Help? Starting dose Lantus?

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Lisa & Nacho

Lisa & Nacho

Member Since 2016
Good evening. I went to the vet today to learn how to inject insulin! Did two water injections today to practice at the vet - wasn't as horrible as I though.

My question is - Nacho tested 366 at the vet today. At home he has been testing between 250-330 or so (see chart).

The vet recommended that I start on 2 units in the morning and 2 at night - which I thought seemed a little high compared to what I read here (for both methods).

For start low go slow obviously I would start him lower.

Even tight regulation based on his weight I think it should be 1.5 in morning and 1.5 at night (he is 13.5 lbs).

Any suggestions?

I am new at this so I don't want to start very high and hurt my kitty.

Thanks!!
 
Hi! Yes I have Lantus.

He is 13.5 lbs as of today (he has been about 13.2-13.8 over the last two months).

I switched him to 100% canned food. fancy feast pate kinds. The vet tried to push the prescription food again today but Nacho doesn't like it.
 
Have you decided yet whether you want to follow Tight Regulation or Start Low Go Slow for dosing? You are right that we would start kitty lower.
 
Just curious - I notice that in your profile it says he was diagnosed in December. Was he being treated for the diabetes between then and now? Other insulin or any oral medication?
 
julie & punkin (ga) said:
Just curious - I notice that in your profile it says he was diagnosed in December. Was he being treated for the diabetes between then and now? Other insulin or any oral medication?
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He was not - he was 100% on dry food only, so I switched him over to wet food during that time. I was having some trouble with the financing for the supplies - so during the holidays I switched vets (to a much more affordable one), then he went for a new visit there, then I worked with the diabetic cats in need group to get him on lantus and here I am now :) ready to begin!

His initial BG level was 524, food change and second visit, 405, today he tested at 366 at the vet. Home testing has been between 250-330 or so, so the food changed has helped some!
 
Wendy&Neko said:
Have you decided yet whether you want to follow Tight Regulation or Start Low Go Slow for dosing? You are right that we would start kitty lower.
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I am not sure - the only issue with tight regulation is I am pretty busy outside being home.

Work M-F so I am already away about 9 hours a day for that with commute, then some nights I have grad school. I was thinking the start low go slow option may be better for me since I will be unable to test him more than a maximum of 3x/day. Right now I am also home by myself for the next 5 months M-F since my significant other is in a police academy till June. Weekends I am home for the most part - it is the M-F that I am worried about.
 
Hi @Lisa & Nacho !!

I was just curious why your spreadsheet ends at +3 on the PM cycle

You'll need to decide which dosing method sounds best for you....If you can test more often, TR allows the best chance at remission, but we've had some cats on SLGS go OTJ too...it really depends on how comfortable you are with getting those tests in

With your schedule, I think you could start with SLGS....if things work out and you find you can test more or change your shooting schedule around to get more tests in, you can always change to TR
 
DCIN is great - I'm glad you've connected with them.

If you want to start with SLGS, the dose would be 0.5u per shot, twice a day. If at some point later you want to switch to Tight Reg, you can.

Here is a post that you might want to bookmark "Where Can I Find?" It'll help you find your way around the stickies to information and it also has lots of our posts with good info that people have saved. One section with a pink header is for cats starting out, and there are lots of tips in there for shooting and testing. Anything to make things easier!

Ask lots of questions - we've all been in your shoes and know it can be overwhelming to start. It gets easier pretty quickly, though, so hang in there!
 
Chris & China said:
Hi @Lisa & Nacho !!

I was just curious why your spreadsheet ends at +3 on the PM cycle

You'll need to decide which dosing method sounds best for you....If you can test more often, TR allows the best chance at remission, but we've had some cats on SLGS go OTJ too...it really depends on how comfortable you are with getting those tests in

With your schedule, I think you could start with SLGS....if things work out and you find you can test more or change your shooting schedule around to get more tests in, you can always change to TR
Click to expand...

Hi! Those columns are there - I just hid them because I didn't think I would use them much since it would be after I go to bed, but they are still in there :)
 
julie & punkin (ga) said:
DCIN is great - I'm glad you've connected with them.

If you want to start with SLGS, the dose would be 0.5u per shot, twice a day. If at some point later you want to switch to Tight Reg, you can.

Here is a post that you might want to bookmark "Where Can I Find?" It'll help you find your way around the stickies to information and it also has lots of our posts with good info that people have saved. One section with a pink header is for cats starting out, and there are lots of tips in there for shooting and testing. Anything to make things easier!

Ask lots of questions - we've all been in your shoes and know it can be overwhelming to start. It gets easier pretty quickly, though, so hang in there!
Click to expand...

Yes they were amazing!! so helpful and sent me a little start up kit :) it was how I was able to get my Nacho the lantus to start off. My vet had recommended the novolin N since it is the most affordable here I guess, but reading it seemed like Lantus was a better option to try first!
 
Chris & China said:
Hi @Lisa & Nacho !!

I was just curious why your spreadsheet ends at +3 on the PM cycle
You'll need to decide which dosing method sounds best for you....If you can test more often, TR allows the best chance at remission, but we've had some cats on SLGS go OTJ too...it really depends on how comfortable you are with getting those tests in

With your schedule, I think you could start with SLGS....if things work out and you find you can test more or change your shooting schedule around to get more tests in, you can always change to TR
Click to expand...

