New Member, May 2, 2023: help switching from Caninsulin 3.8 units to Lantus 1 unit

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So, how am I supposed to get any sleep if I’m not sure when the nadir will be and if it can change at any time???
 
You will learn your cat's patterns over time. Some cats (like mine) were less likely to have a consistent nadir, but others do. Running curves every once in a while will give you an idea of your cat's blood sugar patterns. Note, these patterns tend to be over several cycles. But with the spreadsheet are more easily spotted.
 
Stefania S said:
I wish I had pushed for Levemir. At the time I just wanted to get her off Caninsulin to something better and the vet seemed more familiar with Lantus so I just went with that.
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Just found this posted by a member about Levemir
The biggest difference between Lantus and Lev is that its onset and nadir are later than with Lantus. If a cat's nadir is at +6 with Lantus, nadir with Lev could be a couple of hours later. This may be a consideration for your schedule. I stuck with Lantus because of the timing of the cycle and my cat's time of onset and nadir. Other than the timing, Lantus and Lev act in a very similar way

Part of that process is getting a feel for basic concepts:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
 
So, it’s almost 8am, past time for insulin and I can’t get a read on the sensor. I’m pretty sure the vet would tell me to go ahead with insulin anyway. Trying to do a blood test will freak Jessi out so much that it will jeopardize the shot, which is why I use the sensor.

I haven’t had enough time monitoring yet to know for sure but so far her BG hasn’t gone lower than 100 on Lantus.

Shoot or don’t shoot? We just started, skipping now will really mess with progress

Update: it came back online. I had already given her the shot, though behind schedule. I called the emergency line at the clinic where the Endocronologist who put the sensor on works and they said to do it since the dose is fairly low and her BGs have been moderate, not going below 100 since being on Lantus. So I gave her the shot and about 40 minutes later the sensor decided to speak again. This does happen fairly often, at least once a day that for anywhere from a few minutes to an hour it kind of goes offline. Then it comes back again. Who knows what’s going on in those interstitial pathways...

Anyhow, all good, except for my moment of stress and being late doing the shot, alls well that ends well!
 
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I’m just seeing this. What did you decide to do?
With DKA in recent past it’s not a good idea to skip doses.
Can you tell me what have been the numbers up until the libre stopped
 
Bron and Sheba (GA) said:
I’m just seeing this. What did you decide to do?
With DKA in recent past it’s not a good idea to skip doses.
Can you tell me what have been the numbers up until the libre stopped
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Did you see my update? I did give the insulin and
the sensor did come back online.

The numbers haven’t gone below 100 that I am aware so far, although on the sensor graph it looks as if they may have momentarily gone a little below in between scans (an hour apart). Keep in mind I am scanning very often especially after +3 for several hours. Her onset seems to be between +1 and +2 and her nadir so far seems to be between +5 and +7

So far results look good with Lantus, much more green, much less dark orange.

I will give more numbers soon. Going on 3 hours sleep after a week of no more than 4 every night, and a month of 5-6. I need to find a way to rest more or I won’t make it.
 
Stefania S said:
So, it’s almost 8am, past time for insulin and I can’t get a read on the sensor. I’m pretty sure the vet would tell me to go ahead with insulin anyway. Trying to do a blood test will freak Jessi out so much that it will jeopardize the shot, which is why I use the sensor.

I haven’t had enough time monitoring yet to know for sure but so far her BG hasn’t gone lower than 100 on Lantus.

Shoot or don’t shoot? We just started, skipping now will really mess with progress

Update: it came back online. I had already given her the shot, though behind schedule. I called the emergency line at the clinic where the Endocronologist who put the sensor on works and they said to do it since the dose is fairly low and her BGs have been moderate, not going below 100 since being on Lantus. So I gave her the shot and about 40 minutes later the sensor decided to speak again. This does happen fairly often, at least once a day that for anywhere from a few minutes to an hour it kind of goes offline. Then it comes back again. Who knows what’s going on in those interstitial pathways...

Anyhow, all good, except for my moment of stress and being late doing the shot, alls well that ends well!
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The libre is convenient, but there are glitches and that’s why we recommend home testing.
 
