New here and new to Diabetes - updated Jan 16

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Re: New here and new to Diabetes

okay - Davidson is going on Lantus today..........taking him to the vet at 9:30 and will give him a preshot (ahh, getting the lingo) at 9:15, then do the shot at 9:30 and bring him home. His BG was 16.8 yesterday afternoon, steadily decreasing while on wet food only. Met the new Vet yesterday - young kid, but knows his stuff and was VERY supportive of what I provided and wanted to do based on this FDMB and he agreed with everything.

I'll be doing his curve all day and if he's getting the shot at 9:30ish, should I take BG reading every 2 hrs? How many should I do before I stop? I'll give him his second shot at 9:00 to get back on track.

Tomorrow will be the following schedule...........

6am feed
9am preshot, shot
2-3pm BG
5pm feed
9pm preshot, shot
11pm preshot

The above schedule will be followed and monitored daily until someone tells me to change.

I will advise the dosage of Lantus once home from the Vet

Thanks again for all the positive feedback and advise

Shawna
 
Re: New here and new to Diabetes

hey there good luck a the vets. Don't forget to take your meter to compare it with the vets. (more for your vets comfort than yours ;) )

Also the schedule looks good to start but I would vary the 2-3 pm test when you can just to check the "nadir" or low point isn't wandering. not all cats nadir at +6. Also some comments below

6am feed
9am preshot, shot - this is AMPS
2-3pm BG - this is +5 or +6
5pm feed
9pm preshot, shot - this is PMPS
11pm preshot - this isn't a pre shot test - just a regular +2 BG test. If this number is lower than PMPS then you might want to set the alarm for another test at PMPS+5 or so because it implies an active cycle

Keep us updated!

For the first week you can expect wonky numbers but hold the dose to let it settle. UNLESS he drops under 2.8 in which case you immediately drop the dose by 1/4 unit. OR if your pre shot is under 11.1 in which means you don't want to shoot yet. Come on here and ask for advice.

Wendy
 
Re: New here and new to Diabetes

Thanks...........Vet visit went really well and new Vet is very knowledgeable. He didn't want to do another BG with his device as he said Davidson was already too stressed and to continue to use mine even though the BG readings will be a bit higher then what the 'pet' ones will read (just the nature of human meters vs pet meters). He got the actual shot at 9:45am with 1.5 units Lantus and here is the schedule he said to use:

9am AMPS
9:45am shot 1.5 unit Lantus
11am BG
12pm BG
1pm feed as usual
2pm BG
4pm BG
6pm BG and feed as usual
8pm BG does this become PMPS?
9:15 shot
10pm BG

Thanks and jus about there with the understanding......
 
Re: New here and new to Diabetes

ok cool -who'se idea was the curve? his or yours?

8pm BG does this become PMPS? No you want to test as close to the shot as possible. I would test at 9pm instead.
 
Re: New here and new to Diabetes

filled in the SS and please check to see if I am accurate. BTW - Vet's idea to do the curve as per the times I show.

I just did a BG and it's 18.27 (or 18.3 on the SS) and I put it in at +1 since the shot was at 9:50am..........

So, should I adjust the times of BG test instead of doing 8pm, do it at 9pm and then the shot right after..........but then there is a 3 hr wait between BG tests. Is that okay? or I can do a test at 6 and 8, then do a PMPS at 10pm and a shot........which would be 12 hrs later.

The only reason I was trying to go do the shot earlier was to get back onto the 9/9 schedule. 10/10 is okay too since it's winter time and I'm not exactly out golfing or riding my Harley Davidson........not to be confused with Harley & Davidson :lol:

If the SS is okay, then I think I have it.

Thanks so much!!
Shawna

UPDATE 12PM - BG 15.1.............I do not see the US chart being updated on the SS. I am entering the data in the World SS and is it not supposed to update automatically? I do republish each time, and can enter the date on the US SS manually without any problems........please advise
 
Re: New here and new to Diabetes

UPDATE - 2PM bg 9.22 OR 166...............

Davidson has dropped quite a bit and seems to be working.......I updated the SS but please read my previous post at 11:30 as not sure if it's working as the US SS is not automatically updating

Thanks
Shawna
 
Re: New here and new to Diabetes

He is coming down nicely. The +6 will be interesting. At this fast rate of drop I might even get a +5... and if he hits green you might want to start doing it hourly until he goes back up. You want to check he doesn't drop too low.

