NEW LANTUS USER QUESTION!

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AmySawyer

AmySawyer

Member Since 2014
Started my kitty Marley on Lantus yesterday (first shot 1 unit at 6pm) checked her BG levels +3 (285) & +6 (164).

This morning AMPS her BG is 150. I was told to post here for advice before doing anything else.

Should I feed her (she eats low carb Fancy Feast Classics) & then give a lesser dose?

Please help!

I also should have mentioned yesterday PMPS her BG was 436. Which had been normal pre shot range since we started her on Humulin 30/70 2 weeks ago when she was diagnosed.

As this mornings pre shot number was significantly lower than her "normal" pre shot values, I was unsure what to do. & after posting without getting a reply (it's early I know!) we fed her the Fancy Feast Classics but did not give her a shot... Only because we are so new to Lantus & just wasn't sure how safe it would be. It takes both me & my husband to test or shoot & he had to go to work for 7am. He is planning to come home around 9am for us to test again...

Any insight would be much appreciated!
 
Thanks Dyana I will do that now.

I read a bunch of threads already this morning looking for suggestions.

Still not exactly sure how I should proceed after we test at 9am.... but if it's not extremely high I may just hold off & test & shoot again at 6pm to stay on the schedule we had set up. (will still perform at test at 12pm just to record values as well)
 
For sure now stay on schedule. As If you were to shoot at 9 then you will be on a 9 schedule, trying to back it down for several days to get back on track.
I would suggest your husband doesn't need to come and just do the 6PM. Your cat has already ate, so probably wont eat another full meal to get meds anyhow.
You could have always shoot a less amount at the scheduled time this AM, after feeding a good meal. I do get if he comes home to check BG at 9 and at lunch maybe would be a good idea.
If you aren't getting an answer from someone. Which doesn't happen very often but yes there are only a few early morning folks on here. :)
Just take a breath and start fresh at 6PM he will be fine. Give a lil boiled chicken (or low carb. treat this afternoon, plenty of water and love.
Hope you have a great Sat. Someone will be on to give more advanced advice but just wanted to try to help so your a little less worried. Been there. Still am at times.
Lots of great folks here, Your doing a great thing keep it up!
 
Welcome to Lantus Land!

Just to clarify, you haven't shot yet? (Technically, if you haven't shot, then the test at +12 isn't an AMPS. We write it out as the +12 or your AMBG.)

Usually, if you stall, you want to re-test every 20 - 30 min. so you catch the numbers as they rise. I understand you need an extra hands to help with testing but that's the theory with stalling. The other issue with a lower than usual pre-shot is that you want to be able to get early tests whenever you shoot lower numbers. Typically, you want to get a +1 and +2 test. As long as you have the flexibility to shoot late, shooting when your husband gets back is fine.

I'd really encourage you to see if you can work out a system to test on your own. One strategy is to test Marley on a sofa or chair with an arm. You can put Marley between you and the arm of the sofa. I test Gabby on my kitchen counter. There's good light and she's not too squirmy when she's up higher. Also, you want to give a treat with every, single test -- even if it's not a successful test. Given treats with tests is a positive reinforcement and will, in the long run make the process easier. Others will, no doubt, share their strategies with you.

In looking over your initial post on Health, you've done an incredible job. And yes, I do think you've learned more about feline diabetes in the month that Marley's been diagnosed than your vet knows.
 
Good Morning ~O)
I just read the condo in the main forum. Welcome to LL!
You mentioned 'normal' ps numbers, and holding back now until you see them. I would suggest that Lantus may give you a whole new 'normal', so I would continue to post before shooting or stalling. You are getting some really great tests in there, and that will help you and us see how these cycles might play out. When Twice (my kitty) switched from an insulin like humulin to Lantus, his numbers were quite different. Lantus offers a much gentler cycle with gentler curves and not such dramatic 'drops' (typically ;-) )

How much does Marley weigh? Small kitty or big kitty?
What is your schedule like? Pretty open/work/tight schedule?
Do you have HC (high carb) food with gravy on hand for emergencies as well as karo syrup and an extra set of strips? You DEFINATELY want to be prepared for a hypo when kitty is diabetic and on insulin, but I would be sure to get it ASAP as Marley is new to insulin. Since you skipped the shot today, maybe this would be a great time to stock up and get a kit ready?? Don't want to worry you, but most of us have hypo numbers at least once :cool:

And yes, as the ladies suggested, read the stickies at the top of the Lantus page. How to shoot low numbers, etc. These will soon be your bible :lol: :smile:

Keep posting and welcome again to our family!
 
