I was wondering how long it takes to make a big difference? Are insulin are numbers ever where they should be? (as you can tell from my spreadsheet) I havent been testing before every shot like I used to or even recording it (mostly bc the #ers are always the same). Ive been giving her 1 unit (lantus) 2x a day and she only eats fancy feast classic. She has gained 2 pounds, her coat looks great, she has energy, shes my spunky baby again. I check her blood sugar about 2x a week. They are ALWAYS in the 250-350 range. No matter when I take it. I guess I figured by now they would be lower... do I need to up her dose? And also, she seems bored with the food. What else other than the classic FF can I feed her? Thanks!!!
A few months in... edit: how long does lantus last??
- Thread starter elizhope
- Start date
- Status
Just-As-Appy
Active Member
Re: A few months in...
It sounds like a few things have changed! She is feeling better and her health seems to have improved quite a bit. That said, you are right to look for further improvements. You asked what else she can eat - here is the link to the food chart - http://binkyspage.tripod.com/canfood.html - choose ones that are below about 10% carbs. There should be lots to choose from, and hopefully give her some variety.
Others will be along to give more suggestions for your particular insulin. You're obviously doing a great job, and with a few adjustments your kitty will be even better.
It sounds like a few things have changed! She is feeling better and her health seems to have improved quite a bit. That said, you are right to look for further improvements. You asked what else she can eat - here is the link to the food chart - http://binkyspage.tripod.com/canfood.html - choose ones that are below about 10% carbs. There should be lots to choose from, and hopefully give her some variety.
Others will be along to give more suggestions for your particular insulin. You're obviously doing a great job, and with a few adjustments your kitty will be even better.
Hillary & Maui (GA)
Very Active Member
Re: A few months in...
the only way to truly know how the lantus is working and her bg's are, is if you test more than two times per week.
Think about it this way.
If it were you, your child, spouse or parent who were diabetic. would you test regularly to ensure that your levels were correct? Would you make sure it was safe to give insulin? Or would you just blindly inject yourself with insulin and hope for the best?
I ask this, because it's no different for the cat. I highly suggest that you test more frequently. If you cannot test 4-6 times per day, then at least test a couple times per day, especially before giving the insulin.
When you start doing that and keep records of it, you and we will be better able to see what is happening and how best to offer assistance.
the only way to truly know how the lantus is working and her bg's are, is if you test more than two times per week.
Think about it this way.
If it were you, your child, spouse or parent who were diabetic. would you test regularly to ensure that your levels were correct? Would you make sure it was safe to give insulin? Or would you just blindly inject yourself with insulin and hope for the best?
I ask this, because it's no different for the cat. I highly suggest that you test more frequently. If you cannot test 4-6 times per day, then at least test a couple times per day, especially before giving the insulin.
When you start doing that and keep records of it, you and we will be better able to see what is happening and how best to offer assistance.
Re: A few months in...
Last week I tested more often (about 10+ times, I was seeing if there was a change). And as usual, her before morning shot is always around 250 and her before night shot is always right around 350, and has been for 2+months. Sorry if I havent been testing as frequently as I should
Last week I tested more often (about 10+ times, I was seeing if there was a change). And as usual, her before morning shot is always around 250 and her before night shot is always right around 350, and has been for 2+months. Sorry if I havent been testing as frequently as I should
Hillary & Maui (GA)
Very Active Member
Re: A few months in...
you don't need to apologize, rather, just be aware that you may not see what is really going on by not testing. Look there are some people who go a little overboard and test a whole lot and I'm not suggesting you do that. But you do need to understand the importance of testing and how you are missing vital information by not testing a few times a day. And you can vary the times to accommodate your schedule.
If you look at Maui's ss, you will see that I tested her daily and several times and could start to see a pattern with her. I also was able to adjust her insulin based on these tests and eventually she went off insulin completely and is still off insulin.
this is your cat and only you can decide what you are willing and not willing to do. We can only offer suggestions and guidance. The rest is up to you.
you don't need to apologize, rather, just be aware that you may not see what is really going on by not testing. Look there are some people who go a little overboard and test a whole lot and I'm not suggesting you do that. But you do need to understand the importance of testing and how you are missing vital information by not testing a few times a day. And you can vary the times to accommodate your schedule.
If you look at Maui's ss, you will see that I tested her daily and several times and could start to see a pattern with her. I also was able to adjust her insulin based on these tests and eventually she went off insulin completely and is still off insulin.
this is your cat and only you can decide what you are willing and not willing to do. We can only offer suggestions and guidance. The rest is up to you.
Re: A few months in...
With insulin usage, the blood glucose levels will change (sometimes drastically) throughout the 12-hour cycle. There will be a high point, and there will be a low point. The goal with insulin is to find the right dose so that those numbers will be "even" across the life of the cycle - ie all "blues" or better yet all "greens." To get to that point, you need to find the CORRECT DOSE for your cat. There is only one way to do that, and that is to do a "curve" across the entire 12-hour cycle. With Lantus, you establish your dose based on the LOWEST POINT of your curve. For instance, if your AMPS is 350, but at +6 you find you're at 72, you're giving your cat too high of a dose. I'm sorry to say that you are flying blind right now. If you have a day off, why don't you do a curve by taking BG readings several times across the 12 hours - and look for that low number (aka "nadir'). Then let us know and ask questions.
