First Insulin Shot! Worried About Low numbers

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MangoPie

MangoPie

Member Since 2024
Hey guys! Hugo has been home with me for about 2 days now after recovering from DKA.
I've just administered his first insulin shot at home and I'm really hoping I got it right. He's on 0.5u of Lantus a day-- a VERY low dose as the vets were having issues with hypoglycemia. Really worried I have my syringes mixed up or something. I have the u100 needles and did half a unit on one of those-- barely anything really. He was fed and tested before giving insulin.

After I gave him the shot his blood glucose absolutely plummeted. I'm keeping an eye on it and testing every 15 minutes to make sure it doesn't get dangerous. I have treats and honey to offer if things get dire. He had this issue at the vet so perhaps it's expected. I have my spreadsheet linked in my bio now and will continue to update it over the next few hours.
 
Update: Got a good amount of food in him and a bit of honey to stop things from tanking further (two creamy treats and some gravy Fancy Feast). Numbers still hovering in the low range so I'll continue to monitor. Not exactly how I expected my first shot to go :arghh:
 
squeem3 said:
You have the U100 3/10cc insulin syringes with half unit markings, yes?

There info on using Lantus here, including a picture of the half unit markings: https://felinediabetes.com/FDMB/thr...info-proper-handling-drawing-fine-dosing.151/
Click to expand...

The packet says 0.3ml u100 syringes.
The notation on the looks like the left half-unit scale. I measured carefully to only include one half of a single bar. I drew about this much, noted by the red line.
it seems like there's quite a big margin of error trying to draw such a tiny amount. Perhaps the lighting was off in my room.
 
Is Optisulin the name of the insulin?

My Charlie could do those steep drops too, even on 0.25u of Lantus. He was a steroid-induced diabetic. Watching the BG plummet can be really unnerving, especially in the early days when you have little data.

Sometimes Libres can give wonky numbers, especially in the lower ranges, so if you have a handheld meter, it’s a good idea to get a test on the handheld to confirm a low number.

@Wendy&Neko First dose of Lantus took Hugo below 90, dosing method is SLGS, so that would warrant an immediate 0.25u reduction in dose, would it not?
 
JL and Chip said:
Is Optisulin the name of the insulin?

My Charlie could do those steep drops too, even on 0.25u of Lantus. He was a steroid-induced diabetic. Watching the BG plummet can be really unnerving, especially in the early days when you have little data.

Sometimes Libres can give wonky numbers, especially in the lower ranges, so if you have a handheld meter, it’s a good idea to get a test on the handheld to confirm a low number.

@Wendy&Neko First dose
@Wendy&Neko First dose of Lantus took Hugo below 90, dosing method is SLGS, so that would warrant an immediate 0.25u reduction in dose, would it not?
Click to expand...

Optisulin is the name of the insulin! It comes in a pen. I did not use the pen directly-- I made sure to draw out 0.5u with the separate syringes provided.

Hugo is also a steroid-induced diabetic-- my vet told me it's very likely that he'll go into remission at some point-- thus the dose is very low atm.

I'm aware of the Libre's wonky numbers and I'm hoping that his BG is actually higher then what is given. Since it's the first day though, I don't feel comfortable taking chances. His BG is now steadily rising so I think I've avoided any catastrophes but I was definitely worried to see it keep dropping like that so suddenly. Glad I had the resources here! Food and a bit of honey seemed to do the trick, but I'm going to continue monitoring for a few hours just in case. I'm hoping to get a better BG meter soon-- he only has the Libre since his ears are a bit bruised at the moment, and because I might need to wait and order one online. Any recommendations are welcome as I still need to decide which one I'm going with.

I don't know if I'll be comfortable doing 0.5u again tomorrow, but I'll keep an eye on his numbers to see how the trends go. Not having data really is the kicker, but the vets have informed me that this is what he was like in their care as well. He dropped to below 2 on the reader for them one night. They mentioned Chronic Somogyi Rebound and I had a bit of a read about it here and the validity of the condition. While its not a proven theory I think gives some insight into how his trends have been so far.
 
