Dose help

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slb1107

I haven't been able to do a curve test. But I tested her last night and she was like 290s? It was at least 12 hours after her last shot. I didn't shoot her. I tested her this morning for her AMPS and it was in the 270s..so I didn't shoot her b/c I was worried she'd keep going down! I'm gonna try to test her at lunch. She just started Lantus last week. She was on Humulin N and constantly was in the 400s. She has drastically changed very quickly. I just wanted to see what others thought.

I will update my chart later...I write it on a piece of paper and put it on the computer when I have time..and this morning the laptop wouldn't work.
 
Re: New to Lantus

Welcome to Lantus. Your kitty is very cute.
We will help you to get to a dose that you can shoot consistantly every 12 hours.
For now, read the stickys at the top of the page, and ask as many questions as you have.
 
Re: New to Lantus

What is your kitty's name? Very adorable! You are at the right place to get your questions answered. The people here have a ton of experience and are very generous with sharing. Do check out the stickies, and maybe print them out so you can make notes and re-read. Welcome!
Liz
 
Re: New to Lantus

Hi & Welcome to Lantus Land (LL)!

Jasper sure is a cutie....ask all the questions you want, everyone here is great about helping out. :mrgreen:
 
Re: New to Lantus

Hi guys and welcome, you've found the right spot.

It's great news that Jasper is reacting to Lantus and that her blood sugars are coming down. This is exactly what you want to happen. Take a deep breath and relax, you've already made one of the best steps for your kitty in switching insulins.

A few questions for you:
Do you have the ability to get any mid cycle tests (even if it's not a full curve, the additional data will help you feel better about making choices and know more about what's happening and will allow others to help when you need it).
What is Jasper eating- dry or wet low carb?
What is your work schedule like....is someone around during the day to monitor and spot check?

One of the keys to Lantus is shooting on a very strict 12/12 schedule. Changes to the dose are only made on very specific parameters and these parameters come from the additional numbers you get throughout the day. This info is found HERE(Tight Regulation Protocol) and you should really become familiar with what this says. Ask questions as they come up because I know it seems like a foreign language at the beginning.

It's hard to give any responsible advice right now until more info is listed. I can tell you that Jasper is on a reasonable starting dose 1 Unit (if she's an average sized cat).

I would encourage you to follow the advice of others and read those initial Sticky's as you're getting more data over the next few days. If you post your info each morning, others can help you make decisions about what to.

So...get busy collecting and posting some info and keep asking questions - you're going to do just fine and congratulations on home testing and making the Lantus switch. You'll be a pro before you know it!
 
Re: New to Lantus

I try to test her at lunch but sometimes I can't find her lol

She switched to wet low carb food about a month ago.

I work M-F 8-5 and no one is there to check her or anything :(

I've read all the stickies I could find..I'll read that one you posted as well...
 
Re: New to Lantus

slb1107 said:
I try to test her at lunch but sometimes I can't find her lol

She switched to wet low carb food about a month ago.

I work M-F 8-5 and no one is there to check her or anything :(

I've read all the stickies I could find..I'll read that one you posted as well...
Click to expand...

Soon enough you'll find that she comes running when you go to the testing spot - especially if there's treats involved.
If you have the ability to come home for lunch for a test and can get a curve on the weekend, it will be enough to let others help. So it sounds like a good shoot schedule for you would be 6AM and 6PM. This would allow you AMPS and PMPS data throughout the week, plus lunch (which would be just about +6) and curves on the weekend....with that you should have enough info to make some of these decisions without any hesitation.
If she was my cat, I would shoot the AMPS and PMPS you've been getting all day long, but would feel much more comfortable telling you to do so if you could assure mid day checks.
 
Re: New to Lantus

Well I haven't shot her since yesterday morning. Her # for pmps tonight is 275. I'm way too afraid that if I give her 1u she'll drop a lot. She's already low for her and to go this long without a shot..I'm worried about giving her too much.
 
Re: New to Lantus

Are you home tonight? If yes, I would absolutely shoot 1.0 and feed her some low carb food. Test her at +2 and +3 to see where you're at, post those numbers and ask for someone to take a look if more testing is needed. 275 is high and you are nowhere near low right now. If you can test, you can shoot. You can do this.
 
Re: New to Lantus

And......if we continue tomorrow morning, you'll need to shoot now to stay on schedule.

I will send you my cell number in a PM so that if you have any fears tonight at any time and you cannot get a response on the board (which I've never seen happen....) you know you can call someone.
 
Re: New to Lantus

i'm not sure why you're thinking 275 is too low to shoot. a non-diabetic cat runs about 50-120ish - 275 is pretty high. just because jasper dropped a significant amount from 400 doesn't mean he'll drop a significant amount from 275. look at the preshot numbers in the lantus forum - they're designated by amps or pmps. usually for new people we say not to shoot if the BG is less than 150-200 if you aren't testing and don't have data. but it's important to gather the data (by testing) so that you can become ready to shoot lower numbers. some people are shooting less than 100 - because they've tested lots and learned how to read how their cat is doing.

train jasper to come to you when you call. you can do that by giving him a treat every single time he comes. say his name, give him a treat. make the treat tiny - like a 1/2" cube of chicken, just a finger-pinch of tuna, or something else low carb. then you'll be able to catch those tests.

a lot of people who are at work all day catch the number last thing at night before going to bed. some people get up early - so if you work 8-5, get up, test & shoot at 6 or so. then you can get a late night test and have a better idea of what jasper's doing.

hang in there! it gets easier!
 
