New (continued) Monica & Mia

[Suzanne & Darcy]

It looks like your new syringes hold 1 mL (looking at the photo of the bag. )Correct? I cannot read the numbers on the syringe itself because the photo is too blurry. Do they have a number up to 100 on the side? If they hold 100 units then that is a lot more than you will need. The ones I have are 3/10 mL and hold up to 30 units of U-100 type insulin. A smaller U-100 syringe that holds a smaller amount of insulin (cubic centimeters or milliliters) will be easier for you to read the marks on the side of the barrel - and you need the half unit markings on the barrel so that you can make small adjustments to the dose in .25 units.

 

[Suzanne & Darcy]

As for how to draw the insulin out of the vial, you will do it the same way you currently draw out the insulin from your Caninsulin, by first drawing back the empty syringe to the desired dose, injecting the air into the vial and then drawing back the plunger to the correct dose. If you draw too much, by the way, squirt out the excess into the air or onto a towel because you don’t want to re-inject it back into the vial. The inside of the barrel of the insulin syringes have a silicone coating and you don’t want to risk contaminating the Lantus.

When using an insulin pen, you also draw it out using a syringe just like with the vial, but you do not inject air into the pen. The syringe is simply inserted into the pen and drawn back to the correct dose. The pens work on a negative pressure principle so they don’t need air injected into them. I didn’t mention the pens before because you said you were told the Lantus was only available in vial form there. Either one will work for you.

 

[Bron and Sheba (GA)]

 

[Suzanne & Darcy]

I have just spoken to another member of the forum that is also located in Malta

Stefania? I haven’t spoken with her in a while, but she is a lovely person!

 

[MonicaT]

It will take about a week initially for the depot to build up in Mia — so we won’t see the full effect of the dose until about a week has passed.

@Suzanne & Darcy Not sure what you mean here? What is a depot? Is this in regards to her switching insulins? That I won't see any difference until a week after switching?

You are right about the syringes I bought yesterday, they are 1 ml/100U syringes. The number goes up to 100 and at the bottom it says i.u. on one side and on the other side it says 1ml on the same line as where it is marked with 100. So do you recommend I get the smaller syringes for the Lantus insulin like Stefania suggested too? She mentioned 0.3 ml syringes that she sent me a photo of. Is that the same as the ones you mention that are 3/10 mL?

I first only mentioned the vial as that is what the pharmacy i checked at yesterday said they could get, but seeing Stefania uses the pen, I assume I can get that ordered in too. Is there any reason why using a pen vs. a vial is better? Is it easier/cheaper/lasts longer or is it just preference?

 

[Bron and Sheba (GA)]

Yes please get the 0.3ml syringes. They are much better to use and more accurate.

 

[Suzanne & Darcy]

@Suzanne & Darcy Not sure what you mean here? What is a depot? Is this in regards to her switching insulins? That I won't see any difference until a week after switching?

You are right about the syringes I bought yesterday, they are 1 ml/100U syringes. The number goes up to 100 and at the bottom it says i.u. on one side and on the other side it says 1ml on the same line as where it is marked with 100. So do you recommend I get the smaller syringes for the Lantus insulin like Stefania suggested too? She mentioned 0.3 ml syringes that she sent me a photo of. Is that the same as the ones you mention that are 3/10 mL?

I first only mentioned the vial as that is what the pharmacy i checked at yesterday said they could get, but seeing Stefania uses the pen, I assume I can get that ordered in too. Is there any reason why using a pen vs. a vial is better? Is it easier/cheaper/lasts longer or is it just preference?

Yes. 3/10 and .3 would be the same. And I agree that those will be much better for your dosing.

 

[Suzanne & Darcy]

Not sure what you mean here? What is a depot? Is this in regards to her switching insulins? That I won't see any difference until a week after switching?

Here’s a sticky note about the insulin depot. Lantus is a depot insulin and so not the same as what you are currently using. I hope this will help explain.

https://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/

 

[MonicaT]

Here’s a sticky note about the insulin depot. Lantus is a depot insulin and so not the same as what you are currently using. I hope this will help explain.

https://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/

@Suzanne & Darcy Oh ok, just read through the link! Thank you for sharing, definitely good information to have
I have bought the .3 syringes now, but wanted to wait to buy the insulin until I heard back from any of you. Any thoughts regarding Lantus vials vs. Lantus pens? Pros and cons of both of them?

