? Lantus dosing am/pm

[Fiona & Ruby]

Hi everyone, this is my first post (being efficient with a combined introduction and question ). I first want to say you are all an AMAZING bunch of people and this website has been a sanity preserver for me over the past two weeks. THANK YOU so much for your wisdom, care and normalising.
My beautiful Ruby was diagnosed on 14/9/17 and it's been a vertical ascent to try and get my head around everything = utter stress zone, something everyone of you can no doubt relate to. We are both slowing adjusting to this and after changing vets (another story) feel as though I might just be able to do this. We are on Lantus (not sure if my question might be better posted in the Lantus section) and we're using the pen, after doing syringe for about 10 days before switching vets. Syringes in Australia don't have 1/2 gauge readings, so dosing can be very crude but pen only doses in whole units. My question is: Is it okay to dose unevenly over a 24 hr period, so 2u in the morning and 1u in the evening? I haven't been at this long enough to get Ruby's 'good' dosage established but I have this inkling that she might be a 1.5u gal. This would mean 3u over 24hrs. My vet said a 2u/1u would be fine if that's what readings indicate but wanted to check in you fine folk to get some feedback. I don't particularly want to go back to the syringe because I don't feel confident I'm getting accurate doses.
Thanks, Fiona

 

[Chris & China (GA)]

My vet said a 2u/1u would be fine

Unfortunately, your vet is wrong......Lantus does best when it's given at a consistent dose...the same both AM and PM

We have several other members who live in Australia that use the BD .3ml insulin syringes (8mm needle) that use this Insulin Ruler to measure the "in between" doses....it only works with BD syringes though

 

[Fiona & Ruby]

Thanks Chris, I suspected this was going to be the answer. So much conflicting advice doesn't make for a smooth ride. Thanks a lot for posting the insulin ruler. I've got the BD .3ml syringes and have had a look at the sheet and instructions. I'm not sure if I'm being a bit dim but I can't quite work it out...do you cut out a whole row of markings and then laminate? And then how do you place the ruler to get the measure? If you or anyone has used it I'd be grateful for some guidance as it looks like I may have to revert to syringes.

I've just done a +6 reading and we've gone into scary numbers....2.4. So have just given her some food and will check again shortly. Would you advise to skip a dose tonight if her numbers aren't back up over....what? Many thanks

 

[Chris & China (GA)]

I've never had to use the ruler, but maybe @Bron and Sheba will see this tag and be able to help explain better

We have several other members from Australia.....Ones I can think of are @Girlie's mom , @monty_dweezil , @Myrtlesmum

I'm not sure who's got experience with Lantus (my brain isn't working real well tonight)

I've just done a +6 reading and we've gone into scary numbers....2.4

That's definitely too low and you'll want to reduce her dose down at her next shot time. We usually recommend doing dose changes in .25 unit increments (and there's no syringes anywhere that have .25 unit markings) so we just have to "eyeball" it and do the best we can. It's more important that it be consistent......she needs to go down to 1.75, but if the best you can do for now is 1.5, that's better than risking a hypoglycemic crisis.

I'm happy she came up, but you'll want to continue testing for at least 2 hours from the "low"....we usually want you to test every 30 minutes for an hour, and then (as long as they're safe), one hour after that so you test for a total of 2 hours after the last time you have to feed to bring them up.

If they drop below 50 again (on Tight Regulation) or 90 (on Start Low, Go Slow), that 2 hour clock starts over.

 

[Chris & China (GA)]

Would you advise to skip a dose tonight if her numbers aren't back up over....what?

If you get a Pre-shot under 150, we suggest you stall, DON'T FEED and post for help. The first few times you shoot a lower number, we like to have someone with experience who's able to stay with you as long as necessary to make sure everyone stays safe and sane. Test again in 20-30 minutes to see if she's coming up without food.

As you gather more data, that limit comes down.....Those of us with enough data and experience will shoot the scheduled dose as long as our cats are above 50 (on TR)

 

[Fiona & Ruby]

Thank you so much Chris. Have just done another test (1/2 hr post last one @ +7.5) and she's the same 3.4. Will test again in 1/2 hour and post +8. Your guidance is much appreciated given this the first time with scary low numbers.

 

[Chris & China (GA)]

Another option for you to consider instead of the Insulin ruler is to learn how to use calipers

They're the most exact way to measure since you don't look at the lines on the syringes (which can vary from syringe to syringe)

Here's some information on Dosing with Calipers

 

[tiffmaxee]

Welcome. The digital calipers were a life saver for me as I had to adjust insulin in tiny amounts. Believe it or not syringes in tge same box can vary a lot based upon where the zero line is si I used calipers even though I used syringes with half unit markings. You can also load a used syringe with colored water and measure that way.

 

[Fiona & Ruby]

Thanks a lot for the tips on the calipers. I'm hoping I might be able to get some info on how to use the BD ruler (I noticed on another thread someone who swore by it but unfortunately they've not been around for a year)....not feeling super intelligent at the moment with being bewildered as to how to apply the ruler!

Just done a +9 reading and Ruby's slooowly coming up with 3.7. Chris would you suggest I move this reading info over to the Lantus page or stay here and keep posting up til PMPS?