Welcome to LL (Lantus Land)!

We also had to have two people to test and shoot initially. At first we had to burrito Cobb in a towel. I can now do it by myself while I'm half asleep.

I usually put Cobb on the bathroom counter, tuck him under one arm and get the test. He gets a lot of petting at the same time. If Cobb isn't in our room, I just go to where he is to test. I feel like it's more comfortable for him.

You'll figure it out! And people here have great ideas and work arounds that have worked for them.

Good luck!!

~Suzanne
 
Thanks for all of the advice guys! It helps so much! :smile:

As for testing Marley solo, that won't work. She will end up completely flustered (& so will I) as well as I will end up shredded! She can be quite a difficult cat to deal with, & my husband is "her person" so she responds much better to him than she does to me anyway. He usually holds her while I do all the bad guy stuff. (typical mom right??) & she does REALLY well for tests & shots in this method. We always reward with praises & attention, but I wanted to find out what are some good low carb treats that I can give her at those times?? She normally gets fed before or after her shot anyway, so that is usually her "treat" but she doesn't always get fed after tests, so if you can tell me of some low carb treats I will try to find some... As I live in the Bahamas, it may even be easier if I make my own low carb treats for her... Suggestions?

Yes we have a hypo kit on hand just incase. Karo syrup & high carb dry food as well as high carb Hills W/D wet food. We got the kit in order from the very first day she started insulin (I am a very paranoid fur-mom!)

We have Marley on a 3x per day feeding schedule. As she dropped a lot of weight over the past 3 months before diagnosis. We usually feed her at 6am (shot time), 12pm & 6pm (2nd shot time). We are feeding her Fancy Feast Classics (switched her from Hills W/D 2 days ago). We give her a 3oz can at each feeding & she is eating really well with the Fancy Feast.

She is not a very large cat, but she used to weigh (before any symptoms of diabetes) around 13-14 lbs. But now she is weight about 10-11 lbs. So she lost a significant amount of weight in between.
Our schedule through the week is very tight as my husband & I both have full time jobs (both have to be to work before 8am which is why we want to test & shoot at 6am/6pm). But this morning we were just surprised to see her AMPS value less than 400! So we weren't very sure how to proceed. But like you guys said, this Lantus is much different than the Humulin she was on which is what we got accustomed to. But now we know (more or less) how to proceed if that happens again tomorrow morning. We are going to hold off & just wait until 6pm to give her next dose, & we were thinking it might be a good idea to lower it to .75 unit instead of 1 unit. Thoughts or suggestions on that??

Also, what if we test at 6am tomorrow, the value is low pre shot...we wait 30 mins & test again, & the value has dropped more, what should we do then??
Just trying to ask all the questions racing thru my mind so that we can be more prepared.

I did a lot of reading on this forum this morning, & I feel a bit more comfortable. I guess technically this morning we could have fed her, & then gave a lower dose shot & she should have been fine...but like I said, I am very cautious because 2 days ago she DID drop to 35 (due to my vets negligence & giving me U-40 syringes instead of U-100 when we had her on the Humulin 70/30. When we thought we had given her 2 units it was actually more like 4!!) :o

Got the 9am test value, will update my spreadsheet now. :)
 
hmm... you might not have a high end pet food store there , huh? that's where you would find freeze dried treats ( for cats or dogs)

Does Marley like canned tuna? or raw shrimp?
The treat is a great motivator for cooperation.... so just getting their regular food isn't really a treat. You want something special that really gets their attention.
Some folks use boiled /baked chicken pieces.


I had to give raw shrimp at shot time to get cooperation from my girl. She never did like the shots and she would only cooperate when there were a couple of raw shrimp in front of her.
 
We use the "kitty burrito" method as well when performing tests on Marley. Maybe eventually she will become more accustomed to it (especially if we start doing treats!) & one day I can test her on my own, but for now, this method seems to work & doesn't completely stress her (or me!) out. ;-)

She doesn't seem to mind the shot as much as the test. She usually will just lay on the counter while my hubby pets her & I do the shot.

But as we live in the Bahamas, the island that I live on does NOT have a specialty pet store so I think I will do the boiled chicken treats for her today & see how that goes :smile: She LOVES chicken (& is quite upset she doesn't get table scraps anymore) so I think that will help the process a lot!

Will update my spreadsheet again when we test at 12pm before we feed her.

Thanks again everyone! Every little bit of info & advice is a HUGE help!
 
