Need Help:First time Lantus user!

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Shawny2u

Member Since 2010
Hello Lantus community,
I am a newbie and grateful to be here.
I just switched from the main health board to your side which I was told is the place I should make my postings.
I feel its important to transfer a few postings from the other side to show how I got to use Lantus instead of PZI which I used 4 years ago when my cat "Tubby" was very sick with this disease.
The followings are the events that led me to be here. I want to take this opportunity to thank everyone here for reading my postings to help if they have the time and patience with a newbie who has
a lot to learn yet.


My first posting Nov/2/2010
Hello board members, my male cat Tubby almost 11 years old (20LB) was off insulin for 4 years. His BGL was in 70-85 range for most of this time but two nights ago after coming back home from two month trip tested him and I was appalled by the new readings. His BGL read 367 I thought that must have been a mistake so tried 8 hours later and have realized by then he is back to his diabetes again. This morning I called his vet and asked for PZI insulin which he was on at the time, I was told PZI is no longer available. Tubby will be going for blood work at his vet clinic this morning. Could someone tell me whether it is true PZI is no longer manufactured? And what are the recommended INSULIN nowadays.
I am panicking and need your help here. I NEED HELP as how to resume his treatment or any advice at this point!!!!
Thank you in advance!
His BGL numbers fluctuated between 300-400 in last two days as I tested him at home.
 
My second posting Nov/3/2010

Just came back from his vet and he is recommending Lantus as a sub. for PZI.
as you all mentioned this particular insulin. Tubby was in good hands but I'm not sure what
they may have fed him despite my instructions on his diet. There are other issues with Tubby,
he was diagnosed with hyperthyroid and cardiomyopathy about a year ago which he is on
medication for them. However his teeth are in bad condition but they wouldn't recommend any
type of surgery due to his heart condition. This is his cardiologist's instruction and
she also mentioned when his heart becomes stronger they will consider surgery option.
He will be going on Lantus starting tomorrow when it is available to me. I will be reporting
his progress or lack of as I proceed with his treatment. I need to ask everyone's opinion
as how many unit/units I should start with keeping in mind that his BGL average is about
350 for the last 2 days. His vet recommended to start with 1 unit twice a day for a
week when the insulin will settle in. Then if he is not responding positively and/or his BGL
still high he will raise the dose and will keep it for another week. I'm not sure if this is the
proper way because 4 years ago the most effective method I learned after experimenting
several different ways of administering insulin, I kept his insulin level at the normal range at all time until his
pancreas kicked in and created adequate amount. Now is this something that anyone tried here or
what is to board member's opinion the most efficient method? I do understand that each cat
will respond differently and it could be a very tedious road ahead, believe me I was there before!
I do appreciate any inputs and thank you all for being so kind.
 
My third posting Nov/4/2010

Thank you for the info. his vet recommended lantus as the most common and very effective drug available nowadays. His numbers are still in mid 300s.
Because of his fructosamine being close to the normal range (lab result showed 502 for two weeks) his vet suggested to wait two weeks with high protein diet
which could possibly bring down his BGL to normal. I personally disagree with him but agreed to wait maximum of one week then proceed with the insulin. Any opinion on
what would be the proper way to handle his condition. Bear in mind that his numbers were consistent around mid 300s since I discovered he was in trouble.
He drinks very much just like he used to before, during the 2006 ordeal. BTW, this is very important to me as how much food he should be allowed per day. He is frantically hungry frequently and gained about 2LB during my absence which brings him up to 20LB. I do appreciate any inputs.
Thank you kindly,
 
Posting date Nov/5/2010

Thank you Sue, I am going to pick up his Lantus shortly to start the treatment. I feel nervous but have been
on this road before. But Lantus is a whole different drug than PZI, that troubles me not knowing much about it.
I have been reading a bit here and there about how different this insulin behaves but not enough to feel
confident about it. The fact that it would take much longer than PZI to see the fluctuation of his BGL.
Could someone tell me how much the cost of U100 syringes are? I forgot what they were, it has been a long time.
The local pharmacy is asking $46 for 100 of them and I believe that is way over priced, could someone shed
some light on that for me please.

Thank you in advance!
 
Hi All,

Shawn and I are working on a spreadsheet which should be up today. Here are her numbers:


11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

11/07 +11.5 338 8:24 am 1/3 cup raw chicken breast
11/07 PS +12 423 9:00 am 1.5 Unit Lantus[/quote]
 
Posting date Nov/6/2010

11/5 7:15 pm 398
He was fed dinner mostly chicken breast then right before his pre shot tested again.