 

[Suzanne & Darcy]

I have used both vials and pens. I think I preferred the pens overall because of the ease of just sticking in the needle and drawing out the dose without messing around with injecting air into the vial. I think I got less air bubbles that way too. I always “felt” like the insulin would stay potent longer with a pen…. But that was just a feeling and I do not have scientific proof for it. ​

 

[Suzanne & Darcy]

What kind of numbers have you been getting in the last few days? I was looking at the spreadsheet but it’s not updated. I hope she’s been feeling better?

 

[JL and Chip]

Any thoughts regarding Lantus vials vs. Lantus pens? Pros and cons of both of them?

I’ve used both Lantus vials and pens.

The insulin is the same, it’s just that the vial contains more insulin than the pen—quite a lot more—and often times, with the low doses cats tend to need, the insulin in a vial loses efficacy before you’ve used if all (but not so often with a pen).

If you want the details: a vial of Lantus contains 10ml (at 100 units of insulin per ml, that’s 1000 units of Lantus), whereas a pen contains 3ml (300 units). You can often use the pen to the last drop. Plus, I found it easier to handle/work with the pen, found it easier to store, and was less likely to drop/break it. Just my personal preference, though. And at least where I live, the pens were sold in 5 packs so if one went bad or I did break it, I had another in inventory.

I’m glad you found the 3/10cc U-100 syringes. It might be a good idea to post a photo (or at least the wording from the package) just to double check that you have the correct thing.

 

[MonicaT]

What kind of numbers have you been getting in the last few days? I was looking at the spreadsheet but it’s not updated. I hope she’s been feeling better?

@Suzanne & Darcy I just updated the spreadsheet now she is still going very low so we reduced the dose again from 0.08 to 0.06. she just had another low BG of 1.8 3 hours after insulin. So will be reducing again to 0.04 for her next insulin shot

Will hopefully get the new Lantus insulin tomorrow

 

[Suzanne & Darcy]

Wow. She’s earning reductions like crazy. That’s actually fantastic. It’s a good thing you are keeping such close tabs on her BG. What are you doing when she has these low lime green numbers? Honey? What kind of high carb food.

 

[MonicaT]

Wow. She’s earning reductions like crazy. That’s actually fantastic. It’s a good thing you are keeping such close tabs on her BG. What are you doing when she has these low lime green numbers? Honey? What kind of high carb food.

Yes, always check extra often once she has had a low BG. Every 30min until I see it going up and staying up. I give her a pea size of honey on each side of the gums and then give her her usual wet food. Until today she has also been getting iron syrup supplement, so we would save that for when we check her BG at +3 and +5 Incase the numbers were low. Since it has quite some sugar I gave that in addition to or instead of honey. Haven't been giving her any high carb food. Gave her dreamies treats a couple of times, but most of the times just honey and her usual food

 

[Suzanne & Darcy]

I wish I could see a photo of Mia. It’s definitely good to check frequently whenever you catch a low enough glucose to warrant honey. The problem with simple sugars like honey or corn syrup is that they can wear off quickly and the glucose can drop back down. If you give a little bit of high carb food (a teaspoon) it will last a bit longer. And when you give honey to raise glucose then you should test for two hours after the last HC is given because they can drop back down again. You certainly have had a lot of practice already though in handling low numbers.

 

[MonicaT]

I wish I could see a photo of Mia. It’s definitely good to check frequently whenever you catch a low enough glucose to warrant honey. The problem with simple sugars like honey or corn syrup is that they can wear off quickly and the glucose can drop back down. If you give a little bit of high carb food (a teaspoon) it will last a bit longer. And when you give honey to raise glucose then you should test for two hours after the last HC is given because they can drop back down again. You certainly have had a lot of practice already though in handling low numbers.

@Suzanne & Darcy Yes definitely noticed the honey only lasts for a while, but I have been following up with food in addition to the honey so it has stayed up most of the times, even though it hasn't been high carb food.