With insulin usage, the blood glucose levels will change (sometimes drastically) throughout the 12-hour cycle. There will be a high point, and there will be a low point. The goal with insulin is to find the right dose so that those numbers will be "even" across the life of the cycle - ie all "blues" or better yet all "greens." To get to that point, you need to find the CORRECT DOSE for your cat. There is only one way to do that, and that is to do a "curve" across the entire 12-hour cycle. With Lantus, you establish your dose based on the LOWEST POINT of your curve. For instance, if your AMPS is 350, but at +6 you find you're at 72, you're giving your cat too high of a dose. I'm sorry to say that you are flying blind right now. If you have a day off, why don't you do a curve by taking BG readings several times across the 12 hours - and look for that low number (aka "nadir'). Then let us know and ask questions.
Julia & Bandit (GA)
Very Active Member
Re: A few months in...
Hello, I'm glad your kitty is feeling better!
As others have mentioned, with Lantus dosing is based on the nadir, or the lowest point of the cycle, which is usually at around +6. In order to adjust the dose, you need to be getting at least the AMPS, PMPS, and a +6 in one of those cycles. My guess is that you may need to increase the dose slightly, but you don't want to do it without getting those numbers. Too high a dose can also look like too low a dose without seeing what those middle of the cycle numbers are.
Hello, I'm glad your kitty is feeling better!
As others have mentioned, with Lantus dosing is based on the nadir, or the lowest point of the cycle, which is usually at around +6. In order to adjust the dose, you need to be getting at least the AMPS, PMPS, and a +6 in one of those cycles. My guess is that you may need to increase the dose slightly, but you don't want to do it without getting those numbers. Too high a dose can also look like too low a dose without seeing what those middle of the cycle numbers are.
Vicky & Gandalf (GA) & Murrlin
Very Active Member
Re: A few months in...
You can feed her any type/brand/variety of canned food which is below 10% kcal from carbohydrates. Please check out Janet & Binky's food chart at the link Just-As-Appy included in their reply.
We have to get you and her back on board with testing. It is crucial to properly managing the longer acting type of insulins like Lantus. I noticed that you decreased her dose on March 22nd to .5U because you tested a lower than usual level in the 100s. Seeing that makes me wonder if even 1U might be too much for her. Some cats do very well on a very small amount of insulin.
But before deciding if she needs less than 1U, you must test as described, ideally every 2 hours beginning with the preshot test. That results in a curve which shows when the lowest or peak of the cycle was and how low it went. That establishes the effectiveness of that particular dose, especially if done more than once a week.
Are there any obstacles for you with testing? Does she cooperate easily or does it bruise her ears? Or was it just that the numbers always seemed the same, so you don't feel the need to test? As evidenced from the spreadsheet you have, her numbers were not always the same and there could even have been times when she had a very low BG value. You just don't know without testing, at minimum before every shot. And like Julie said, without a curve it's impossible to know what her dose should be.
How can we help you test more often? If it seems a hassle to do it when her numbers are the same, we can give suggestions to make it seem less troublesome.
You can feed her any type/brand/variety of canned food which is below 10% kcal from carbohydrates. Please check out Janet & Binky's food chart at the link Just-As-Appy included in their reply.
We have to get you and her back on board with testing. It is crucial to properly managing the longer acting type of insulins like Lantus. I noticed that you decreased her dose on March 22nd to .5U because you tested a lower than usual level in the 100s. Seeing that makes me wonder if even 1U might be too much for her. Some cats do very well on a very small amount of insulin.
But before deciding if she needs less than 1U, you must test as described, ideally every 2 hours beginning with the preshot test. That results in a curve which shows when the lowest or peak of the cycle was and how low it went. That establishes the effectiveness of that particular dose, especially if done more than once a week.
Are there any obstacles for you with testing? Does she cooperate easily or does it bruise her ears? Or was it just that the numbers always seemed the same, so you don't feel the need to test? As evidenced from the spreadsheet you have, her numbers were not always the same and there could even have been times when she had a very low BG value. You just don't know without testing, at minimum before every shot. And like Julie said, without a curve it's impossible to know what her dose should be.
How can we help you test more often? If it seems a hassle to do it when her numbers are the same, we can give suggestions to make it seem less troublesome.
Karisa and Tasha(GA)
Member
Re: A few months in...
We have a very active lantus support group here at fdmb. They have helped many kitties and their beans get to either the falls (remission), or at least find a good level to shoot. You are more than welcome over there. Come join the fun.
Karisa
We have a very active lantus support group here at fdmb. They have helped many kitties and their beans get to either the falls (remission), or at least find a good level to shoot. You are more than welcome over there. Come join the fun.
Karisa
julie & punkin (ga)
Very Active Member
Re: A few months in...