Its ok to wait 3 hours between tests or just get an extra test in. But its important to test within about 20 minutes of your shooting time.
 
Re: New here and new to Diabetes

Thanks Wendy........

I'll do another BG at 4/5 and check to see what it is.........then if good will do one at 7/9 then shoot at 9.

Sound good?
 
Re: New here and new to Diabetes

Not at all! These are great numbers. Maybe get another test in an hour though - its not like we are worrying so much as curious.. i.e. how low will this dose take him?

Please can you update your sheet. Also where is jan 13 and 14th on the world tab? I think its confusing your US tab not having those.

Wendy
 
Re: New here and new to Diabetes

Wendy........

See a couple of my posts earlier as I've asked if there is a problem as for some reason the US are not updating..............not sure what went wrong as it was working fine and the other day it stopped converting the World over to the US side.

I also enter the data on the World side..........not the US.

Let me know what I am doing wrong and I will correct it.

I'll do another BG at 5pm
 
Re: New here and new to Diabetes

UPDATE:

BG test at 5pm was 9.88, so NADIR is 6.8 which vet said is perfect. Doing another BG at 7pm, then at 9pm.

Summary if BG is: 4-10 then no shot at 9pm
10-13 give 1 unit of Lantus
13+ give 1.5 unit of Lantus

Test BG again at 11pm, 6am and continue schedule

So far so good. Question - what do I do with the NADIR reading?

Vet said to take a reading at 4ppm tomorrow as that was when he got the NADIR

Thanks!!!!
 
Re: New here and new to Diabetes

Looking good so far. But you put the 9.8 on the US instead of world sheet. If you use the US sheet you need to multiply by 18.

Is the vet saying that if he is 10-13 at pre shot you should give 1 unit from now on, or just for tonite?

I agree you should not shoot at all if he is under 10.

Nadirs vary. But for now you can test at +6 (4pm) but I would vary it over the next few days because they do change. and the lantus is still settling

Wendy
 
Re: New here and new to Diabetes

What a goofball I am............okay fixed. (maybe just seeing if you were paying attention haha)

Only tonight for the shot if between 10-13 of 1 unit, then will depend on testing but don't want to move it around too much and he said better a bit lower then too much. I will be calling him in the morning after 9am once we see what he levels are tonight and tomorrow morning.

*** Any reason why my data when entered on the WORLD SS is not automatically transferring to the US SS? Or do I have to enter them manually?

Thanks Wendy!!

Shawna
 
Re: New here and new to Diabetes

:lol:

The key to lantus is consistency. Like i said, it has this depot which has to fill, and if you continue to vary dose it messes it up.
So... If he is 10-13 tonite and you reduce to 1 unit, I would hold this 1 unit for now because it likely means the dose is too high. Because if he is dropping low enough that it isn't too safe to shoot, you gotta wonder what will happen when the depot is full. But lets see.

Don't know about the SS - something wonky I guess? I would just use the US one and blow away the world. You have a US meter anyway so no big deal on the math.

Wendy
 
Re: New here and new to Diabetes

Yes, absolutely right and by the looks of things he is now at +9 (7pm) 12.88 so if the 9pm BG is under 13 then I'll reduce the dose to 1 unit and HOLD it there for a few days and get readings.

Question - do I take his food away now as I think you don't want to feed him 2 hrs before the shot, then I can put it back down..........please confirm.

So at 9pm I will enter the PMPS reading in that column, then do the shot and enter it in the 0 column I think............after today is done then I'm good!

Shawna
 
Re: New here and new to Diabetes

yep no food for two hours before the shot as you need to know that the pre shot test isn’t influenced by food. He can have food right after,

Yes if the BG is between 10-13 its fine to reduce the shot to 1 unit from now on. Under 10, don’t shoot at all. But he looks like he is heading up so no problem there... probably ;)

yes - Your 9pm test goes in the PMPS column "O" (p.m. pre shot)

I would recommend you get a before bed test to see what his nighttime plans are.

You did GREAT today by the way! He is responding well to the insulin.


Wendy
 
Re: New here and new to Diabetes

Food was taken away and I'll enter the date once I do the shot (a bit nervous but did 2 saline injections today at Vet).

THANKS TO EVERYONE.............without all of your input and guidance I'm not sure how I would have managed.

NOTE TO NEWBIES: DO NOT ALWAYS TAKE YOUR VET'S WORD FOR WHAT THEY TELL YOU. The experience and education on this Forum from all those who input and reply to our questions is PRICELESS and they are far more knowledgeable with hands on information then most vets. If you are not comfortable with what your vet is telling you to do then DO NOT DO IT and refer to this Forum for answers.............these people know what to do and they are helping you for your benefit.