11/5 9/15 pm 297 PS
1 unit injected

11/6 5:30 am 384

Its about 8:30 am and I'm getting ready to test him for hi PS. his vet said to give him 1unit every 12 hours.
Is that about right? With PZI I was injecting as soon as he was over 150 and it worked so well that his
pancreas kicked in after couple of months. I know Lantus suppose to be working differently.
Obviously 1 unit is not doing very much however his vet said it'll take 3 days to one week before this
insulin kicks in. I don't know how if that really would be the case. I wish the PZI was available!!!!
Question:
Is 12 hour period the way to go with Lantus?
 
hi

just linking your health thread for others: viewtopic.php?f=28&t=28853


11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

11/07 +11.5 338 8:24 am 1/3 cup raw chicken breast
11/07 PS +12 423 9:00 am 1.5 Unit Lantus

let me get this straight, you began lantus on 11/06 at 1u, and this morning you gave 1.50u? correct?
 
Posting date Nov/6/2010

I just finished giving his shot after testing. Followings are the results, rather disappointing numbers.
But again today is the first day and I'm hoping it will improve in time.

11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

Well, as you can see his numbers are very much the same except between 2 to 4 hours after his
pre-shot. Even then those numbers are significantly high.

Any interpretation is more than welcomed!!
 
Good morning,
I strongly believe 1 unit of Lantus is way too low, so I did increase his dose to 1.5 unit.
I do understand this particular insulin takes several days to have its full effect however
knowing Tubby I know he needed increased amount. I would like to make my postings
on Lantus group side, how do I switch to that side?

11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

11/07 +11.5 338 8:24 am 1/3 cup raw chicken breast
11/07 PS +12 423 9:00 am 1.5 Unit Lantus
 
Welcome to Lantus Land.

I had posted on one of your early Health threads so welcome to this side of the Board. I believe that I mentioned we are very numbers driven here and that we follow a specific dosing protocol. The information about how this Board works, how to handle Lantus, the Tight Regulation Protocol, and key concepts can be found in the sticky notes at the top of the Board. What will be critical is getting a spreadsheet set up and attached to your signature. I've linked the instructions.

Some of the basics to be aware of are in the protocol sticky:
Tight Regulation Protocol sticky said:
WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR...

* Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.

* It will be necessary to test kitty's blood glucose levels multiple times per day.

* Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.

* Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).

* Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.

* Feed a high quality low carb canned or raw food diet.

* Feed small meals throughout the day. Some kitties adapt well to free feeding.
Click to expand...

Please let us know what questions you have. The people here are very generous with their support and information.

To answer your questions:
Your vet is correct. It takes 5 - 7 days for Lantus to build a "shed." Lantus is a depot-type of medication. It requires a storage pool and it allows one dose to build on the next. It also makes it a much gentler type of insulin. It also means that it requires patience. The first dose is held for approximately one week. Other, subsequent doses are held for 2 - 3 days unless a low number dictates a change. You really need to hold the dose and not increase prematurely. However, the initial dose of Lantus can be based on a cat's ideal weight. (initial dose = 0.25 x ideal weight in kilograms)

Most importantly, Lantus dosing is not based on pre-shot numbers. Dosing decisions are based on the nadir.

Lantus is a twice a day insulin. Shots are given as close to every 12 hours as possible. Early or late shots have an effect on the shed and you effect the way the overlap between shots acts.
 
Ditto.
Print the protocol and put your patience cap on.
Lantus requires patience.
Doses need time to settle.
Shed needs to build up.
You're going to hear a lot of this, it's going to be overwhelming and all that, but you are in a good place here.


Protocol

Because of the increase this morning, you may have to monitor very closely.
Do you have high carb gravy wet foods? or are you just feeding raw?
plenty of strips?
 
Ronnie & Luna said:
Ditto.
Print the protocol and put your patience cap on.
Lantus requires patience.
Doses need time to settle.
Shed needs to build up.
You're going to hear a lot of this, it's going to be overwhelming and all that, but you are in a good place here.


Protocol

Because of the increase this morning, you may have to monitor very closely.
Do you have high carb gravy wet foods? or are you just feeding raw?
plenty of strips?
Click to expand...
Ronnie & Luna said:
hi

just linking your health thread for others: http://felinediabetes.com/FDMB/viewtopi ... 28&t=28853


11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

11/07 +11.5 338 8:24 am 1/3 cup raw chicken breast
11/07 PS +12 423 9:00 am 1.5 Unit Lantus

let me get this straight, you began lantus on 11/06 at 1u, and this morning you gave 1.50u? correct?
Click to expand...

