8/3 AMPS - 247/ Buddy starting Lantus

[Teresa & KitKat]

Buddy will be be taking Lantus starting on 8/4 or 8/5, that all depends on how long his Prozinc last. I have a few questions to ask of the kitty owner's on this forum.

We will be using a lantus pen and a syringe. Do you leave your pen in the refrigerator once you start using it or leave it out of the refrigerator. I spoke to someone from Mark's Marine Pharmacy and they told me to leave it in the refrigerator, even if we had started using it, he said the insulin would last longer. Do you draw a dose simply by taking the cap of the pen and putting the syringe needle in the rubber stopper, or is there more that needs to be done to draw out the insulin.

Several weeks ago I started a thread asking what dose would be the best for Buddy to start taking the Lantus on. Lately I have been trying a lower dose, to see if I had been passing on the perfect dose. I have not found the perfect dose, so I have started raising his dose a little with each increase. Somewhere between 5.6u & 5.8u Buddy starts to take a dive, he goes low just before AMPS or PMPS, at the end of a cycle. With this in mind, I am asking if anyone has any idea's on what would be a good starting dose for Buddy. Previously, when I asked on this forum, the answer I received was 5u. I did not know if that would still be the right dose.

Buddy has not eating much lately, I have had him to his vet twice in two weeks. I asked for appetite stimulants and he phoned some in. The prescription said to use 1/4 a pill, twice a day, which is not doing much for his appetite. Buddy seems to only want to eat his YA, he is not interested in his canned food and today he has not ate much YA. I know Buddy still needs his insulin, even if he is not feeling well, I just don't want to give him too much.

 

[tiffmaxee]

Sounds like he's having a pancreatitis flare and is nauseous. It's not a good idea to use appetite stimulants unless you treat for nausea. Ondansetron worked well for Max. Cerenia is another option. Max had chronic pancreatitis for several years. Mostly the nausea meds made the appetite stimulant unnecessary.

As for lantus, it should be kept in the fridge and handled as little as possible. Never shake it. It doesn't need to be mixed. Yes you insert the syringe into the rubber stopper. I was able to use my pens to the last drop.

Which stimulant are you giving? Cats don't all have the same reaction. I preferred cyproheptadine as it can be given twice a day and just a sliver worked for Max. I knew he was not going to make it when the drugs didn't help the last week. I lost him quickly to CHF and CKD but he was tightly controlled until the last week when he was shutting down.

Have you read the pancreatitis primer? I like the Roundtable discussion that explains tge therapy for pancreatitis.

 

[Wendy&Neko]

Here is your last post here: http://www.felinediabetes.com/FDMB/threads/buddy-needs-information-on-dosing-with-lantus.180906/so people can follow on the history.

In the Syringe and Handling Sticky Note, there is a video on how to draw insulin from pens. Yes you keep it in the fridge. Only if you use the pen needles (which we do not because you can't do smaller doses), do you keep it out of the fridge.

Did you talk to your vet about antinausea medicine? (cerenia or ondansetron) Often a kitty can be nauseaous which causes inappetance. Giving an appetite stimulation when they are nausesous does not help. Addressing the nausea can help them eat. That was my experience with Neko. Which appy stim are you giving? As for dosing, I found when Neko wasn't feeling well, her numbers were higher as a result and it was OK to give full dose. But if needed to, I could always assist feel her calories.

As for dose, I don't think I'd change my original suggestion of 5.0 units, provided you can monitor closely for the first couple of days. By that, I mean getting a +2, +6 and +9 for the first couple of cycles. Depending on his numbers, you might be able to skip on of the night time ones. You could start at 5.5 units, but with his appy being iffy, I am giving you some cushion. Post here daily, and if needed, we can get you increasing sooner.

Welcome aboard.

 

[Teresa & KitKat]

Sounds like he's having a pancreatitis flare and is nauseous. It's not a good idea to use appetite stimulants unless you treat for nausea. Ondansetron worked well for Max. Cerenia is another option. Max had chronic pancreatitis for several years. Mostly the nausea meds made the appetite stimulant unnecessary.

As for lantus is should be kept in the fridge and handled as little as possible. Never shake it. It doesn't need to be mixed. Yes you insert the syringe into the rubber stopper. I was able to use my pens to the last drop.

