9/18/22 Scared to change insulin

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JBat75

JBat75

Member Since 2022
I was planning on changing insulin (Lantis) for my baby and then she seemed to be doing better on ProZinc. She did well for awhile now she's staying pretty high again. Her preshot is usually around the high 400s and her +4-5 is around high 100s to 200s .
I'm leaving the country for 9 days in 3 weeks (Oct 7th -Oct 16th) and my husband will be taking care of her. He works 10 hour days and can't watch too closely. Kaia is getting neuropathy in her front foot!! Do I dare change insulin before I go?? Help!

@FrostD
@Diane Tyler's Mom
@Bandit's Mom
 
Yes I would not wait any longer. That's plenty of time for the depot to build and adjust doses. Please post over on the Lantus forum for starting dose advice.

You have U100 syringes for the Lantus, correct?
 
If you do change to lantus please let us know when

If you live in the US Lantus is very expensive but I can tell you where you can purchase the generic Lantus ,many members here use it because it's much cheaper and works the same way as Lantus

You will need to add that to your signature and the date you start
Also will need to put a blank line above the date you start it so members know and can write Started Lantus .
If you don't know how to do any of this just ask when the time comes and I will ask one of our members to do it for you

You should read all about Lantus ,especially the 2 dosing methods , you need to pick one to follow as they will tell you when either to increase or decrease.
You haven't chosen one yet for following the ones for Prozinc, you have missed many times when you should have reduced

https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Read all the yellow stickys

Favor can you please tap the work like that's to the right of everyone's reply back to you so we know you have read it :cat:

@JBat75
 
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Wow! All this seems so very overwhelming. My husband isn't going to do well with any dosing changes while I'm gone.
I'll do my best to look at the 2 dosing methods.
It's very confusing when to reduce the dosage so much as she ends up staying so high.
I'm overwhelmed
 
We would not change the dose while you are gone, except in extreme circumstances (earned reductions, ketones). We would call it a "vacation dose" and err on the side of keeping her in slightly higher BG range to keep her safe.

Just post on the Lantus forum, they'll give all the help you need!

Remember Lantus behaves differently than ProZinc. You should see some flatter curves; the bouncing will likely continue for a little while but it should improve quite a bit.
 
UPDATE:

I'm not going to change insulin until after my return from Scotland. My husband asked that I wait as he is unable to watch her as closely with working 10 hour days. I will keep you all updated and appreciate you all more than you know!
 
JBat75 said:
UPDATE:

I'm not going to change insulin until after my return from Scotland. My husband asked that I wait as he is unable to watch her as closely with working 10 hour days. I will keep you all updated and appreciate you all more than you know!
Click to expand...
Hi Jeni ,enjoy your trip
One thing I did notice on your spreadsheet that you are not following one of the dosing methods
We also adjust the dose by how low the kitty is dropping, not by the Pre Shots
Since you are feeding dry you need to follow SLGS method
You can add SLGS to your signature and spreadsheet up top
Here is what it says
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
Kaia has dropped below 90 numerous times which meant you should have decreased her dose by 0.25 units

I'm going to tag Melissa to confirm this
@FrostD
Will your husband be testing herc at all?
Maybe 2 days before you leave you might want to post and ask about what dose would be good in case your husband won't be able to test as much as you do

@JBat75

@FrostD
 
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Hi Jeni, I'm also a Prozinc user contemplating a switch to Lantus (not decided yet) and my cat's spreadsheet looks quite similar to yours, numbers all over the place. When I had to leave Bella for a few days with a cat sitter who wouldn't test her, we reduced her dose from 3 to 2.5 units, and everything went well.
 
Diane Tyler's Mom said:
Hi Jeni ,enjoy your trip
One thing I did notice on your spreadsheet that you are not following one of the dosing methods
We also adjust the dose by how low the kitty is dropping, not by the Pre Shots
Since you are feeding dry you need to follow SLGS method
You can add SLGS to your signature and spreadsheet up top
Here is what it says
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
Kaia has dropped below 90 numerous times which meant you should have decreased her dose by 0.25 units

I'm going to tag Melissa to confirm this
@FrostD
Will your husband be testing herc at all?
Maybe 2 days before you leave you might want to post and ask about what dose would be good in case your husband won't be able to test as much as you do

@JBat75

@FrostD
Click to expand...
Thank you for this. Is this what I follow once I switch Insulin? Or I'm to follow this now?

