5/9Jack:AMPS =372,+3=299,+6 =274,+9= 381-First day on Semglee PM dose suggestion?

Jack & Mopem'sMom

Jack & Mopem'sMom

Member Since 2020
Hope title is formatted ok, apologies if it isn't: We just switched from ProZinc to Semglee today. Vet said to start at 1 unit of Semglee after 5 units of ProZinc and hold the dose for at least 3 days (6 cycles) before going to 1.5 units regardless of how high his BG #'s went. However, Jack is having a ketone issue, that we are doing 200mls sub Q's daily at home for. I had posted on the general forum earlier today looking for advice on transition dose and ketones. It was suggested to give Jack 4.5 units at his PM shot, but to obviously watch his #'s throughout the day and to post here for additional advice. Looking at today's #'s now, I'm confused and worried that may be too high a dose. I thought from what I read in a sticky that Semglee and Lantus are depot insulins that sort of 'build up' in his system. I can stay up til 1am tonight to get more readings, but I don't want him to go too low. I would appreciate any advice on a PM dose prior to 7pm Eastern US time. I'm a chicken, so I'm tempted to stay with the 1unit, but I also live in fear of the ketones (which were 1.0 on the Nova Max Blood Ketone meter) and the vet saying the only real thing that takes them down is lowering the BG.

Thanks in advance for any and all advice.
 
Jack & Mopem'sMom said:
Hope title is formatted ok, apologies if it isn't: We just switched from ProZinc to Semglee today. Vet said to start at 1 unit of Semglee after 5 units of ProZinc and hold the dose for at least 3 days (6 cycles) before going to 1.5 units regardless of how high his BG #'s went. However, Jack is having a ketone issue, that we are doing 200mls sub Q's daily at home for. I had posted on the general forum earlier today looking for advice on transition dose and ketones. It was suggested to give Jack 4.5 units at his PM shot, but to obviously watch his #'s throughout the day and to post here for additional advice. Looking at today's #'s now, I'm confused and worried that may be too high a dose. I thought from what I read in a sticky that Semglee and Lantus are depot insulins that sort of 'build up' in his system. I can stay up til 1am tonight to get more readings, but I don't want him to go too low. I would appreciate any advice on a PM dose prior to 7pm Eastern US time. I'm a chicken, so I'm tempted to stay with the 1unit, but I also live in fear of the ketones (which were 1.0 on the Nova Max Blood Ketone meter) and the vet saying the only real thing that takes them down is lowering the BG.

Thanks in advance for any and all advice.
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Tagging Sienne for you since I saw she gave you advice on your previous post
@Sienne and Gabby (GA)
https://felinediabetes.com/FDMB/thr...-switch-w-ketones-advice.263069/#post-2947634

Just in case Sienne is not available I will tag a few other members for you
@Wendy&Neko

@tiffmaxee


Thank you ladies
 
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@Jack & Mopem'sMom
Hi Christine
When posting on the lantus you would put the
Date Jack AMPS-372 and the tests after that like you did
We like to do a new post everyday and link the previous days post to it ,like I just did above in blue
You might want to add to your signature showing signs of ketones
Are you still feeding any dry yet?
On your spreadsheet I see you noted in the remarks section when you switched to Semglee
Members might not see it there. Can you please make a line above today's date and put
Switched to Semglee so members are aware of it
Have you read about SLGS I see you noted that on your spreadsheet, it would be helpful if you can also add that to your signature
Thank you

Dosing methods
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
 
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Ok, I fixed the title, I'll go fix the signature after this. Jack is not transitioning well to wet. I have read the sticky, he didn't...LOL. He will pick at the wet, but refuses to eat it. He is only slightly entertained by human food, so we are stuck with a 50/50 mix of Young Again Zero and Dr Elsey's Pure Protein dry kibble. (More than 50% YA gives him diarrhea). It's a multiple cat household, so to feed just him is a project- he hates being put in a room to eat; he claws, howls and refuses to eat even dry food in his own room. Between his personality and my ever changing schedule, we are stuck at free-feeding the dry for now. I watch to make sure he eats before the insulin, we haven't had an issue with that yet, but it's so far from what should be happening, I know it's part of the problem. I just don't have a workable way to solve it. BTW, I didn't want to wait more than 15 mins past his 7pm shot, so i just gave him the 1 unit. His blood ketones came down to 0.5 so i went with 1 unit. I guess at this point I'm looking for an AM shot suggestion. Going to try to manage testing every 2 hrs tomorrow, I'm working from home again, and I think my schedule should allow it. Thanks for your input! I really appreciate it.
 
As one whose cat was on a 5 unit dose of another insulin before switching to Lantus at 1 unit, I can tell you that's a bad idea. It took me literally months to get back where i should have started. It's even more so an issue with ketones in the picture. Has Jack ever been in DKA? 200ml of fluids a day is a lot!