That is correct, I think I should have started with 1.5 units to begin with. I will check him closely today. And thank you for paying attention to my case.
I do have plenty of FF gravy based can food, but I am trying to avoid those , perhaps they were one of the causes of his problems today!
 
Ronnie & Luna said:
Ditto.
Print the protocol and put your patience cap on.
Lantus requires patience.
Doses need time to settle.
Shed needs to build up.
You're going to hear a lot of this, it's going to be overwhelming and all that, but you are in a good place here.


Protocol

Because of the increase this morning, you may have to monitor very closely.
Do you have high carb gravy wet foods? or are you just feeding raw?
plenty of strips?
Click to expand...

I'm sorry if posting all over the place, just learning and don't know how to navigate yet.
Yes I do have plenty gravy based FF can food, but do you honestly think he will be needing that? Well,
I'm going to check his BG right now, its been more than 2 hours since the pre shoy.
 
Hi and welcome to Lantus Land! :mrgreen:
We only use the high carb gravy form the canned foods in case we see very low numbers but we use LC food for meals and snacks. What food were you feeding previously? What type of LC food do you serve now?

Wondering what your kitty's name is and yours too....

As others have said, this does take patience. Lantus is very different from PZI so try to forget a lot of what you remember from that insulin and read the protocol information that Ronnie linked for you. We have noticed that many kitties do have elevated numbers if they have dental issues. Inflammation and infection can elevate the numbers so until they are resolved, the BGs might be rather high. It is good that you caught his elevated numbers and got right back into doing something about it! I am sorry you have to be dealing with this again, but we are here and will try to help you in any way possible!

Please work on getting your spreadsheet working. We can only help if we can click on a SS to see the numbers, ok?
You are doing great...home testing is so important and you are well prepared. Please post any questions you have here in this condo (thread) There are many experienced people here who will be here to help... :mrgreen:
 
Welcome to LL, Shawn. I'm glad you found us. We are also former PZI users and Lantus is different, so I hope you've been doing your homework and reading all the stickies. You will find a lot of support here in this group. I wanted to tell you that I think the $40 for syringes is way to much. If you go to hocks.com (link is at top of the page) you can get syringes much cheaper there. I recently switched from Walmart's Relion to Monoject, but I also bought the GNP brand and they are a little cheaper than Monoject and I think they are identical. I've had much better luck getting the bubbles out with the Monoject.

I hope Tubby will get back to good numbers soon.
 
Powder and I welcome you and Tubby. The advice you are being given is good. My cat, though struggling for more even numbers has improved so much. His coat is getting it's bloom back and he is up and about more. Lantus will take time to lower BGs but in time it will. The adviser's here will be there for you and every one will support you.
 
Welcome! Lantus does take a little time. Be patient. Look at Sue's spreadsheet if you want to see how well Lantus can work! :)

Have you seen Janet and Binky's canned food chart? I use it and take it with me every time I go to the store. I try to buy varieties that are around 4 carbs. I also have to watch the phosphorous levels because I have a kitty with kidney disease as well.
http://binkyspage.tripod.com/CanFoodNew.html
I buy primarily:
Wellness Beef & Chicken, Chicken and Turkey
Merrick BG Beef and BG Chicken
Merrick Cowboy Cookout
EVO 95% Chicken, Beef and Venison

Sometimes I buy FF or Friskies as they tend to get sick of the expensive stuff and I use the cheaper stuff because they tend to like it more.

Good luck and I hope your kitty feels better soon!!!!
 
I am trying to understand how this insulin works. With all your highly valuable experience and knowledge
I feel so much better having such network of support. I begin to realize maybe raising his does by .5 unit
was hasty, the question I have now is whether it he should go back to 1 unit on his next shot or keep on
with 1.5 unit. He had 1.5 unit only this morning. Keeping in mind that hypoglycemia is not a possibility
in his condition. In fact after 1.5 unit you can see his numbers which are slightly higher than yesterday.
I have tested him again since someone here mentioned the nadir with Latus usually occurs 6 hours after
the shot. I did test him a few minutes ago, it was 310. below you'll see his today's numbers.

11/07 PS +12 423 9:00 am 1.5 Unit
11/07 +3.5 323 12:23 pm
11/07 +6.5 310 3:26 pm

There is one important factor here that I would like to share with this thread and ask anybody who has
any opinion please share it with me.
Tubby was diagnosed with hyperthyroid and cardiomyopathy about a year go or so. Unfortunately I didn't know
the symptoms and perhaps his thyroid level was too high for too long. He is on medication for these conditions
and is under control. BTW, if anyone cares to know the drug he is taking I would be more than happy to post
them as well.
My question is could his medication interact with insulin? If so, what are the alternatives.
He is acting well and does not seem to be sick at all.
Thank you all in advance,
Shawn & Tubby
 
Went back to 1 unit and will stay there until his BGL allows the dose to change.