Lots of people use freeze dried chicken and such for treats. And yes, treats really are a must! Just ask any kitty! :lol: I use Benny Bully's Beefy Chops. Not sure what is available there, but your one ingredient treats are easiest as it is just dried meats.
Go with what works for testing and shots for sure, but I agree that getting Marley used to just you doing it will be way easier in the long haul. Especially if you have a situation arise where you need to test and DH isn't there. The treats will hopefully help with this. Most kitties do not like being held and poked, etc..but surprisingly they get into it and we end up with an amazing bond. Twice would go to his test site on his own and wait for me (and this was after a very short period of time), and even come looking for me if I was late for a test or he felt his bg was low!
I wouldn't bother with the hc dry. In a crunch when you need to get those carbs into Marley, the dry takes way too long to kick in then last too long after, really messing with the glucose numbers. It also fills them up too much and in a hypo situation you need them to eat NOW and every half hour quite often. Dry is no good for this. You really want to try and give just the gravy part of the hc wet, with little 'food' parts (again, so as not to fill them up).
Yay on the kit! You are a very prepared mamabean...lucky Marley ;-) :-D
As for the test tonight or tomorrow: Do not shoot a dropping number. Try to always get at least a +11 so that you can compare it to the ps #. The number should be on the rise as they get close to shot time. If the number is rising and feels low to you definitely post. You will be asked if you will be able to test that day and monitor. This is why it is good to be able to test on your own. Lantus works at its best if given at 12hr intervals, same dose, without having to skip. But when starting out, you will need to figure out the safe starting dose level first. I'm guessing 1U may be fine, but you might need to lower to .5U to start...depending on how Marley reacts to it. Since you just switched from a higher carb food to a low one, this could be why Marley is reacting so positively with low readings. The food really DOES affect the numbers. Get a couple tests throughout today to see what the bg is looking like with a skipped shot.
There will be lots of experienced members looking your numbers and posts over, so know that you are not alone. I have to go and find some of your older posts now to get more familiar :-D
 
Thanks Kim! :smile:

My original post in the main forum is quite long, but I tried to put as much details into it as possible so that people on here can see what I've been doing & how she's been reacting.

But just from the food change 2 days ago, & the 1 unit of Lantus yesterday, her numbers are SO much better already!! Before last night, it had been 6 days since we saw a number in the 100-200 range! Although there were many other factors that could have caused that...such as the type of insulin & food she was on which together seemed to be causing major drops & sky high spikes! & the fact that my vet gave me the wrong syringes!! But I feel like we may finally be able to make some progress now! :smile:

Will definitely try to get a +11 # after her 6pm shot this evening. So that we can start to see what her pattern is like. I think I will decrease the dose slightly (since we are just starting out) & see how that goes.

Will keep updating the spreadsheet throughout the day!
 
Cooked or even raw chicken -- if Marley likes it -- is a great option. Some people here will cook a chicken breast, dice it up, and freeze it then defrost the treats as the need them. Wellness makes a jerky-style treat that my kitties like. Jerky treats are fine I would just be very careful that they are not manufactured in China since there have been major recalls on products made in China. As others noted, freeze dried treats are great! They are available at pet food stores -- often with the dog treats. If the shipping costs aren't prohibitive, you can buy them on-line.

Giving Marley multiple, small meals is a great idea. It's much easier on a healing pancreas. Since you and your husband both work, you might want to look into a timed feeder. That way, there's food available when you're both out of the house.

Just a note about Lantus. It's very different than Humulin. Humulin works quickly (especially the type your vet had you using). It also can pull numbers down quite fast. Lantus is much longer acting and is a depot-type of medication. The depot allows for overlap between doses which ideally, creates flat cycles. However, it takes 5 - 7 days for the depot to form. Because of the depot, you base your dosing on the nadir (lowest point in the cycle) and not on your pre-shot numbers. Because you're out of the house during the day, it will be important to get some spot checks during the PM cycle.

As for high carb, using dry food is not the best option. It takes a while for dry food to be metabolized and as a result, to raise numbers. It also takes a long time for it to clear out of a cat's system. A better option is Fancy Feast or Friskies that have a gravy base. If you check on Dr. Lisa's food charts, any variety that is over 15% carb is a good choice for a high carb food.
 
I am currently defrosting a large chicken breast that I will boil & dice up into treats for her this evening. I went to our local supermarket to see what they had & they had no good quality low carb treats (as I suspected). So I think the boiled chicken will be the best option for now. Will look on amazon to see if they have any of the freeze dried treats too.