Thank you! Yes I was thinking to start with SLGS because I don't want to put Nacho in danger if I start too high and I am not home to react if needed, that was just my fear of the TR. Giving his first practice shot today was not too bad - he was stressed because he was at the vet though so it should be easier at home!
 
Chris & China said:
Good that they're still there because despite which dosing method you use, there may come a time when you're going to have your first PJ party and you'll need them ;);)
Click to expand...

Would it be possible to begin with 1 unit in AM and PM? so it would be in between SLGS and TR? since based on his weight he is 13.5 lbs I think if I did the math right that is 1.5 units on TR? or is it best to choose one or the other? Seems like the vet wanted to start pretty high at 2 units
 
It would be better to choose one or the other. We discourage mixing/matching from the two - each method has certain safeguards and it's best to think of them as a package deal.

However, you can start at 1u. Depends on how much you are able to test. If you want to start higher than the 0.5u (SLGS) then I'd start when you can test more for the first 3 days, so say on a Friday pm if you have the weekend off. The TR guidelines suggest checking every 3 hours during the day for the first 3 days.
 
julie & punkin (ga) said:
It would be better to choose one or the other. We discourage mixing/matching from the two - each method has certain safeguards and it's best to think of them as a package deal.

However, you can start at 1u. Depends on how much you are able to test. If you want to start higher than the 0.5u (SLGS) then I'd start when you can test more for the first 3 days, so say on a Friday pm if you have the weekend off. The TR guidelines suggest checking every 3 hours during the day for the first 3 days.
Click to expand...

Thank you! I plan to begin this Friday so the first few days I am with him to make sure all goes well :)
 
I was assuming you were ready to start today and that being the case, I was going to suggest starting at a lower dose. If you're going to wait until closer to the weekend when you'll be around, starting at 1.0u would be fine. I would, however, pick up some Ketostix. These are urine test strips that will tell you whether there are ketones present in Nacho's urine. Given that he's been sitting in higher than normal numbers for a bit, testing for ketones is a way to catch what could be a major health issue early. (The biggest headache is stalking your cat to catch him in the litter box.)

I'd also suggest taking a look at the sticky on using TR if you work full time. Many of the people here work or are in school or like you, both. While the sticky is aimed at TR, there are still some good ideas that will help you get into a routine. For example, while you may not be testing into the wee hours of the night, grabbing spot checks if you wake up to use the "facilities" is a way to get a routine handle on what the PM cycle looks like. Some members deliberately will drink a glass of water at bedtime to insure that they get up. Getting an "out the door" test or a test when you come home can also help to fill in the blanks on a spreadsheet.

 
Sienne and Gabby (GA) said:
I was assuming you were ready to start today and that being the case, I was going to suggest starting at a lower dose. If you're going to wait until closer to the weekend when you'll be around, starting at 1.0u would be fine. I would, however, pick up some Ketostix. These are urine test strips that will tell you whether there are ketones present in Nacho's urine. Given that he's been sitting in higher than normal numbers for a bit, testing for ketones is a way to catch what could be a major health issue early. (The biggest headache is stalking your cat to catch him in the litter box.)

I'd also suggest taking a look at the sticky on using TR if you work full time. Many of the people here work or are in school or like you, both. While the sticky is aimed at TR, there are still some good ideas that will help you get into a routine. For example, while you may not be testing into the wee hours of the night, grabbing spot checks if you wake up to use the "facilities" is a way to get a routine handle on what the PM cycle looks like. Some members deliberately will drink a glass of water at bedtime to insure that they get up. Getting an "out the door" test or a test when you come home can also help to fill in the blanks on a spreadsheet.
Click to expand...

Thank you!
 
julie & punkin (ga) said:
How's it going, Lisa? I saw you started the Lantus last night.

Did you get some more tests today?
Click to expand...

Sorry I put it on the wrong date on my phone - just updated on my laptop. Started the lantus this evening. Just did a +1 shot (well about 1.5 hours after) and it was at 288.

Nacho has gotten just 1 dose so far but I am home for the next 3 days so I can track it closer before I go back to work :)
 
Do you mean you got a +1 or +1.5 test? I think you mean that and not shot, right?

Since you started higher than the SLGS guidelines, even though less than the dose suggested for those following Tight Reg guidelines, I'd still try to get a test every 3 hours or so this weekend while you are awake. If you see a big dip in his numbers, then make sure you post here. Someone can help you figure out when you would need to test next.
 
I mean I tested his blood sugar about 90 minutes after the test.

Ok sounds great! I will work on that over the next 3 days to get good data to start off with - thank you!

He did great on his first insulin shot - didn't even notice I was doing it.... he is more concerned when I try to get the blood sample from his ear!
 
I always gave shots while punkin had his face in his bowl - and he also didn't notice it. Just make sure you give a treat after every blood sugar test. Then Nacho will associate the testing with the treat.
 
Welcome to LL.

Good job giving Nacho his first shot, like Julie I used to give George his shot while he had his head in the bowl.:)
Hope you see some progress soon.
 
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