New member - rising BG numbers

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Jessica’s Panini

Jessica’s Panini

Member
Hello!

I tried filling out profile and signature with proper information.
Story time -
My cat panini has been on vetsulin since diagnosis 2021 he has been on 2 units twice daily. I monitor his BG at home with relion human test meter. His diabetes has been manageable until recently. I have had him on an all wet food diet for a few years now already - unfortunately I was not able to get him in remission I would have some days that his number would be under 200 and I would skip insulin those days. I’ve been having a hard time with managing his blood glucose recently - he had pancreatitis diagnosed in July he wasn’t eating, throwing up, and having diarrhea. Panini LOVES food he never not eats this is why we are in this predicament lol
So I knew something was wrong took him to the vet and they said he has pancreatitis. I was given metronidazole he was given fluids and anti nausea and anti diarrheal medication. And I was told to limit fatty foods so I checked all my canned food I was giving him. while this is happening his BG is under 100 they vet does a fructosamine test and says he has been hypoglycemic and may not need insulin and to monitor numbers and if over 200 give 0.5units (which he was previously taking 2 units BID) i followed what she said and whenever it went over 200 gave this small dose of insulin.
So - I tracked his BG and it started to creep back up to higher numbers but I kept giving small dose
I switched his food to all raw food to see if it would help him with managing pancreatitis and I also think he has IBD. Which I forgot to mention in profile. And his numbers keep climbing. I went back to 2 units because 1/2 was doing nothing
And I just increased to 2.5 BID and his numbers are still high! And I don’t know what to do. I’ve been reading about lantus and I have an appointment tomorrow with vet because I feel like his dose or insulin or both are no longer working. I have been checking his BG after starting a new vial of vetsulin and his numbers are increasing. I’m very worried about this.. I am doing a curve today to check every two hours. His appointment tomorrow is 5pm w/ vet.

I am just baffled because he is on all raw pure protein diet and does not really have much carbs if any in his diet. So I don’t understand why his numbers are going up so much rather than down..

I have included his numbers around July with the pancreatitis

7/21 6:01pm before dinner 90
7/22 5:18pm before dinner 92
7/23 5:46am before breakfast 167
7/23 181 at vet
7/24 5:50am before breakfast 115
7/27 4:28pm before dinner 210
7/29 7:02pm after dinner 457
7/30 5:45am before food 306
7/30 5:11pm before dinner 329
7/31 5:43pm before dinner 370
8/01 5:30pm before dinner 282
8/02 5:11am before food 217
8/03 3:53pm before dinner 365
8/06 6:23pm before dinner 266
8/07 5:08pm before dinner 251

during this time 1/2 unit was given as instructed.

This is more recently blood glucose numbers I am trying to be a little more detailed

10/07
6:05am before shot 404 2 units
7:58pm +2hr after eating and shot 510
11:04pm +5hr after eating and shot 346

10/08
5:47am before shot/eating 363
2 units given
6:35pm before shot 510
2 units
8:25pm after shot/eating 520

10/09
5:06am back paw before eating/shot 524
5:10am before shot 310 front paw
(Switching sites and different numbers didn’t make sense to me)
5:30am 2 units given
5:21pm before eating and shot 442
5:30pm 2 units
8:40pm after eating/shot 492

10/10
6am GB 370
6:15am food & 2.5 units
4:53pm before food 214
6:30pm food
7:46pm 228

10/11
6:18am 451
2.5 units given W/ food 6:30am
5:04pm 424 before food
2.5 units given w/ food 5:45pm

10/12
6:32am 526 before food
6:35am food and 2.5 units
+2hr 8:45am 542


I did test relion meter on myself and my BG was normal. I did think it was also meter issue but I’m not sure what is going on with him.
 
Welcome to FDMB!

Panini's situation does sound confusing. A word of warning -- I'm going to link a fair amount of reading.

The first thing I want to suggest you look over is our post on helping us to help you. It has instructions not just for your signature but for setting up a spreadsheet. It's a more visual way to look at Panini's blood glucose numbers so we can track his progress along with you. (We're used to looking at the spreadsheet vs a column of numbers.)

We regard a cat as being in remission if blood glucose is consistently in the 50 - 120 range. Your vet seems to lean toward higher numbers hence telling you not to give insulin if numbers are below 200. I'm also guessing that it will take a bit for you to get comfortable with shooting lower numbers. We would definitely suggest insulin if numbers are over 90. I'm also glad you're asking your vet about a switch to Lantus. If you need a bit of support for talking to your vet, I'm linking the diabetes guidelines from the American Animal Hospital Assn. They have not recommended Vetsulin since 2018. While some cats do well on Vetsulin, most do not get sufficient duration and it may be why Panini wasn't able to reach remission.