Davidson is well on his way to being himself and hopefully he won't need to Lantus for very long. Either way, he's in great shape now and that's all that counts!! His brother Harley is happy too and soon they will be the Harley Davidson team

Shawna
 
Re: New here and new to Diabetes

Davidson seems a bit sluggish, he's getting his BG test at 9pm and then more then likely a shot. Is this normal since he had his last shot at 9am and today is his first day on insulin? Just wondering..........
 
Re: New here and new to Diabetes

I doubt it's related to the insulin, but what do you mean by sluggish?

He has had a hard day with the vet n all, so probably nothing but have you checked his ketones recently?

Wendy
 
Re: New here and new to Diabetes

just a bit tired and maybe due to the Vet and all the attention and poking he's getting. We did play a bit and he wants to eat but I'm not giving him food again until after the shot

Question - I did the first shot at 9:45 this morning and was going to do the second at 9pm, however that is a bit early and I'd like to get on a 9/9 schedule. Is it okay to give it to him at 9, or better wait until 9:15 and insert the PMPS for 9?

Thanks
 
Re: New here and new to Diabetes

I would wait till 9.15 and do 9 tomorrow. And insert the PMPS value in that column O.

Will you be able to get a PMPS +2?
 
Re: New here and new to Diabetes

I will stay up with you. It is a good idea just to see where he is headed. I will be looking for your post.

Good luck , it's shot time now right?did you get the short syringes.

Wendy
 
Re: New here and new to Diabetes

I have the proper syringes............I will do the BG preshot in 15 min, then the shot right away at 9:15 and post the reading on my SS. He's good right now, calm and sitting half on my keyboard so in a good position to give him the needle. I'm a bit nervous being my first time, but it will be okay. Funny - Harley wants to get in no the action as he sees Davidson getting treats all day and he jumps up to join in on the fun, so he thinks.

Oh - the Vet used my needles today and said they were good to use and very easy since they are so thin and Davidson never flinched..........so will go well I am sure.
 
Re: New here and new to Diabetes

I just wondered cos they come in short and long needles. Just remember to tent and inject into it. It's such a small amount you will barely notice.
 
Re: New here and new to Diabetes

okay, done but not sure it went as well as expected...........as I put the needle in he moved and chirped a bit as if to say I hit the muscle. I got the insulin in and hope it's okay.

BG was 17.38 so it went up close to the level at 11am

Hope it works and will be okay........assuming at 11pm the BG should drop a bit.

Hmmmm
 
Re: New here and new to Diabetes

My bailey does that if I shoot near the spine , where on his body did you shoot him? Try a different spot next time. Another reason i asked about the needle length...
 
Re: New here and new to Diabetes

shot him a few inches behind his shoulders where the scruff is and maybe too much towards the center of his back. Tomorrow will do it more on the scruff.

I notice on his ears that the fur is off and may be because of the cream I am using? He's okay with pricking his ears, so think I will just warm them as I usually do, prick, hold tight for about 30 seconds with a cotton ball and then not use the poly cream.

I use the U-100 3/10ml small needles that you told me to get...........I think they will be fine since the Vet today used it, we did some saline injections and he was fine. He may have noticed I was nervous and moved a bit. I will do the BG at 11pm and going to practice on an orange :lol:
 
Re: New here and new to Diabetes

BG at 11pm 12.5 so assume I am safe to go to bed and not have to wake up at 3am?? Remember I lowered the dose to 1unit, and started this morning at 1.5 units
 
Re: New here and new to Diabetes

Why did you reduce the dose? Vet said reduce only if 10-13 right?

Too late now though. Now that you did reduce though I would advise you stick to this dose for the week unless he drops under 2.8.

Lets start talking in + instead of time - people are on different times zones here so won't know what time you mean. So I would set the alarm for a +5 actually (2am) and see where he is at. You didn't get a +5 today and he might have actually nadired a little earlier. If I am awake at 3am testing my boys I will check on you.

Wendy

PS if there is a case where you shoot and are not sure it got in.. whatever you do, do NOT shoot again - you could overdose. Just mark "fur shot" in the preshot column and chalk it up to experience. I always touch the fur and smell my fingers after to check.. its a strong smell or you can get damp fingers if you do fur shot. And it does happen. But never ever reshoot!
 
