4/19 Carter (First Day On Lantus) AMPS 529, +3 @ 512, + 6 @ 438, +9 @ 438 PMPS: 441

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Erica & Carter

Erica & Carter

Very Active Member
Hello everyone!

Carter started his Lantus today and I have high hopes this will be better regulation than the Vetsulin.

Carter is acting completely normal today, and every day since he started insulin, so you'd really never know his BS has been so high every AMPS the past two weeks. Last night, however, his PMPS was 79, his first green number, which is ironic as I'm about to now switch insulins! I skipped last night's Vetsulin dose as even stalling didn't bring him up over 100, not sure if that will have a carry-over or bounce affect today... he seems to be the king of bouncing, at least on Vetsulin.

The needles and 1/2 unit markings are making me be extra cautious, as well as drawing insulin out of the pen properly so it provides maximum use.

He is eating all of his portions, drinking but not OVER drinking, urination normal (slightly larger amounts, but only 2-3 times a day) and I've been testing him for ketones for the past 5 days. No history, just wanted to try and grab a sample whenever I saw him go in, as I learned a few days ago hovering over him does not make him want to use the litterbox any faster and is a huge waste of a day. Barely caught him in the box today with just a few dribbles on a spoon, haha! All tests have been negative.

Sorry if I post with a lot of seemingly silly questions over the next week, I just have to adapt in the mindset of Lantus versus Vetsulin. I'm currently in between jobs so the next week or two is when I'm going to try to gather as much data as possible so I'm more prepared and aware of the dosing.

I also just ordered 3 automatic feeders and a pet fountain (to encourage more drinking from all the cats, since they like drinking out of the tap/the toliet)

Here we go! Hope everyone has a good Tuesday! Mine will be job applications and BG tests!!
 

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Hi and welcome to LL. There is no such thing as a silly question here nor no fact not worth reporting. I hope lantus works well. Carter is a cutie.

As for the syringes you will find that the darn lines vary by quite a bit at times. Lots of us use digital calipers since even .25 increases and decreases can be too much plus it takes the difference from syringe to syringe out of the equation. You might not need them but something to keep in mind. Even changing brands of syringes can make a difference. I'm on my last 2 boxes before I have to deal with that. :banghead:
 
Hello and Welcome. I hope Lantus works well for Carter. Ask as many questions as you need to, even if you're asking the same thing again. We're here to help.
 
tiffmaxee said:
Hi and welcome to LL. There is no such thing as a silly question here nor no fact not worth reporting. I hope lantus works well. Carter is a cutie.

As for the syringes you will find that the darn lines vary by quite a bit at times. Lots of us use digital calipers since even .25 increases and decreases can be too much plus it takes the difference from syringe to syringe out of the equation. You might not need them but something to keep in mind. Even changing brands of syringes can make a difference. I'm on my last 2 boxes before I have to deal with that. :banghead:
Click to expand...

Where would I get a digital caliper? Does that just show the markings on the syringe for clearly?

I'm currently using the Relion brand from Wal-Mart (because it's close by) but I know there are other options online as well, Wal-Mart just seemed more convenient. Are there better brands with clearer markings that you'd recommend?
 
carfurby said:
Hello and Welcome. I hope Lantus works well for Carter. Ask as many questions as you need to, even if you're asking the same thing again. We're here to help.
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Thank you. Most of my questions will probably be when his AMPS and PMPS start getting into the blues and greens, regarding stalling, reducing doses in order to shoot, etc. As you can see on my spreadsheet those colours are pretty foreign territory so I'll be nervous to shoot when he's at the low numbers. I know from speaking to other members that since I'm starting on Lantus and have no data for it, to stall and ask if he's below 150 on PS.
 
Thank you! I might order one off Amazon since I have Prime, probably need to wait until payday this week though, my bank account took a hit from those automatic feeders lol

How do you calculate the mm for 1u for your specific type of needle brand? Like for the Relion, for example.
 
Welcome, Erica! Like the others said, there's no such thing as a silly question here. The people here are incredibly generous with their knowledge and time so please, ask away!

The hardest change in thinking in switching from Vetsulin to Lantus is that dosing is based on the nadir value with Lantus and not on the pre-shot number. The pre-shot numbers let you know whether it's safe to shoot but dose adjustments are based on the lowest number in the cycle. The other big difference is that Lantus is a depot-type of medication. Practically speaking, this means that you need to hold doses for several days to allow the depot to stabilize vs. changing doses back-to-back. If you haven't done so already, the sticky notes at the top of the board have an overwhelming amount of information that will make this journey more understandable. Don't expect to master all of the information in the notes immediately. There's a lot there to digest.

Don't expect that Lantus will immediately "cure" Carter's bouncing. Cats will bounce until they don't. It's a normal phenomenon -- annoying but normal.

To use the calipers, find a syringe that looks like it's measuring accurately. Measure your dose. Set the calipers for that dose. The video, etc. have all of the instructions for how to set the measurements for the calipers. The issue is that the markings on the syringes are not uniform. If you compare a bunch of syringes, you'll see that the zero lines vary and sometimes, even the thickness of the printed lines on the syringes vary. All of this makes giving a consistent dose challenging. The calipers allow you to be consistent.