Do you know how your vet diagnosed pancreatitis? There are blood tests that can be run. This is our Primer on Pancreatitis. It will provide background on diagnosis and management. While pancreatitis may be a reason for elevated blood glucose levels, I would expect that the problem would have resolved by now. Any infection or inflammation can cause blood glucose to be high. Has the vet run any blood work given what your cat's blood glucose levels look like? One other explanation for elevated levels can be the need for dental work. We've seen lots of cats who have been in remission fall out of remission due to gingivitis.

From your description, IBD does sound like a possibility to be ruled out. Diagnosis is a bit more invasive, though. Starting out with an ultrasound can be helpful but it's not definitive. Typically, IBD is diagnosed by a biopsy. This is a link to a very good website on IBD. They promote a raw diet but also have a wealth of information on diagnosis, use of supplements to manage symptoms, etc. and also have a Facebook page where you can ask questions.
 
Thank you for all of the information.
I have setup his spreadsheet and have linked it to the signature.
I agree, I have been doing some reading and don't understand why he was put on vetsulin if Lantus works better or other insulins work better for longer. He hasn't had an issue before but it doesn't seem to be working as well anymore. I thought it was because I had an older vial which was part of it i believe - I did read some posts of people being able to get 3-5 months post 42 day recommendation. As soon as I saw it wasn't lowering his numbers I switched to a new vial and his numbers are not getting any better. I would like to learn how to shoot low and stay low once we can get his numbers under control.
When I brought him in for pancreatitis the doctor did a fructosamine assay test, BG test, and SNAP fPL test to check for pancreatitis which she said had a strong positive result. He does seem fine symptomatically now. He's acting like his normal self. Panini has had dental work in the past and had several teeth removed because of a gingivitis diagnosis. I'm not sure if he has any other bad teeth currently. He doesn't paw at his mouth and has no issues eating.
He was never diagnosed with IBD, he does consistently have soft or looser stools - they were worse with the pancreatitis bought he had more diarrhea. One of the benefits I read about switching to raw diet included that it might help with IBD and help firm up stools. He still has softer stools. I started adding supplements to his diet to try to help with his pancreas and digestion/bowels.
He has been on a raw diet recently now for about three weeks not too long. Honestly I thought his numbers would improve a lot more with his new diet..
 
Okay, it looks like his BG is finally trending down. I updated the spreadsheet. Going to check it again in another two hours, then it will be close to his dinner time. Depending on his number near dinner could you please advise dosage that you would recommend? I don't know if i should administer 2.5 again if it's still below 200. And i don't really understand why yesterday it was in the 400s after giving 2.5 same dose and 500 in the morning..
 
A lot of vets have used Vetsulin for many years and are comfortable with it. They are less knowledgeable about Lantus and tend to stick with what they know. It's also used with dogs so they can stock it for most of the animals they treat. Since they sell it directly, it also means it's a revenue stream for them. They can't sell Lantus since it's a human insulin and you can only purchase it at a pharmacy or similar source.

Just so you're aware, the manufacturer suggests that Lantus be used for 30 days. If you look at my cat's spreadsheet, you'll see that like most members here, I got a substantially longer life from a Lantus pen than 30 days -- usually around 4 months. I did have a time or two when I questioned if the insulin was still good and went with a new pen.

I'm glad your vet did the Snap fPL. Was Panini given pain meds? It may be irrelevant now since it sounds like the pancreatitis is history. As for the dental, if the problem is gingivitis, it's unlikely he would be pawing at his mouth. It's hard to get a good look at teeth when a cat is awake especially if the cat is not happy with being at the vet's office. I'd ask the vet to take a look though. The inflammation from gingivitis can have an effect on numbers.

Also, some cats' systems get upset with a food change. It could be contributing. However, it also looks like Panini's numbers dropped by +8. That was a huge drop in numbers from your pre-shot reading. What you are very likely to see is reaction that we refer to as a "bounce." When a cat's blood glucose drops low, drops fast, or simply drops into a range the cat isn't used to, there's a protective reaction by the liver and pancreas. The organs release a stored form of glucose along with counterregulatory hormones which cause numbers to spike back upward. Since you don't have mid-cycle data, there's no way to know how often this has been occurring.