Today BGs went quite LOW: lowest was 59 at +6.25

I was assured by several different vets previously that this is ok as long as she at. She had an entire can about an hour and a half before, so I don't know why it stayed low for so long (about an hour). I offered honey on the food but she wouldn't eat it. I offered it again on a teaspoon with some of the gravy from her food and she licked it a little. She is looking very tired. She also has an infection and just started antibiotics. I know she is in pain from the infection.

I kept a close eye on BGs with the sensor. I was told that the Libre reads about 10 lower than the glucometer so that 61 might have actually be a 71.

There are so many different things affecting this little kitty, it's hard to know what is doing what and why she is looking the way she is. The infected anal gland is about to rupture so that is hurting a lot.

I wonder why the numbers were so much lower today? Possibilities: she didn't nibble between meals like yesterday. In fact she had eaten 3 cans by 2pm whereas today she only had 2. Yesterday she at lots of little meals rather than a couple of big ones like today. Also she forgot to ask me for food and I got distracted with some things I was doing and the time went by without her eating for more than 6 hours. And also, when I was dosing the syringe the plunger was ever so slightly under the line, while yesterday it was every so slightly over it. A few drops extra and a few nibbles less...

could there be other factors making it go so low today?

Btw, she doesn't like honey. I had a feeling. So that isn't going to work. I have to get my hands on some corn syrup and see if she likes that better. I am still in the process of finding and ordering high carb food. I already have some medium carb food in the house but who says she'll eat it.

Onto dosing. I am finding it very hard to be precise with dosing. Lantus is harder for me because I can't inject back into the cartridge. That means I have to take a lot extra because there is always one bubble that won't go away easily. Today it took more than 2 units extra and having to put the syringe back in the cartridge to take out some more before I got the bubble out. And I am still unsure about the amount that is in the syringe. Even though the plunger is ever so slightly above the 2 mark, which I intentionally did, because the upper most mark is quite a bit below the upper part of the syringe, not quite a half unit but close.

This is where it gets very stressful for me. It seems like just a few drops more or less can make such a big difference especially with Lantus. So now I am much more unsure about getting it right when I am filling the syringe.

Since she went so much lower today, should I take off .25? How the heck do I manage to do that precisely? And without having to repeatedly stick the needle back into the cartridge because I overshot the mark.

Help please!

I have to do the shot soon so if you can advise quickly that would be great, thanks!
 
Stefania S said:
Btw, she doesn't like honey. I had a feeling. So that isn't going to work. I have to get my hands on some corn syrup and see if she likes that better.
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In a low numbers event (lower than today's numbers) if your cat will not eat high carb food, you would dip your finger in honey then open the cat's mouth and swab the inside of the cheek.

Did you try mixing honey in a bit of food?

Ask your pharmacist for "liquid glucose" for diabetics. It usually comes in small tubes. I believe this product is common in the EU.
 
Yes, she earned a .25 reduction since we talked about you following SLGS. I’m sorry I don’t remember your dose and I know you don’t have a spreadsheet setup yet so I can’t check.

are you using 1-2 unit marked syringes. Can you please take a pic and post it?
 
Another thing. The honey or Karo they don’t have to like it. If it’s an emergency, you rub it on their gums. Neither one of my cats liked either so I’d just put some on my finger and rub it on the side of their mouths.

I’ll let others talk about the best way to measure Lantus. I always just eye ball the 1/4 units
 
I took a photo of the filled syringe but then I couldn't find a way to share it here.

I reduced it yes, but I'm not sure if I reduced it enough. What's happening is that she feels awful from the sacculitis which just burst a little while ago, so hopefully she'll feel better soon but this is coinciding with the sensor quitting, her eating less and nadir probably happening in the next hour at +6. She did eat about two thirds of a can about an hour and a half ago but I had to hand feed it to her while she was lying down.

I did manage to get a pre preshot number which was around 302 and rising, but nothing after that. Makes me nervous considering her low numbers earlier today and

Bad timing with all of this.

I may break out the glucometer at this point, but it could get pretty crazy at almost 2 am with me feeling dizzy from exhaustion trying to test a very uncompliant cat who is gushing bloody stuff all over and in a lot of pain to begin with. I might end up doing more harm than good....

or I may have to take her to the clinic which I was trying so hard to avoid...

I'm so tired I'm falling asleep as I'm writing this even though I'm stressed about the situation.