11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

11/07 +11.5 338 8:24 am 1/3 cup raw chicken breast
11/07 PS +12 423 9:00 am 1.5 Unit Lantus
11/07 +3.5 323 12:23 pm
11/07 +6.5 310 3:26 pm
11/07 PS +12 366 8:82 pm 1 U
 
Without knowing the medications that Tubby is on, there's no way to know about interactions. However, unless you have different vets prescribing and none of the vets communicate with each other, I would doubt there's a drug interaction. If you live anywhere near a vet school, they undoubtedly have a veterinary pharmacy. Call and talk to a pharmacist at the vet school. They love these kinds of questions! They live for these kinds of questions!!
 
welcome to Lantus Land!

Keep posting, ok? We'll help you keep an eye on the numbers and we can help interpret them too.
 
Sienne and Gabby said:
Without knowing the medications that Tubby is on, there's no way to know about interactions. However, unless you have different vets prescribing and none of the vets communicate with each other, I would doubt there's a drug interaction. If you live anywhere near a vet school, they undoubtedly have a veterinary pharmacy. Call and talk to a pharmacist at the vet school. They love these kinds of questions! They live for these kinds of questions!!
Click to expand...

Thanks for the tip, I will do that today if find a vet school. Live in DC, anyone knows of any vet school around here?
 
Libby and Lucy said:
welcome to Lantus Land!

Keep posting, ok? We'll help you keep an eye on the numbers and we can help interpret them too.
Click to expand...

Its nice to hear paople are paying attention and watching Libby, thank you!
 
11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

11/07 +11.5 338 8:24 am 1/3 cup raw chicken breast
11/07 PS +12 423 9:00 am 1.5 Unit Lantus
11/07 +3.5 323 12:23 pm
11/07 +6.5 310 3:26 pm
11/07 PS +12 366 8:82 pm 1 U

11/08 +9 364 5:49 am

Too early to concentrate but mid 300 is the magic number with Tubby, doesn't seem like goes anywhere !
 
hi, guys! i've been a little absent last few days, so just got here to say welcome!

you have found a wonderful resource here... folks here are very knowledgeable, and extremely helpful and supportive!

celi & binks
 
mybuddybinks said:
hi, guys! i've been a little absent last few days, so just got here to say welcome!

you have found a wonderful resource here... folks here are very knowledgeable, and extremely helpful and supportive!

celi & binks
Click to expand...



Thank you, I am happy to hear!
 
***Day one***
11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

***Day two***
11/07 +11.5 338 8:24 am 1/3 cup raw chicken breast
11/07 PS +12 423 9:00 am 1.5 Unit Lantus
11/07 +3.5 323 12:23 pm
11/07 +6.5 310 3:26 pm
11/07 PS +12 366 8:82 pm 1 U

***Day three***
11/08 +9 364 5:49 am
11/08 PS +12 388 9:03 am 1Unit
 
Any word on that spreadsheet (SS)? That would really be a good thing to get done soon, if you can (for the dosing gurus, I mean)...
 
In the link from the Tech Support center, there are instructions on how to link the SS to your signature. It's easiest to keep it there rather than as a post in your condo.
 
sorry to report that my spreadsheet encountered some technical difficulties and failed
to work. Unfortunately I was too busy to work on it but will be glad to hear any suggestions.
However until getting the spreadsheet available I'm afraid you have to put up with my
manual test results. I've been posting the results daily to show his progress or lack of.
I think it would be a good idea to have the whole first week test result in as it goes on.

As it shows the numbers are very steady and has been since day one. I'm not sure whether
this is the way Lantus suppose to work or something needs to be re-analyzed?
I would like to hear from people here if they have or had the same responses.
Is it time to raise the dose or wait longer? Some of you said in earlier postings the "shed" must be
built. Does anyone know how long it takes to reconsider the insulin doses? Obviously 1 unit
kept him at mid 300s and did not even fluctuate between pre-shots. You may look at the
first three days to observe insulin is not doing much. (BTW, couple of days before using any insulin his BG numbers were about the same)

I will be talking to his vet after 7 day insulin shots, but your opinions as being in
the same predicament as I am will be far more valuable than any vets to me!
Thank you in advance for contributing!