I'm having a Libre attached so he can check her. He works 10 hour days so with drive time it's around 12 hours. I'm hoping he'll be able to come home for lunch and check her numbers.

I appreciate your help more than you know. Next month will be 5 years since her diagnosis and it's only been since DKA that I've checked her glucose myself. The first 4 years I took her to the vet for glucose check once or twice a month
 
Alicia2022 said:
Hi Jeni, I'm also a Prozinc user contemplating a switch to Lantus (not decided yet) and my cat's spreadsheet looks quite similar to yours, numbers all over the place. When I had to leave Bella for a few days with a cat sitter who wouldn't test her, we reduced her dose from 3 to 2.5 units, and everything went well.
Click to expand...
Thank you for letting me know. I'll reduce the units for fear she'll drop.
I'm really scared to change insulin! I just want to see if she gets a little more regulated...
 
JBat75 said:
Thank you for this. Is this what I follow once I switch Insulin? Or I'm to follow this now?
Click to expand...
As long as you are feeding any dry food at all you will have to follow SLGS

If you do switch to lantus later the 2 dosings methods are either SLGS ( if you are feeding any dry food )
Or TR ( tight regulation) but you can't follow this because you are feeding dry food

We can talk about this later on when you get back from Scotland
 
Diane Tyler's Mom said:
As long as you are feeding any dry food at all you will have to follow SLGS

If you do switch to lantus later the 2 dosings methods are either SLGS ( if you are feeding any dry food )
Or TR ( tight regulation) but you can't follow this because you are feeding dry food

We can talk about this later on when you get back from Scotland
Click to expand...
Ok, it is a bit confusing. Thank you
 
Also, because I don't know what I'm doing!! Her PMPS was 184. I fed her and waited 30 minutes and it went to 235. I still only gave her 1.5 units. Is that wrong??
 
JBat75 said:
Also, because I don't know what I'm doing!! Her PMPS was 184. I fed her and waited 30 minutes and it went to 235. I still only gave her 1.5 units. Is that wrong??
Click to expand...
That 184 was @+11 ,not @+12 (PMPS) I'm going to tag Melissa again since she's a prozinc user but I think it was OK to give 1.5 units
@FrostD
Melissa I had mentioned to Jeni that she should have reduced before because her kitty had dropped below 90 numerous times before, this is correct right?
You should test at PMPS ,not test @+11 and then feed .
@FrostD
 
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JBat75 said:
I'm leaving Oct 7th thru the 16th.
Click to expand...
Ok. First, I would reduce her dose to 1.5U for at least a week, unless she earns another reduction. Shoot that dose any time she's above 250; below that some sort of reduced dose (I will probably tweak this after I see how the rest of tonight goes). A day or two before.you leave, post here asking for a vacation dose.

Now the trouble is tonight you fed then waited, so that 235 was food influenced. We recommend to stall without feeding. She nadired later today, we just don't know when (experience tells me likely after that 110). Likely, she was pretty flat if you hadn't fed, so I'd have reduced the dose a little more, probably 1U since standard dose should be 1.5U. Tonight will be a good data point though...she'll bounce by morning though.
 
I have to get to bed, I will tag @Bandit's Mom to keep an eye out for possible hypo, hopefully she is around.

If Kaia drops below 80 at your next test, I would give some medium carb. If she's below 60 next test, I would do high carb. Below 40 is always high carb + honey. Always retest every 20-30 mins, repeating food as needed, until she's rising without food for a few hours (or back above 120).

(Bhooma this goes a little against typical guidance since dose is too high and not quite sure when nadir is...I'd rather over-carb since I can't stick around)
 
Jeni --

Please don't get yourself overwhelmed by worrying about the switch to Lantus until you are back home. There's plenty of time to work through any questions you may have.

Also, if you're husband is in need of help while you're out of the country, make sure he knows your password for FDMB. Cats being cats, there's a good chance that Kaia will decide to cause your husband to have a few extra gray hairs at a time when you're sleeping. We're here and there's often people on the board 24/7.
 
Sorry everyone! My phone usually alerts me to new posts, it did not.

I've started 1.5 units this morning. I leave Friday and I'll get with you all again before I go.

I'm soooo stressed about this.
 
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