Little Boy new to Lantus

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Anyname

Anyname

Member Since 2010
Thank you to Sue and others for all their help getting us set up with a spread sheet for Little Boy. We have filled in the spread sheet.
With numbers so high yesterday we decided to open a new vial of Lantus. The numbers have come down a little since then. We have attempted to attach the spreadsheet to the signature as per the instructions - don't know if it works.
 
You can always copy and paste it into your post until you get the mechanics of attaching it figured out. Post a note in the Tech Center and someone will lend a hand with it.
 
The spread sheet is accessed by clicking on Little Boy under my posts.

I hope I can get some input to how Little Boy is going. He is very hungry and eats a lot. His hunger doesn't seem natural. He is drinking more than he did when he started on Lantus.

thank you.
 
He's probably hungry because his body can't process things quite right just yet. You should notice less "starving kitty" once you gt his dose right and start seeing him in lower numbers. Right now he literally is starving though so do feed him as much as he wants/needs. You can cut back as his numbers improve and his body starts using the food properly.

Adding water to his canned food should help some with his thirst.

Is he eating any dry food or treats at all? I noticed when I was watching my sisters cats that on the days I had to give them kibble they drank a lot more than on days they ate only canned food.

Hopefully some of the more knowledgeable folks will be by to help you out with the dose. I'm not even close to knowing enough to advise on that but my gut is really telling me that 3u is too much. I don't know if that's just because I just adopted a diabetic kitty who has been overdosed for who knows how long though. He was being given 9u of insulin (split twice a day) and never tested so the shelter was shooting blind and just kept od'ing him.

Lots of vets start kitties out on too high of a dose. The folks who really know that stuff will be here to help out though =) With the help of the folks here, you'll have things under control in no time =)
 
Good job with the SS....Little Boy will be thirsty and hungry for awhile...my Shadow was insatiable at first, before DX.
Welcome to LL ~ you are on the right track now. Each day, we post a "condo" for our kitties with their numbers. You can add any questions you might have to those posts. We also link the previous day's condo the the first one in the morning... (that way, everyone can easily link to what transpired the day before...)

Please read the stickies at the top of the page....welcome to lantus..etc. Be sure to familiarize yourself with the information contained there.. so glad you are here...welcome to you and Little Boy! :mrgreen:
 
You and Little Boy have come to the right place!

I have some concern that 3 units may be too much to start him on; as Marvie said many vets aren't dosing experts. It's possible that starting over from a lower dose would be a good idea, but wait and see what the more experienced people here will say. Very nice work on getting started testing, and the data will starting adding up soon so you can get some solid advice.
 
WElcome to Lantus Land--Hope Little Boy does great on lantus, as we have great success here--Read the stickys at the top of the page, ask questions here, and be consistant & patient--It will get better!! :mrgreen:
 
Where are you located? Just wondering since you're using mmol... I like the idea of dual spreadsheets though! Right now, I just do the math in each cell to convert to US for other members here
 
I'm not sure where it is but somewhere there is a spreadsheet that automagically converts the numbers... hopefully someone can point y'all to it.
 
Your SS is working wonderfully! And good job getting tests in.

I went back to your initial (long) condo/thread on Health. When you have a chance, can you complete a Profile? This will consolidate a lot of information so we don't keep bugging you for things like: when Little Boy was diagnosed, any health conditions, what you're feeding, etc. All of this is important for us to know in order to have the big picture.

For a newly diagnosed cat, the Tight Regulation Protocol suggests that starting dose is based on a cat's ideal weight.
Tight Regulation Protocol said:
In many cases, the starting dose of Lantus or Levemir has been 0.25 IU per kg of the cat's ideal weight and is always dosed BID (two times a day, 12 hours apart). If the cat received another kind of insulin previously, the starting dose should be raised or lowered by taking this information into account.
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For a starting dose of 3u, Little Boy would need to weigh 12 kg (almost 26.5 lbs). Somehow, I don't think Little Boy is that big. What is his ideal weight? And, would you be open to reducing his dose?

One of the issues with starting with a high dose, and this is a high starting dose, is that you don't know if you've missed what may be an optimal dose for your cat.