As to dose, there are two considerations. How low are you comfortable shooting and if you're shooting a lower number than usual, can you test during the PM cycle to make sure Panini stays in safe numbers? I'm not suggesting you stay awake all night! It's just a matter of getting a couple of tests to be sure his numbers are in a safe range. That said, unless there's a compelling reason to shoot a lower dose, I'd stick with the 2.5u.

This is a link to our guide for using Vetsulin. It may be helpful to see how we approach dosing. I'm hoping you're feeding Panini 20-30 min before you give a shot.
 
Thanks for your advice. That is good to know about the lantus pen - Do you think I would have to specify to the vet that i want the pen vs or vial or it shouldn't matter when ordering through chewy? Lantus uses different needles too vs vetsulin, right? I have U-40 needles now but they do have 1/2 unit measurements.

I will have the vet check his gums tomorrow to check for gingivitis.

I'm not sure I have usually skipped insulin shots if below 200 or in the 100s, but as long as it is safe range I am willing to give it a shot. lol
Honestly I have always given Panini his insulin as he is eating, I didn't know I had to wait 20-30mins before.. I was not told this. I was told he has to eat, if he isn't eating then don't give him insulin as it can put him hypo. I will now be waiting 20-30s after eating.
So i will test him again soon - let him eat wait 20-30 mins, retest and then shoot?


And I am very sorry for your loss of Gabby. I lost one of my cats in July this year and it was very tough, the first baby I lost. I miss her all the time.
 
Hi Jessica
If you do switch insulins
I would suggest Lantus or the generic form
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menu says generic glargine 1carton of 5 3ml pens.

Lantus usually doesn't kick in until 2 hours after the shot

We buy the pens but use the syringes to draw out the insulin because if you use the pen you can only adjust by full units ,we adjust the doses by 0.25units
If you do switch to lantus the generic you will need
U -100 SYRINGES WITH HALF UNIT MARKINGS
I can suggest a few if you would like


Also
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus

If you use the Good Rx
GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you any issues.

I think I found it for you
GoodRx / Customer service

1 (855) 268-2822

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Just call around and see who has the cheapest price , it's really not that expensive

With Lantus or the generic such as Glargine you need U-100 syringes with half units markings

you can get U100 insulin syringes with half unit marks for $12.58/100.
You have to go into the store , you can't order them on line

Either of these 2 boxes are the ones you want (with a purple stripe)
upload_2024-4-22_23-37-23-jpeg.69946


You can order the U-100 syringes with half unit markings from Amazon without a doctors script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO


upload_2024-10-5_9-40-51-jpeg.71138

The ones in the left is what we use

Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen! You will see a small gray rubber stopper, insert the syringe there
syringe-in-pen-pic-jpg.45006


We use the syringes because with using the pens instead of a vial you can only adjust the dose by whole units with a pen so we use the syringes since we either increase or decrease by 0.25 units at a time
 
Hello Diane!

Thank you for all of the information - that's amazing and much more affordable! I usually go through chewy for vetsulin and see that they do have the lantus pens for $65 per 3mL pen. That is a much better deal :D I will definitely be calling around tomorrow.
You're amazing!

I just checked Panini's blood again it is 369 +2 after vetsulin.
 
It's likely that you're either seeing the influence of food on Panini's numbers or his numbers are on the way up from a bounce.

Diana provided good information about Lantus. It's now available in a generic/biosimilar form and is much less expensive now.

Thanks for your condolences re. Gabby. She crossed the Bridge about 9 years ago. She's still very much missed.
 
Jessica’s Panini said:
Hello Diane!

Thank you for all of the information - that's amazing and much more affordable! I usually go through chewy for vetsulin and see that they do have the lantus pens for $65 per 3mL pen. That is a much better deal :D I will definitely be calling around tomorrow.
You're amazing!

