Newbie - 07/25 Blackie AMPS 447

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Angela & Blackie & 3 Others

Angela & Blackie & 3 Others

Member Since 2010
Yep, I'm new to Lantus Land, and to the insulin. Picked it up yesterday for the first time after seeing that the ProZinc she was on wasn't working (see SS).

Blackie's History

She was diagnosed in March of this year. Vet put her on Hill's Prescription W/D (wet at the vet's during curves and dry at home). We had her on Glipizide for a short period of time. Didn't work. Tried Vetsulin. Found out it was recalled (vet told us company wasn't making it anymore). Put her on ProZinc on March 12th. Vet kep increasing the dosage through the duration of use. June 12th - was increased from 6 to 8U BID. June 19th - went back to vet and told them that I wanted to put Blackie on wet food (I mentioned Fancy Feast). Vet was fine with that, but wanted to keep her on the W/D wet formula instead. Told them we'll try that for a week, and then if no improvement, we'll try my way. Blackie had hypo'd the Tuesday after that vet visit on the previous Sat (just 3 days). Immediately dropped Blackie's insulin dose to 1u BID, and immediately put her on the FF diet (Turkey & Giblets). Got her BG back up to normal. Called vet Wed and told her the situation. Vet said to continue doing what I'm doing, and to give them the #'s. Ok. About a month later, still not seeing any improvement on ProZinc. Went to vet's yesterday, and asked for a prescrip for Lantus. Thought for sure that she wouldn't give it, but she did. I think under some concern. Thankfully, no charge for the vet visit (sans cat).

And that's where I'm at now. I started Blackie on a 1.0u, but I think it was just level at the bottom of the line. I was compensating for a bubble (I have issues with trying to get rid of a bubble from the plunger... They always lodge just beside the needle where it's flat, and they jump from side to side when I tap the syringe... I try and squeeze the plunger as hard as I can before inserting the needle into the vial, and then gently pull back to hopefully eliminate any more bubbles... So, this dose may be a bit too much... I don't know. :( )

Please DON'T flame me. I'm still very new at this insulin thing, and especially Lantus. I appreciate any and all advice that you may provide. Yes, I have read the stickies, too. And will probably re-read them over and over again.
 
HI! And welcome aboard! I am sure the experts here will be along shortly to send their greetings and offer opinions and advice. You have found a great place here - very knowledgeable and caring people!

Very interesting history for Blackie - It sounds like your vet is willing to work with you (so nice!)- kudos to you for telling them how it is. I hope that you see improvement with the lantus - it is a great insulin.

I hope that the both of you have a great day today! And you have 8 others? nice!
 
Hi and welcome!

Here's my recipe for success with getting rid of bubbles: I had a terrible time with bubbles when I was using BD syringes... I switched to WalMart Relion brand syringes and it was much easier...I draw little extra insulin into the syringe. I remove the needle from the vial and push the plunger till the air pocket at the top (near the needle) disappears or I see a drop of insulin forming on the needle. Then I tap the syringe firmly several time, tilting it sideways or whatever is necessary to get all the bubbles to rise to the top... Then I draw back the plunger to "catch" those little bubbles and press it again till either the air pocket disappears or I see a drop of insulin forming at the end of the needle. Occasionally I have trouble getting that air pocket to fully disappear, but I find if I pull back on the plunger and keep trying, it will eventually disappear...

Hope that helps...

Wishing you great success with Lantus!

Edit: BTW, you are going to hear people tell you it would be nice if you could get more numbers on the evening cycle... The kitties may go lower at night and it's good to see how they react...
 
Yes, I have 8 other cats, thankfully they're not diabetic. LOL The only sugar kitty is my Blackie.

Thank you for your warm welcome, Michelle. :) I look forward to everyone's knowledge about this insulin.
 
Welcome to Lantus Land (LL)!

Congrats on taking a very active and involved stance with your vet. I suspect that hypo incident was due to a food switch. I don't know what your vet was thinking -- W/D is about 25% carb. The FF you're feeding is around 4%. The dry W/D is 37%. I'm not sure how much insulin you'd need to give to overcome that amount of carb. It sounds like you've found Janet & Binky's food charts.

I suspect that the problem with bubbles has more to do with the syringes that you're using than what you're doing or not doing. I've been very happy with the GNP brand syringes that I get from Hocks. (There's a link at the top of the Board for Hocks. FDMB gets a commission is you link through the Board.) If you are not already using syringes with half unit increments, you will want to get a supply of them since our dose changes are typically made in 0.25u amounts.

There are differences in the way you need to think about Lantus vs. ProZinc. First and foremost, dosing is based on the nadir, not on the pre-shot test value. We do not slide doses the way you do with ProZinc (or other types of insulin). Because dosing is based on the nadir, spot checks are very important -- including checks during the PM cycle.

You should anticipate holding the 1.0u dose for 5 - 7 days. As you've read in the sticky notes, it will take several days to build the shed. Numbers may run a little higher since not all of the insulin you're giving is available for use -- some goes toward getting the shed established.

