative father was the homeliest cat I ever saw. His full sister is so pretty her name is Beauty. He is very smart and a wonderful patient. He's understood from the beginning that the insulin is good for him.
 
that's fine. the thing to remember while we're doing this today is we don't want to fill him up for two reasons...
we want him to eat when we need him to eat and we don't want him to get so full that he'll vomit.

right now we just want to stop the drop...
 
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