Which stimulant are you giving? Cats don't all have the same reaction. I preferred cyproheptadine as it can be given twice a day and just a sliver worked for Max. I knew he was not going to make it when the drugs didn't help the last week. I lost him quickly to CHF and CKD but he was tightly controlled until the last week when he was shutting down.

Have you read the pancreatitis primer? I like the Roundtable discussion that explains tge therapy for pancreatitis.

I am very sorry for the loss of your precious pet.

Buddy had a partial pancreatectomcypn 2/17. I have taken Buddy to the vet who did his surgery twice in 2 weeks and he keeps saying he does not see any sign's of pancreatitis, well I did. He is taking cyproheptadine and I have Cerenia & Ondansetron. I have been giving him Cerenia, I am going to give him some Ondansetron. Buddy, has a history of pancreatitis. He has been eating YA, because he needs to eat for his insulin.

I have read the pancreatitis primer, maybe I will read it again. These doc's make me so darn mad! His doc said he had hoped his surgery had taken care of the pancreatitis problem, well it has not!

Wonder why they say not to refrigerate pens after you start using them, when you can get longer use out of them by keeping them in the refrigerator. What do you think would be a good starting dose for Buddy.

 

[Wendy&Neko]

Wonder why they say not to refrigerate pens after you start using them, when you can get longer use out of them by keeping them in the refrigerator.

Because most people use the pen needles. Apparently the needle mechanism can't handle being refridgerated. But we are dosing cats with U100 syringes drawing insulin out of the pens, so that doesn't matter to us.

Are you giving Buddy fluids or pain meds if you think it's a pancreatitis flair?

 

[Teresa & KitKat]

Here is your last post here: http://www.felinediabetes.com/FDMB/threads/buddy-needs-information-on-dosing-with-lantus.180906/so people can follow on the history.

In the Syringe and Handling Sticky Note, there is a video on how to draw insulin from pens. Yes you keep it in the fridge. Only if you use the pen needles (which we do not because you can't do smaller doses), do you keep it out of the fridge.

Did you talk to your vet about antinausea medicine? (cerenia or ondansetron) Often a kitty can be nauseaous which causes inappetance. Giving an appetite stimulation when they are nausesous does not help. Addressing the nausea can help them eat. That was my experience with Neko. Which appy stim are you giving? As for dosing, I found when Neko wasn't feeling well, her numbers were higher as a result and it was OK to give full dose. But if needed to, I could always assist feel her calories.

As for dose, I don't think I'd change my original suggestion of 5.0 units, provided you can monitor closely for the first couple of days. By that, I mean getting a +2, +6 and +9 for the first couple of cycles. Depending on his numbers, you might be able to skip on of the night time ones. You could start at 5.5 units, but with his appy being iffy, I am giving you some cushion. Post here daily, and if needed, we can get you increasing sooner.

Welcome aboard.

I remember talking with you before, so much has happened since then. I did not know with his appetite being so poor, if he should stay with 5u. Buddy has been taking Cerenia, just because I have always heard that Cerenia had anti-inflammatory properties that helped pancreatitis. He has now switched over to Ondansetron, I have different meds because Buddy has had chronic pancreatitis for years. I have 1 syringe of Bupe, his current doc gave him Metacam, which is an anti-inflammatory.

We changed vets last year at Christmas time, his vet was closed for holidays and he was sick. I got Buddy in to see the vet he has now and it turned out that he had diabetes. The only reason Buddy has not went back to his original vet is she is in 3
days a week, no nights or holidays. Most docs for humans don't know how to handle pancreatitis, let alone vets.

I think I will stay with 5u and see how he does.

 

[Teresa & KitKat]

I am very sorry for the loss of your precious pet.

Buddy had a partial pancreatectomcypn 2/17. I have taken Buddy to the vet who did his surgery twice in 2 weeks and he keeps saying he does not see any sign's of pancreatitis, well I did. He is taking cyproheptadine and I have Cerenia & Ondansetron. I have been giving him Cerenia, I am going to give him some Ondansetron. Buddy, has a history of pancreatitis. He has been eating YA, because he needs to eat for his insulin.

I have read the pancreatitis primer, maybe I will read it again. These doc's make me so darn mad! His doc said he had hoped his surgery had taken care of the pancreatitis problem, well it has not!

Wonder why they say not to refrigerate pens after you start using them, when you can get longer use out of them by keeping them in the refrigerator. What do you think would be a good starting dose for Buddy.

Sounds like I was really blowing off, Sorry. I get really concerned about my cats, maybe too much.