Can you get half unit marked insulin syringes in your country (what country? Do you have a profile?)? That would make it a lot easier to measure half unit doses more accurately.
 
MangoPie said:
The packet says 0.3ml u100 syringes.
The notation on the looks like the left half-unit scale. I measured carefully to only include one half of a single bar. I drew about this much, noted by the red line.
it seems like there's quite a big margin of error trying to draw such a tiny amount. Perhaps the lighting was off in my room.
Click to expand...
Hi I think you are from Australia correct ?
Those are not half unit marking syringes
If you tap on this link and look at post #55 you will see where you can order the half unit marking syringes
One of our members from Australia said she ordered them from that site
https://felinediabetes.com/FDMB/thr...o-take-charge-after-hypo.281913/#post-3120225

bd_microfine_insulin_syringes_demi_0-3ml_lg.webp
 
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When following SLGS, any number below 5.0 (90) means the dose needs to be reduced. You did keep in safe numbers - we don't want them below 2.8 (50) - good job on the feeding.

Which brand of syringes are you using?
 
@squeem3 @Diane Tyler's Mom
I am from Australia yes! A little bit confused since my syringes look like the ones on the left image? It has a 5 mini bars before reaching 5. I attached an image in my first post showing how much I gave but I can also get a photo of the syringe later.

@Wendy&Neko
The brand is 'BD ultra fine'

His numbers are back up now! I'll be going to work for today but I will test and see how things go once I arrive home.
 
If you are using the pic of the syringe I posted above them yes they are half unit markings which are great
Are these the ones you're using if so they are correct

  • Veo Syringes 31g 3/10cc 6mm Half Unit Markings 100 Count

BD Veo Syringes 31g 3/10cc 6mm Half Unit
 
Diane Tyler's Mom said:
If you are using the pic of the syringe I posted above them yes they are half unit markings which are great
Are these the ones you're using if so they are correct

  • Veo Syringes 31g 3/10cc 6mm Half Unit Markings 100 Count

BD Veo Syringes 31g 3/10cc 6mm Half Unit
Click to expand...
Sorry for the confusion! I was misreading the image detailing the syringes and I'm now sure I actually have the one with single unit measurements and not half units. I have ordered some online but I'll check my pharmacy today yo see if j can get my hands on some Half Unit ones.
 
MangoPie said:
@squeem3 @Diane Tyler's Mom
I am from Australia yes! A little bit confused since my syringes look like the ones on the left image? It has a 5 mini bars before reaching 5.
Click to expand...

You have whole unit marked insulin syringes. The lines starting at the top is zero, the next one down is 1, then 2, then 3, then 4, then the bold 5. See the image that Diane Tyler's Mom posted above, the scale on the right side. You can sort of eyeball where a half unit is but you're not going to get exactly a half unit every single time.
 
I forgot to mention two other options for smaller doses when you don't have 1/2 unit marked syringes available, or are waiting for them to show up.

Back in the day when I started, we had one member who used sample syringes. She'd fill a syringe with some coloured liquid (tea, juice, pop) and leave that out as what she figured was 1/2 unit (or 1/4, or 3/4), then compare against the sample every time she loaded the syringe. It's more important to be consistent in dosing, then worry if it's actually a tiny bit more or less than the markings on the syringe.

Another option we've started using is to dose with digital calipers. Post with information here: Dosing with calipers. You can buy calipers on line or my hubby got some for me at his go-to metal/woodworking tool shop. A couple key features for calipers: you want to be able to set the dose and use a locking screw to tighten it down. Since you are using BD syringes with the ring near the top, you also want thin arms (the smaller ones on the calipers), that are used to measure inside things. Fat arms will get in the way with the BD ring.
 
7
Wendy&Neko said:
I forgot to mention two other options for smaller doses when you don't have 1/2 unit marked syringes available, or are waiting for them to show up.

Back in the day when I started, we had one member who used sample syringes. She'd fill a syringe with some coloured liquid (tea, juice, pop) and leave that out as what she figured was 1/2 unit (or 1/4, or 3/4), then compare against the sample every time she loaded the syringe. It's more important to be consistent in dosing, then worry if it's actually a tiny bit more or less than the markings on the syringe.

