Bacardi is starting with Lantus today

BacardiTheGreat

BacardiTheGreat

Member Since 2018
Hi guys, some of you know me from my previous posts in general. I am happy that my kitty Bacardi and I can finally join the Lantus board. After a bit of a hassle getting it we are starting with Lantus today! Switching from 1.25 u of Caninsulin, which never got him regulated. Going for the SLGS protocol, starting with 0.5 u of Lantus (because Bacardi is on a low carb vet diet). Wish us luck please, I desperately want to get this cheeky kitty regulated :) Kate
 
Welcome to the L&L family! Love the name and the photo!

There are lots of experts on this board who will give you great advice. I think you should try to get plenty of tests and provide as much data as you can. They can't advise if they have no information to go on.

Bacardi was recently diagnosed so wishing you luck that he goes beyond regulation and into remission!
 
Hello and welcome. I too started on Caninsulin, so glad we switched. I hope you will be too. I presume you are using the U-100 syringes now? Even though you are starting on SLGS, we typically would take the dose of the previous insulin in mind when switching, which would mean probably starting at 1.0 units. Fortunately that’s not too far off 0.5 units. I too went backwards to 1.0 unit to start Lantus, and unfortunately my girl needed a lot more and it took a few months to get to where we needed to be on the dose.

By the way, SLGS is not a protocol, but rather a dosing method developed here. It still has lots of cats using it.

I also see you just have the World tabs on your spreadsheet. Although I can read that because I am Canadian, many of the people here are American and cannot. Tagging @Marje and Gracie who can help get you set up for the extra tabs. You won’t need to do anything different when you enter data, it’s just for other readers,
 
Thank you for the warm welcome and some good advice guys. My vet told me to start with 1u daily based on how steep were Bacardi's BG drops when on Caninsulin - he usually went from over 25 mmol/l to around 5 on 1u (she wanted me to shoot just once a day though, so I thought twice a day would better and thus 0.5u). But you are probably right. Tested him 3 times and we are nearing 30 mmol/l again. So I'll just go with what you are telling me and start with 1u right away. @Wendy&Neko I'll have a look at the spreadsheet, we only do mmol/l here but it should not be a big problem to convert it :) And yes, U-100 syringes now. Too bad I could not get those small ones with 0.5 unit scale - not available in my country's pharmacies.
 
Where do you live?
The 1/2 unit U-100 syringes can be ordered online from the UK.
I live in Australia and they tale less than a week to get here.
 
Thank you very much Bron. Bookmarking the link and will definitely order them. As for Lantus, it's way too soon to tell, but from what I see so far I am hopeful. Bacardi's curve seems to be much flatter than on Caninsulin..if it is the case, the only thing is to find the correct dose and we're good! I am excited :)
 
So after a first couple of days on Lantus I have a mixed feelings. I am happy that Bacardi's BG levels are much more steady. And one more improvement - might be a mere coincidence, but he had this odd rash on his head, which he was scratching constantly, and the inside of his ears was itchy. We rules out ear mites, but never found out what it was. And all of the sudden his head cleared up and his ears seem to be less irritating. So, I am thinking, maybe he was alergic to Caninsulin or something in the syringes? Just a guess.

Anyway, as for the actual BG levels - although nice and flat, we are waaay to high. I haven't done a full curve yet (might do it tomorrow if needed), but I already feel like we need a bigged dose rise than just 0.25 - I don't feel comfortable leaving Bacardi that high (around 18 - 19 mmol/l, which is over 300 mg/dl) literally all the time. What would you guys suggest? Wait longer with 1 unit? Rise by 0.25? O rise more?
 
Have you decided if you are going to do the SLGS method or the Tight Regulation? It will make a difference as to how long you hold the initial dose and what you do going forward.
Have a look at the protocols... they are at the top of the Lantus and Levemir forum in the yellow stickies.
With the SLGS you hold the initial dose for a week unless he drops low or has had ketones. With the TR the dose is held for 5 to 7 days to let the depot fill unless he drops low or has ketones.
So I think you need to be holding the dose a bit longer but do test for ketones most days while he is high.
With increases we recommend you increase in 1/4 unit increments.
I know how frustrating it can be but don’t be tempted to rush things.
Try and get him to drink more water while he is high by adding a teaspoon or 2 of warm water to his food.
Keep asking questions.
 