***Day one***
11/06 PS +12 376 8:56 am 1U
11/06 +2 271 11:05 am
11/06 +4 255 1:00 pm
11/06 +6 380 2:58 pm
11/06 +8 365 5:10 pm
11/06 PS +12 386 9:05 pm 1U

***Day two***
11/07 +11.5 338 8:24 am 1/3 cup raw chicken breast
11/07 PS +12 423 9:00 am 1.5 Unit Lantus
11/07 +3.5 323 12:23 pm
11/07 +6.5 310 3:26 pm
11/07 PS +12 366 8:82 pm 1 U

***Day three***
11/08 +9 364 5:49 am
11/08 PS +12 388 9:03 am 1Unit
11/08 +6 293 3:01 pm
11/08 +12 372 8:53 pm 1 Unit

Clock was turned by on e hour

****Day four***
11/09 PS +13 385 9:57 am 1 Unit
11/09 PS +10 348 7:55 pm 1Unit

***Day five***
11/10 PS +13 321 8:54 am 1 Unit
11/10 PS +12 321 8:34 pm 1 Unit

***Day six***
11/11 PS did not test 10:50 am 1 Unit
11/11 PS +10 307 8:43 pm 1 Unit

***Day seven***
11/12 PS +12 349 8:50 am 1 Unit
 
Hi welcome.
Sorry about your spreadsheet problems.....I hope you can have that fixed soon.

We open a new thread (called a condo) each day so that one does not get lost or too long.
You can put the date, kitty's name and AMPS (AM pre-shot number) in the subject line it would be helpful for those that would like to help you out. We use PMPS for the evening pre-shot. (PM pre-shot number)
For example: 11/12 Fluffy AMPS 250. If you need help with dosing etc. you can also put something like "dosing help." in the subject line.


What is your kitty eating and what is the feeding schedule?
I noticed that you have a lot of testing data for the daytime but are you able to get any tests at night? Those nightime tests often give a lot of data that we don't see during the day.

Keep posting and asking questions. :mrgreen:
 
I would strongly suggest posting your spreadsheet problem over in Tech Support. I didn't notice that you'd asked for assistance there. They can help you with getting your SS linked and published.

It would also help if you set up a Profile. The instructions are also in the Tech Support forum.
 
Sienne and Gabby said:
I would strongly suggest posting your spreadsheet problem over in Tech Support. I didn't notice that you'd asked for assistance there. They can help you with getting your SS linked and published.

It would also help if you set up a Profile. The instructions are also in the Tech Support forum.
Click to expand...

I will do that as soon as find time but no later than this weekend!
Thank you.
 
Miriam and Putty said:
Hi welcome.
Sorry about your spreadsheet problems.....I hope you can have that fixed soon.

We open a new thread (called a condo) each day so that one does not get lost or too long.
You can put the date, kitty's name and AMPS (AM pre-shot number) in the subject line it would be helpful for those that would like to help you out. We use PMPS for the evening pre-shot. (PM pre-shot number)
For example: 11/12 Fluffy AMPS 250. If you need help with dosing etc. you can also put something like "dosing help." in the subject line.


What is your kitty eating and what is the feeding schedule?
I noticed that you have a lot of testing data for the daytime but are you able to get any tests at night? Those nightime tests often give a lot of data that we don't see during the day.

Keep posting and asking questions. :mrgreen:
Click to expand...

He eats mostly chicken breast and low carb Fancy Feast can food. No dry food, I will adjust his dose by tomorrow morning
if his number remains in the same neighborhood. Will bump it to 2 units for another week to see whether he
would respond positively.
I did put the dosing question forward but no one responded. I hope 2 units start to make some movement!

I will try the condo but I'm not that familiar with this site, hope it works.
Thank you for your advice!
Shawn
 
Shawny2u said:
He eats mostly chicken breast and low carb Fancy Feast can food. No dry food, I will adjust his dose by tomorrow morning
if his number remains in the same neighborhood. Will bump it to 2 units for another week to see whether he
would respond positively.
I did put the dosing question forward but no one responded. I hope 2 units start to make some movement!

I will try the condo but I'm not that familiar with this site, hope it works.
Thank you for your advice!
Shawn
Click to expand...

Shawn,

I'm glad to hear that Tubby is eating low carb Fancy Feast can food and no dry food. I hope the chicken breast you are feeding him is a relatively small part of his diet, since plain meat is not a complete diet. It's fine as long as you are just using it to supplement, not as the main part of his diet.

I see the link to your SS in your signature, but it doesn't work. I'm glad to see you are trying to get the SS working, that will help A LOT!