Hi,
I remember when you joined - i was a week or so before you! Here's some info that you need:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139
That's from the "new to Lantus/Levemir" page and will give you all of the basics. I'm not an expert, but Karisa has asked for someone to pop over and help you. Everyone is correct, that you simply have no idea what's going on with Garland without more mid-cycle tests. the pre-shot numbers only tell you if it's safe to give insulin at that moment. it doesn't tell you anything about what's happening with the Lantus is at its peak strength and effect on Garland.
Without that information, I'm not sure what to tell you that would be helpful. The best thing you can do to help Garland is to get those mid-cycle tests in and recorded so the pattern will emerge on how Garland's body is responding to the Lantus.
Have a great day! julie
Hi,
I remember when you joined - i was a week or so before you! Here's some info that you need:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139
That's from the "new to Lantus/Levemir" page and will give you all of the basics. I'm not an expert, but Karisa has asked for someone to pop over and help you. Everyone is correct, that you simply have no idea what's going on with Garland without more mid-cycle tests. the pre-shot numbers only tell you if it's safe to give insulin at that moment. it doesn't tell you anything about what's happening with the Lantus is at its peak strength and effect on Garland.
Without that information, I'm not sure what to tell you that would be helpful. The best thing you can do to help Garland is to get those mid-cycle tests in and recorded so the pattern will emerge on how Garland's body is responding to the Lantus.
Have a great day! julie
Re: A few months in...
Thanks! The testing is a bunch of things. The time it takes, she hates it, her numbers had seemed very similar, the strips are expensive and the food issue. Everyone had told me to make sure not to feed her 2-3 hours before testing/shooting bc the numbers would be skewed. I have to have her on a 8/8 schedule(bc of when the night shot can be given by me) and she cant wait until 8am to eat. (shes starving and wanders around begging for food) So since we were feeding her right when we wake up, i felt if i tested her at 8 before shooting, the numbers were going to be high anyways bc she had just eaten an hour or so before. So i started slacking... i realize i need to get back on with testing before every shot, and I will get back on track.. But what do i do about the morning food situation?
And so I should also test at +6 everyday too?
Oh, and her Pre shot this morning was 268 and I just tested her now at +4 and its 234
Thanks! The testing is a bunch of things. The time it takes, she hates it, her numbers had seemed very similar, the strips are expensive and the food issue. Everyone had told me to make sure not to feed her 2-3 hours before testing/shooting bc the numbers would be skewed. I have to have her on a 8/8 schedule(bc of when the night shot can be given by me) and she cant wait until 8am to eat. (shes starving and wanders around begging for food) So since we were feeding her right when we wake up, i felt if i tested her at 8 before shooting, the numbers were going to be high anyways bc she had just eaten an hour or so before. So i started slacking... i realize i need to get back on with testing before every shot, and I will get back on track.. But what do i do about the morning food situation?
And so I should also test at +6 everyday too?
Oh, and her Pre shot this morning was 268 and I just tested her now at +4 and its 234
Beth & Atlas
Very Active Member
Re: A few months in...
If possible before making any changes at this point,
Can you put aside a day to do a BG curve, that is a day where you take a reading every two hours?
You've been on this dose a while and the data is incomplete. A decent way to resolve that issue a bit quicker is to get a full curve completed.
If not that perhaps a mini-curve of readings at the +3, +6, +9 and several before bed reading?
What meter are you using? You may find the Walmart Relion brand meter and strips much more reasonably priced.
If possible before making any changes at this point,
Can you put aside a day to do a BG curve, that is a day where you take a reading every two hours?
You've been on this dose a while and the data is incomplete. A decent way to resolve that issue a bit quicker is to get a full curve completed.
If not that perhaps a mini-curve of readings at the +3, +6, +9 and several before bed reading?
What meter are you using? You may find the Walmart Relion brand meter and strips much more reasonably priced.
julie & punkin (ga)
Very Active Member
Re: A few months in...
that's cool - it means the insulin is starting to kick in. cats seem to respond differently, but most seem to hit the lowest number around +4-+7, of course cats are different and even within my cat, i've seen the nadir (lowest point) move from being +6 to +4 to +8ish, depending on the day and the cycle of the moon and what i'm wearing, apparently.
that's a joke - in other words, who knows what makes it slide around!
yeah, i sympathize on the starving kitty. they make you think they're dying. punkin has a particular yowl (I like to call it his 911 yowl) that says i'm nearly dead, feed me.
part of what you have going on is the high numbers means that Garland's not regulated yet, and an unregulated kitty doesn't use the food as well. you don't want to overfeed them in response to it, but you might have to give him (?) a little bit more as long as he's not gaining weight.
