BS going up after first Lantus shot

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Sarah and Baby

Sarah and Baby

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I dosed her with her first Lantus shot, she's not really eating, and my numbers so far are like this


7/31
amps - 333 ~1.5
pmps -378 ~1u lantus
+2 - 392


I am planning on a full curve for her tonight, but should i be worried that they've gone up that much since I gave the Lantus?
 
She ate dinner between test and shot? I'm not familiar with lantus at all. I think the increase is a boost from eating, and that the lantus hasn't started having an effect yet. The 1.5 this morning was her old insulin? What type was that?
Carl in SC
 
You said she's not really eating.... did she eat at all?
 
That number is only 14 points higher than the preshot, so, I wouldn't worry too much tonight.

I use Levemir and not Lantus, but, I would not curve on the first day (or night) of a new insulin. Preshots and spot checks should be enough. Give kitty a few days to get used to the insulin before you curve - that's my opinion.

If Baby's appetite is waning you need to address that with your vet asap.

Best,
Pam & Layla
 
Sarah
I just posted in Lantus and asked for someone to come here and take a look. There's a few people online over there. Hopefully someone will come over here soon and help out.
Carl
 
The food wouldn't really affect her sugar because it's very low carb food. she is eating right now cuz i put the food in front of her
 
Sarah,
Any food is going to increase her BG. Low carb will just increase it less than crappy food.

Carl
 
Sarah,
Pam is right also. It's going to take Baby a few days to get used to a new insulin. What is still important, no matter what insulin we use, is that you get her to eat something so that she can handle the insulin and not go really low. If you can, test her around +6 so you can try to find out where she's at when she is supposed to be at "nadir". In the morning, you need to see if her BG is rising before you dose her, and try to get her to eat. If she hasn't eaten when time comes for morning dose (say an hour before or so), post and ask for AMPS dosing help. You don't want to keep dosing on an empty stomach.

Carl
 
I don't think more than that is needed. The curve might not make much sense yet, as it'll be her first time on lantus which is a long lasting insulin. +4 and +6 should show you her drop. A +10 would be good. It'll hopefully show a rise before your AMPS test.
But like I said, tonight, her body is going to be asking "what the heck is going on, what's this new stuff?" Much like her very first day on Humulin, where all of a sudden, some foreign thing was introduced to her. Don't be surprised or stressed if her numbers don't make much sense this first cycle or two.
As long as you don't get a hypo number or some outrageous 500 result, it's going to be what it's going to be.
Carl
 
Sarah, I told you to test every two hours at first when you start Lantus in case she reacted really well to it, but I guess that wasn't the case. Don't worry. The shed needs time to build up in her body. You can now start with the pre shot test (before you feed her) and then do a couple spot checks throughout the cycle. After about 5 to 7 days, we'll decide if the dose needs to be adjusted. Have you started a spreadsheet yet, with her numbers? Hang in there Sarah. Patience.
And if she doesn't eat at all, please let us know, okay? Has Baby ever had ketones?
 
Sarah and Baby said:
I dosed her with her first Lantus shot, she's not really eating, and my numbers so far are like this


7/31
amps - 333 ~1.5
pmps -378 ~1u lantus
+2 - 392
Click to expand...


I wouldn't worry about the slight increase. Insulin doesn't drop blood glucose levels right away, especially if you just started an insulin. It typically takes about 4 to 6 hours, some cats may be 8 or more hours, for insulin to drop bg levels.

I am planning on a full curve for her tonight, but should i be worried that they've gone up that much since I gave the Lantus?
Click to expand...


I wouldn't bother with a curve tonight or for the next week. Lantus needs at least a week to "settle" in your cat's body before it levels out and works on bgs. You may see slight increases and decreases in bg levels during the "settling" time. A few random bg checks is fine and even those won't show you much.

My two cents :smile: Have you read the stickies on the Lantus board?
 
Welcome, Sarah.

Lantus and Humulin N are very different types of insulin. You shouldn't expect that Lantus will act like N mostly because Lantus is a long-acting insulin as well as a "depot" type of medication. In other words, it will take roughly 5 - 7 days for the insulin reservoir (we call it a "shed") to be built up. Baby's numbers may actually look worse on Lantus for a few days than they did on N. How you think about Lantus is also very differnt than how you think about dosing with N.