I have been able to get hold of the insulin pens so will pick up later today, so hopefully will give her the first dose of Lantus today. I need help with dosing though. My vet told me to calculate 0.5 units per kg and she is approx. 3.6 kg right now, but I think that sounds like alot considering she is now down to 0.04 units of Caninsulin twice a day. So according to my vet I should start with Lantus at 1.8 units? Don't want to switch insulins until I am 100% sure about the dosage as I am terrified of giving too much since she is already going so low with the Caninsulin even at low doses. With new syringes and a new insulin I am so nervous about calculating the dosage wrong.

These are the photos of the new syringes I bought to start using with Lantus. And a photo of my two babies, Mia is black and white

 

[MonicaT]

I’ve used both Lantus vials and pens.

The insulin is the same, it’s just that the vial contains more insulin than the pen—quite a lot more—and often times, with the low doses cats tend to need, the insulin in a vial loses efficacy before you’ve used if all (but not so often with a pen).

If you want the details: a vial of Lantus contains 10ml (at 100 units of insulin per ml, that’s 1000 units of Lantus), whereas a pen contains 3ml (300 units). You can often use the pen to the last drop. Plus, I found it easier to handle/work with the pen, found it easier to store, and was less likely to drop/break it. Just my personal preference, though. And at least where I live, the pens were sold in 5 packs so if one went bad or I did break it, I had another in inventory.

I’m glad you found the 3/10cc U-100 syringes. It might be a good idea to post a photo (or at least the wording from the package) just to double check that you have the correct thing.

@JL and Chip I will go with the pens for now then and see how it goes! Will be picking them up later today.

 

[Suzanne & Darcy]

I would be very uncomfortable with you starting with 1.8 units. From the dosing methods information on the Lantus forum:

 

[Suzanne & Darcy]

And from the SLGS guidelines is also says:
Starting Dose:

• 1u BID if kitty is not on a wet/canned low carb diet
• 0.5u BID if kitty has been switched to a wet/canned low carb diet
• If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration

 

[Suzanne & Darcy]

You have two beautiful cats there! Which one is Mia and what is the name of the other kitty?

 

[Suzanne & Darcy]

Those are the correct syringes and it looks like they have half unit markings.

 

[MonicaT]

And from the SLGS guidelines is also says:
Starting Dose:

• 1u BID if kitty is not on a wet/canned low carb diet
• 0.5u BID if kitty has been switched to a wet/canned low carb diet
• If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration

@Suzanne & Darcy So Caninsulin is a shorter acting non-deposit insulin? don't understand the explanation of 90mg/l that is explained in the text. Not sure what you mean by BID either?

Mia is on a low carb wet food diet now.

I would love some specific recommendations for Mia based on her BG readings and current insulin dose of 0.04u caninsulin before switching, as I feel completely lost at where I should start considering her low BG numbers and also switching from a 40u insulin to a 100u insulin. So no idea how the calculations should be based on going from 40u caninsulin to 100u lantus.

 

[Suzanne & Darcy]

Not sure what you mean by BID either?

That just means twice a day (shots given every 12 hours.). 90 mg/dL would be 5 on your human meter in European numbers. That number 5 would only be a consideration if you were following the Start Low Go Slow. If you were following TR (Tight Regulation) dosing method, the point at which your cat would earn a dose reduction would be 50 (2.8 on your meter.)

Yes. Caninsulin is a short action non-depot insulin.

 

[Suzanne & Darcy]

I would feel comfortable with you starting at .5 units as long as you still would be able to monitor her cycles well - and that would mean being able to get some mid-cycle tests around her nadir time. We will have to find out what her nadir time will be because it’s probably not going to be the same as it is on Caninsulin — probably later around +6-ish — but every cat is different. We should know within a few days if that dose is too small, but it is better to start with a smaller dose in a cat who has been seeing a lot of lime green lows recently, in my opinion. Let me tag @Bron and Sheba (GA) to see what her recommendation would be for a starting dose for Mia.

Edited to add: My reason for recommending the .5 unit dose of Lantus is: She is already receiving .4 (using a U-100 syringe) Correct? Drawing U-40 insulin to the .4 line on a U-100 syringe is equivalent to 1 unit of a U-100 syringe. So to be cautious with a new insulin, I recommended half of that — a .5 unit dose. Now if this is all incorrect and you have not been using U-100 syringes already to draw Mia’s dose (currently .4 on that syringe) then I am completely confused and completely wrong.