Regarding dosing, please do NOT increase his dose to 2 units! The protocol we use here calls for small dose increases, usually 0.25u at a time, to ensure that you will not over shoot the dose he needs. Have you read the stickies at the top of the Lantus forum? If not, please do! The protocol is here: viewtopic.php?f=9&t=1581&start=0 You will notice in looking at it that we adjust dose based on the nadir, or the lowest point in the cycle. The last few days of data, I only see preshot data. It's very important to get those preshot tests so that you know if it's safe to give the insulin, but in order to see if Tubby needs a dose increase, you need to collect some tests in the middle of the cycles too, ok? So please try to get some more tests and post them and we can talk about his dose. In the meantime, please keep his dose at 1 unit.

Are you testing for ketones? If not, please get some ketostix at the pharmacy and start testing. It's important to know if he has ketones.
 
Tubby eats fancy Feast to get the nutrition he needs, chicken breast is not all he is currently eating but I have raised his chicken intake as
new diet. I had a conversation with his vet this morning regarding his situation. He did suggest to raise the insulin to two units. According to his
statistics every unit will drop his BG numbers by 100 points at his nadir. I tend to agree with him, so this morning he received 2 units of Lantus
and I'll spot check every two hours which results will be posted here. I do appreciate comments and any thoughts that might be useful in helping
my cat. BTW, his vet firmly believes I must wait 7 days before changing his dose. As some of you mentioned earlier that this particular insulin
takes time to show results. In around 6 hours when his lowest point give and take an hour which is most crucial I will be testing.
Ladies and Gentlemen, I do thank you for looking!


11/12 PS +12 351 8:02 pm 1 Unit

***Day 8***
11/13 PS +12 331 8:35 am 2 Units
11/13 +2 340 10:40 am
 
Shawny

Welcome to Lantus Land. Our motto here is "start low, go slow"; I'm not a dose advisor but that seems like a big jump in a new kitty. Just as an example, I started my girl at .5u bid and very slowly worked up to 1.25u doing it .25u at a time but waiting a minimum of six cycles with no action before raising it...we did go up and down a bit and that's kind of how it seems to work; in LL you'll often hear that you have to go up to come down and I have found this to be true. The other thing I've found to be true is our advisors have so much more knowledge of Lantus and experience in recommending how to dose it. There is someone here almost 24/7 which you can't get with your vet. Absolutely, he needs to know what's going on...my vet stays up on what we're doing by me allowing her access to my google spreadsheet but she does not get involved in our dose changes...I work on that with the advisors. The advisors aren't just people like me ....they talk to each other, they review SSs together, they know which cats need extra watching, they monitor all that goes on and they are experienced with Lantus...they know the intricacies of it and they can quote the protocol and have used it on their own cats. I hope you stay around and take their advice. They have gotten alot of cats off the juice!!

Good luck!! And I'd be sure and do a lot of testing to monitor what he does on this new dose...it might take a bit to see the effects as his shed fills.
 
Hello, I have been trying to publish the spreadsheet for days now. I even had help from one of
members with more experience but keep having trouble with my Google account "confirmation"
message in order to activate the account. Trouble is I do not receive that confirmation message!
Would someone here please look into this problem and guide me to right direction?

Thank you in advance,
Shawn
shawny2u Tubby's spreadsheet


https://spreadsheets.google.com/pub?key ... html&ui=1#
Shawny2u

Joined: Tue May 04, 2010 7:59 am
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Re: Need help with spreadsheet!
by Sue and Oliver » Sat Nov 13, 2010 10:39 am

I'm the one who has been trying to help Shawn. I set up the account on my computer but signed on with a yahoo email account of his and his password. As Shawn said, he kept getting the message from google. As did I each time I signed in as him.
 
Check that the confirmation messages from Google docs aren't going into your Spam or Junk mail folder?

Also your URL in your Sig isn't right - looks like maybe you don't have the whole URL in between the and tags?
 
Marjorie and Gracie said:
Shawny

Welcome to Lantus Land. Our motto here is "start low, go slow"; I'm not a dose advisor but that seems like a big jump in a new kitty. Just as an example, I started my girl at .5u bid and very slowly worked up to 1.25u doing it .25u at a time but waiting a minimum of six cycles with no action before raising it...we did go up and down a bit and that's kind of how it seems to work; in LL you'll often hear that you have to go up to come down and I have found this to be true. The other thing I've found to be true is our advisors have so much more knowledge of Lantus and experience in recommending how to dose it. There is someone here almost 24/7 which you can't get with your vet. Absolutely, he needs to know what's going on...my vet stays up on what we're doing by me allowing her access to my google spreadsheet but she does not get involved in our dose changes...I work on that with the advisors. The advisors aren't just people like me ....they talk to each other, they review SSs together, they know which cats need extra watching, they monitor all that goes on and they are experienced with Lantus...they know the intricacies of it and they can quote the protocol and have used it on their own cats. I hope you stay around and take their advice. They have gotten alot of cats off the juice!!