Also, I really want to caution you about not getting a pre-shot test before your evening shot. While Lantus dosing is based on the lowest point of the cycle, shooting blind is dangerous. You have no idea where you're starting and whether it's safe to give a shot. My cat, Gabby, is notorious for quick drops. Without knowing where you're starting, you could end up with a +1 that is very low. Please, please, please do not shoot blind. It is a terrible habit to get into. You also need to get at least one spot check per cycle. More is better but one is good.

I also saw your note in Health about injecting air into a vial. There is more of an issue with injecting air back into the cartridges or pens. It's not something you want to do with a vial, but the concern is less since the insulin in the vial is not in a pressurized form. You don't want to get into the habit of injecting air. You will find that buying the pens or cartridges will end up costing less and being more economical with respect to waste. The manufacturer recommends that once opened, Lantus' shelf-life is 28 days. Many people here get a longer use from their insulin. Many of us don't. As a result, there is much less to discard in a pen or cartridge than in a vial.
 
I have to agree with Sienne. Shooting blind is not good. I did it for a while with Tugger when his numbers were really high and he was eating dry food but I was not educated about this stuff yet and just thought I was "saving his poor ears."

Yesterday I adopted Brady, a shelter kitty from Louisiana. He's diabetic, obese, has a host of problems. I have to wonder if some of these problems aren't caused by or made worse by the fact that the shelter was shooting blind. This cat has not had a shot since Thursday night at the shelter and he has only gone over 100 once since then. I have no way of knowing how long they've been overdosing this poor boy on insulin. I do know he must have been feeling like crap for a while now though.

It is not uncommon, even in these early days, for the preshot number to be too low to shoot safely. If that happens and you haven't tested, his numbers will plummet and he will go hypo. So even if you can get no other testing done that day, never ever give a shot without getting a number first.

Yep ;-) here we go nagging again, but it's because we want to keep Little Boy safe!
 
Diet is something I will address better this week. He's currently eating raw meat only. He often goes looking for his biccies but I've stopped them due to carb content. Yes, certainly hoping to receive opinions on dosage in light of data provided. I think his ideal weight would be around 8.5 kilo's but he was over 9 before he got sick - and close to 8 on dx. He was too heavy at 9kilo's. Mostly tummy fat. :roll: He had been on cortisone for 3 months prior to dx for diabetes. growth on tongue (granuloma)

I am now trying very hard not to feed him for 2 hours before morning and nite gb test. Not always easy as he gets frantic for food. only one hour this morning as I too tired to argue with him at 6am - I shot early as have to go out

The vet started him on 3 units of Lantus and insisted that it was the correct dosage. He wasn't monitored because he gets too distressed staying over at the vet clinic and our vet doesn't do home-testing. I am not sure what he will think about all the figures we will present him with in a weeks time. I am not even sure if the vet is relevant since they are somewhat vague about how they manage diabetes in OZ.

yes, profile needed.

also thought the figures were converting to us figures naturally. D'oh!

also thought I posted this last nite. but found it unposted this morning
 
I've changed the spread sheet to US reading - hope this will help.

Can anyone provide me with a good reason to drop from 3 units? I am unhappy with his high BG levels after 2 weeks on Lantus. I can't see how dropping units will help. I realise you all think he should have started on much less but if he's not responding well to 3 units how is giving him 1 or 2 unit going to work better? Am I missing something? I don't think we should be thinking about accumulation under the skin yet as his lowest number with 2 weeks on 3 units is 219. He's not in any danger of a hypo state. I am worrying about ketones at his current levels and will buy the test strips to test for that this morning.

Vet pathology reading done on 4th June, said: Results indicate dehydration, stress, mildly ketoacidotic diabetes melitus and probable fatty liver.

time differences with the US don't bother me. You don't need to consider it as I don't think it's relevant. We are all on the same page but I'm reading the page a bit sooner than you are.

yes profile needed but Dr David (phd) couldn't manage to do that either and his wife Marilyn is computer illiterate! But we ARE gonna keep trying as we want you guys happy so you will help us nurse Little Boy back to heath.

Can I just tell you that Little Boy has been such a star in all this. It's as if he knows that we are looking after him. He lets us blood test him with no probs at all.
Marilyn
 
how long is it until your next shot is due? I want to read back through your threads and look at your spreadsheet a little more closely.

Am I reading correctly that Little Boy has had a history of ketones? Has he had DKA (Diabetic Ketoacidosis?).
 