 

[Suzanne & Darcy]

And I see you said Mia is black and white. She’s beautiful.

 

[Suzanne & Darcy]

@JL and Chip can you explain the dose here? I mean, if Monica has been using tuberculin syringes drawn to the .4 mark (I was thinking she was using U-100 syringes with U-40 insulin using the conversion chart but that makes no sense because she just got the U-100 syringes yesterday. How much insulin is Mia currently getting using the tuberculin syringes (if that is what she has been using)? I was making a starting dose recommendation and consulting @Bron and Sheba (GA) as well — but now I remember there was a lot of confusion about what type syringe was being used.

 

[MonicaT]

That just means twice a day (shots given every 12 hours.). 90 mg/dL would be 5 on your human meter in European numbers. That number 5 would only be a consideration if you were following the Start Low Go Slow. If you were following TR (Tight Regulation) dosing method, the point at which your cat would earn a dose reduction would be 50 (2.8 on your meter.)

Yes. Caninsulin is a short action non-depot insulin.

@Suzanne & Darcy Oh ok, noted regarding the BID and meter readings, hard to keep up with all this new stuff. I am not sure which of the two options you mention I have been following or should be following, the only thing I have been doing is reducing slowly, sometimes by 0.20u at a time and sometimes by 0.25u at a time as she has had low BG readings.

I will definitely still be monitoring her closely, on Caninsulin I was recommended to check at +3 and +5 hours in addition to extra times when she had a low BG reading as those were supposed to be the times she would be at her lowest. So on Lantus this should be around +6 instead? So let's say if I check at +5, +6 and +7 to begin with, I would be on the safe side in regards to when she should be the lowest?

What I am confused about is if a 0.05u dose of Lantus equals the same as a 0.04u dose of Caninsulin seeing Lantus is 100u and Caninsulin is 40u, which from my understanding means that Lantus is over double the strength than what Caninsulin is?

I have been using 100u syringes, which apparently are tuberculin syringes since we started her on insulin. I purchased the wrong insulin 100u syringes yesterday before I was recommended to buy 0.3 syringes for more accurate doses. I haven't switched over to any of the new syringes yet as I want to wait to switch until I switch to Lantus.

My head is spinning now

 

[MonicaT]

@Suzanne & Darcy This is the syringe I am currently using with the Caninsulin u40, where I started out on the 0.05 line, which I was told was 2units. Since then we have reduced and reduced several times, as of latest last night where she was given 0.01, which should be 0.4 units.

 

[JL and Chip]

Yes, with all of the numbers, decimal points, different insulin concentrations, units vs ml, and mg/dl vs mmol/L terminology flying around, this can get wildly confusing.

First rule of thumb—we always talk in terms of units of insulin (regardless of where we draw to on the syringe). That allows us to focus on actual dose without the variables of syringe type and conversion charts and so forth.

In the US, veterinarians usually dispense insulin syringes and speak in terms of how many units of insulin to give. However, in Europe, we’ve seen more than once where vets dispense tuberculin syringes (some of which have dual markings for a u-100 insulin) and give dosing in ml’s (not units). Basically they are just telling the client where to draw to on the syringe, not how many units of insulin they’ll actually be giving. This is especially true when dispensing a non-u-100 insulin such as Caninsulin. So we sort of have to “translate” to figure it all out if we want to speak in actual units of insulin given.

For @MonicaT , the charts I provided in my prior posts indicate how many units of Caninsulin she was administering if she drew to a certain ml line on her syringe. Given that Caninsulin is NOT a u-100 strength insulin, she couldn’t just go by the unit markings on the syringe.

So in the end, Monica was actually dosing 0.4 units of Caninsulin and Mia was still dropping into lime green numbers. I suspect changing to low-carb food had a significant impact on lowering BG.

I don’t generally give dosing advice, but given the lime green numbers on 0.4u Caninsulin and another dose reduction already earned, I would start Lantus at 0.25u BID. @Suzanne & Darcy @Bron and Sheba (GA)

edited to add: Suzanne, the info you added in your above post in bold is incorrect and kind of tangled up — let me know if what I just wrote clarifies it or if I can explain something better.

 

[Bron and Sheba (GA)]

I agree. It is very confusing with the different syringes. After reading all the above, I think that starting with 0.25 unit BG would be a good idea as @JL and Chip suggested. The low carb food has make a big difference. What do you think @Suzanne & Darcy ?