I just checked Panini's blood again it is 369 +2 after vetsulin.
Click to expand...
You can definitely get 5 pens cheaper than the Chewy site for one pen

Like I said. Check
CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens either Lantus or the generic Glargine , plenty of members use the generic
Just call around and see who has the cheapest price , it's really not that expensive
With the pens just keep them in the fridge middle shelf , they all have the expiration date on them . They will probably say 2025 or 2026
I have to tell you if it wasn't for the experienced members here and me taking their advice I know Tyler would never have gone into remission for 3 years and 6 months.
Unfortunately I had to let him go on 8-26-2024 due to small cell lymphoma. He lived a good life .
He was 16 and 4 months old
@Jessica’s Panini
 
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I have to tell you if it wasn't for the experienced members here and me taking their advice I know Tyler would never have gone into remission for 3 years and 6 months.
Unfortunately I had to let him go on 8-26-2024 due to small cell lymphoma. He lived a good life .
He was 16 and 4 months old

What a cute pic of Panini and your other kitty cuddling
@Jessica’s Panini
 
Diane,

That’s amazing, I would love for Panini to be able to go into remission. I still have hope even though sometimes I feel like it won’t happen. I saw mentioned that they can go into remission but it’s hard if they regress to get them back into remission. I’m wondering if he missed his window.
Looking forward to all of the information and advice that can help.

Aw, I’m sure he did live a good life. That’s very sad I’m sorry for your loss as well. It’s never easy. My cat Lilly passed in July from histiocytic sarcoma, it was aggressive I was hoping to get a year after diagnosis but it was a few months after. She was 9 years old. Too young to go! But she’s not in pain anymore.

thank you! That is our newest squad member Heiny lol
 
Sienne and Gabby (GA) said:
It's likely that you're either seeing the influence of food on Panini's numbers or his numbers are on the way up from a bounce.

Diana provided good information about Lantus. It's now available in a generic/biosimilar form and is much less expensive now.

Thanks for your condolences re. Gabby. She crossed the Bridge about 9 years ago. She's still very much missed.
Click to expand...

You’re welcome. Okay, I will check his BG again in another hour. Hopefully it starts trending down. I’m curious what it will be in the morning.

Thanks for your help!
 
@Diane Tyler's Mom GA

Thank you! :bighug: I won't give up hope for him to be in remission one day.

@Sienne and Gabby (GA)

I just got back from the vet's office and got a script for lantus :) I called Walgreens and they only had one pen in stock so they are going to order the carton of 5 for me of the generic glargine. It should be ready by tomorrow or Tuesday to pick up. The doctor checked his teeth and they look good, he doesn't have many left. No signs of infection and she checked his ears and he does need some ear drops. His ears tend to bother him often, she suggested I clean them twice a week and give the drops for 10 days.
Based on his weight 12.5lbs she recommended a dosage of 1.5 units once daily. Does that sound correct?
 
@Jessica’s Panini
I'm so glad you got the script for the Glargine.
Just be sure you will have the U-100 syringes with the half unit markings. The day you do start the Glargine you will need to add that to your signature
After Vetsulin in your signature do it like this
Vetsulin/ Glargine and the date started.

Also on your spreadsheet do the same up top where you have Vetsulin, then when you start the Glargine we would like you to put a blank line above the date you start it and type Glargine Now and highlight it any color you want to
I'm going to let Sienne answer the question about the starting dose :cat::bighug:

Just noticed you said the vet said give 1.5 units once daily, that not correct at all

Also to show you what I mean about putting a blank line above the date you start the Glargine take a look at this members spreadsheet
https://docs.google.com/spreadsheet...dTNmsLk66QvaT1pGdJUjIzfZOeD5PoJ6SHHJa/pubhtml

Do you see how she put a blank line above the date 1-13-2024 the red line
So do the same when you switch to Glargine
@Jessica’s Panini
 
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Jessica’s Panini said:
@Diane Tyler's Mom GA

Thank you! :bighug: I won't give up hope for him to be in remission one day.

@Sienne and Gabby (GA)

I just got back from the vet's office and got a script for lantus :) I called Walgreens and they only had one pen in stock so they are going to order the carton of 5 for me of the generic glargine. It should be ready by tomorrow or Tuesday to pick up. The doctor checked his teeth and they look good, he doesn't have many left. No signs of infection and she checked his ears and he does need some ear drops. His ears tend to bother him often, she suggested I clean them twice a week and give the drops for 10 days.
Based on his weight 12.5lbs she recommended a dosage of 1.5 units once daily. Does that sound correct?
Click to expand...
@Sienne and Gabby (GA)
@Bron and Sheba (GA)
@Wendy&Neko
@tiffmaxee

I'm sure they will tell you giving 1.5 units once daily is not the way to go per your vet
 
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Diane Tyler's Mom GA said:
@Jessica’s Panini
I'm so glad you got the script for the Glargine.
Just be sure you will have the U-100 syringes with the half unit markings. The day you do start the Glargine you will need to add that to your signature
After Vetsulin in your signature do it like this
Vetsulin/ Glargine and the date started.