Hi Marilyn,

The reasoning behind lowering the dose, from what I've been told here (someone can then chime in with a better, more educated answer than my newbie one) is that when you start them out on too high a dose, they go into "rebound". Their bodies panic at the sudden amount of insulin, and dump more glucose into the blood, leading to very high BG levels. My vet started me on 3 units twice faily of Novolin, and then after two weeks his BG was much higher than at diagnosis. The vet increased to 5 units twice daily. It wasn't until I started decreasing his dose that I got better numbers. Switching to an even lower dose, and of Lantus instead of Novolin, also helped. Still have a long way to go though, as you can see from my spreadsheet. But let's just say I'm no worse off on less insulin than I was on more!

Hope this helps,

Sophia
 
another question (or two) - are you generally home to test during the day? What about after the evening shot?

I'm concerned about ketones too, that's why I'm asking questions, to help figure out the best way to proceed with Little Boy's dose.
 
Libby and Lucy said:
another question (or two) - are you generally home to test during the day? What about after the evening shot?

I'm concerned about ketones too, that's why I'm asking questions, to help figure out the best way to proceed with Little Boy's dose.
Click to expand...
and another question...
you mentioned fatty liver disease. is little boy eating well now?
 
Marilyn:

There are times when backing down on an initial dose makes sense. When there are issues with ketones, we proceed very cautiously since the insulin fights off the ketones. At this point, now that there's more information consolidated here, I'll defer to Jill and Libby. They are very experienced and will help you get the dose established. The primary issue is keeping Little Boy healthy and safe.

(And if you let us know what the glitch is with the Profile, maybe we can help with that, too! There are some very tech savvy people here.)
 
you mentioned you are feeding raw food - which one out of curiosity? Or are you making homemade?

Raw food is a perfectly acceptable diet for kitty, just make sure it's low carb.
 
Results indicate dehydration, stress, mildly ketoacidotic diabetes melitus and probable fatty liver. (THIS IS WHAT THE LAB TEST SAID)

The spread sheet automatically put the BG evening test in the wrong place - there is no box for the time we test. We test about 3 minutes before giving insulin at 7.130 pm. WE ALWAYS TEST PRIOR TO EVENING INSULIN. It doesn't mean anything to us but we do it coz it will give you guys the information you need. At this point we are too ignorant to know what it means. Slowly but surely we are putting the puzzle together but there is no real picture emerging yet for us. We are retired so we can test thru the day depending on our commitments away from home. We can't stay up too late to test because we need sleep. We are often up very early for LB.

Yes we are open to dose lowering now that we understand why. We had a lot of suggestions to lower the dose as soon as we joined the forum but we were unable to process the information as to why at that time. Even now we are nervous because of ketones. We are picking up 10 ketone testing strips this afternoon - cost $26AUD. Not cheap.

Little boy is eating well.

It seems that we may have forced LB's glucose production in to over drive. We will test for ketones in blood tonite and if they are present then should we reduce insulin to 2 units or leave it at current level of 3 units?


5.5 hrs till next shot. I can hold off till 8pm to see what others think. I can BG test at 7pm and also test ketones and report in- someone may be up and about in the US by then. @-)

thanx everyone. I really DO get how helpful this site is. It's fantastic really!!
 
I'm actually not convinced you should decrease the dose with a ketone prone cat. Normally, a cat who is just starting out would be fine to go back down to 1 unit, and that would save some possible grief for you in the future (if you start over, you'll know FOR SURE that you built up to your dose according to protocol so you'll know you didn't bypass the right dose). In most cases that is the right advice.

With ketones as a possibility, the rules change. Ketones sort of force us to be more aggressive. What I would do, and you can take this if you want or you can leave it, would be to *increase* his dose. With a ketone prone cat, we want to get them out of the pink as quickly as we can safely do so. BUT - I also suggest going out TODAY and buying high carb wet food, if you don't already have any. That is the best tool for bringing up low numbers and for controlling the curve.