 
Sienne and Gabby (GA) said:
Welcome, Erica! Like the others said, there's no such thing as a silly question here. The people here are incredibly generous with their knowledge and time so please, ask away!

The hardest change in thinking in switching from Vetsulin to Lantus is that dosing is based on the nadir value with Lantus and not on the pre-shot number. The pre-shot numbers let you know whether it's safe to shoot but dose adjustments are based on the lowest number in the cycle. The other big difference is that Lantus is a depot-type of medication. Practically speaking, this means that you need to hold doses for several days to allow the depot to stabilize vs. changing doses back-to-back. If you haven't done so already, the sticky notes at the top of the board have an overwhelming amount of information that will make this journey more understandable. Don't expect to master all of the information in the notes immediately. There's a lot there to digest.

Don't expect that Lantus will immediately "cure" Carter's bouncing. Cats will bounce until they don't. It's a normal phenomenon -- annoying but normal.

To use the calipers, find a syringe that looks like it's measuring accurately. Measure your dose. Set the calipers for that dose. The video, etc. have all of the instructions for how to set the measurements for the calipers. The issue is that the markings on the syringes are not uniform. If you compare a bunch of syringes, you'll see that the zero lines vary and sometimes, even the thickness of the printed lines on the syringes vary. All of this makes giving a consistent dose challenging. The calipers allow you to be consistent.
Click to expand...

I read the stickies yesterday and there is a ton of information but I'm finding myself going back and reading certain paragraphs, pertaining to the Tight Regulation.

Because it's a depot insulin I was told by other members to stay at 1u for a week, (5-7 days) then do a curve, and then ask for advise based on adjustments from that. If an increase or decrease is necessary, to hold that dose for 3-5 days.

I will purchase the calipers this week and play around with it. I watched the video where she put the 1.25mm into the caliper knowing that equals 1u for her particular syringe, but in order to find out how many mm equal 1u on my syringe (Relion) would I just have to take a syringe, fill it with water (like just for this purpose only) and then fiddle with the caliper itself and then once it's lined up, it will read how many mm it is on the screen? I'm just confused if you have to do the process almost backwards sort of in order to get the mm? Like once you manually line it up the calipers will automatically translate it into mm for you?
 
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Erica & Carter said:
I read the stickies yesterday and there is a ton of information but I'm finding myself going back and reading certain paragraphs, pertaining to the Tight Regulation.

Because it's a depot insulin I was told by other members to stay at 1u for a week, (5-7 days) then do a curve, and then ask for advise based on adjustments from that. If an increase or decrease is necessary, to hold that dose for 3-5 days.

I will purchase the calipers this week and play around with it. I watched the video where she put the 1.25mm into the caliper knowing that equals 1u for her particular syringe, but in order to find out how many mm equal 1u on my syringe (Relion) would I just have to take a syringe, fill it with water (like just for this purpose only) and then fiddle with the caliper itself and then once it's lined up, it will read how many mm it is on the screen? I'm just confused if you have to do the process almost backwards sort of in order to get the mm? Like once you manually line it up the calipers will automatically translate it into mm for you?
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Erica, Practice drawing up 1 unit consistently on your syringes. Make sure the one your using has the 0 line in the proper place.

Then on the calipers there is a button to set to mm. With the calipers closed all the way make sure you zero it out. Then pull very lightly to open calipers until the measure your sample 1 u syringe. Once they line up, turn the knob to lock it. Write down what your 1u = in mm.

Then you do the calculation for the dose you give. Then reset calipers to your dose calculation and lock it again. You can keep it locked until you change the dose.
 
Woodsywife said:
Erica, Practice drawing up 1 unit consistently on your syringes. Make sure the one your using has the 0 line in the proper place.

Then on the calipers there is a button to set to mm. With the calipers closed all the way make sure you zero it out. Then pull very lightly to open calipers until the measure your sample 1 u syringe. Once they line up, turn the knob to lock it. Write down what your 1u = in mm.

Then you do the calculation for the dose you give. Then reset calipers to your dose calculation and lock it again. You can keep it locked until you change the dose.
Click to expand...

Gotcha okay, so you can move it and then lock it. I thought it meant you had know the mm first for the caliper to open a certain amount, I didn't know it could move BEFORE having the mm put into it.

Right now I'm on 1u for Carter so whatever lines up will be my dose for the moment. However, how did the OP of that original post calculate the rest of her numbers for her syringe chart? By using math or lining up each measurement and repeating the first step used to get mm amount of 1u?
 
Also +3 @ 512

I know I really won't see any affect until the depot sets in but when should I expect to see a little more of a drop, like even into the 400s? Somebody I believe told me not to expect to see much change in the firs 24 hours. I just hate that he has to stay at such high numbers while it starts to adjust. :(
 
Erica & Carter said:
Gotcha okay, so you can move it and then lock it. I thought it meant you had know the mm first for the caliper to open a certain amount, I didn't know it could move BEFORE having the mm put into it.