Another option we've started using is to dose with digital calipers. Post with information here: Dosing with calipers. You can buy calipers on line or my hubby got some for me at his go-to metal/woodworking tool shop. A couple key features for calipers: you want to be able to set the dose and use a locking screw to tighten it down. Since you are using BD syringes with the ring near the top, you also want thin arms (the smaller ones on the calipers), that are used to measure inside things. Fat arms will get in the way with the BD ring.
Click to expand...

Thank you so much for all the information! The method with the calipers is really interesting. I might try the printable rulers for now but I'll be keeping an eye on this method too.

Just hoping things go a little better today when I give Hugo his shot. I'll be arround to monitor him but the big drops are always scary to see.
 
Diane Tyler's Mom said:
If you tap on this link and read post #7, #8 #9 and # 10 another member from Australia ordered the half unit syringes from the same place I gave you in my post above #8

https://felinediabetes.com/FDMB/threads/newbie-to-shoot-or-not-to-shoot.282693/#post-3115676
Click to expand...

Thanks for the advice! I've now purchased some of these, hoping to get them soon :]

I've administered 0.25u today and will be tracking his BG over the next few hours. We've gone from 355 to 277 in the first hour. We are dropping again but it at least seems to be going more slowly this time around. Hoping that things level out and that I don't have to panic at 12am!

Edit: also please let me know if I should move to the 'Lantus / Levemir / Biosimilars' forum! Still new and working out where to post things and/or the appropriate way to format.
 
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You're welcome to post either here or in the Lantus forum :) It might be better to start your own "condos" on the Lantus forum with your cat's daily bg numbers soon and ask away on Lantus specific stuff there.
 
MangoPie said:
Edit: also please let me know if I should move to the 'Lantus / Levemir / Biosimilars' forum! Still new and working out where to post things and/or the appropriate way to format.
Click to expand...
On your spreadsheet I'm a little confused on how you have the dates listed on the left hand side. You started with 29/01/24, 30/01/24 , 31/01/24
Then you have 01/02/2024 , 01/03/2024 01/04/2024 , and so on.
After the 31/01/2024 you should have 01/02/2024 (Feb 1, 2024) ,then 02/02/2024 (Feb 2, 2024) and so on
Take a look at Tyler's SS , he's been in remission for 3 years now so that's why you don't see a lot of testing.
You can look at other members spreadsheets also

You can introduce yourself and just say first time posting on the Lantus Board. May I ask you your name?
To post in the Lantus we like to do a new post everyday like this
Date, Hugo, then AMPS # and any other tests you do , then continue with his PMPS# and any other tests after that.
To add the additional tests look to the right and tap on the word Thread Tools, then tap on Edit Title add the tests and then tap Save.
When you do a post everyday we link our previous post to the new one, so in case members need to go back and read something they won't have to go searching for it. There are a lot more eyes on the Lantus Board.
Your previous days post will be all the way up top where it starts with https:// in green. Just copy and paste it to you new post .
@MangoPie
 
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Diane Tyler's Mom said:
I'm a little confused on how you have the dates listed on the left hand side. The oldest dates should be listed first and end with today's date
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Hi Diane, much of the world uses the format where the day is shown first, then month, then year. So, January 31, 2024 is written 31 January 2024 or 31/1/24. The US reverses the day and month — 1/31/2024. Anyway, MangoPie is in Australia and the dates for the completed rows of the spreadsheet are entered using the day/month/year format, which I believe is standard there. That’s probably why the first column looks a bit odd to you. :)
 
yep, just like the metric system...my wife is always complaining about the backwards way we do the date. And I have to admit, Day/Month/Year does make more logical sense.

@MangoPie I loooooooooooooooooooooove the pic! What a cute moggy! Such a bewdy :bighug::bighug::bighug:
 
Hi,

I had a very similar issue happen and was freaked out, almost exactly:
https://www.felinediabetes.com/FDMB/threads/low-glucose-warning-up-and-down-every-15-min.285808/

One thing that was noted was that the next day I saw a huge spike in his BG levels due to the extra food and honey, I believe it's called bouncing. He also had some slimy poop due to the honey.