@Bron and Sheba I want to begin with the SLGS one. As a Lantus beginner, I might be overthinking it a bit (thinking what if his final dose is, lets say, 4 units - does it mean that he has to spend 3 months in high numbers before he's low enough?). But as you said, I will try to be more patient and make sure Bacardi is eating well and drinking enough. I always put water in his meals, sometimes some home made broth. He never objects ;) I am also testing for ketones, but probably not as often as I should - rarely do I catch him peeing (usually only hear him after he's done and scratching in the litter box) and even if I do, once he notices me sticking the test under him he just leaves and comes back when I am not looking. And tricks like putting foil over the litter box to catch the urine don't work for me, as I have 3 cats sharing the litter box. Any tips appreciated in this regard :)

PS: fixing the new SS with mg/dl now, it will be hopefully up soon
 
Kate, can you note in your signature that you are doing the SLGS method please?
I know it is hard to see our kitties in high numbers, but really Bacardi was getting down into the greens at nadir in Dec before you swapped insulins, it was the duration though that was not good. It will just take time for his body to get used to the longer acting Lantus and for the depot to build up. Keep getting inbetween tests....they are very valuable information.. also the PM cycle if you can....just get them at different times so we can see how he is managing the insulin.
You are doing everything right. He was getting down into greens on caninsulin on much less than 4 units so let's see how he goes with the Lantus.. ( it is easy to overthink things especially in the beginning ....we all did it) .....the thing is it takes time for a kitty to be regulated. Insulin is a hormone not a medication like an antibiotic or a pill that starts to work straight away. It takes time to start working effectively.
If I need a urine specimen I pop a tiny container under them. I have also tried putting a small container in the favourite wee spot.
:bighug:
 
I went through both the methods again and have a question: do I understand it correctly that the main difference is the frequency of testing? For TR it's 5 times a day or more, whereas for SLGS you basically only do a curve after a week of holding a dose? (and preshot tests to make sure it's safe to shoot?). So if I test like I have done, I can pretty much go for TR too, right? Is TR the method that the most of you guys do?

Thank you Bron for the tip to use a tiny container - I'll try that. And I will also try to get those ketone testing stripes that you recommend here. At the moment I have stripes that my vet recommended, but they have 7 testing areas for various other things, like protein, blood etc - and the ketone one is right in the middle, so I have to wiggle the whole thing under Bacardi to get him pee on the right one and he feels it and it disturbes him.
 
The main differences between TR and SLGS are the amount of time you hold a dose before increasing, and the reduction point. Because TR is a more aggressive, though safe, method, it requires more testing to keep kitty safe. With TR, you test for each preshot plus at least one more time each cycle, for a minimum of four times a day. Another major differ nice is that TR requires feeding only low carb canned or raw food.
.
 
Wendy&Neko said:
With TR, you test for each preshot plus at least one more time each cycle, for a minimum of four times a day. Another major differ nice is that TR requires feeding only low carb canned or raw food.
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Click to expand...

Thank you for the clarification. I was not sure it we "qualify" for TR, but now I think we do! And thinking about it, I'll try to go for that one rather than SLGS, because I want to get Bacardi to low numbers ASAP. He's on low carb wet food and I am OK with testing at least 4 times a day (and prepared to test/feed more if he happens to drop too low). With the help you good people provide here (and a huuuuge thank you for that) I think we'll be fine!
 
And we have the first purple morning value, yay! Looks like we're already averaging down a bit. Plus tomorrow is an increase day (isn't it?), so come on you numbers, go lower! :)
 
It’s probably time to start a new post. Most of us start a new post every new datpy with a link to the previous post for those who want to follow the history. It’ll also help us help you if you put SLGS in your signature. Good luck with the increase.
 
@Wendy&Neko OK, I was wondering what are all the posts with dates, now I know. I will start a new one next time, thank you for telling me

As for SLGS, after some discussing with the guys here wwe figured out that I can try to go for TR instead, so that's what I'll do - I'll put it to my signature for everyone to see.
 
I wrote a new post here, if you want to follow up. I'd be grateful for some confirmation. Thank you guys, you have been lifesavers for me, trully. Without you (especially @Kris & Teasel ) we would still be on Caninsulin, handling HI readings and stuff... :)
 
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