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

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Maureen & Sammy said:
111 at +3.5 + hc food & 1 cc Karo a half hour ago
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fantastic!
i think you could probably wait about 45 minutes to retest. he's probably going to bobble up and down for awhile. our goal is to control his numbers with food and karo (if necessary).
 
awww, don't cry. you're doing great and so is sammy!!!
stuff like this happens... i couldn't tell you how often.
see you in 45 minutes...
 
Welcome to Lantus Land, Maureen and Sammy! It is a very dramatic entrance, I mustsay :lol:

I see Jill is taking very good care of you, she is a life saver and is very very knowledgeable. Listen and you will learn! And since Jill is on board, I really don't have much to advise since she has got it all covered!

I have absolutely no experience or knowledge of PZI since Spot started on Humulin N (BIG UGH) and then he went on Lev, but I can tell you that you really do have to change your way of thinking when you switch insulins. Lantus and Lev are based on nadar, not pre-shots.

FWIW, I bought a black magic marker and marked the carb content on the lids and sides of all the cans of food that I bought so that I wouldn't make a mistake in feeding the wrong carb food at the wrong time. This system worked out very well, especially when I wasn't home and my mom needed to get some hc/mc food into him.
 
Yeah, the vet wanted to put Sammy on Humulin N. I even have a script for it here. But after Sammy got over the operation on his teeth I argued with him that Humulin N wasn't ideal. And I wasn't sure I could get the extra PZI Vet that someone else has here in time and importing the bovine stuff from England can take a long time so from what I'd read Lantus was Sammy's best bet. The doctor was under the impression that Levemir is better for cats with higher BGs than Sammy runs but Sammy's numbers have been really scattershot lately although getting those poisoned teeth out of his head could make a real difference (we postponed the operation for years because of his heart condition) so I thought that maybe even PZI (if we could get it) wouldn't be the best for him at this point
 
(((((maureen)))))
this was a simple misunderstanding. it could happen to anyone... and has happened before. you're doing a wonderful job managing sammy's curve. hang in there, k? we will get through this and soon it will become a distant memory...
 
And when you see someone post that has done the same or similar, you will have quite a bit of first hand experience! It's not exactly the most pleasant way to get it, but you have it now!

For the food, I also use a marker to label the %carb on each can and I also have 3 separate bins for LC MC and HC foods. The HC ones are in an entirely different drawer so that there is no chance of my reaching for LC and grabbing some HC by mistake.

And I agree; you did an awesome job working with Jill. Well done! :thumbup
 
(((Maureen & Sammy))) Welcome to Lantus Land, it sounds like you are doing a fabulous job with the support of many educated, experienced furbaby friends on FDMB. Don't feel too bad about this at all, when Baby began Lantus I was planning to give .5 units & ended up giving 5 UNITS!! Can you believe that? I about died! I had no clue how to read the syringe & thought the 5 marking was a .5 we (meaning FDMB & I) realized it when I got her +3 reading, look at my SS when you have time (1/7/09 -first entry) Needless to say, we got thru that day/night due to the help of a lot of great people, it was a real rough 24 hours for us - please listen to everyone (like you are)Jill completely saved my Baby's life that night & has been with us ever since. It is soooo scary :YMSIGH:
I just wanted to drop by & show my support & encouragment - you are handling this all so well. If you need anything - please let me or others know - we are here for you & I know it is a big job to do all this testing, monitoring/manipulating the #s, but we just have to & it is well worth it. Keeping an eye on Sammy with you & I just know everything is going to be OK :mrgreen:

Believe me, everything I have went through since that night has been a piece of cake in comparison - Baptism by Fire! ;-) That night helped me deal with many factors that I encounter now with expertise & ease!!

**This is not your fault - you did nothing intentional - if someone has the link to my 1st night - please feel free to share it .. you will see what a mess I was (& sometimes continue to be :lol: ) !!
 
No tears, Maureen. You are doing great!

This falls into the category of sh*t happens! I'm sorry your vet didn't have the box of cartridges or vial clearly marked with the amount you needed to be injecting. It is one of the huge advantages of this forum. There are a number of experienced people here who have walked members through situations like this and we are here pretty much 24/7. LL doesn't close like the vet's office (and we're much less expensive).

Nicole mentioned her first day in LL. Here's the link to Baby's condo.
 
Well.. seems you are having an edge of your seat kind of day!! Like others have said.. not the most stress-free introduction to Lantus..

What's done is done.. mistake or not you are doing the right thing right now which is all that matters (and we've all goobered something up at some point.. so welcome to the club :) ).. watching her close, testing lots and getting help.. you'll get through it.. and be a pro at the whole HC/karo deal right off the bat :)..

Boy aren't you going to be disappointed when you find out how boring Lantus usually is ;).
 
Maureen & Sammy said:
Promise me it's boring. Promise me. Promise me. Oh, promise me.
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It is.. it's (in the right dose ;) ) a really gentle insulin.. you will probably spend most of your time getting frustrated that nothing exciting is happening.. once in a while there's a bit of excitement.. and then you wonder why you wanted it so bad.. and then back to booooring.. wishing something exciting was happening.. ;)
 
Welcome to Lantus Land Maureen! Sammy likes to make an entrance doesn't he? {{{Maureen}}} What a morning for you! You're in the very best of hands though. This is a pretty amazing bunch of folks here =) Congratulations on making it through a pretty darn scary morning nailbite_smile
 
ok, a little bit of a drop, but not much. how about giving him a couple teaspoons of his regular (low carb) food and retesting him in one hour?
 
i'll look for you then.
before i forget, if sammy's numbers start going up, don't disappear on us. depending on the numbers, we'll need to look at a dose for tonight... if we decide to shoot tonight. i've been thinking about an appropriate starting dose. i'd like to see how the rest of the day plays out before suggesting anything, but i'm thinking it might be better to start sammy out with a lower dose than his last pzi dose. his insulin requirements may have decreased substantially since his dental 12 days ago. it may be why you've been seeing what you've described as weird spikes.
make sense?
 