Re: New here and new to Diabetes

Wendy I screwed up and took the 7pm reading in error. ohoh. SORRY. Yes, understand not to shoot again in case I miss.

I will do a BG at +5 as you say and can you suggest when to do it again by giving me some numbers? Maybe help with a set time schedule I should stick to for a few days so not to mess up again. Hope the reduction is not going to be a big PROBLEM.......

Shawna
 
Re: New here and new to Diabetes

It will be fine. As I said , it's better to start low and work up. I would hold this new dose of 1unit for now though so the depot can establish at this level.

I would test before every shot obviously. Then one midday randomly between +4 and +7. Then one before bed. But if the before bed test is lower then get a +4 to +7 at night too.

Wendy
 
Re: New here and new to Diabetes

Definately, his +2 was lower than PMPS which implies an active cycle. And we need to ensure he isn't going to drop too low.

If the +5 (2am) is green I would get another test in an hour.

Wendy
 
Re: New here and new to Diabetes

okay, will do..........going to get a bit of sleep before I have to wake up...........haha, I'm wired now so most likely will be up until 2. Don't need much sleep when you have ADHD to work with.......... :lol:
 
Re: New here and new to Diabetes

Hey there,

He is high so you can sleep well now. It's probably the lantus settling, something we call new dose wonkiness. So to tomorrow at 9am unless he is under 11, I would still shoot just one unit... Even if he is high.. Don't panic. New dose wonkiness is normal...especially the first week.

I am in the office tomorrow so won't be around much.

Wendy
 
Re: New here and new to Diabetes

Sorry, didn't see this post until now and did the BG upstairs at 6am..............16.5. Guess he's 'wonky'..........will give the shot at 9.

QUESTION: do I still do a BG test before the shot? Do I ALWAYS do a BG test before the shot? If so, I will just do them at 9/9 and one in eh middle of the day while he gets used to the Lantus.

Thanks, enjoy your day..........

Shawna
 
Re: New here and new to Diabetes - updated

Yes test ALWAYS before the shot as you don't want to shoot when he is too low ie under 11.

Plus one test at +4 to +7

Then one test before bed

Because things change and today the wonkiness could clear
 
Re: New here and new to Diabetes - updated

Great! Today if you have time I would re read the stickys on top of the lantus board plus review how to handle hypos now you are on insulin. U have your hypo kit ready right?
 
Re: New here and new to Diabetes - updated

okay, I have read them this morning but will have to re-read about 20 :roll: times since it's a lot to digest and just not being able to retain the info being and all new to me..........I've got most of it figured out and YES , have the hypo kit with the exception of the FF with gravy which I will get today, but have honey and the rest.
 
Re: New here and new to Diabetes - updated Jan 16 - ANY HELP

BG at AMPS 16.5 or 347, shot with 1 unit Lantus.

+7 BG 12.88

Hope this is okay - any suggestions as I accidentally decreased his dosage last night from 1.5u to 1u, and this morning gave him his shot at 1u...........which explains why he is still high. He's a big cat at 14.1 lb

ANY suggestions??

Shawna
 
Hi Shawna,

Davidson is looking good since you started him on insulin. Keep this 1U dose for 5-7 days, to let the insulin depot build up. The exception to holding this dose would be if he dropped < 2.7 mmol/L (50 in US numbers). In that case, you would immediately reduce the next dose by 0.25U.

You've been getting some great suggestions from Wendy.

Sorry no one was around this morning to answer your questions, but it looks like you went ahead and gave the 1U dose. You are learning already. Good job on that decision.

(I took a peak at your SS and so far so good!)

If you are ever uncomfortable about giving a dose because of the BG reading you have gotten, please post here for suggestions. If there is no one here on the Feline Health forum, you can always post over in the Insulin Support Group (ISG) for Lantus (glargine) Tight Regulation. There are usually folks over there that can help you out if you are not getting a timely response here on this forum.

Be sure to put the question mark Post Icon on your post, to let folks know you have a question.
 
I was at work today but I checked your SS a few times just to make sure all was ok.

I agree with Deb too - Remember Lantus is a depot insulin so in a few days we might find this dose is actually enough once the depot has built up. Better to start low and work up anyway. If this doesn't work we will get to a higher dose soon enough!

So hold the dose for 5 days (10 cycles) and we will see where he is. Patience grasshopper! remember to check for ketones every day or two.

This is good - it will give you time to read up and let things sink in.

Wendy
 
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