 

[Suzanne & Darcy]

Talk about your head spinning!
Since you apparently have been giving.4 units of insulin, I am in total agreement that we start Mia with the small dose of .25.

 

[Suzanne & Darcy]

edited to add: Suzanne, the info you added in your above post in bold is incorrect and kind of tangled up — let me know if what I just wrote clarifies it or if I can explain something better

Exactly what I was trying to establish. I thought she was actually giving 1 unit of insulin by using a u-100. She was not. It’s a good thing you understand the tuberculin syringes. I mean, I dose certain meds for my cats using mL measurements with a tuberculin syringe, but I certainly never used them for insulin. I only have ever used U-40 syringes and U-100 syringes for insulin. I also use insulin syringes to give B-12 shots to my cats, and that is a very simple conversion using a U-100 syringe, but it’s good you are here to sort this out for us!

 

[JL and Chip]

Hi @MonicaT — I think you have an extra zero in the recent “unit” entries in your spreadsheet.

For example, if you’re drawing Caninsulin to the 0.01 ml mark on your original syringe, that would be 0.4 units of Caninsulin (not 0.04).

Drawing to the 0.015 ml mark would be 0.6 units (not 0.06 units). And so on. It’s just the last couple of days that need to be updated—basically after you dropped below the 1 unit dose.

And again, these measurements only apply to Caninsulin and your original 1ml tuberculin syringes.

It’ll be much easier once you switch over to Lantus and use the 3/10cc syringes you just purchased.

Speaking of Lantus … when you switch over, please add a row to the spreadsheet indicating you are now using Lantus.

Also monitor BG closely, especially the first few cycles. I’d get a +2 or +3 in addition to the +6 that was already mentioned. Some cats have an immediate and strong response to Lantus and just in case Mia is one of those cats, we want to catch any abrupt BG drops as quickly as possible so we can intervene with food, etc.

One final suggestion … once you get started on Lantus with your new 3/10cc u-100 insulin syringes, I’d put all of the other syringes away in a drawer or cupboard so you don’t accidentally grab the wrong one.

 

[Suzanne & Darcy]

Do you feel ready to begin now, Monica, with the .25 units? I definitely would re getting that first test after the shot by about +2, especially in the beginning while we learn Mia’s patterns on Lantus. Try to get a few tests at different times on different days to sort of fill in any blanks. For the first week, though I would monitor frequently (+2, +4, +6) or as needed based on numbers.

 

[MonicaT]

Yes, with all of the numbers, decimal points, different insulin concentrations, units vs ml, and mg/dl vs mmol/L terminology flying around, this can get wildly confusing.

First rule of thumb—we always talk in terms of units of insulin (regardless of where we draw to on the syringe). That allows us to focus on actual dose without the variables of syringe type and conversion charts and so forth.

In the US, veterinarians usually dispense insulin syringes and speak in terms of how many units of insulin to give. However, in Europe, we’ve seen more than once where vets dispense tuberculin syringes (some of which have dual markings for a u-100 insulin) and give dosing in ml’s (not units). Basically they are just telling the client where to draw to on the syringe, not how many units of insulin they’ll actually be giving. This is especially true when dispensing a non-u-100 insulin such as Caninsulin. So we sort of have to “translate” to figure it all out if we want to speak in actual units of insulin given.

For @MonicaT , the charts I provided in my prior posts indicate how many units of Caninsulin she was administering if she drew to a certain ml line on her syringe. Given that Caninsulin is NOT a u-100 strength insulin, she couldn’t just go by the unit markings on the syringe.

So in the end, Monica was actually dosing 0.4 units of Caninsulin and Mia was still dropping into lime green numbers. I suspect changing to low-carb food had a significant impact on lowering BG.

I don’t generally give dosing advice, but given the lime green numbers on 0.4u Caninsulin and another dose reduction already earned, I would start Lantus at 0.25u BID. @Suzanne & Darcy @Bron and Sheba (GA)

edited to add: Suzanne, the info you added in your above post in bold is incorrect and kind of tangled up — let me know if what I just wrote clarifies it or if I can explain something better.