Also on your spreadsheet do the same up top where you have Vetsulin, then when you start the Glargine we would like you to put a blank line above the date you start it and type Glargine Now and highlight it any color you want to
I'm going to let Sienne answer the question about the starting dose :cat::bighug:

Just noticed you said the vet said give 1.5 units once daily, that not correct at all

Also to show you what I mean about putting a blank line above the date you start the Glargine take a look at this members spreadsheet
https://docs.google.com/spreadsheet...dTNmsLk66QvaT1pGdJUjIzfZOeD5PoJ6SHHJa/pubhtml

Do you see how she put a blank line above the date 1-13-2024 the red line
So do the same when you switch to Glargine
Click to expand...

Yes, I will be buying the U-100 syringes w/ half units. I'm going to try to find the ones you mentioned in the store first. I did add the others from amazon to my cart already in case I can't find the Relion syringes.

Thanks for the example, I will do that as soon as he starts the Glargine.
Yeah I didn't think so, it looked like the tech used a calculator online to determine the dosage with his weight. So based on his calculator it said 1.42 units then she later came in and said 1.5 units. I've noticed that all the spreadsheets I look at everyone is dosing twice with Lantus - similar to Vetsulin so I was surprised when she said once every 24 hours.

I've been thinking about switching vets soon anyways I have not been 100% happy lately whenever I take my animals. They used to be better but I feel like they're too busy now and don't spend much time in the room. I'm just happy I was able to get the script to change and found you guys for advice!
 
Jessica’s Panini said:
Yes, I will be buying the U-100 syringes w/ half units. I'm going to try to find the ones you mentioned in the store first. I did add the others from amazon to my cart already in case I can't find the Relion syringes.

Thanks for the example, I will do that as soon as he starts the Glargine.
Yeah I didn't think so, it looked like the tech used a calculator online to determine the dosage with his weight. So based on his calculator it said 1.42 units then she later came in and said 1.5 units. I've noticed that all the spreadsheets I look at everyone is dosing twice with Lantus - similar to Vetsulin so I was surprised when she said once every 24 hours.

I've been thinking about switching vets soon anyways I have not been 100% happy lately whenever I take my animals. They used to be better but I feel like they're too busy now and don't spend much time in the room. I'm just happy I was able to get the script to change and found you guys for advice!
Click to expand...
Be sure to put the syringes you used for Vetsulin away some where so you don't accidentally use one.
giving Lantus once daily will only last 12 hours , so
his numbers at night will be high
See what the members I tagged will have to say about this
@Jessica’s Panini
 
If Lantus/glargine was the first insulin you were starting on, the 1.5u would be fine. When switching from a different insulin, in most cases you can make a direct switch. If it were me, I'd start the dose at either 2.0 or 2.25u.

I'd encourage you to do a bit of reading about Lantus. There are sticky notes at the top of the Lantus forum. The information in the notes will help you to understand how Lantus works. This is important since it's a very different insulin than Vetsulin.
  • It's a depot insulin. It takes 5 - 7 days when starting out on Lantus to see much of a response (although some cats do respond when it's a change in insulin). A change in dose can likewise take several days for your cat to respond. This applies to both dose increases and reductions.
  • You do not need to feed, wait a while, then shoot. You can test, feed, then shoot immediately following each step.
  • Lantus doesn't start to kick in immediately. Onset takes roughly 2 hours (although this can depend on your cat -- every cat is different) to start. The lowest point in the cycle is at around +6 but again, this can vary.
  • Dose changes are made in 0.25u increments.
There are likely some other things I'm not remembering but it's all covered in the sticky notes.
 
@Sienne and Gabby (GA)
Hi Sienne , did you happen to see that the vet tech said to Jessica
She said

it looked like the tech used a calculator online to determine the dosage with his weight. So based on his calculator it said 1.42 units then she later came in and said 1.5 units once daily .I've noticed that all the spreadsheets I look at everyone is dosing twice with Lantus - similar to Vetsulin so I was surprised when she said once every 24 hours.

Based on his weight 12.5lbs she recommended a dosage of 1.5 units once daily. Does that sound correct?


I told her shooting once a day is not correct
@Bron and Sheba (GA)



Sienne suggested above
When switching from a different insulin, in most cases you can make a direct switch. If it were me, I'd start the dose at either 2.0 or 2.25u.