 

[Chris & China (GA)]

would you suggest I move this reading info over to the Lantus page or stay here and keep posting up til PMPS?

You could move over to the Lantus forum and just put the link to this thread into your post there so people can quickly go back and see what's been going on

That's how we post over there anyway. Each day we start a new thread and put the link to our previous day into the message so it's easy for people to go back and see what's been going on.

You can also post in both the Health forum and Lantus if you want to.....it's getting late so there aren't as many people on, but @Tricia Cinco(GA) & Harvey is experienced with Lantus and she spends most of her time over on the Lantus forum (she's on the west coast so she's up later than some of us are)

It's after 1am here, so I'm going to have to leave you for tonight

 

[Tricia Cinco(GA) & Harvey]

Hi Fiona, and welcome!

You certainly can post on the Lantus & Levemir page whenever you are ready. You will probably get more responses from people experienced with Lantus by doing so.

Just a tip - most of the people here that help are from the US, so we use the US format for BG readings in our condos - mg/dl as opposed to mmol/L - so that everyone knows what we're talking about. You don't have to do the conversions - just have a look at the tab on your SS that says US and you'll see the numbers there.

Nice catch on that 43, and good work bringing Ruby up to safety without panicking. Most people get pretty shook up with their first low green numbers. It can be pretty scary, for sure.

If my math is right (and that would be unusual), you're about 2.5 hours from your PMPS. I know you are concerned about whether or not Ruby's BG will be high enough to shoot. If you can get a test around +11.5 and post the result here, then we will see where she is headed. It will also help to compare it to the test at PMPS - we'll know if she's going up or down. That will aid in the decision whether or not to shoot. Chances are she'll be headed for a bounce, but cats are notoriously unpredictable, so let's not assume anything. I'll be checking back to see how it's going.

 

[Fiona & Ruby]

You could move over to the Lantus forum and just put the link to this thread into your post there so people can quickly go back and see what's been going on

That's how we post over there anyway. Each day we start a new thread and put the link to our previous day into the message so it's easy for people to go back and see what's been going on.

You can also post in both the Health forum and Lantus if you want to.....it's getting late so there aren't as many people on, but @Tricia Cinco(GA) & Harvey is experienced with Lantus and she spends most of her time over on the Lantus forum (she's on the west coast so she's up later than some of us are)

It's after 1am here, so I'm going to have to leave you for tonight

Thanks so much Chris for all your support and advice today it's been invaluable. Will follow your suggestion and post over in lantus. Good night!

 

[Fiona & Ruby]

Hi Fiona, and welcome!

You certainly can post on the Lantus & Levemir page whenever you are ready. You will probably get more responses from people experienced with Lantus by doing so.

Just a tip - most of the people here that help are from the US, so we use the US format for BG readings in our condos - mg/dl as opposed to mmol/L - so that everyone knows what we're talking about. You don't have to do the conversions - just have a look at the tab on your SS that says US and you'll see the numbers there.

Nice catch on that 43, and good work bringing Ruby up to safety without panicking. Most people get pretty shook up with their first low green numbers. It can be pretty scary, for sure.

If my math is right (and that would be unusual), you're about 2.5 hours from your PMPS. I know you are concerned about whether or not Ruby's BG will be high enough to shoot. If you can get a test around +11.5 and post the result here, then we will see where she is headed. It will also help to compare it to the test at PMPS - we'll know if she's going up or down. That will aid in the decision whether or not to shoot. Chances are she'll be headed for a bounce, but cats are notoriously unpredictable, so let's not assume anything. I'll be checking back to see how it's going.

Hi Tricia, thanks for the welcome, wasn't quite expecting the day to turn out like this! I really appreciate your tips (and will post US numbers from now on too). Just did a +10.5 and she's 3.7. I'll post another reading +11.5 on LL as you've suggested for some PMPS advice (which is very much needed today! ).

 

[Tricia Cinco(GA) & Harvey]

Hi Tricia, thanks for the welcome, wasn't quite expecting the day to turn out like this! I really appreciate your tips (and will post US numbers from now on too). Just did a +10.5 and she's 3.7. I'll post another reading +11.5 on LL as you've suggested for some PMPS advice (which is very much needed today! ).

That's great, Fiona.

FYI, when you take a reading that isn't at the top of the hour, the US page of the SS doesn't know how to translate it, so you'd need to enter it manually (multiply by 18). So the 10.5 reading of 3.9 would be 70. You appear to be pretty computer and spreadsheet savvy, which is wonderful! We get a lot of members who have very little computer experience and it's hard for them to grasp the use of the spreadsheet, but it really is a fabulous tool.

 

[Myrtlesmum]

Sorry for late reply - just saw the tag. Yes, it's a bummer that we don't have half unit syringes in Australia and I haven't been able to figure out the ruler either. I don't have any experience with Lantus but when I was using half or quarter units I would eyeball it and try to remember what i did last time - eg a quarter is just under the line, half was a stopper away from the line - I don't know how accurate that was but it was always consistent - so I knew that if I thought I was giving half, it was always a stopper from the line and if I wanted to give less, it was less than a stopper - if that makes sense???