Update: just when I had decided if it didn't work I would give it a go with the glucometer, the sensor came back with 224 at +5. That's quite a bit higher than it was the last few times at +5 so I feel a little better. It could and should still go down some and probably this time I gave her too small of a dose, but better to be safe given the unpredictable situation, right? at least I don't have to worry as much about her eating. I think her appetite will return soon.

The sacculitis is quite painful but once it opens it heals quickly and she feels better fast, at least that was how it went last time.

Poor little one, so many physical challenges all at once...
 
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Stefania S said:
I tried taking a photo but then I couldn't find a way to share it here.

I reduced it yes, but I'm not sure if I reduced it enough. What's happening is that she feels awful from the sacculitis which just burst a little while ago, so hopefully she'll feel better soon but this is coinciding with the sensor quitting, her eating less and nadir probably happening in the next hour at +6. She did eat about two thirds of a can about an hour and a half ago but I had to hand feed it to her while she was lying down.

I did manage to get a pre preshot number which was around 302 and rising, but nothing after that. Makes me nervous considering her low numbers earlier today and

Bad timing with all of this.

I may break out the glucometer at this point, but it could get pretty crazy at almost 2 am with me feeling dizzy from exhaustion trying to test a very uncompliant cat who is gushing bloody stuff all over and in a lot of pain to begin with. I might end up doing more harm than good....

or I may have to take her to the clinic which I was trying so hard to avoid...

I'm so tired I'm falling asleep as I'm writing this even though I'm stressed about the situation.
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The libre only lasts for about 2 weeks. How long have you had it for? 302 is high enough but it would be great if you could get another reading now. I don’t know that trying to hand test at 2am for the very first time is a good idea honestly
 
Ale & Bobo & Minnie (GA) said:
The libre only lasts for about 2 weeks. How long have you had it for? 302 is high enough but it would be great if you could get another reading now. I don’t know that trying to hand test at 2am for the very first time is a good idea honestly
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No more readings. It lasted about 7 days. It could also be internet since we are in flood zone here. Or it could be the App, don’t know...I noticed it needs a consistent strong internet connection, which normally we have but right now could be wobbly.

She’s doing much better now that the sac opened. I will watch her very closely. Later if I can’t get a read close to nadir I will attempt an ear prick. Not my first time, but every time has been VERY unsuccessful. She goes into underground (deep hiding) mode and then everything gets super hard including getting her to eat, doing injections, etc...she remembers these things for a long time. Not like other cats who shake it off. That’s why I opted for the sensor. Otherwise I never would have. I don’t like making her have this thing on her body.
 
Are you giving her a treat immediately after testing? Whether it’s a success or a fail, give her a treat to build positive association. I also do a lot of petting and verbal praise telling them how good a boy or girl they are and what a good job they did
 
HELP again!

We are in LOW numbers and going down as far as I can tell.

The Sensor is giving me some readings and strangely it keeps charting a broken up graph even when it doesn't give me a number reading and right now it shows me she is in the red zone, above 50 still, but going down.

I just fed her and poured some juice from canned corn in her food, hoping that will do it. She ate almost an entire can but I notice it takes quite a bit for numbers to rise after feeding regular food. I went to take a long needed shower and wash my hair and this is what I find when I get out.

Jessi loves corn, so I may just offer her some of that and see if she'll eat it. That would be high carb enough, right?

I'm supposed to give insulin in the next half hour. I can't give her insulin when she is that low right? Even if it is Lantus with a slow release...

I notice a lot of up and down with Lantus throughout the day, not as dramatic maybe but definitely more frequent than with Caninsulin. It makes it really hard to pinpoint the nadir.

I thought I had a sense of that and now this!

I'm going to wait for the numbers to go back up, hoping the sensor will show me what I need to see, before insulin, right?

How far up do they need to go?
 
You def don’t shoot if she’s in the 50 range. Can you you free hand test to make sure the libre is accurate? I wouldn’t shoot anything under 150 maybe even 200. You still don’t have a spreadsheet so I can’t tell what the progression was or how she got to the 50 and I can’t see how she does with the food. This is why it’s so important. I’m not positive about corn. It should be but I’d rub some honey or Karo on her gums like I mentioned before. If she’s going low, you want to feed and retest in 20-30 minutes to see if what you gave her is sending her bg up or not.

also for the future if you want a fast response you need to start a new thread with help on the tile and or a 911 before it depending on how life threatening it is.
 