However, if you're going to keep or raise his dose, you NEED to be more aggressive about testing. When the numbers do break, they usually do so all of a sudden. That's a good thing, as long as you are testing and can catch it. I would get some mid-cycle checks in every cycle, whenever you can get them. Once the numbers break, Little Boy might need to move down the dosing scale quickly. Often we climb up to a good dose, then they start getting low numbers and earn several reductions in quick succession. You can look at Lucy's spreadsheet to see how that happened for her. Post here daily and we can help you interpret the patterns and see what is going on. Safety is the first priority, but that includes safety from low numbers AND safety from ketones.

Questions?
 
and by increasing the dose, I only mean increasing to 3.25, to get a little more insulin on board without giving too much.
 
Anyname said:
Results indicate dehydration, stress, mildly ketoacidotic diabetes melitus and probable fatty liver. (THIS IS WHAT THE LAB TEST SAID)
----
We will test for ketones in blood tonite and if they are present then should we reduce insulin to 2 units or leave it at current level of 3 units?
Click to expand...

Totally agree with Libby (she types faster than me) if you see ketones, I would NOT lower your dose at this point. Do your best to keep Little Boy hydrated, fed and keep giving insulin. Anything above trace ketones should have a vet appointment.

Ketones signify - lack of sufficient insulin (natural or exogenous.)

When you determine Little Boy has no ketones, then you can discuss when would be a proper time to lower the dose.

Good luck and I hope the tests are clear of ketones.
 
::::::::::::With ketones as a possibility, the rules change. Ketones sort of force us to be more aggressive. What I would do, and you can take this if you want or you can leave it, would be to *increase* his dose. With a ketone prone cat, we want to get them out of the pink as quickly as we can safely do so. BUT - I also suggest going out TODAY and buying high carb wet food, if you don't already have any. That is the best tool for bringing up low numbers and for controlling the curve.

We are using a syringe and not a pen at this time. Dosage is difficult to measure accurately. Will go out now and collect ketone strips and also call by the vet to see if the pen is in yet.

I don't get why I would want to introduce high carb wet food. You are telling me that if I gave LB carbs (wet) it will bring his level of BG down? OK.

David did the profile. So little fuss this time. Dunno what came over him!!! The SS is now converted to US figures and now it's all about Little Boy. He looks exactly like Big Mac.

Marilyn
ps don't worry, I will be checking in every day to seek help/advice!
 
Anyname said:
We are using a syringe and not a pen at this time. Dosage is difficult to measure accurately. Will go out now and collect ketone strips and also call by the vet to see if the pen is in yet.
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no, do not waste your money buying the pen. the pens will only dispense insulin in increments of whole units. dispensing in whole units works great with humans, but not so well with cats when we're measuring such tiny doses.

instead, use U-100 syringes marked with half units. to measure 3.25 units, you would draw up the insulin to halfway between the 3u and 3.5u mark on the syringe. many of us use a magnifying glass and/or a pair of reading glasses to help us draw doses accurately.

the STICKY: LANTUS & LEVEMIR - NEW TO THE GROUP? PLEASE READ... contains some pictures and explanations of fine dosing.

i'm glad you're picking up some ketostix so you can check LB's urine for ketones.
i simply use a long handled soup ladle to collect urine when i check my kitty.


I don't get why I would want to introduce high carb wet food. You are telling me that if I gave LB carbs (wet) it will bring his level of BG down? OK.
Click to expand...
we use high carb wet/canned food to bring numbers UP if the insulin is dropping the numbers too low. a teaspoon or two of high carb wet food will usually bump the numbers up if kitty is dropping too low.

if you haven't already, now is a good time to stock your HYPO TOOLBOX - tells you what to have on hand in case of an emergency.

speaking of emergencies, please print these out and keep them handy:
HOW TO TREAT HYPOGLYCEMIA - what to do if your kitty experiences a hypoglycemic event
- and -
LIST OF HYPO SYMPTOMS - some signs to look for.


David did the profile. So little fuss this time. Dunno what came over him!!! The SS is now converted to US figures and now it's all about Little Boy. He looks exactly like Big Mac.
Click to expand...
wonderful! a spreadsheet and profile will help others help you. LB must be quite the handsome kitty if he looks like Big Mac! :-D


ps don't worry, I will be checking in every day to seek help/advice!
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fantastic! hope to see you posting often...
 