OK, guys, while we have a semi-quiet moment I need to know what the protocol calls for. In PZI-ville we'd shoot at +6 or beyond if at 150 or over. What's Lantus' duration (like this isn't diabetes and I'm going to get a consistent answer)? How do I establish the nadir? Ah, I see you're reading my mind. Well, I think the infection could definitely have been playing havoc with his numbers. He was on an antibotic for 10 days too. Clindamyclin Hydrochloride (1.5ml every 12 hours). Last dose was last Monday (4/12). Since then he's done things like 309 at +11.5 and 171 at +23 or 236 at +24 and 79 at +17 after being at 74 at +7.5. His last PZI dose, however, was way over the norm at 11U. Sammy usually doesn't tolerate 10 and above well and has rarely needed it. He probably never had that much ever until this year.
 
Maureen & Sammy said:
OK, guys, while we have a semi-quiet moment I need to know what the protocol calls for. In PZI-ville we'd shoot at +6 or beyond if at 150 or over. What's Lantus' duration (like this isn't diabetes and I'm going to get a consistent answer)? How do I establish the nadir? Ah, I see you're reading my mind. Well, I think the infection could definitely have been playing havoc with his numbers. He was on an antibotic for 10 days too. Clindamyclin Hydrochloride (1.5ml every 12 hours). Last dose was last Monday (4/12). Since then he's done things like 309 at +11.5 and 171 at +23 or 236 at +24 and 79 at +17 after being at 74 at +7.5. His last PZI dose, however, was way over the norm at 11U. Sammy usually doesn't tolerate 10 and above well and has rarely needed it. He probably never had that much ever until this year.
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lantus is a 12/12 insulin. it also has a cumulative effect... meaning one dose builds on the next. you won't see the "real" results of any single dose for a few days... which is why we generally hold a dose for 3 days (6 shot cycles) before increasing a dose. check out the protocols sticky towards the top of the forum. lantus dosing is different than what you've been used to.

testing is the only way to find out kitty's nadir... and as soon as you think you have it figured out... it'll move. :-D
initially, i'd start looking for nadir by doing some random spot checks between +4 and +8.

to make sure we're all on the same page and to avoid confusion, when we talk pzi let's talk U40 units. when we talk lantus, let's use U100 units.
sammy's last good dose of pzi was 4.4 units, correct?
 
Hope you are holding up Maureen :YMHUG: :YMHUG: :YMHUG: when you get time the sticky's at the top of this page have a wealth of information about using lantus maybe a in few days when you get a quiet moment you can take a look at them I still keep going back to them a reading them again since Do Lou and I are pretty new here :-D
 
i'd go ahead and give him some high carb gravy again. it's not that he's too low... it's just to prevent him from from taking a nose-dive on us.
i'd retest in about 30 minutes to see if the drop has stopped.
 
hc is a real treat for him! :lol:
see you soon...
 

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Jill had to step away from the computer for a few minutes. good, maybe this time he'll stay up. I think you can wait another hour to test now.

Sammy's very last PZI shot was 4.4 units. You've said a couple of times that was much more than normal. What dose did you normally shoot? I assume you were doing a sliding scale.
 
looks good. i'd retest in an hour.

i have a few questions about his pzi dose, but need a couple minutes to get them together.
will be back shortly...


edited to add: never mind. libby asked the most important question...
 
Yes, I did the sliding thing. I was trying to figure out what a norm would be. :lol: His "normal" range was from 1.8U to 3U, maybe 3.5U.
 
Maureen & Sammy said:
Yes, I did the sliding thing. I was trying to figure out what a norm would be. :lol: His "normal" range was from 1.8U to 3U, maybe 3.5U.
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hmmm. that sheds a different light on things when trying to figure out a good starting dose for lantus. let's see how the rest of the cycle goes...
 
Years ago - in August of 2007 actually - Sammy wasn't responding as well as he should have to 1.5U at 151-170 or 2U at 171-185. So he went 1.8U at 151-170 and 2.2U at 171-185 with anything higher remaining the usual ratio. He's been on that protocol ever since.
 
from May of 2006, five months after starting PZI Vet, he went on a honeymoon that lasted until May of 2007 then he was above 100 but rarely above 150. At the tail end of June 2007 he spilled sugar in his urine. The vet wouldn't give me insulin until he hit 300. That was in July 2007.
 
we'll have to see how the rest of the cycle goes. it may be wise to just skip tonight's shot to let his body calm down after this over dose. that will also give you a chance to get a good night's sleep and recoup from today's experience. you must be worn out.

libby and i have been discussing a good starting dose. after seeing the scale you've been using and considering the effects the dental may have had... it may be a whole lot safer to start with a reduced dose of 1.5u bid. if the dose is too low, we can always fast track him up the dosing scale if necessary. better to be safe than sorry.
what do you think?
 
lol! sleep is what you're probably going to enjoy tonight... so savor every minute of it! :lol:
i'm going to be off-line for the next several hours, but will check back here as soon as i get back. libby will be keeping an eye on what's going on here. she's one of the few people i would trust enough to care for my own kitty. you'll be in the best of hands...
 
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