So Jessica decided to start with 2 units twice a day
Panini is on Vetsulin now, Jessica should be getting the Lantus maybe tomorrow . She ordered the half unit syringes also and they should arrive on Friday
So as soon as she has everything she will start the Lantus this weekend
Do you agree with starting with 2 units,
Jessica works Monday through Friday from 7 AM to 5 PM so she can only get a AMPS test in them off to work. So in the weekends she will be able to do a lot more testing.
@tiffmaxee
@Bron and Sheba (GA)
@Sienne and Gabby (GA)
I told Jessica to start posting on the Lantus Board this weekend
 
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Sienne and Gabby (GA) said:
If Lantus/glargine was the first insulin you were starting on, the 1.5u would be fine. When switching from a different insulin, in most cases you can make a direct switch. If it were me, I'd start the dose at either 2.0 or 2.25u.

I'd encourage you to do a bit of reading about Lantus. There are sticky notes at the top of the Lantus forum. The information in the notes will help you to understand how Lantus works. This is important since it's a very different insulin than Vetsulin.
  • It's a depot insulin. It takes 5 - 7 days when starting out on Lantus to see much of a response (although some cats do respond when it's a change in insulin). A change in dose can likewise take several days for your cat to respond. This applies to both dose increases and reductions.
  • You do not need to feed, wait a while, then shoot. You can test, feed, then shoot immediately following each step.
  • Lantus doesn't start to kick in immediately. Onset takes roughly 2 hours (although this can depend on your cat -- every cat is different) to start. The lowest point in the cycle is at around +6 but again, this can vary.
  • Dose changes are made in 0.25u increments.
There are likely some other things I'm not remembering but it's all covered in the sticky notes.
Click to expand...

Thank you for the information, once I get it and the needles I will start at 2u and see how Panini responds. Since its a 12 hour insulin like vetsulin I'm assuming 2u BID not once a day like vet suggested. I was confused why she said that especially after showing her my spreadsheet with Panini's numbers.

I will do some reading and check the sticky notes. :)


@Diane Tyler's Mom GA
I have looked over Tyler's spreadsheet, I have checked out quite a few I like to see how everyone has them and their detailed information/notes. I feel like I'm slacking!
 
Jessica’s Panini said:
Thank you for the information, once I get it and the needles I will start at 2u and see how Panini responds. Since its a 12 hour insulin like vetsulin I'm assuming 2u BID not once a day like vet suggested. I was confused why she said that especially after showing her my spreadsheet with Panini's numbers.

I will do some reading and check the sticky notes. :)


@Diane Tyler's Mom GA
I have looked over Tyler's spreadsheet, I have checked out quite a few I like to see how everyone has them and their detailed information/notes. I feel like I'm slacking!
Click to expand...
@Jessica’s Panini
Hi Jessica , yes you would give insulin twice a day
When you read the yellow stickys for Lantus and read the 2 dosing method see which one you think you want to follow. Each one would tell you when an increase or decrease is needed. So when you start the Glargine be sure to also add that to your signature and spreadsheet.

I assume you work, what will be your shooting times ? What hours do you work
Most all of us feed the bigger meal in the AM when you give the insulin, same goes for the PM cycle.
Then feed smaller meals around +2 and +4.
You want to try and test at different times , day one day you test @+2 and +4 , day and night.
The next day @+3 and +5 or @+6 .
If you are not sure if you should give insulin you would put in your Title
? Should I shoot Date Panini AMPS BG

By the way what did Walgreens charge you for the 5 pens of Glargine
 
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Diane Tyler's Mom GA said:
@Jessica’s Panini
Hi Jessica , yes you would give insulin twice a day
When you read the yellow stickys for Lantus and read the 2 dosing method see which one you think you want to follow. Each one would tell you when an increase or decrease is needed. So when you start the Glargine be sure to also add that to your signature and spreadsheet.

I assume you work, what will be your shooting times ? What hours do you work
Most all of us feed the bigger meal in the AM when you give the insulin, same goes for the PM cycle.
Then feed smaller meals around +2 and +4.
You want to try and test at different times , day one day you test @+2 and +4 , day and night.
The next day @+3 and +5 or @+6 .
If you are not sure if you should give insulin you would put in your Title
? Should I shoot Date Panini AMPS BG

By the way what did Walgreens charge you for the 5 pens of Glargine
Click to expand...