Skipping the dose entirely.

I tried to test in a location and at a moment where I thought it might work, she seemed so lethargic and passive but as soon as she felt me holding her down even just a little and holding her ear between my fingers she used all her strength to do what cats do to escape.

How can the vets tell me to just give her the usual dose even when I can't see the numbers??? Clearly 2 is too much for her. This was even a lower dose, this morning I gave her about 1.75 units. But I think her numbers were in the mid 200 which is lower than usual preshot. I say I think because the Libre is giving me occasional numbers but broken up charts that show much more than the scanned BG numbers. So often I can see what came before the scan.

She goes bonkers for corn, I haven't seen her that excited for food in a while. I only gave her about a spoonful but she would have eaten a lot more. I don't want to make her BG spike but I also want to get her out of danger.

I can try another test, but there is no way to coax Jessi into being restrained. She goes ballistic, not aggressive, but in complete flight (as in run and hide) mode. I have to use a lot of force to restrain her and that makes it nearly impossible to put a needle into her ear and then put a test strip to the drop of blood at the same time.

When it comes to being restrained in any way, Jessi is a wild animal. She has always been that way. Same goes for having any part of her body held for more than a split second.

Tried a second time, the calm, gentle soothing way. Nothing doing. As soon as she felt the needle against her ear she jumped away. Only thing left is the forceful, confining way, but that will have permanent damaging effects on her. Will try again tomorrow.

If we skip two shots, I have no idea what will happen. Vets not very helpful at all in this situation.

Guess I'll post a new thread next time. Don't quite understand the 'etiquette' on that, but as you wish.
 
With DKA in the recent past it is not a good idea to skip doses. Don’t skip two shots please. If Jesse is lethargic, that is another reason why not to skip a dose. I would test again in an hour to see if the BG has risen enough to give the dose. You may need to give a reduced dose.
Are you testing for ketones in the urine?
Stafania, we really want to help you but unless you set up a spreadsheet, it is almost impossible for us to give you dosing advice.
@Bandit's Mom is happy to do that for you but you need to respond to her PM. For us to help you, we need to see the recent BGs and the dose of insulin Jesse is on. We can’t keep scrolling back through 70 posts to find out information all the time.
We want to help you, but we need that Spreadsheet set up please.:)
 
I am putting on my moderator's hat.

It is virtually impossible to offer informed guidance without benefit of a spreadsheet. Our cardinal rule involves the safety of your cat. Not being able to see your cat's blood glucose values in a consolidated format that is more than what's going on this minute is a problem. You are asking for advice and saying the situation is emergent. We cannot in good conscience help if we don't have the full picture. Experienced members have been pleading with you to get your spreadsheet set up.

Personally, I will not put myself in a position of offering input that could potentially harm someone's cat. Not having a spreadsheet to look at puts me in that position.
 
Stefania S said:
Skipping the dose entirely.

I tried to test in a location and at a moment where I thought it might work, she seemed so lethargic and passive but as soon as she felt me holding her down even just a little and holding her ear between my fingers she used all her strength to do what cats do to escape.

How can the vets tell me to just give her the usual dose even when I can't see the numbers??? Clearly 2 is too much for her. This was even a lower dose, this morning I gave her about 1.75 units. But I think her numbers were in the mid 200 which is lower than usual preshot. I say I think because the Libre is giving me occasional numbers but broken up charts that show much more than the scanned BG numbers. So often I can see what came before the scan.

She goes bonkers for corn, I haven't seen her that excited for food in a while. I only gave her about a spoonful but she would have eaten a lot more. I don't want to make her BG spike but I also want to get her out of danger.

I can try another test, but there is no way to coax Jessi into being restrained. She goes ballistic, not aggressive, but in complete flight (as in run and hide) mode. I have to use a lot of force to restrain her and that makes it nearly impossible to put a needle into her ear and then put a test strip to the drop of blood at the same time.

When it comes to being restrained in any way, Jessi is a wild animal. She has always been that way. Same goes for having any part of her body held for more than a split second.

Tried a second time, the calm, gentle soothing way. Nothing doing. As soon as she felt the needle against her ear she jumped away. Only thing left is the forceful, confining way, but that will have permanent damaging effects on her. Will try again tomorrow.

If we skip two shots, I have no idea what will happen. Vets not very helpful at all in this situation.