HI Marilyn

I'm just clarifying the high carb wet food request. You will not feed this to LB. You just need to have it in the house on hand, just in case his numbers drop suddenly and you have a potential hypo on your hands. IF this happens, you can then post the number on the board and the members will guide you on using the high carb to bring his numbers back up safely. I had my high carb wet food in a sealed bag with the words "DO NOT FEED FOR HYPO"S ONLY" written on it.

The last thing you want is a cat going hypo, shops closed and no decent high carb food in the house to help him out of it. Although this might never happen, it's a precaution and is part of our "hypo kit".
 
Blood Ketone 0.1 (very low)
BG 318.6
lantus 3units. PMPS

suggestions welcome - details are on the spread sheet.

I got the message about high carb wet food now. We bought glucose powder to rub in his mouth for an emergency hypo attack.

Little Boy is the exact replica of Big Mac. Little Boy is a few months younger. He's probably a bit heavier too. Want to put a picture up but all our pictures can't be sized down to the size requirement for a picture.
 
The 17.7 is 319. Is this value your pmps BG?

Also, a presence of ketones does not mean you can lower the insulin, but I know really nothing about them as my two have always tested negative.

Would you be able to start a new thread for today, using today's date, cat name, ps ## - 6/21 Little Boy amps 319

if you are testing and the results are any amount of ketones, I think you need to address that issue.
 
Anyname said:
Blood Ketone 0.1 (very low)
BG 318.6
lantus 3units. PMPS

suggestions welcome - details are on the spread sheet.
Click to expand...
as suggested, please take the dose up to 3.25u at the next shot time. a blood ketone reading of 0.1 is low, but we don't want it to get any higher. you can also mix as much water into LB's food as he will tolerate. is LB eating well? more insulin + extra fluid + food will help to get rid of those ketones.

I got the message about high carb wet food now. We bought glucose powder to rub in his mouth for an emergency hypo attack.
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glucose powder or any sweet syrup such as honey, karo, or maple syrup are very effective in case of an emergency, but the effects do not last very long. having some high carb foods (usually foods with gravy) on hand will help you manage the curve. sometimes just a bit of the gravy from a high carb food is all it takes to bump the numbers up a little bit.

Little Boy is the exact replica of Big Mac. Little Boy is a few months younger. He's probably a bit heavier too. Want to put a picture up but all our pictures can't be sized down to the size requirement for a picture.
Click to expand...
we'd love to see him! perhaps one of us can help you out with pictures...
 
Yes he's eating well. Will test in the morning and then consider the higher dose. Thanks to the person who gave me the Australian link It's a little out of date. It's been a couple of years since fancy feast was 89 cents a can. Certainly feeling satisfied at how much we've achieved in 2 weeks.

Do their little ears end up all ragity? I was always proud that his ears never got damaged in his neighbourhood arguments over territory. (he considers the whole block to be his). Yes really want to put up a piccie - it's not like we don't have hundreds of pictures of him. Probably got more of him than we took of our children.

thanx everyone
marilyn
 
Marilyn, their ears don't get scarred up from testing. They may bruise once in a while if you hit the vein and/or don't apply pressure after but pinching the poked spot generally prevents even that. I tested Tugger a LOT while he was on insulin and you'd never know it to look at his ears today, or even during the process. The only bruise he ever even had was from when the darned vet used a giant needle and opened up the vein in his ear to get blood. Poor Tugger bled for five minutes and was bruised there for weeks.
 
I have increased to 3.25. Will go looking for the syringes that will provide us with a clearer marker for .25 extra amount. Ketone 0.1 again this morning. Anything else I need to be following up on? Will test as often as possible to keep an eye on levels.

Marilyn
 
Anyname said:
Do their little ears end up all ragity? I was always proud that his ears never got damaged in his neighbourhood arguments over territory. (he considers the whole block to be his). Yes really want to put up a piccie - it's not like we don't have hundreds of pictures of him. Probably got more of him than we took of our children.

thanx everyone
marilyn
Click to expand...
His ears shouldn't get raggedy, as Marvie said, just make sure to hold firmly for a few seconds after the poke to prevent bruising.

If Little Boy looks just like BigMac, then he must be a beautiful kitty... not that I'm biased or anything, hahaha! Had to laugh at the "hundreds of pictures... probably more than you took of your children."

Can I help you with re-sizing a photo for your Avatar? I'll send you my email in a private message. Look at the top of the page for messages - click on that.
 
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