Marley was a dry foot cat her whole life, until recently. With her weight loss, we thought (before diagnosis) that our other cat had been bullying her away from the dry food (they were free feeding), so we started giving her fancy feast back in October, but since Marley's diagnosis, we have stopped the dry food all together with both cats. They are both on wet food now 3x a day. Marley is getting her Fancy Feast Classics, & our other cat Ziggy, (who is not diabetic) is getting Friskies Pates (which I read Marley can have too so that makes life easier). I have some Fancy Feast wet food (with gravy) on hand that is higher in carbs in case of an emergency.

Will perform another test at 12pm (& update the spreadsheet) & try to get at least one more test in before the 6pm test & shot. & will definitely get the +11 value at 5am tomorrow before the AMPS # at 6am.

Being a diabetic cat momma is very tiring! But hopefully it will become less stressful as we figure the dosage level & her BG Patterns on the Lantus.
 
Hi Amy and welcome to FDMB!

I was exactly where you are a few months ago! :-D I felt like I was taking a graduate course in feline diabetes and so did Scooter! :lol: From what I read you are doing a great job and I understand the Momma gene that kicks in to.

I wanted to tell you that you are in the best place you never wanted to be. The folks here will guide you through everything you need and laugh with you to. My best experience was to read and re-read all those sticky notes especially the ones at the top of the lantus tight regulation board. I needed that information in my head so I wouldn't second guess my self to much in an emergency.

Again welcome to you and your husband and your kitties too! :-D

Linda
 
when i started on FDMB most people either gave boiled chicken or shrimp for treats. i always did the chicken as Sienne described. simmer it for about 10 minutes in enough water to cover, then cut it up into very small dice - 1/2" cubes. freeze most of it and keep a couple of tablespoons out in the fridge. punkin never tired of his chicken treats. the freeze dried treat options have become popular recently on here and either will work just fine.

i haven't read your previous posts (i will), but wanted to suggest that you take the important parts of her history and put it into a profile for us. That links to your signature and then anyone will be able to get the story easily. It helps anyone giving advice to do a better job! Creating a Profile

For many cats it helps to divide the food up evenly between the day and night cycles. So if Marley eats 3 cans of ff per day, give her one at preshot and 1/2 at +3 or so in both cycles. If no one is home mid-day, you can order an automatic feeder. They give great peace of mind. We use food as our first strategy with low numbers, and if you both leave for work there will surely come a day when you see a low number but have to go anyway. I had that happen many times. I bought thisPetSafe 5 Compartment Feeder from a local PetCo, but the link goes to Amazon. There were many times that i thought he might go low, when i put food in 4 compartments set to go off every 1/2 hr for punkin while i was at work. We used it every single day to feed him at +3. It's more than worth the cost for a diabetic cat owner. If you have 2 cats together and you can't be sure that Marley will get the food, you might either need to separate them during the day or get 2 feeders.

The only thing about this particular feeder that i saw in complaints, is that you have to be sure it's fully seated in the base before you leave it. We always seated it, then used the manual feature to rotate the compartments forward one opening. that let us know it was fully seated and could be counted on to open on time. other than that, you can set whatever times you want and i think that's a pretty perfect feeder. hahahha if only i got a commission on them . . . ;-) but i am a fan. It let me feel ok when i had to leave to go to work.

the reason i'm suggesting something other than feeding at +6 is that for many cats, as the insulin wanes in the second half of the cycle, it's less able to process the carbs and the preshots can end up higher. Many people feed most of the food in the first few hours of each cycle. it's just an option to try out that works for many.

that's probably enough for now - as others have said, the yellow starred stickies are full of great information. i still reread them and glean new bits. it often doesn't stick until you need a particular bit of information. You don't have to remember it all - we'll help point you to information as well.

Just want to add my welcome to you and Marley! I hope you'll post often so we can get to know you and Marley and help you both out. :-D
 
Hi Amy.

Just wanted to add my welcome to LL. You are in the best possible place to get help and support as you navigate the obstacle course that is FD. The people here are very knowledgeable, patient and supportive. They saved my kitty's life, and my sanity.

Some of us don't feel like we have enough knowledge or experience to give advice, but we are happy to provide anecdotes about how a situation affected our kitties, and give lots of moral support. Never underestimate the value of support from people who have been there!

