New to Lantus - PMPS 212 Do I shoot or not?

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Rob & Harley (GA)

Rob & Harley (GA)

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I posted this in health but I'm looking for some guidance on weather to shoot 1 unit, or .5 or not. on a 212

Hi all,

We were coming up on our 1 year OTJ anniversary, but now we are starting all over. I'm hoping it may be transient, I'll explain below.

Last time Harley was on Vetsulin, this time he is on Lantus. I've updated his ss and included the daily Vet info in the comments.

Last Wednesday I had to go out of town for work. Monday night my kitty sitter cancelled on me so Tuesday afternoon I had to board him at the Vet Clinic. He was skeert bad, they scrapped his teeth and said that he had givgivitus, his gums were bleeding and they said that they would give him an antibiotic since they messed with his teeth. They insisted on updating his vacinations since he was being boarded. I left his food with instructions on how much water to add, etc.

Here is how his week went:
Day 1 (afternoon only) - He didn't eat, he didn't pee, he didn't poop.
Day 2 - He didn't eat, he peed in the morning but not in the evening, he didn't poop all day.
Day 3 - He didn't eat, he peed in the morning but not in the evening, he didn't poop all day. They started
Cyproheptadine 2mg bid and gave him fluids.
Day 4 - He ate, he peed in the morning and in the evening, he didn't poop all day.
Day 5 - He ate, he peed in the morning, he didn't poop. I picked him up at 6pm.

I tested him when we got home he was 308, he ate really good and pooped twice.
pmps 325 - 1 unit Lantus
+1 - 261
+2 - 283
+3 - 238

6/6 amps 221 - 1 unit Lantus
+2 - 178
+4 - 131
+9 - 164
pmps 212 - What do I do now. Last time my no shoot number was 200, but a different insulin.

I've spent the weekend re-reading the info and reading up on Lantus. I'm hoping this is transient from the vet stress, messing with his teeth, antibiotic, vaccinations, etc.

Any suggestions or advise will be greatly appreciated.

If you're still reading this Thank you,
Robin & Harley
 
This is a safe number to shoot. You shot 221 this morning which, once you factor in meter variance, is essentially the same number. Our only caveat if you are not sure about shooting a lower pre-shot number is to have high carb food in the house and strips should you need them. If you look at the subject lines on the board, you'll see that we routinely shoot numbers much lower than the 200s. Lantus is very different than Vetsulin. It's onset is slower and more gentle. For those new to insulin or where you don't have much data accumulated, the general "no shot" number is 150. If you take a look at the LANTUS & LEVEMIR - DATA READY TO SHOOT LOW NUMBERS? sticky, it will give you some guidelines.
 
Thank you.

I'll check out that sticky. I've been re-reading the info and trying to get up to date on Lantus. I just wasn't sure about it because I only have 24 hours of data.

Do I shoot the 1 unit?

Robin
 
yes, you can shoot your regular dose. Usually we tell newbies they can shoot over about 150 or so. Lower than that, you can always post for advice and someone will walk you through deciding what/when to shoot.
 
I would. The Lantus motto is, "Shoot low to stay low."

If you are concerned, get a +1 and a +2. Post the numbers in your subject line. (click the edit button in your first post of the day in this thread, make the change, then click submit) To move a post up the queue, you need to add a new message.
 
I'm too new to advise about dosage, but want to say that I'm sorry about Harley's awful boarding experience. Poor guy. I'm glad he's home and being monitored by you! That's got to make him feel better.

If you shoot tonight, I just echo what others have said about having some high carb food on hand that he can eat a little of if he gets too low. Be sure to do spot checks. I'm sure you'll be up to speed on Lantus in no time.
 
I read the stickey and I don't have BOS. I shot .5, I guess old habits die hard.

My thinking was that if he is coming off the vet stress he might drop too low. I still have a hypo kit ready from before and I bought more test strips today and will test for the next few hours.

Lantus is so different from the Vetsulin, I will work really hard to re-learn the thought process.

Thank you for your replies.

Robin & Harley
 
It really is a very different insulin. There are quite a few recovering Vetsulin users here. If you put a note in your subject line, they will drop by and share their experience.

No one here will push you to do something you're not comfortable doing. We may try to coach or coax -- especially if your logic is based on Vetsulin, or any other insulin, for that matter. (One example is what we would consider a very early shot - like a +8. With Lantus, this is generally not a good idea. Lantus is a depot drug -- there is a reserve that builds in the system over the first 5 or so days of Lantus use. This allows for overlap between doses. If you shoot early, it functions as a dose increase due to the depot - or "shed" - and the overlap between doses. A couple of early shots in a row and you could have sufficient build up to be in trouble.) If you have questions, please ask. Visit our condos (threads) and look at our spreadsheets. It's a great way to learn about Lantus.
 
Coach and Coax away, I need all the help I can get.

I spent most of yesterday afternoon looking at spreadsheets and reading.

Unfortunately not only am I a newbie at Lantus I'm also tech dumb on message boards so the info on how to edit my subject line is sooooo valuable.

Also, I picked him up at 6:30, and gave him his first shot at 8:30. I need to move him to a 7am - 7pm schedule. How do I do that safely?

Thanks,
Robin
 
Rob & Harley said:
Coach and Coax away, I need all the help I can get.

I spent most of yesterday afternoon looking at spreadsheets and reading.

Unfortunately not only am I a newbie at Lantus I'm also tech dumb on message boards so the info on how to edit my subject line is sooooo valuable.

Also, I picked him up at 6:30, and gave him his first shot at 8:30. I need to move him to a 7am - 7pm schedule. How do I do that safely?

Thanks,
Robin
Click to expand...

You could do it slowly by 15 minute increments if you have a few days to transition shot time.

How soon do you need to be on the 7am/7pm schedule?

The thing about dose? Is that you want to try to keep the same dose for at least 3-5 days (6-10 cycles) and for the first dose, usually 5-7 days.
Libby and Sienne are much more present in Lantus Land, so Im sure they'll give you great guidance in where to go from here.
 
Cyn is correct about shifting the times. You can move your shot time back by 15 min. per cycle or 30 min. once a day. If Harley's numbers are over 300, you could move the shot back by one hour -- it just doesn't look like this will be the case with Harley, though.

For now, the most important info is from the Dosing Protocol sticky:
"General" Guidelines:

--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Click to expand...
 
Thanks for the help. I was still reacting from the Vetuslin mind set. His +2 was 246 so you were all right.

I'll slowly move him to the 7am/7pm schedule. I figure that my work schedule brought him out of diet controll so now they owe me. I can go in late and stay late to make it up.

Thanks,
Robin
 
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