I feed punkin as he's getting the shot am & pm, and then I always test him 3 hours later (+3) then feed him a little more. He complained mightily about having to wait in between at first, but now he knows i've simply rewritten The Feed Me Contract and he's accepted it. Punkin is 14+ pounds and I give him 1 can of fancy feast with the shot and 1/2 can at the +3. I also shut my cats elsewhere at night so they won't wake me up in the early mornings. we all survive this terrible mistreatment that i've inflicted on them. :lol:
as far as the pokes go, well, no cat is eager for it, but if you consistently give them a treat (tiny, like 1/4"x1/2" of boiled chicken breast) when you poke, they will accept it. i had to burrito wrap punkin for a few weeks cuz he was such a maniac, but now, he really does purr through it, like others told me their cats did. he flicks his ear when i'm trying to get the strip up there, which is annoying, but i guess that's his civil disobedience!
just looked at your post to see if i answered everything - the thing is it's not just testing before shots, you just have to catch those mid-numbers. i would guess (NOT AN EXPERT) that you probably need to increase, but I sure wouldn't do it without a commitment from you to test more. just being honest. and please don't do it because i said that!!!! you have to have more info and stay on top of monitoring him.
from what i understand, numbers over 225ish become levels of sugar that can damage cat's organs. my vet scared me to death when he told me punkin could go blind overnight with high numbers. now i'm not certain that's true and lots of cats here still have high numbers, but it did poke me into action.
edited to add: sorry i got her gender wrong!
that's cool - it means the insulin is starting to kick in. cats seem to respond differently, but most seem to hit the lowest number around +4-+7, of course cats are different and even within my cat, i've seen the nadir (lowest point) move from being +6 to +4 to +8ish, depending on the day and the cycle of the moon and what i'm wearing, apparently.
that's a joke - in other words, who knows what makes it slide around!
yeah, i sympathize on the starving kitty. they make you think they're dying. punkin has a particular yowl (I like to call it his 911 yowl) that says i'm nearly dead, feed me.
part of what you have going on is the high numbers means that Garland's not regulated yet, and an unregulated kitty doesn't use the food as well. you don't want to overfeed them in response to it, but you might have to give him (?) a little bit more as long as he's not gaining weight.
I feed punkin as he's getting the shot am & pm, and then I always test him 3 hours later (+3) then feed him a little more. He complained mightily about having to wait in between at first, but now he knows i've simply rewritten The Feed Me Contract and he's accepted it. Punkin is 14+ pounds and I give him 1 can of fancy feast with the shot and 1/2 can at the +3. I also shut my cats elsewhere at night so they won't wake me up in the early mornings. we all survive this terrible mistreatment that i've inflicted on them. :lol:
as far as the pokes go, well, no cat is eager for it, but if you consistently give them a treat (tiny, like 1/4"x1/2" of boiled chicken breast) when you poke, they will accept it. i had to burrito wrap punkin for a few weeks cuz he was such a maniac, but now, he really does purr through it, like others told me their cats did. he flicks his ear when i'm trying to get the strip up there, which is annoying, but i guess that's his civil disobedience!
just looked at your post to see if i answered everything - the thing is it's not just testing before shots, you just have to catch those mid-numbers. i would guess (NOT AN EXPERT) that you probably need to increase, but I sure wouldn't do it without a commitment from you to test more. just being honest. and please don't do it because i said that!!!! you have to have more info and stay on top of monitoring him.
from what i understand, numbers over 225ish become levels of sugar that can damage cat's organs. my vet scared me to death when he told me punkin could go blind overnight with high numbers. now i'm not certain that's true and lots of cats here still have high numbers, but it did poke me into action.
edited to add: sorry i got her gender wrong!
Julia & Bandit (GA)
Very Active Member
Re: A few months in...
It's recommended that you not feed 2 hours before the preshot number, but if you have to, then you have to. Just make sure you note it in your spreadsheet so you know that number may be a little higher. What about adjusting the feedings or the shot times so that you don't have to feed right before the preshot? I fed Bandit 4 times a day (at both shot times, and at the +6 of both cycles). Could you feed her right before bed? Or what about an auto-feeder? I used them when I wasn't there in the day or needed to sleep through the 1am feeding.
The more numbers you have, the better you'll be able to determine the dose, but I would say at minimum you need the AMPS and PMPS, and a +6 from either cycle daily. Once a week you should do a curve (testing every 2 hours for a 12 hour cycle). Getting another extra number daily (in the same cycle as the +6) would help you out even more.
Are you giving low carb treats after every test? If those aren't working, there are other tricks people use. I used to put Bandit in a basket and wrap him up in a blanket while I tested him. He hated it at first, but the more I did it the more he got used to it and eventually he just didn't care if I tested him anymore. I found that the biggest thing that would upset him about testing was me being upset and stressed. The moment I resolved myself and said, "You're getting this test, cat, whether you like it or not, because it's the only way you're going to get better," he calmed right down and stopped fighting me.
It's recommended that you not feed 2 hours before the preshot number, but if you have to, then you have to. Just make sure you note it in your spreadsheet so you know that number may be a little higher. What about adjusting the feedings or the shot times so that you don't have to feed right before the preshot? I fed Bandit 4 times a day (at both shot times, and at the +6 of both cycles). Could you feed her right before bed? Or what about an auto-feeder? I used them when I wasn't there in the day or needed to sleep through the 1am feeding.
The more numbers you have, the better you'll be able to determine the dose, but I would say at minimum you need the AMPS and PMPS, and a +6 from either cycle daily. Once a week you should do a curve (testing every 2 hours for a 12 hour cycle). Getting another extra number daily (in the same cycle as the +6) would help you out even more.