Does Blackie have any medical history other than the diabetes? Any medications that she's currently taking?
 
Welcome Angela and Blackie! Very nice SS and great comments, they are helpful to read. Love the exercise program you are trying with Blackie, cute!

If I understand correctly you now have Blackie on a wet food diet, no dry any more? Great!

Congratulations on starting Lantus. We are very happy you are here! And wowee! Lots of kitties to play at your house!
 
Hi Angela & Blackie and welcome to Lantus Land (and thanks for visiting Stu's condo this morning),

It sounds like you are on the right track. Food is the best way to influence Blackie's numbers. Do read the food chart "sticky" and find some flavors Blackie likes. Stu was overdosed at first on Lantus because our vet hadn't ever prescribed it before and didn't realize that it had to be dosed differently than PZI vet. But, like you, I went down to a low dose on my own and then gradually upped the dose following the Tilly Protocol. Good luck, and always ask whatever questions you need answered. Someone will be along.

Ella & Stu

p.s. OTJ party for Maggie today and Full Moon Party at Shadow's & Raja's tomorrow. All the kitties will want to meet Blackie.
 
Sienne, no other medications are given to Blackie. Only insulin for her diabetes. She's been neg for ketones so far, also. I need to try and catch her for another ketone check today. I'll have to check out the Hocks site. Right now, I'm set for syringes (was given another box of 100 U-100 from a very good friend of mine last night).

CD, Blackie ONLY gets Fancy Feast wet food, the Turkey & Giblets flavor. And for treats, she also gets boiled chicken. No oil or anything added. I don't want to jeopardize her BG's if at all possible.

Overall, I don't mind holding the dose for 5-7 days. This will hopefully give me some data as to what's going on with her, and hopefully give you folks some insight as to how to help me help her. I'm not sure if she'll ever get OTJ in the future. If not, that's ok and I'll try and give her the best quality of life humanly possible.
 
Welcome!

We just switched over from ProZinc too. I am having the same issue with the bubble. There is one where it's flat...no matter how slow I go or how I try to tap it out. I have been grabbing a new syringe to try again only to wind up with the same issue. I didn't have this problem on with the U40/ProZinc. Strange...

I do hope that Blackie starts seeing better numbers on Lantus. Fin has already moved into yellow and actually had a blue nadir for the first time ever. It gives me hope, although I know it takes patience and we have a little ways to go to fine tune his dosage.

Again, welcome to Lantus Land...place of attentive and helpful guides :smile:

Barbi, Fin, C.C. and MiAmor
 
Thank you, tecwmn. :) May Blackie FINALLY see blues (again... See SS), and hopefully maintain them.

May YOU continue to see more blue #'s, too. :) Wishing both of us beans and our sugarkitties tons of luck, and good wishes. :)
 
Hi and welcome to LL!!!

Good luck with Lantus and I love this group they are the BEST!!!

I'm curious with your other fur kidz have you changed their diets along with your sugar baby? I changed Gotti's diet when Doodles was diagnosed. He was not happy
and wanted that kitty krack BAD...he's a big boy and has lost a couple of pounds now that he's been on his lean and healthy diet :-D My vet did the same thing with the high
carb wet and the flippin kitty krack. I took all that food I bought and gave it to the animal shelter. The dry they took down the pier and gave to the homeless pier kitties :-D

I did the same thing with my vet, she had me on humilin N and all the bad food. But she did write me script for the Lantus and now I keep her involved with my SS. I'm her only
patient on Lantus. Everyone else is on humilin N ohmygod_smile I hope Doodles will be a good example for her and maybe she'll try someone else?

I'm sure Blackie going to great! Have a great day and you are soooo ahead of the game!!!
 
welcome Angela and Blackie!

I'm going to copy your question from your other thread here. We like to keep all of a cat's info from each day in one thread, otherwise it gets confusing with so many kitties here.

Angela & Blackie & 8 Others said:
I understand that there are 2 Blackie's on this thread, so as to not confuse anyone, I'm going to add in brackets (Lil Mama), as that's her nickname from me.

Anyway, Blackie (Lil Mama) started on Lantus this morning after being on ProZinc for about a month with no results. Since giving her the insulin this morning, she's been steadily decreasing, albeit very slowly. (Pls see SS). Is this normal for a first time Lantus user?

If I understand it correctly (or try to understand it), Lantus is a very slow going insulin whereas ProZinc is more of a "quicker" result type of insulin.

Thank you for any advice and help with this.
Click to expand...

Yes, a very slow decrease is normal for Lantus. In fact, Lantus is known for giving very flat curves when at the right dose. Most likely Blackie is still just filling her shed. Most cats don't see any action the first few days on Lantus, though of course there are always some who do. Patience is the key at this point, just keep doing what you're doing.
 
Welcome, Angela and Blackie! You sound like you've done your homework on Lantus and the good folks here can help with the rest. I hope Lantus is a great fit for Blackie and those numbers start coming down. Prepared to get teary-eyed as you see Blackie start to feel like her old self and do things you hadn't realized she had stopped doing.