Good luck!! And I'd be sure and do a lot of testing to monitor what he does on this new dose...it might take a bit to see the effects as his shed fills.
Click to expand...

Thank you for your advice, I do read everything and pay special attention to people who are willing to express their opinion.
Unfortunately I am not lucky enough to have many experts' opinion as of yet, I don't undermine those who were gracious enough
to share their experiences so far. I do appreciate their inputs but frankly I have not had any serious talk to anyone on this thread
about Lantus dosing. I have listened to those who explained how this insulin works by building up "shed" in a week or so. That's
exactly what I followed plus consulting with Tubby's vet. I have raised his dose today and I know many here disagree with such
aggressive increase. But I have gone through with Tubby's diabetes 4 years ago, even though Lantus is a different drug but his
reaction just like different cats have different threshold and react differently, my cat has high resistance to insulin until the
right dose is being administered. I do welcome any scientific arguments and guidances more than anything if I had one interested
enough to come forward. Currently Tubby is on low carb high protein diet with no dry food. He is being tested every 2 hours or so
with every new dose to make sure he is not in any danger of hypoglycemia keeping in mind that each dose increase will go through
7 day cycle.
I am new here and have a lot to learn yet, frankly i thought there would be more exchanges than what I had but again I understand
people have their own full schedule and I'm grateful to have people like yourself taking time talking to me.
Unfortunately my spreadsheet encountered all sorts of problems and as I write to you now my technical problem is posted all over
the place including the "tech support thread".
I think maybe most people do not bother if the spreadsheet is not available but I do try my best and post his test result manually here
as I go along.
Hopefully when I get the spreadsheet problem resolved I will have more people to look at Tubby's struggle with this dreadful disease.

Thank you for chatting with me,
Shawn
 
Latest test results after 2units of Lantus.

11/12 PS +12 351 8:02 pm 1 Unit

***Day 8***

2 Units injected

11/13 Tubby AMPS 331 +2 340 +4 297 +6.5 263 +8 324
 
Of the people who have responded to you in this condo so far, Libby, Sienne, Miriam, Laurie, Pat, Ronnie are some of our most experienced folks and there are many others who have not yet chimed in. I can only guess that the biggest problem is getting a SS going so they can look at the trends in a more productive way. Also, even if you can't get a SS going (not sure why), then opening the condos as suggested each day will really help. So, I would suggest that you open a new condo for today and in the subject line put:

11/13 Tubby AMPS 331 +2 340 +4 297 +6.5 263

In the area where you write the text, put "previous condo" and then copy and paste this link:
viewtopic.php?f=9&t=29234

Tonight when you get his PMPS, then open up the new condo you created for today, hit the "edit" button, take out all the info from AMPS on and put in "PMPS xxxx" and start over again. Hit "submit". Then go back in and reopen the same condo and in the large text space, I would suggest you recap the morning numbers and put any questions you have.

Is this what you've been using to try and set up your SS?

eta: cool, WCF!!! We cross posted but I can look at Tubby's SS.

viewtopic.php?f=6&t=18207

It's really important that you get the link that looks like this (as an example): http://spreadsheets.google.com/pub?key=p4nuph4W6EFUSqZA10igCfg&output=html
I'm trying to find a post I sent to another newbie with a little more straightforward directions and if I can, I'll send it to you. Pls hang in there with us.
 
Marjorie and Gracie said:
Libby, Sienne, Miriam, Laurie, Pat, Ronnie are some of our most experienced folks. I can only guess that the biggest problem is getting a SS going so
they can look at the trends in a more productive way. Also, even if you can't get a SS going (not sure why), then opening the condos as suggested each
day will really help. So, I would suggest that you open a new condo for today and in the subject line put:

11/13 Tubby AMPS 331 +2 340 +4 297 +6.5 263

In the area where you write the text, put "previous condo" and then copy and paste this link:
http://felinediabetes.com/FDMB/viewtopi ... =9&t=29234

Tonight when you get his PMPS, then open up the new condo you created for today, hit the "edit" button, take out all the info from AMPS on and put in "PMPS xxxx" and start over again. Hit "submit". Then go back in and reopen the same condo and in the large text space, I would suggest you recap the morning numbers and put any questions you have.