Guess I'll post a new thread next time. Don't quite understand the 'etiquette' on that, but as you wish.
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Can you try maybe testing her in a bathroom, so she has no where to go, that might help get her more used to testing. It doesn't hurt her, she's just not used to getting poked & poking her is not traumatic for her. I never thought I would be able to test my boy whom is known as the terror at the vet, but I just kept trying & giving him boiled chicken as a treat. Now he comes running when I say test time & sometimes he's already laying in his chewy box that I test him in. Check out his spreadsheet when you get a chance, I guess I'm a test aholic :smuggrin::D
 
Stefania S said:
Skipping the dose entirely.

I tried to test in a location and at a moment where I thought it might work, she seemed so lethargic and passive but as soon as she felt me holding her down even just a little and holding her ear between my fingers she used all her strength to do what cats do to escape.

How can the vets tell me to just give her the usual dose even when I can't see the numbers??? Clearly 2 is too much for her. This was even a lower dose, this morning I gave her about 1.75 units. But I think her numbers were in the mid 200 which is lower than usual preshot. I say I think because the Libre is giving me occasional numbers but broken up charts that show much more than the scanned BG numbers. So often I can see what came before the scan.

She goes bonkers for corn, I haven't seen her that excited for food in a while. I only gave her about a spoonful but she would have eaten a lot more. I don't want to make her BG spike but I also want to get her out of danger.

I can try another test, but there is no way to coax Jessi into being restrained. She goes ballistic, not aggressive, but in complete flight (as in run and hide) mode. I have to use a lot of force to restrain her and that makes it nearly impossible to put a needle into her ear and then put a test strip to the drop of blood at the same time.

When it comes to being restrained in any way, Jessi is a wild animal. She has always been that way. Same goes for having any part of her body held for more than a split second.

Tried a second time, the calm, gentle soothing way. Nothing doing. As soon as she felt the needle against her ear she jumped away. Only thing left is the forceful, confining way, but that will have permanent damaging effects on her. Will try again tomorrow.

If we skip two shots, I have no idea what will happen. Vets not very helpful at all in this situation.

Guess I'll post a new thread next time. Don't quite understand the 'etiquette' on that, but as you wish.
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I've actually have a much stronger bond with Panzer since testing, alot of us on here develope a bond, he is definitely my heart kitty ❤
 
Stefania S said:
I tried to test in a location and at a moment where I thought it might work, she seemed so lethargic and passive but as soon as she felt me holding her down even just a little and holding her ear between my fingers she used all her strength to do what cats do to escape.

I can try another test, but there is no way to coax Jessi into being restrained. She goes ballistic, not aggressive, but in complete flight (as in run and hide) mode. I have to use a lot of force to restrain her and that makes it nearly impossible to put a needle into her ear and then put a test strip to the drop of blood at the same time.

When it comes to being restrained in any way, Jessi is a wild animal. She has always been that way. Same goes for having any part of her body held for more than a split second.
.
Click to expand...

Just a suggestion…. try wrapping kitty in a towel. I use it with rescued ferals who do NOT like restraint. Put the cat on a open towel and pull the corner or edge up and over. Some cats actually like the security for a short time.
 
After the stickies about not letting threads be longer than a certain amount, I felt like I shouldn't post here anymore. But then I was dropping the conversation and starting a new one which is a little awkward.

I just wanted to say that I skipped the dose last night and this morning after a good meal gave her a little more than 1 unit. I was writing a new thread earlier, but it's really like a continuation of this one, so...not sure what to do.

Sensor stopped working completely probably because she was kicking it so much. It lasted about 7 days so I did collect a lot of data, but most of it was while we were on Caninsulin. Still, I learned a lot. I will get a replacement very soon. Until then 1 unit Lantus, half the original dose seemed like a good choice.

I'll go ahead and post the message I wrote in a new thread in response to some of the replies here. You can let me know if it doesn't read well.
 
All you have to do is type something like "Previous thread:" then copy the link for this page and paste it on your new thread. That way, people don't have to search for your initial thread and neither do you.
 
Well, as a Moderator, I'm strongly encouraging you as to what to do and what the conventions of this board are. There is a sticky note at the top of the board with this information. Scrolling though 80 posts will likely ensure that people will not read the entire thread. As was suggested, copy the URL into your new thread and anyone can go back to find information.
 
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