@JL and Chip Thank you so much for this! It is definitely confusing with all these numbers and mixes and matches. I have now tested one of the 0.3 syringes to try measure a 0.25u dose just using water. Can you have a look at the photo and let me know if it looks correct? Let me know if you need photos from other angles in order to see it correctly.

 

[MonicaT]

Hi @MonicaT — I think you have an extra zero in the recent “unit” entries in your spreadsheet.

For example, if you’re drawing Caninsulin to the 0.01 ml mark on your original syringe, that would be 0.4 units of Caninsulin (not 0.04).

Drawing to the 0.015 ml mark would be 0.6 units (not 0.06 units). And so on. It’s just the last couple of days that need to be updated—basically after you dropped below the 1 unit dose.

And again, these measurements only apply to Caninsulin and your original 1ml tuberculin syringes.

It’ll be much easier once you switch over to Lantus and use the 3/10cc syringes you just purchased.

Speaking of Lantus … when you switch over, please add a row to the spreadsheet indicating you are now using Lantus.

Also monitor BG closely, especially the first few cycles. I’d get a +2 or +3 in addition to the +6 that was already mentioned. Some cats have an immediate and strong response to Lantus and just in case Mia is one of those cats, we want to catch any abrupt BG drops as quickly as possible so we can intervene with food, etc.

One final suggestion … once you get started on Lantus with your new 3/10cc u-100 insulin syringes, I’d put all of the other syringes away in a drawer or cupboard so you don’t accidentally grab the wrong one.

@JL and Chip Yes, I see I have been adding an extra 0 on the SS lately, I have updated the numbers now

Will be sure to check her BG regularly once we switch over to Lantus, checking like you say at +2, +4, +6 etc. and vary a little for a couple of days so we get in some numbers in the SS. I think I will do the switch on her next dose, which is now due in approx. 5 hours. And great tip about removing the other syringes, easy to grab the wrong one!

So on the photo above, I have tried to fill the 0.3ml syringe to between the 0 and half lines, which from what I have understood now should be 0.25units?

 

[Suzanne & Darcy]

So on the photo above, I have tried to fill the 0.3ml syringe to between the 0 and half lines, which from what I have understood now should be 0.25units?

Yes. This is correct— to draw a .25 unit dose, you have to just “eyeball it” to the best of your ability to between the 0 and the half unit line.

 

[MonicaT]

Yes. This is correct— to draw a .25 unit dose, you have to just “eyeball it” to the best of your ability to between the 0 and the half unit line.

@Suzanne & Darcy ok thank you for confirming! Think I am ready to go with the new insulin for her next dose then, wish us luck!

 

[JL and Chip]

So on the photo above, I have tried to fill the 0.3ml syringe to between the 0 and half lines, which from what I have understood now should be 0.25units?

Yes, to get 0.25 units, you draw to half way between the 0 and 0.5 line. Your photo looks about right to me.

A few tricks to help you measure those small doses:
- move the plunger up and down in the syringe a couple of times before drawing the insulin. It helps lubricate it so the plunger moves easier.

- draw a little too much insulin into the syringe initially, then remove the needle from the pen and squirt the excess insulin out (into the air, not back into the pen). If you have bubbles, you can move the plunger a bit and tap the barrel of the syringe before squirting out the excess.

Good luck and let us know how it goes!

edited to add: ahh, I see Suzanne and I cross posted.

 

[Suzanne & Darcy]

What you can do to test your dose is to see how many drops are in a half unit (.5) dose and how many drops are in your .25 unit dose. You can test it with water. Sometimes using colored water can help (by adding a drop of food coloring) or, I suppose tea would work. This would just be for practice to see if you are getting about half of the .5 dose in your .25 dose. Make sense?

 

[MonicaT]

Yes, to get 0.25 units, you draw to half way between the 0 and 0.5 line. Your photo looks about right to me.

A few tricks to help you measure those small doses:
- move the plunger up and down in the syringe a couple of times before drawing the insulin. It helps lubricate it so the plunger moves easier.

- draw a little too much insulin into the syringe initially, then remove the needle from the pen and squirt the excess insulin out (into the air, not back into the pen). If you have bubbles, you can move the plunger a bit and tap the barrel of the syringe before squirting out the excess.

Good luck and let us know how it goes!

edited to add: ahh, I see Suzanne and I cross posted.