Yes I work full time so I can’t really test during the day after the morning shot except for the weekends. Right now I’m working 7am - 5pm most days M-F but afternoon time varies sometimes it’s a little earlier or later.
Feeding times are around 5:30-6am/pm - so you feed additional smaller meals throughout the day?

I thought it was better to avoid extra feedings for BG. Sometimes on the weekends they get a small lunch lol and I give my cats freeze dried protein treats since I try not to give panini carby treats.

thank you! I did pick up the insulin today and I have the needles coming via Amazon Friday. My Walmart does not have the relion needles and neither did my pharmacy.
My Walgreens did not have the generic in stock initially they told me they did have one and could order it but turns out they didn’t/couldn’t for whatever reason and only had Lantus pens. I was able to get the 5 pens for $105. I was looking forward to the $47! But that was for generic. I put it on my care credit! Lol I’m just happy that I was able to get them.

i plan on starting insulin this weekend once i get the needles and then I can monitor him and check BG.
 
Jessica’s Panini said:
My Walmart does have the relion needles and neither did my pharmacy.
Click to expand...
Did you mean Walmart didn't have the syringes ?
Well those 5 pens should last you about a year.
The reason we feed smaller meals through out the day it's easier on the pancreas.
Can you leave some of the wet food out for Panini while you're at work or at least some of the freeze dried protein treats .
Wow you do work long hours .
Starting on the weekend will be good so at least you can monitor Panini more often and get more tests in to see how he responds to the Lantus.
Get a test in ad soon as you get home from work and then get his PMPS test.
After his PMPS test try and get a +2 and a +4 and if possible a +6 in. Most cats drop lower at night so you want to try and catch his nadir
With SLGS you would reduce the dose by 0.25 units if he drops under 90 at any time if you are going to follow that dosing method.
Found this post about members who work full-time and follow TR method, but you might not be able to do this
https://www.felinediabetes.com/FDMB...ion-possible-with-a-full-time-job-yes.129378/

I would still re read the 2 dosing methods

Be sure to have your hypo kit ready
Hypo kit if needed
Med and High Carb food and have honey in your house



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs



Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods



https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

@Jessica’s Panini
 
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@Jessica’s Panini
Jessica when you do start the Lantus I would start to post on the Lantus Board, there are a lot more eyes on that board if you need help.
This is how you would post there first put the
Date Panini AMPS number and any additional tests after that, you can continue with his PMPS number and any additional tests after that
To add the additional tests tap on the word Thread Tools then tap on Edit Title and add those tests ,then tap save.
You can introduce yourself that you were posting on the Feline Health Board and this is your first time posting the Lantus Board.

https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
To the right it will say post new thread
We like you to try and do a new post everyday and then link your previous days post to your new one in case we need to go back and read something
I'll tell you how to do this


To link your previous posts
Your previous days post will always be in the URL all the way up top ignore where it says insert or cancel I'm just trying to show you where your previous days post will be
Just ignore where it says insert and cancel
Just copy your previous days post and then paste it when you do your new post





Like I said
your previous days post it will be the one all the way up top, above the pic of that cat and the picture of a bottle of insulin there, let me know if you understand it




austin-logo-240.jpg


PS I'm not that great at explaining things :p
I hope you understand this .
So when you start the Lantus and post on the Lantus Board you will link this post you started to the Lantus Board . You will always link your previous post to your new one.
I'll watch out for you ok:cat:
Just remember it will take 5 to 7 days for the depot to fill.
We withhold feeding 2 hours prior to testing the AMPS and the PMPS because we don't want the BG number influenced by food
 
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Jessica’s Panini said:
no syringes yet. They’re on the way.
Click to expand...

Seems like every Walmart in my area has been out of these syringes all week. They keep telling me they are "on the way" and will arrive "tomorrow" but I finally broke down and got the more expensive ones from Amazon, it had been 5 "tomorrows" and no syringes in sight

I wonder if something is going on with Relion, or if it's just a coincidence? I'd love to know if yours arrive, if you don't mind updating me ❤️
 
Diane Tyler's Mom GA said:
Did you mean Walmart didn't have the syringes ?
Well those 5 pens should last you about a year.
The reason we feed smaller meals through out the day it's easier on the pancreas.
Can you leave some of the wet food out for Panini while you're at work or at least some of the freeze dried protein treats .
Wow you do work long hours .
Starting on the weekend will be good so at least you can monitor Panini more often and get more tests in to see how he responds to the Lantus.
Get a test in ad soon as you get home from work and then get his PMPS test.
After his PMPS test try and get a +2 and a +4 and if possible a +6 in. Most cats drop lower at night so you want to try and catch his nadir
With SLGS you would reduce the dose by 0.25 units if he drops under 90 at any time if you are going to follow that dosing method.
Found this post about members who work full-time and follow TR method, but you might not be able to do this
https://www.felinediabetes.com/FDMB...ion-possible-with-a-full-time-job-yes.129378/

I would still re read the 2 dosing methods

Be sure to have your hypo kit ready
Hypo kit if needed
Med and High Carb food and have honey in your house



@Jessica’s Panini
Click to expand...