Re: New to Lantus

btw, you need to stay at a dose and not move it based upon the preshot numbers. you've bounced around with the dosing - from 1unit to .75 to .5 to .25 to none to .5. lantus doesn't work that way. you have to stay with the dosage to let it settle into the body. you also absolutely have to get some tests that are in the middle of the cycle. those mid-cycle tests are what determine dose. even if you're at work 8-5, you can get late night, early morning, any times to fill in the spreadsheet so we can see what jasper's doing.
 
Re: New to Lantus

Hello and welcome! Jasper is indeed quite the cutie!!!

I agree with Julie... 275 is definitely not a "low" number and is a number that clearly indicates a need for insulin. Jasper will indeed decrease on the insulin. You are shooting to ultimately get Jasper to spend as much of the day as possible between 50 and 120. Unless Jasper is under 50 (or clearly headed there), there is no real need for worry on your part.... it's just the insulin working as it should!

the other problem is that Lantus really needs consistency to do it's job. Skipping shots will decrease the insulin's effectiveness in Jasper's system. Picture a shed in the back yard. When you first start using Lantus, Jasper will take some out to the shed in the backyard to use longterm, then will use the remaining to get his numbers down that cycle, and he will do this each cycle until his shed is "full." It can take several days for the shed to get full. When Jasper doesn't get insulin, his body will send him out to the shed to get some of that to use that cycle, but then the next time you give a shot, more has to go to the shed. Ultimately, you want to be shooting a consistent dose of Lantus on a 12 hour schedule. Doing so will allow the insulin to work at maximum effectiveness.

Keep getting spot checks where you can so you can learn how Jasper responds to the insulin. But ultimately, to understand his reactions, you will need to shoot consistently for several days before you can really get a sense of how Lantus works for him.

Continue posting your questions and numbers... people here are very generous with their time and knowledge!!
 
Re: New to Lantus

Welcome to Lantus land. I was just looking at you SS and Julie beat me to the punch. You cannot vary the doses on Lantus the way it is done w/ short acting insulins. Lantus is a shed building insulin. A reserve is stored in the body and slowly released. Every time you change the dose the shed is altered, resulting in "wonky" numbers. You need to be very consistent when using Lantus, hold the dose for at least 3 day for the shed to build and get advice here before adjusting. That is the hardest part about it, the waiting. You also need to be sure to stay on a 12 hour schedule. Early shots act like an increase in dose and late shots like a decrease, so it is just like changing the dose too frequently. Skipping shots is even more of a disruption of the shed and you have to start the three day countdown all over again.

I too don't see any problem w/ shooting the numbers you have had recently. We have a saying here,, you have to shoot low to stay low. I know it is unnerving at first, but you will gain confidence.
 
Re: New to Lantus

okeydokey - i just read through your other posts. so to bring everyone up to speed - jasper (sorry for calling her a he!) has been a diabetic for 3 years and was on humulin.

i think you're still thinking in terms of how humulin works. i'm not really familiar with it, but i think you can do a preshot test and don't do mid-cycle shots - is that right? you're going to have to make a mental switch and kinda toss out what you know about insulin because humulin and lantus work differently.

what Christie is telling you about is one significant difference in how lantus works from how humulin works. lantus injects as a liquid (by the way, no rolling, shaking or mixing of lantus) and it turns into tiny crystals under the skin. that's the shed. then the crystals slowing dissipate over time, giving the longer blood sugar control effect.

every time you change the dose, the shed changes also. if you skip a shot, the shed gets used up and then you're starting from the beginning again. when you increase the dose, some of it has to build the shed and some is immediately used in the body. it's like there's a delayed reaction from any dose change. consistency of shooting the same dose at the same time 12 hours apart is critical to getting good control. probably jasper peed on the dog blanket because she's still uncontrolled in her diabetes.

the very very best thing you can do to help her is to test her more and shoot the same dose 12 hours apart. if you test her and post the number here, someone will give you advice on whether it's safe to shoot or not. for now, testing is your #1 friend! and it will help jasper because we'll be able to give you help.
 
Re: New to Lantus

Alright it's too late to try and start the dosing every 12 hours. I'll start in the morning. 1 unit won't be too much? I wouldn't be here to monitor her if she went too low. I'll be dosing at 6:30/6:30.
 
Re: New to Lantus

would you go to your first post of this condo and edit it? you can edit the subject line to say "dose advice?" to get some help figuring out what dose you should re-start with. that should get some more experienced eyes on your condo to answer about the dose.
 
Re: New to Lantus

Hello there and Welcome!
Jasper is indeed a cutie!

I see that you have been given all the information on the importance of 12/12 shooting and consistent dosing when it comes to Lantus.

What is your goal? Do you want to try for remission, if possible? Or regulation in a safe BG range?

If you don't feel comfortable starting at 1.0u, how about starting at .5u? Whichever you chose, make a choice you believe you can comfortably stick with shooting 12/12 for 3-5 days.
During that time try and get at least 1 mid cycle check, each cycle. Then you can evaluate and see if an increase is in order. With Lantus, dose decisions are based on nadir, rather than pre-shot numbers and increases are considered only after a new dose has had a chance to "settle in", which generally takes 6 cycles.

I think it will benefit Jasper greatly if you took these first small steps. Plenty of us here to hold you hand along the way.
 
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