There is a huge volume of information about Lantus in the starred sticky notes on the Lantus forum. Below is an overview.
  • 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 this 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.
 
Baby is barely eating right now. yes, she has had ketones in her urine in the past. yes, I am worried about this development. i'm also so tired i can barely see straight.

Baby's shots are at 11 and 11. how can i go about adjusting her schedule for the 7a-3p i work this week and next week should i really just skip her lantus shot in the morning or can i do like, 10p tonight and 9a tomorrow morning and 9p tomorrow night or something along those lines?? am i making any sense?

I made her spreadsheet linkable in my signature so you all can look at my numbers as they come up.
 
Lets think about this schedule a little.
The latest you can shoot is 6:00am? (I'm guessing) when you do the 7a-3p shift? That's a five hour difference. I don't know how you could change your shot schedule by 5 hours in a couple of days.
An early shot (over 15 or 30 minutes) is like a dose increase and a late shot is like a dose decrease. Is there anyway that you can take a lunch break and get home for the 11:00am shot, or have someone else do this shot for you?
Just trying to help.
 
Hi Sarah,

I started Casey on Lanus 5.5 days ago and had also seen her numbers go up; I was also worried, loosing sleep, and looking for answers as to "Why?" and "Is this normal?"

I am happy to let you know, that in time, the BG#'s will start to look like what you would expect. Yesterday and this morning I have finally relaxed, I have finally started to see Casey's BG# start to go down.

So, from one newbie to another....take a deep breath and try to relax (and get some sleep), give it some time, and as (sorry I for got who told you this) said -long as she is not getting the real highs or lows, don't worry about that. Casey made it past that stage, and so will Baby!

You and Baby will be in my thoughts,

Roberta
and Casey

PS - I just saw your post about the schedule change...newbie myself, I can not avise you on it, but I am sure someone will be able to help you. Good luck with that.
 
OK, possibly I can have my mom shoot her in the AM. It sucks that I have a very odd schedule, this could (and does) happen quite often. Some days I work 3-11 and some days i work 7-3. It's fairly common for my schedule to vary greatly.
 
Lantus really requires you to stick to a 12 hour dosing schedule, with the same dose each time.
When you shift the time, it is usually by either 15 minutes per each shot time, or 30 minutes total per day. Over 7 days, the most you could realistically shift is 3.5 hours worth.

Note: Moving the time earlier has an effect like a dose increase (shed doesn't empty as much before next shot); moving the time later has an effect like a dose decrease (shed empties more before next dose.

If your schedule is going to vary so greatly that you can't be consistent, you may be better off with something like ProZinc, which is a bit more flexible in dosing.
 
How long do i wait for her to eat? I need to give the lantus it's already an hour late. but she won't eat. she eventually eats her food, she just doesn't eat it on my schedule. i don't want to force feed her if she is eating on her own for the most part!!
 
Sarah,
You are going to need to get her to eat. If necessary, you'll give her a reduced dose late. But she needs to eat something. When did she last eat, and how much?

Carl
 
OK, give me a couple minutes to look at her sheet.
carl
 
sarah, did she get a unit this morning? The SS is blank but shows she got a PM dose....
 
ok, that's good.
I understand you've got a screwed up schedule. Sounds like you change shifts every week or two weeks? I can understand how hard that makes this dance. My schedule is different every week. We have 4 different shifts. And my days off change every week. When I was faced with trying to figure out how I could test and shoot and feed Bob, I was completely lost.
But I did it. What I really sucked at was the mid-cycle tests. If I rearanged my life to make sure I tested before shooting, that messed up the trying to fit in the +3s and 4s and 6s very often. I also had to pretty much do this alone (as far as the hands on stuff). So I know how you're feeling. I didn't have to stress over the being broke like you have. Luckily, I had the money (had being the operative word ;-) ) at the beginning to pay for the vet tests and the initial supplies.
I've figured out that this is costing me only 2 or 3 dollars a day at this point, so I buy insulin and crap and eat hamburger instead of steak. It's all been worth it because Bob is doing tremendously better and I can't really put a price on that anyway.

Anyway, don't let this tear you up. It's going to get better and it's going to get easier and Baby is going to be okay too.
Take a breather, and wake up tomorrow and take this one day at a time.

Carl
 
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