We do take how the cat is doing on the current insulin dose in mind when switching. 5.0 units of Prozinc wasn't anything special for Jack so I would have suggested 5 units to start. I would definitely increase as the recommendation, even if it's just 4.5 units. If not, please test daily for ketones. I also highly recommend getting a before bed test every night, as long as it's a +2 or +3. Many cats go lower at night. We dose based on how low the dose is taking the cat. It's entire possible for a cat to dive at night and bounce during the day, making it look like kitty's dose is too low.

Thanks for answering about the food transition, at least it's mostly low carb.

A favour to ask on the spreadsheet, could you put a blank line line after yesterday, and label it "start glargine".
 
Wendy&Neko said:
As one whose cat was on a 5 unit dose of another insulin before switching to Lantus at 1 unit, I can tell you that's a bad idea. It took me literally months to get back where i should have started. It's even more so an issue with ketones in the picture. Has Jack ever been in DKA? 200ml of fluids a day is a lot!

We do take how the cat is doing on the current insulin dose in mind when switching. 5.0 units of Prozinc wasn't anything special for Jack so I would have suggested 5 units to start. I would definitely increase as the recommendation, even if it's just 4.5 units. If not, please test daily for ketones. I also highly recommend getting a before bed test every night, as long as it's a +2 or +3. Many cats go lower at night. We dose based on how low the dose is taking the cat. It's entire possible for a cat to dive at night and bounce during the day, making it look like kitty's dose is too low.

Thanks for answering about the food transition, at least it's mostly low carb.

A favour to ask on the spreadsheet, could you put a blank line line after yesterday, and label it "start glargine".
Click to expand...
I changed the spreadsheet to note the switch in a more prevalent spot than the notes. He has not been in DKA, his blood ketones were gradually increasing from 0.3 to 1.0 today on the Nova Max plus meter. When he hit 0.8 we went to the vet even though he was non-symptomatic, and she recommended 150-200mls of fluids a day until ketones are 0.0-0.2. Some days I can't get the whole 200mls into him, I'm alone and he isn't always cooperative. I'm testing every 3 hours, I'll be up until my 1am to test. The only missing spot overnight will be 4am. I can change the testing schedule tomorrow to grab 2 hr intervals . Thanks
 
With Lantus/glargine, the +2 or +3 number is a good one to get. If it's quite a bit lower than the preshot, you do want to get a later test as it can signify a fairly active cycle. If +2 is about the same as preshot, it'll be a typical Lantus cycle with some downward movement. A higher +2/+3 means a quiet cycle and you can save test strips, unless you just want to gather data. Personally I preferred gathering data during the day time. ;)

How much does Jack weigh?
 
Thank you everyone for your help. I am going to test at +3 and +6 PM tonight. If overnight he stays about where he did today, if I'm understanding correctly, I should give him 4.5u tomorrow morning, assuming his AMPS number is in the 300's?
 
Wendy&Neko said:
With Lantus/glargine, the +2 or +3 number is a good one to get. If it's quite a bit lower than the preshot, you do want to get a later test as it can signify a fairly active cycle. If +2 is about the same as preshot, it'll be a typical Lantus cycle with some downward movement. A higher +2/+3 means a quiet cycle and you can save test strips, unless you just want to gather data. Personally I preferred gathering data during the day time. ;)

How much does Jack weigh?
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He weighs about 18 pounds. He was 18 pounds in Jan when he was diagnosed, he may be 16 or 17 now, but he's still a big boy
 
Jack & Mopem'sMom said:
He has not been in DKA, his blood ketones were gradually increasing from 0.3 to 1.0 today on the Nova Max plus meter. When he hit 0.8 we went to the vet even though he was non-symptomatic, and she recommended 150-200mls of fluids a day until ketones are 0.0-0.2. Some days I can't get the whole 200mls into him, I'm alone and he isn't always cooperative. I'
Click to expand...

@Wendy&Neko
I see you mentioned
200ml of fluids a day is a lot!
 
Jack & Mopem'sMom said:
if I'm understanding correctly, I should give him 4.5u tomorrow morning, assuming his AMPS number is in the 300's?
Click to expand...
You will have to make a mindset change with glargine. We dose based on how low the dose takes the cat, with minimal consideration for the preshots. When following SLGS, and in the beginning of that process, you might not shoot under 200. If you aren't sure, post here first thing tomorrow after taking AMPS for help.

His size would make the amount of fluids a bit more. Presumably the vet took a listen to his heart and didn't hear anything amiss. Fluids are contraindicated with heart disease. I found out the hard way with my girl, and it was a lot less fluids.
 
Wendy&Neko said:
You will have to make a mindset change with glargine. We dose based on how low the dose takes the cat, with minimal consideration for the preshots. When following SLGS, and in the beginning of that process, you might not shoot under 200. If you aren't sure, post here first thing tomorrow after taking AMPS for help.

His size would make the amount of fluids a bit more. Presumably the vet took a listen to his heart and didn't hear anything amiss. Fluids are contraindicated with heart disease. I found out the hard way with my girl, and it was a lot less fluids.
Click to expand...
No heart issues, thankfully. Thanks for dosing advice and the change of mindset direction. That's the piece I think I was missing in my understanding.
 
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