FF Turkey & Giblets was on our menu yesterday. :smile: If you haven't already checked out the food list Sienne linked above, there are lots of other flavors that Blackie might like. Although Blackie might be a one-flavor kind of gal and that's totally fine too. Just wanted to let you know there were other similarly carbed (not a word, lol!) FF varieties available.
 
Hi Angela,
There are now 3 Blackies in LL! Team Blackie was here before us. We switched from PZI Vet in March, but my Blackie has been diabetic for 5 years. I hope your Blackie does really well with Lantus.
 
Blackie, thankfully, has been neg for ketones (I've posted them on the remarks section each time I test her). She's due for another test, and hopefully I can catch her today.
 
You asked me in PM Land if Blackie should have started at a higher Lantus dose. The answer is, maybe. :mrgreen:

Blackie's most recent numbers on ProZinc make me think that he could have started at a little higher dose of Lantus, probably 1.5 units. However, he did once have good numbers on a lower dose of ProZinc, so starting at 1 unit is also a perfectly reasonable option. Since Blackie doesn't have a history of ketones and since you have already started at a 1 unit dose, then I would probably follow this part of the protocol:

Cats that have a tendency to get ketones and/or who are getting relatively high flat curves after the switch should have their dose raised earlier (after 24-48 hours).

That is, I would hold the 1 unit starting dose for 4-6 cycles (2-3 days) and if numbers are still high and flat, increase the dose. The amount of the increase will depend on the numbers, but if she is still in the 300's then I would go ahead and increase to 1.5 units at that time.

If you want to go ahead and increase to 1.5 now and call that your starting dose, that is fine too.

The other thing you HAVE to start doing is getting a test before bed each night. Most cats have very different cycles at night than they do during the day, so it's very, very important to know where they are when you go to bed, so you know where the morning number is coming from. Your high morning numbers COULD be bounces from something lower that happened at night, but you have no way of knowing. Night tests are more important than day tests, for most cats, so get whatever you can and get the bed test every single night.

OK?
 
Welcome Angela and Blackie! Yoda and Oscar just switched too - we wish you the best of luck with Lantus! cat_pet_icon
 
Angela & Blackie & 8 Others said:
Thank you, Krys, for that advice. I may have to call on you for that advice again. LOL I hope that you don't mind.
Click to expand...

Feel free to ask away...

Looks like Libby said it's your call on the dose, if you want to start at 1.5...
 
yes, it's your call, start wherever you're comfortable. Whatever dose you pick, let's hold it for a minimum of 4 cycles unless the numbers go too low. Keep posting daily so we can help you make adjustments as needed.
 
Well... GOOD NEWS!!! :) Here are Blackie's #'s from today (so far) = 1.0u of Lantus:

AMPS - 447 @ 5:54 a.m.
+2 = 396 @ 7:57 a.m.
+4 = 393 @ 9:43 a.m.
+5 = 343 @ 10:57 a.m.
+6 = 361 @ noon
+9 = 372 @ 2:30 p.m.
PMPS = 294 @ 5:45 p.m.

So far... So good. :) I'm very cautiously optimistic here. I understand it'll take about 3 days for it to actually take affect. The ONLY other time that she was in the 200's at PMPS was on July 4th, where she was at 280.

And... after PMPS, +4 she was 277 @ 9:46 p.m. :) It's all on the SS. :) I'm heading to bed here shortly, but wanted to share the news. This is the first day on Lantus. I "think" this insulin is working (so far). If this continues to do nicely for her, our vet will be extremely surprised. :) I'm looking forward to giving her the #'s, and seeing the look on her face. She looked to be very skeptical about providing a prescrip for the insulin, but so far, so good. :) Let's just say that I've never seen her this low before. Sorry for gushing so much. I"m VERY happy. :)
 
very nice. :smile:

Get your before bed test, this was a dropping number so you might see an even lower number tonight.

eta: never mind, I saw your bedtime test number. Yay!
 
That was the before bed test. I'm usually in bed before 10, or about 10-ish. I wanted to update everyone. :) I'm sticking with 1.0u for now. I think it's working. :) I wait 2-3 cycles, right, to adjust the dose...? I think I may need help with this. LOL
 
Angela & Blackie & 8 Others said:
That was the before bed test. I'm usually in bed before 10, or about 10-ish. I wanted to update everyone. :) I'm sticking with 1.0u for now. I think it's working. :) I wait 2-3 cycles, right, to adjust the dose...? I think I may need help with this. LOL
Click to expand...

With the first dose you wait 5-7 days to adjust the dose unless ketones are involved. The first few doses - part of that dose goes to fill the shed, so you don't have a true idea of how the dose will effect the numbers until a couple of cycles in and then you need a little time for the dose to settle. After that initial intro dose, you can change the dose every 3 days according to the Tilly Protocol posted in the stickies.

Nice to see those yellow numbers tonight!!!!!
 
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