@JL and Chip ok thank you for confirming! Also, is there anything else that changes when switching to Lantus? I have been removing food 2 hours before testing pre-dose, then testing, followed by food and waiting 30min until giving her the insulin dose. Is it correct that I now don't have to wait the 30 minutes between feeding and shooting?

I have also read that Lantus is not to be shaken or rolled like caninsulin. Anything else I should know?

Thanks for the tips on measuring these tiny doses! Will definitely be using them

 

[JL and Chip]

Is it correct that I now don't have to wait the 30 minutes between feeding and shooting?

Correct. You can test and then feed/shoot immediately.

I have also read that Lantus is not to be shaken or rolled like caninsulin. Anything else I should know?

Keep the insulin refrigerated. Don’t inject air into the pen or shoot excess insulin back into the pen.

You might want to read the “Sticky” posts on the Lantus forum—they have an abundance of good information.

Here’s a link to one of the “Insulin Care and Syringe Info” Sticky:
https://www.felinediabetes.com/FDMB...info-proper-handling-drawing-fine-dosing.151/

 

[Suzanne & Darcy]

Things are different with Lantus. You don’t need to wait for any time after they eat to give the insulin. The procedure is test, feed, shoot …. and can all be done rather quickly. I used to shoot Darcy’s insulin while he was eating, in fact. He didn’t even feel the shots so it didn’t put him off at all.

It’s perfect that you are not feeding for two hours before the tests. That’s very good to do especially when your cat is new to insulin.

Keep up the snacks or food availability during the early part of the cycle before nadir.

 

[JL and Chip]

And remember that Caninsulin is an “in-and-out” insulin (meaning the effects of the insulin pretty much wear off by the next insulin shot) … whereas Lantus is more of a “depot” type insulin (that basically means that the insulin has some “hang time” and thus the shot given now can impact not just the current cycle but future cycles as well). Dealing with a depot can be a bit of a different mindset, so be sure to ask questions.

Here’s a link to the “What is the Insulin Depot” Sticky”:
https://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/

 

[MonicaT]

@Suzanne & Darcy @JL and Chip @Bron and Sheba (GA) I won't be able to switch to Lantus this evening due to schedule issues so will hold off until tomorrow morning.

Just had a preshot BG reading of 9.8. she has never been this low before giving a shot. Do o decrease caninsulin dose again? Currently giving 0.4u

 

[JL and Chip]

She already earned a Caninsulin dose decrease because she dropped into the lime greens (I see both a 2.6 and 2.4), so I would give NOT give 0.4u again.

I’d do no more than 0.2 units of Caninsulin tonight, assuming you can monitor her. If not, I might give even less or skip. @Suzanne & Darcy what do you think?

 

[MonicaT]

She already earned a Caninsulin dose decrease because she dropped into the lime greens (I see both a 2.6 and 2.4), so I would give NOT give 0.4u again.

I’d do no more than 0.2 units of Caninsulin tonight, assuming you can monitor her. If not, I might give even less or skip. @Suzanne & Darcy what do you think?

@JL and Chip I reduced, measured as good as I could to between the 0 and 0.01ml, so I would guess she got 0.3units. Checked her BG after 1,5 hour and it went down to 1.3. Given honey, treats and food. Will check again now

 

[JL and Chip]

Honey can wear off quickly so please stay on top that; 1.3 is way too low, dangerously so. It also proves that even the small dose of Caninsulin you gave was too much. Now we know.

Looking forward to seeing where things go with Lantus. It’s possible that Mia will be one of the lucky ones who only needs a short course of insulin and becomes diet controlled. Low-carb food can truly make a huge difference. Fingers crossed.

 

[MonicaT]

Honey can wear off quickly so please stay on top that; 1.3 is way too low, dangerously so. It also proves that even the small dose of Caninsulin you gave was too much. Now we know.

Looking forward to seeing where things go with Lantus. It’s possible that Mia will be one of the lucky ones who only needs a short course of insulin and becomes diet controlled. Low-carb food can truly make a huge difference. Fingers crossed.

@JL and Chip will definitely keep on testing until I see it keeps on going up a couple of times, and keeping a constant eye on her the whole time too. It has gone up to 2.6 and now 2.9 for now.

Will start Lantus tomorrow as I will be able to monitor closely during the weekend.