Is this what you've been using to try and set up your SS?

eta: cool, WCF!!! We cross posted but I can look at Tubby's SS.


Thank you, it looks much better your way, I'll try implementing it.

http://felinediabetes.com/FDMB/viewtopi ... =6&t=18207

It's really important that you get the link that looks like this (as an example): http://spreadsheets.google.com/pub?key=p4nuph4W6EFUSqZA10igCfg&output=html
I'm trying to find a post I sent to another newbie with a little more straightforward directions and if I can, I'll send it to you. Pls hang in there with us.
Click to expand...
 
Shawny2u said:
Tubby eats fancy Feast to get the nutrition he needs, chicken breast is not all he is currently eating but I have raised his chicken intake as
new diet. I had a conversation with his vet this morning regarding his situation. He did suggest to raise the insulin to two units. According to his
statistics every unit will drop his BG numbers by 100 points at his nadir. I tend to agree with him, so this morning he received 2 units of Lantus
and I'll spot check every two hours which results will be posted here. I do appreciate comments and any thoughts that might be useful in helping
my cat. BTW, his vet firmly believes I must wait 7 days before changing his dose. As some of you mentioned earlier that this particular insulin
takes time to show results. In around 6 hours when his lowest point give and take an hour which is most crucial I will be testing.
Ladies and Gentlemen, I do thank you for looking!


11/12 PS +12 351 8:02 pm 1 Unit

***Day 8***
11/13 PS +12 331 8:35 am 2 Units
11/13 +2 340 10:40 am
Click to expand...

I wish it were as simple what your vet has said....unfortunately it isn't. Have you looked at the stickies and links that others have posted for you? In case you are having difficulty with it, here's the text of the stickie about the shed, along with the link. (emphasis added by me)
There's a storage shed/insulin depot under your cat's skin. It has first dibs on the insulin. Once it is filled, the insulin that you shoot doesn't have to go into the shed. It can be used. The shed HAS to be filled before the Lantus or Levemir gets to use the extra on cat's BGs. So by skipping shot, or waiting too long to shoot, or giving a fur shot... the cat starts dipping into it's shed and the next shot or shots have to partially go to refilling shed before they can work on BGs.

When you get impatient and overfill the storage shed by upping the dose too fast, you get into a situation where at first it looks like nothing is happening because the shed is still filling up. Then you reach the point where it is totally full and yet you are still giving a dose that's too high. Now suddenly none is going into shed, because that is full. It is all working on the cat... and the numbers drop out on you.

Worse case scenario is when you over fill the shed/insulin depot... get very low numbers... then empty out shed by dropping dose too much... or having to skip the shot. Then you'll see high numbers from the combo of the effects of rebound and an empty storage shed/insulin depot. Most react by bumping the dose back up which overfills the shed/depot again resulting in a roller coaster ride to nowhere. Not the way to work this insulin.
Click to expand...

Storage Shed Stickie

You need to increase by small increments so that you can allow the shed to fill again in between adjustments, and then see if another adjustment is needed. If you go up by full units, you run the risk of overdosing your cat. The protocol we use here is geared toward getting your cat regulated as quickly and safely as possible.
 
As Marjorie said, I find it difficult to follow numbers in a piecemeal fashion. Having a SS to look at and seeing what you're doing with dosing will help. I'm not willing to engage in a discussion of dose, scientific or otherwise, without having the data. If it's not already obvious, this forum is rather data driven. I would also point out that understanding the principles of a randomized clinical trial is one thing. Applying it to an individual situation is often an entirely different matter. Not every protocol generalizes exactly as written to any one individual whether that individual is a human or a cat.

I would also not discount the amount of input you've received. There is a great deal more to managing FD than just the numbers. The members here are exceptionally generous with their support as well as their knowledge. Not everyone has access to a medical/veterinary library system. As I noted, any one person's experience with their cat may be very helpful to yours, or it may not.
 
And I just want to clarify....we have alot of extremely experienced people in Lantus (not me) and the ones I listed are just the ones who have already visited your
condo today....but there are many others...too many to name but you will learn who they are if you hang around.
 
hey Shawn i just checked your ss. it is publishing. go ahead and update with data since 11/8, and the rest of the peeps here should be able to see it. sent you a pm too, when you get a chance, take a look at that, k?
 
Just want to add when you get your ss running please start a new thread. This one is getting too long and it is about a week old.
You just click "new topic" and put the date and Tubby's name in the subject line. We can help you from there.

Thank you.
 
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