Right now I'm on 1u for Carter so whatever lines up will be my dose for the moment. However, how did the OP of that original post calculate the rest of her numbers for her syringe chart? By using math or lining up each measurement and repeating the first step used to get mm amount of 1u?
Click to expand...

Once you figure out what 1 unit equals in mm on your syringe, you multiple by the dose you give to get a new mm. Then reset calipers to the new number.

Example (do not use these numbers).

Let's say you give 2.25u of insulin. On your syringe you aldreay figured out that 1u of insulin = 1.34mm.

Then you take the 2.25 you give multiple by 1.34 = 3.015mm.

Make sure calipers are closed and zero out (push the zero button). Then start opening calipers until you get to 3.015. When you do turn the knob to lock. Now anytime you pull up insulin and line it up with the calipers.

Anytime you change dose or brand of syringes you would have to recalculate.

Once you get them and practice you will understand. It really easy.
 
Congratulations on day 1 of Lantus....Hopefully it'll be a much better fit for Carter

Now you just have to be patient for a few days.....Have to get that depot full so don't get discouraged if you don't see magically better numbers immediately
 
Chris & China said:
Congratulations on day 1 of Lantus....Hopefully it'll be a much better fit for Carter

Now you just have to be patient for a few days.....Have to get that depot full so don't get discouraged if you don't see magically better numbers immediately
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Yeah, I hope so too!

I just feel bad that his BS needs to stay so high when the depot fills. By looking a lot of people's spreadsheets on the board most people didn't start off on Lantus with as high of numbers as Carter it seems... but I'm probably worrying myself and stressing just to stress at this point.
 
Hello and welcome to LL hope that lantus ends up being a good fit for Carter.



Erica & Carter said:
By looking a lot of people's spreadsheets on the board most people didn't start off on Lantus with as high of numbers as Carter it seems...
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George did;) take a look at 2015. It didn't help that I god confused about the starting dose:oops::rolleyes::confused::confused::confused:

If you are planning to do TR and you find that Carter is staying high you can change his dose sooner you don't have to wait a week, there is an allowance for that on the protocol, I've highlighted it on the extract from TR protocol below

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles)

I did that initially with George as he was not showing signs of budging on the starting dose, and for a while we were reassessing every 6 cycles because he stayed in high numbers. TR gives you that flexibility. Just keep posting and ask for advice before taking the dose up.

Good luck:bighug::bighug::bighug:
 
Gill & George said:
Hello and welcome to LL hope that lantus ends up being a good fit for Carter.





George did;) take a look at 2015. It didn't help that I god confused about the starting dose:oops::rolleyes::confused::confused::confused:

If you are planning to do TR and you find that Carter is staying high you can change his dose sooner you don't have to wait a week, there is an allowance for that on the protocol, I've highlighted it on the extract from TR protocol below

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles)

I did that initially with George as he was not showing signs of budging on the starting dose, and for a while we were reassessing every 6 cycles because he stayed in high numbers. TR gives you that flexibility. Just keep posting and ask for advice before taking the dose up.

Good luck:bighug::bighug::bighug:
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Oh wow you weren't kidding! That makes me feel a bit better.

Okay so in 3 days if there is no movement do I increase by .2.5 (which is half of .5, correct? or no?) or do I increase by .5? He's a pretty hefty boy, I need to get a fresh weight on him but he was 17.6 pounds a month ago. He was in the 20s when we first adopted him. :/

I ordered my Calipers today but I won't get them probably in time and I don't know how comfortable I am increasing by anything other than .5u or 1u without those to measure...
 
Erica & Carter said:
Okay so in 3 days if there is no movement do I increase by .2.5 (which is half of .5, correct? or no?) or do I increase by .5? He's a pretty hefty boy, I need to get a fresh weight on him but he was 17.6 pounds a month ago. He was in the 20s when we first adopted him. :/
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George is Fluffy too:rolleyes: he is down to 16pounds after calorie controlling his diet from 17 pounds at diagnosis, has a little to go yet but we are getting there.
Good job on working on Carters fluff, he is a gorgeous boy.

Looking back we went up by 0.25 after three days and then by 0.5 after three more days (he was still in reds), but what I would suggest is that you should post up by cycle 5 and ask the question before you do anything, that way you will be sure to get some experienced eyes on it.:bighug::bighug::)
 
Gill & George said:
George is Fluffy too:rolleyes: he is down to 16pounds after calorie controlling his diet from 17 pounds at diagnosis, has a little to go yet but we are getting there.
Good job on working on Carters fluff, he is a gorgeous boy.

Looking back we went up by 0.25 after three days and then by 0.5 after three more days (he was still in reds), but what I would suggest is that you should post up by cycle 5 and ask the question before you do anything, that way you will be sure to get some experienced eyes on it.:bighug::bighug::)
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Gotcha. So on my third day (which is cycle 5, or 6? depending on AM/PM) and then get some confirmation on whether to increase and by how much?
 
Chris & China said:
We'll take red over black anytime.....next stop, pink!!!....then yellow....then blue....then :D
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Haha it's just reassuring to see everyone's spreadsheets for Lantus and how the numbers can actually hold for multiple hours instead of like a rollercoaster affect like with Vetsulin.
 
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