One hint I like to share: If you can shop at Amazon.com, be sure to get there through the SHOP link at the top of this page. When you do that, FDMB gets a small commission, and we want to support the site that supports us! :-D
 
Hi Amy and Marley and welcome to Lantus Land,

You are asking good questions and getting good answers. We are all here to help, so keep on asking questions, reading the informational "stickies" at the top of this forum, and keep up the good work. I'm sure that soon Marley will associate those delicious treats you made for her with "test time". Also, cats love their routines, so as soon as she becomes used to her tests, she will expect them. That's why you want to make the experience a pleasant one. You can spend some time petting or grooming, rubbing her ears gently while praising her, etc. whatever you and she enjoy. Warming the ear with a warm wash cloth wrapped in a plastic baggie helps the ear to bleed. A little vaseline on the ear will get the blood drop to bead up. Many of us use a little Neosporin (triple antibiotic ointment or creme with pain reducer) to help ears heal fast after the last test of the evening. But nothing is better than praise and a treat after every test (even if you couldn't get a blood drop; i found out early on that if I couldn't get blood after 3 trys, just to abandon that test).

Welcome!

Ella & Rusty
 
Just wanted to add my name to the list of folks welcoming you and Marley here to Lantus Land! You have been doing a fantastic job to this point! Don't be too hard on your vet.... just keep in mind that their job is not an easy one... they have to be "experts" on all conditions for a multitude of species, which doesn't really afford them the opportunity to be abreast of the latest research/technology on all of them. This is where being well-informed comes into play, and you're doing that, and you're in the right place! Willie and I came here in December, 2010 and are back for what we hope is a brief visit after achieving remission 6 months ago. Every person on here has been in your shoes and will do everything they can to help!

Another treat suggestion would be dried fish bits... We get human grade ones in big bags from Amazon. They are far less expensive than the ones marketed to pets, and I feel more confident feeding them to Willie as regulations on people food are far more stringent that regulations on pet foods. You may be able to find something similar locally?

Just keep testing where you can... in the beginning, it is important to get a full picture of how Marley tends to respond to insulin. You'll see us say ECID (Every Cat is Different) all the time, and it is true. My Willie tends to respond to insulin very well and his curves tend to be relatively flat and stable with few bounces. Some cats here will start a cycle near 300, then will be in the 40s and hour or two later. The more you test, the more you can understand how Marley's body works... and your choices can be better informed (and much less stressful!). Most of all, just keep asking questions as you have them and enjoy the community here.... it's a fantastic group that fully understands what you're going through.

Looking forward to reading more about Marley!
 
THANK YOU ALL!! for all of the advice & making me feel welcome & that we CAN deal with this!! It has been a very rough 2 weeks since diagnosis, but I feel like today for the first time, things are NOT as horrible as I thought they would be. Today is the first day since diagnosis that Marley has been under 400 ALL DAY. She just got her second shot of lantus, (last shot was 6pm yesterday, so 1 unit seemed to last a REALLY long time, so we dosed with .5 unit this evening) & I am about to update the spreadsheet now.

Will definitely work on making up a profile for her so you guys can know her full background.

We use the warm wash cloth in a plastic baggie method too! (I read that on this forum actually!) Before starting that method we were having all kinds of trouble drawing enough blood for a test, but ever since starting that method it's been smooth sailing at test time! :smile: One less thing to worry about!

We tried the treat method at shot time this evening too. My husband distracted her with treats while I gave the shot & it went much more smoothly!

Will test again at +3 & +6 & again at +11 just to try to get her pattern on the lantus figured out.
 
I'm glad you'll be getting those +11s, as being able to see whether she is rising or falling at shot time will really help you a bunch.
Good job, and have a nice evening.
 
Now that you're at 0.5u, let's have you stay with that dose unless you catch a BG under 50.

One important characteristic of Lantus is that it likes consistency. Marley will have the best blood sugar control with one shot every 12 hours of the same dose.

It's a depot type of insulin, which means it builds up in the body and slow releases. that helps to control the BGs and ideally, once you get to a good dose, it will hold them as flat as possible.

it's a very manageable disease. once you get the hang of it, it becomes routine. when i realized i could test punkin while talking on the phone, i knew i'd made it! :lol:

The best information is found in the yellow-starred stickies at the top of this forum. You'll want to keep referring to those and people will help you find where info is if you can't find something. I think it's helpful to download & read the "Management of Diabetic Cats.pdf" on the Tight Regulation Protocol page. It's very optimistic. We do regularly see cats go off of insulin here and become diet-controlled. It doesn't happen to every cat, but most every cat can get regulated.
 
The sticky notes have been extremely helpful! I printed most of them out to have as a quick referance if needed.
I think Ive read them all at least a dozen times... But the more I read them the better grasp I have of everything.

Will update the spreadsheet tomorrow with her BG levels from this cycle.

Thanks again everyone!! Good Night!
 
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