Are you giving low carb treats after every test? If those aren't working, there are other tricks people use. I used to put Bandit in a basket and wrap him up in a blanket while I tested him. He hated it at first, but the more I did it the more he got used to it and eventually he just didn't care if I tested him anymore. I found that the biggest thing that would upset him about testing was me being upset and stressed. The moment I resolved myself and said, "You're getting this test, cat, whether you like it or not, because it's the only way you're going to get better," he calmed right down and stopped fighting me.
julie & punkin (ga)
Very Active Member
Re: A few months in...
another thought - as awful as it sounds, some people set an alarm to get up and test during the night. it's not like you have to do it every night. i've had to do it just when punkin was really low numbers and i was worried when i went to bed.
you might want to adjust your 8-8 shot times too - say to 6:30-6:30 or 7-7 - which might allow you to get more testing in the evening before you head to bed.
another thought - as awful as it sounds, some people set an alarm to get up and test during the night. it's not like you have to do it every night. i've had to do it just when punkin was really low numbers and i was worried when i went to bed.
you might want to adjust your 8-8 shot times too - say to 6:30-6:30 or 7-7 - which might allow you to get more testing in the evening before you head to bed.
Re: A few months in...
LOL- No worries, I wouldnt change the dose without getting permission from my vet first. I was just wondering if it was time for me to call him. And I was planning on doing an all day curve before that as well. LOL
When I first joined, I was told it takes a few weeks for it to start working and now that Im a few months in, I was just curious why the numbers still looks the same as they did when I first started. I will do more testing today and do an all day one tomorrow and record it for you guys so you can tell me what you think.
I also free feed her the canned food all day. Anytime she starts asking for food I open a new can for her. Is that okay? SHe looks great now, she had gotten soo skinny and I weighed her a couple days ago and shes gained almost 3 pounds.
One more question, what happens when you miss a dose? Last week I missed one... Hectic morning and it totally slipped my mind (my kids were all kinds of crazy that morning LOL) I didnt do anything except give her her normal dose at the normal time that night. Was that right?
And the reason I do the 8/8 is bc I cant give the night shot before 8. I know it will get overlooked as the hours before that is a very very very busy part of my day, and its also the part of the day both kids are screaming and crying alot bc they are tired and hungry. I have 2 kids under 2 and from 5-8 I am cleaning, cooking dinner, feeding the kids, bathtime, PJ's, brushing teeth, putting them to bed and getting my husbands dinner ready for when he gets home at 8. So after all that, I go and give Garland her shot.
Thanks for all the advice
LOL- No worries, I wouldnt change the dose without getting permission from my vet first. I was just wondering if it was time for me to call him. And I was planning on doing an all day curve before that as well. LOL
When I first joined, I was told it takes a few weeks for it to start working and now that Im a few months in, I was just curious why the numbers still looks the same as they did when I first started. I will do more testing today and do an all day one tomorrow and record it for you guys so you can tell me what you think.
I also free feed her the canned food all day. Anytime she starts asking for food I open a new can for her. Is that okay? SHe looks great now, she had gotten soo skinny and I weighed her a couple days ago and shes gained almost 3 pounds.
One more question, what happens when you miss a dose? Last week I missed one... Hectic morning and it totally slipped my mind (my kids were all kinds of crazy that morning LOL) I didnt do anything except give her her normal dose at the normal time that night. Was that right?
And the reason I do the 8/8 is bc I cant give the night shot before 8. I know it will get overlooked as the hours before that is a very very very busy part of my day, and its also the part of the day both kids are screaming and crying alot bc they are tired and hungry. I have 2 kids under 2 and from 5-8 I am cleaning, cooking dinner, feeding the kids, bathtime, PJ's, brushing teeth, putting them to bed and getting my husbands dinner ready for when he gets home at 8. So after all that, I go and give Garland her shot.
Thanks for all the advice
Julia & Bandit (GA)
Very Active Member
Re: A few months in...
Just remember that if you do raise or lower the dose, you want it to be in small increments (.25u or less). Many vets raise the dose by too much and you miss the cat's ideal dose.
Just remember that if you do raise or lower the dose, you want it to be in small increments (.25u or less). Many vets raise the dose by too much and you miss the cat's ideal dose.
julie & punkin (ga)
Very Active Member
Re: A few months in...
ah, been there done that. small kids - i remember. it is the very hardest time of life! my baby is now a college freshman - it does get easier.
the good thing is the better you get at the shots the quicker it is, so you might be able to make a change at some point on the timing. for now, you have to do what you have to do.
as far as free-feeding - there are people who do that with their cats. i can't say, but i can say that when punkin stopped getting food after +3 his numbers greatly improved. ie, there were lower lows, which are healthier numbers. most people seem to try to give their cats all their food in small meals between right when they get their insulin shot and the first 3-4 hours after that. perhaps someone else who free feeds can give you better advice on that than i can.
the thing about the food is that food is the first tool we use to treat hypoglycemia. it always pulls up the numbers if they are too low - the higher the carb content of the food, the higher and quicker the numbers go. Is she getting any dry food? because that will zip you right up to the top of the number charts.
ah, been there done that. small kids - i remember. it is the very hardest time of life! my baby is now a college freshman - it does get easier.
the good thing is the better you get at the shots the quicker it is, so you might be able to make a change at some point on the timing. for now, you have to do what you have to do.
as far as free-feeding - there are people who do that with their cats. i can't say, but i can say that when punkin stopped getting food after +3 his numbers greatly improved. ie, there were lower lows, which are healthier numbers. most people seem to try to give their cats all their food in small meals between right when they get their insulin shot and the first 3-4 hours after that. perhaps someone else who free feeds can give you better advice on that than i can.
the thing about the food is that food is the first tool we use to treat hypoglycemia. it always pulls up the numbers if they are too low - the higher the carb content of the food, the higher and quicker the numbers go. Is she getting any dry food? because that will zip you right up to the top of the number charts.