Diane,

Yes I meant that walmart didn't have the syringes.
That's great!
Unfortunately I can't leave wet food or any food out when I'm gone, I have five cats and a dog and our sphynx Heiny will devour any food left out. I have to put up any food that wasn't finished by the others so they have a chance to eat cause he's a little piggy - also Panini will eat everyone's food two. I have two hungry boys not including the hungry dog.
Yes, we are short staff at my clinic and it has gotten much busier. I meant that my afternoon work hours vary sometimes I can get off before 5pm , sometimes after 5pm.
Panini and the others have a set feeding schedule.
Yes I have been trying to test as soon as I get home or I have my fiancé test for me if he gets home first. That is a good idea.

I will read the links you mentioned. I briefly looked over the full-time TR method.

I do have my kit ready :) I just got some Karo syrup - I will label my foods that a good idea. I try to keep a variety of wet foods mainly for the other kitties now I have a little of everything. Panini is getting his raw food daily but I do have other canned foods in case he needs a high carb food. I'll have some put aside for emergency.
 
Diane Tyler's Mom GA said:
@Jessica’s Panini
Jessica when you do start the Lantus I would start to post on the Lantus Board, there are a lot more eyes on that board if you need help.
This is how you would post there first put the
Date Panini AMPS number and any additional tests after that, you can continue with his PMPS number and any additional tests after that
To add the additional tests tap on the word Thread Tools then tap on Edit Title and add those tests ,then tap save.
You can introduce yourself that you were posting on the Feline Health Board and this is your first time posting the Lantus Board.

https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
To the right it will say post new thread
We like you to try and do a new post everyday and then link your previous days post to your new one in case we need to go back and read something
I'll tell you how to do this


To link your previous posts
Your previous days post will always be in the URL all the way up top ignore where it says insert or cancel I'm just trying to show you where your previous days post will be
Just ignore where it says insert and cancel
Just copy your previous days post and then paste it when you do your new post





Like I said
your previous days post it will be the one all the way up top, above the pic of that cat and the picture of a bottle of insulin there, let me know if you understand it




austin-logo-240.jpg


PS I'm not that great at explaining things :p
I hope you understand this .
So when you start the Lantus and post on the Lantus Board you will link this post you started to the Lantus Board . You will always link your previous post to your new one.
I'll watch out for you ok:cat:
Just remember it will take 5 to 7 days for the depot to fill.
We withhold feeding 2 hours prior to testing the AMPS and the PMPS because we don't want the BG number influenced by food
Click to expand...

You are great at explaining things!
Thank you for all of the information it's very helpful. I will start a new post when I start the Lantus and make changes to my signature and SS.

Appreciate all your help and everyone's quick responses and guidance. :) It's nice to have a support system especially when the vet is lacking in both.
 
Vasalisa said:
Seems like every Walmart in my area has been out of these syringes all week. They keep telling me they are "on the way" and will arrive "tomorrow" but I finally broke down and got the more expensive ones from Amazon, it had been 5 "tomorrows" and no syringes in sight

I wonder if something is going on with Relion, or if it's just a coincidence? I'd love to know if yours arrive, if you don't mind updating me ❤️
Click to expand...

I will keep you updated if I can get them or find them. I just ordered the ones on amazon as well. I even tried to look them up to see where else I can find them. Walgreens had syringes but theirs are expensive if you bought a case. They charge $30 for a box. The Relion website mentions that walmart is a provider but mine didn't have them either. -__- lol I was looking forward to less expensive syringes.
 
Jessica’s Panini said:
You are great at explaining things!
Thank you for all of the information it's very helpful. I will start a new post when I start the Lantus and make changes to my signature and SS.

Appreciate all your help and everyone's quick responses and guidance. :) It's nice to have a support system especially when the vet is lacking in both.
Click to expand...
Great I'll keep an eye out for you :bighug::cat:
@Jessica’s Panini
 
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