I had a couple other nights where I would get the low alarm, but instead of jumping to food or honey, I was told to give it a few minutes and keep an eye for any signs of hypo. His numbers ended up going back to normal, it seemed as though during his sleep he would intermittently drop low, and then back to normal

It's since stabilized pretty well, but that post may have some helpful comments from others

Out of curiosity, what was the BG level at when giving the insulin?
 
JL and Chip said:
Hi Diane, much of the world uses the format where the day is shown first, then month, then year. So, January 31, 2024 is written 31 January 2024 or 31/1/24. The US reverses the day and month — 1/31/2024. Anyway, MangoPie is in Australia and the dates for the completed rows of the spreadsheet are entered using the day/month/year format, which I believe is standard there. That’s probably why the first column looks a bit odd to you. :)
Click to expand...
Hi JL yes I understand that but she had
01/02/2024 , 01/03/2024 , 01/04/2024 , under 31/01/2024 I see she corrected them and deleted them ,so all is good :cat:
@JL and Chip
 
Diane Tyler's Mom said:
Hi JL yes I understand that but she had
01/02/2024 , 01/03/2024 , 01/04/2024 , under 31/01/2024 I see she corrected them and deleted them ,so all is good :cat:
@JL and Chip
Click to expand...

Yep! Just fixed them haha. I tried to auto populate the cells but didn't realise they were calibrated for the American date format and not the Australian format. all my dates are in DD/MM/YY format.

I've taken a look at the board and I think I've got the gist of it! Since I now have my spreadsheet and a better understanding of things, I might pop over there to continue with questions and etc.

ETheCat said:
Hi,

I had a very similar issue happen and was freaked out, almost exactly:
https://www.felinediabetes.com/FDMB/threads/low-glucose-warning-up-and-down-every-15-min.285808/

One thing that was noted was that the next day I saw a huge spike in his BG levels due to the extra food and honey, I believe it's called bouncing. He also had some slimy poop due to the honey.

I had a couple other nights where I would get the low alarm, but instead of jumping to food or honey, I was told to give it a few minutes and keep an eye for any signs of hypo. His numbers ended up going back to normal, it seemed as though during his sleep he would intermittently drop low, and then back to normal

It's since stabilized pretty well, but that post may have some helpful comments from others

Out of curiosity, what was the BG level at when giving the insulin?
Click to expand...

So sorry to hear it happen to you too!! Hugo's BG did spike upwards after the extra food and honey too. I'm aware of the term bouncing but man was this a steep bounce! He dropped from 452 to 79 within three hours and it only kept getting lower so I was super scared. Thankfully after a bit it started to trend upwards again.

Had a bit of a drop again today after 0.25u but it was nowhere near as steep.
Hendrick Cuddleclaw said:
yep, just like the metric system...my wife is always complaining about the backwards way we do the date. And I have to admit, Day/Month/Year does make more logical sense.

@MangoPie I loooooooooooooooooooooove the pic! What a cute moggy! Such a bewdy :bighug::bighug::bighug:
Click to expand...

Thank you!! He's a very pretty cat-- if only he didn't come with all the health conditions. He's getting older though so perhaps I should just be happy they are only popping up now haha!
 
MangoPie said:
Had a bit of a drop again today after 0.25u but it was nowhere near as steep.
Click to expand...
At low doses like that make sure you know where the zero mark on the syring is in relation to the plunder being fully depressed. I have noticed that for some individual syringes the zero mark can be off bu ½ unit. For me that would be mean if I drew up to the ½ unit marking the real dose would be 1 unit.
 
Larry and Kitties said:
At low doses like that make sure you know where the zero mark on the syring is in relation to the plunder being fully depressed. I have noticed that for some individual syringes the zero mark can be off bu ½ unit. For me that would be mean if I drew up to the ½ unit marking the real dose would be 1 unit.
Click to expand...

Thanks for the advice! Do you know exactly which syringes are like that? I'm using the BD ultra fine 100u needles. Here is a photo (ignore the amount drawn out, this was the vet showing me at an earlier time when he was on a higher dose. I am currently giving him nowhere near as much.)
 
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