Re: A few months in...
I'd really encourage you to read the starred sticky notes at the top of the Lantus Board. This is an overview of what they contain:
I'd also be curious if you've started a new vial/pen of Lantus. If you have been using the same Lantus for several months, there is a good chance you're Lantus is no longer effective.
I'd really encourage you to read the starred sticky notes at the top of the Lantus Board. This is an overview of what they contain:
- Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
- New to the Group: Everything you wanted to know about the Lantus forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
- Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
- Lantus depot/shed: This is an important concept for understanding how Lantus works.
- Becoming Data Ready: What data you need in order to be able to work toward remission or tight regulation.
I'd also be curious if you've started a new vial/pen of Lantus. If you have been using the same Lantus for several months, there is a good chance you're Lantus is no longer effective.
Vicky & Gandalf (GA) & Murrlin
Very Active Member
Re: A few months in...
A timed feeder would help immensely! You could set it to go off in the early AM, like 1AM, then again at 5AM or so. That way she eats well before you have to give her the shot at 8AM and should be getting more food to keep her happier. With the numbers she's having her system isn't able to use the food well enough to keep her from being hungry all the time. And as long as the food is low carb, it won't affect the blood glucose so much.
Have you tried giving her treats after the testing and also after the shot? Difficult to test cats often react well when they're more focused on the treat than they are on what you're doing to them. There are freeze-dried chicken or salmon treats which most cats love and won't affect the blood glucose level like something like Temptations will.
As for expensive strips, it really depends on what meter you're using. Some like Wal-Mart's Reli-On brand are cheaper than others. Also, if you've used Ebay, diabetic people who have insurance get lots of strips free and then sell them on Ebay and you can get great deals that way.
Hope this gives you some useful ideas. And on the insulin dosing, once you understand better how Lantus works, a do-it-yourself approach to dose is the best course. You don't need your vet's approval to change the dose. You only need the vet to prescribe the insulin for you. Knowledgeable Lantus users in the Lantus ISG can help you make dose decisions.
elizhope said:
A timed feeder would help immensely! You could set it to go off in the early AM, like 1AM, then again at 5AM or so. That way she eats well before you have to give her the shot at 8AM and should be getting more food to keep her happier. With the numbers she's having her system isn't able to use the food well enough to keep her from being hungry all the time. And as long as the food is low carb, it won't affect the blood glucose so much.
Have you tried giving her treats after the testing and also after the shot? Difficult to test cats often react well when they're more focused on the treat than they are on what you're doing to them. There are freeze-dried chicken or salmon treats which most cats love and won't affect the blood glucose level like something like Temptations will.
As for expensive strips, it really depends on what meter you're using. Some like Wal-Mart's Reli-On brand are cheaper than others. Also, if you've used Ebay, diabetic people who have insurance get lots of strips free and then sell them on Ebay and you can get great deals that way.
Hope this gives you some useful ideas. And on the insulin dosing, once you understand better how Lantus works, a do-it-yourself approach to dose is the best course. You don't need your vet's approval to change the dose. You only need the vet to prescribe the insulin for you. Knowledgeable Lantus users in the Lantus ISG can help you make dose decisions.
Larry and Kitties
Very Active Member
Re: A few months in...
Very possible that the insulin you are using is no longer effective. I would try another/new cartridge. They only last a couple of months.
Very possible that the insulin you are using is no longer effective. I would try another/new cartridge. They only last a couple of months.
Re: A few months in...
Okay now I am confused. When I first joined I was told by many many people here to get the cartridges (even though they are much more expensive) because I will be able to use every drop in each one before moving on the the next one. Versus the vials, which must be used within so many days of opening (hence insulin gets thrown away). Was this wrong information?? Are my cartridges only good so many days after the first use?????
Okay now I am confused. When I first joined I was told by many many people here to get the cartridges (even though they are much more expensive) because I will be able to use every drop in each one before moving on the the next one. Versus the vials, which must be used within so many days of opening (hence insulin gets thrown away). Was this wrong information?? Are my cartridges only good so many days after the first use?????
Re: A few months in...
Yes, Lantus guaranteed for 28 days, and Levemir for 42 days.
I know people say that their insulin lasts alot longer and it may well last longer, but that's another vital reason for testing before every shot and doing regular curves, because when that insulin goes for crap, you will see it in your BG numbers.
You were likely told to get the cartridges because each one is 3ml and the vial is 10ml.... unless you are giving a very high dose to your cat, the odds are that you will be wasting most of that vial, but the cartridge may get mostly used.
Yes, Lantus guaranteed for 28 days, and Levemir for 42 days.
I know people say that their insulin lasts alot longer and it may well last longer, but that's another vital reason for testing before every shot and doing regular curves, because when that insulin goes for crap, you will see it in your BG numbers.
You were likely told to get the cartridges because each one is 3ml and the vial is 10ml.... unless you are giving a very high dose to your cat, the odds are that you will be wasting most of that vial, but the cartridge may get mostly used.
Re: A few months in...
Yes, Lantus guaranteed for 28 days, and Levemir for 42 days.
I know people say that their insulin lasts alot longer and it may well last longer, but that's another vital reason for testing before every shot and doing regular curves, because when that insulin goes for crap, you will see it in your BG numbers.
You were likely told to get the cartridges because each one is 3ml and the vial is 10ml.... unless you are giving a very high dose to your cat, the odds are that you will be wasting most of that vial, but the cartridge may get mostly used.
Yes, Lantus guaranteed for 28 days, and Levemir for 42 days.
I know people say that their insulin lasts alot longer and it may well last longer, but that's another vital reason for testing before every shot and doing regular curves, because when that insulin goes for crap, you will see it in your BG numbers.
You were likely told to get the cartridges because each one is 3ml and the vial is 10ml.... unless you are giving a very high dose to your cat, the odds are that you will be wasting most of that vial, but the cartridge may get mostly used.
Julia & Bandit (GA)
Very Active Member
Re: A few months in...
The pens are much better economically, because there's no way you will go through 10ml of Lantus before it goes bad. You might go through 3ml, but it depends on the dose. Bandit was always on a low dose so we never even went though an entire pen before it went bad, but we would come close. Probably about 45 days was the longest it ever lasted, but most of the time they would go bad after 30-35 days.
elizhope said:
The pens are much better economically, because there's no way you will go through 10ml of Lantus before it goes bad. You might go through 3ml, but it depends on the dose. Bandit was always on a low dose so we never even went though an entire pen before it went bad, but we would come close. Probably about 45 days was the longest it ever lasted, but most of the time they would go bad after 30-35 days.
julie & punkin (ga)
Very Active Member
Re: A few months in...
you are still MUCH better off money-wise with the pens. that was good advise you got, but neither the pen nor the vial last forever. the vials here are around $110, the pens $41 each or 5 for $200ish (i buy 1 pen at a time) - punkin's pens don't quite last a month because he has a high dose, so i do use it up. but the vial i had to throw away a lot of it.
in general, you get a month, perhaps a few days more than that if you are lucky. so that makes a pen at $41 and a vial at $110 last about the same amount of time.
a couple of things - you make sure it stays refrigerated, but not frozen, and understand that lantus is fragile so don't shake or roll it. it doesn't need to be mixed up like some insulins. Don't shoot air back into the lantus - don't prefill the syringes, don't leave it out.
you are still MUCH better off money-wise with the pens. that was good advise you got, but neither the pen nor the vial last forever. the vials here are around $110, the pens $41 each or 5 for $200ish (i buy 1 pen at a time) - punkin's pens don't quite last a month because he has a high dose, so i do use it up. but the vial i had to throw away a lot of it.
in general, you get a month, perhaps a few days more than that if you are lucky. so that makes a pen at $41 and a vial at $110 last about the same amount of time.
a couple of things - you make sure it stays refrigerated, but not frozen, and understand that lantus is fragile so don't shake or roll it. it doesn't need to be mixed up like some insulins. Don't shoot air back into the lantus - don't prefill the syringes, don't leave it out.
Re: A few months in...
I bought a box of 5 cartridges. Each cartridge has 3ml. I gave the first dose from the first cartridge the first week of March. So does that mean that cartridge ive been using is bad now and needs to be thrown out? It looks fine.... What about the other 4 I have left in the box, are they okay since ive never stuck the needle in the rubber part? I thought i was told I should be able to just use it until I ran out, even up to 6 months per cartridge ..... I keep it in the door of my fridge (as the back of the fridge tends to freeze things) is that okay?
I bought a box of 5 cartridges. Each cartridge has 3ml. I gave the first dose from the first cartridge the first week of March. So does that mean that cartridge ive been using is bad now and needs to be thrown out? It looks fine.... What about the other 4 I have left in the box, are they okay since ive never stuck the needle in the rubber part? I thought i was told I should be able to just use it until I ran out, even up to 6 months per cartridge ..... I keep it in the door of my fridge (as the back of the fridge tends to freeze things) is that okay?
Without having BG numbers, it's not possible to tell if the insulin has lost its punch.
I would open a new one, make a note on the ss that you started a new cartridge, then test before shots.
If you see good improvement, chances are that the old cartridge stopped being of any use and you can chuck the old one.
Start counting the days when you open a new container of insulin.
I would open a new one, make a note on the ss that you started a new cartridge, then test before shots.
If you see good improvement, chances are that the old cartridge stopped being of any use and you can chuck the old one.
Start counting the days when you open a new container of insulin.
I dont think Im understanding the "opening" of these cartriges. There is no cap, there is no "seal" to take off, there is nothing. All 5 of them look exactly the same. Just lined up in a box. They have a rubber end that ive been sticking the needle in to draw out the liquid. Does the first poke "open" it somehow? After that, that one is considered open while the ones I havent touched are still "sealed"?
Sorry if I cant seem to understand this very well....
Sorry if I cant seem to understand this very well....
Christie & Willie (GA)
Very Active Member
The longest I've ever gotten out of a vial of insulin was less than 45 days. I was using the vials at first, then switched to the pens. I tend to draw out extra insulin to get out bubbles, so I find a pen lasts about a month. Some folks will stretch them, but again, wonkiness is noted by many folks fairly quickly. There are a few folks that get long life out of the vial, but I've noticed they are few and far between (and must have magic refrigerators!! LOL). From my limited experience, insulin doesn't last any longer in the vial than it does in the pen, so the pens are a more economical choice if you are at lower doses as you will throw away much less insulin, so the cost per day of the pens is far less than the cost per day of the vial.
The door isn't the best place to keep it as it gets jostled each time you open/close the fridge. Is there a spot on a shelf where you can keep your pens? I now keep the pen I'm using at room temp (it is good for 28 days under those settings), but before I would keep all the pens in a coffee mug on the shelf, with the unused pens in a ziploc bag so I always would grab the right one. Also, try to keep the cap on as much as possible. Exposure to light can degrade the insulin as well.
You will likely not notice any physical changes when the insulin starts to peter out. It may still be clear and not have any flecks or anything. It also doesn't just magically die all at once. What I've noticed when the insulin is going bad is that Willie's numbers will suddenly get very wonky for no explained reason... one cycle he'll be fine, but the next he'll suddenly be high, even though there should be no reason for a sudden bounce (well, except for the "he's a cat." reason! :lol: :lol: :lol: ). At that point, I would swap out the insulin. As others have noted, one advantage to getting twice daily pre-shot tests and a spot check or two each cycle is that it allows you to see what the insulin is doing and give you an idea of when it is time to change it. Even though I started on the first this month and thus it is easy to keep track, I still post on my speadsheet what day the pen is on as a reminder, especially if Willie's numbers suddenly go weird on me.
Good luck!
The door isn't the best place to keep it as it gets jostled each time you open/close the fridge. Is there a spot on a shelf where you can keep your pens? I now keep the pen I'm using at room temp (it is good for 28 days under those settings), but before I would keep all the pens in a coffee mug on the shelf, with the unused pens in a ziploc bag so I always would grab the right one. Also, try to keep the cap on as much as possible. Exposure to light can degrade the insulin as well.
You will likely not notice any physical changes when the insulin starts to peter out. It may still be clear and not have any flecks or anything. It also doesn't just magically die all at once. What I've noticed when the insulin is going bad is that Willie's numbers will suddenly get very wonky for no explained reason... one cycle he'll be fine, but the next he'll suddenly be high, even though there should be no reason for a sudden bounce (well, except for the "he's a cat." reason! :lol: :lol: :lol: ). At that point, I would swap out the insulin. As others have noted, one advantage to getting twice daily pre-shot tests and a spot check or two each cycle is that it allows you to see what the insulin is doing and give you an idea of when it is time to change it. Even though I started on the first this month and thus it is easy to keep track, I still post on my speadsheet what day the pen is on as a reminder, especially if Willie's numbers suddenly go weird on me.
Good luck!
Amanda
Active Member
You don't want to store the Lantus in your door - its pretty fragile stuff all things considered and the banging of the fridge door several times a day can cause it to go bad on you. I store mine on the shelf between the wall of the fridge and the eggs! :lol: The pens last Kazi anywhere from 2.5-3.5 months at a time before they start to go bad.
Hillary & Maui (GA)
Very Active Member
Regarding feeding and timing. I too free feed my cats always have. I bucked the recommendation here about not feeding prior to preshot test and allowed Maui to eat whenever she wanted. IF the food was there and she ate before the test, so be it, for me it was important that she eat.
So, if you follow a similar path, then as long as you are consistent your BG's over time will reflect that.
Regarding the insulin, as long as you don't use the pens (stick a needle in them) then they should be good until the expiration date. It's once you stick a needle in that the clock starts ticking to when the insulin may no longer be effective. You may never see anything visibly wrong with the insulin (such as floaties or cloudiness), but you will know if the BG's aren't doing anything or going in the wrong direction (up). Then you know it's time to toss that pen and start a new one.
Hope this helps.
So, if you follow a similar path, then as long as you are consistent your BG's over time will reflect that.
Regarding the insulin, as long as you don't use the pens (stick a needle in them) then they should be good until the expiration date. It's once you stick a needle in that the clock starts ticking to when the insulin may no longer be effective. You may never see anything visibly wrong with the insulin (such as floaties or cloudiness), but you will know if the BG's aren't doing anything or going in the wrong direction (up). Then you know it's time to toss that pen and start a new one.
Hope this helps.
Hillary & Maui (GA)
Very Active Member
If you have an appy drawer or veggie draw, you could put it there. They don't get opened as often as the door and won't freeze like the back of the fridge.
- Status