Newbie Peyton is now on Lantus!!!

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jcc1531

Member Since 2014
For those of you tgat do not know Peyton went back to the vet on Monday after an up and down weekend on Novolin N. The vet called yesterday and started him on Lantus yesterday afternoon. Just got off the phone with the vet and he is responding to the Lantus wonderfully...almost too well. Lol
They have him 2u this morning and his BG had dropped to 64 at 4:00. They fed him to increase it and sai they will start with 1.5u tomorrow and see how he does. Vet believes he may end up only needing it once a day and could possibly be in remission pretty quickly. Hip hip hooray!!!!
I'm not sure what they have been feeding him while he has been at the vet but I will let everyone know when I find out. I picked up several cans of low carb wet food yesterday but know he will have to be transitioned VERY slowly if they still have him in the wet WD.
I will update my spreadsheet when I have more information and know how to use it. Marje was kind and got it set up for me. Thank you all so much!!!
Julie
 
Tell you vet that BID dosing is recommended as Lantus will not last 24 hours, putting the glucose on a cycle of up nd down.

Also, Lantus effects build up over 5 days for the first dose level and are CUMMULATIVE. I'd suggest 1 unit and hold for 5 days, checking between +5 and +7 hours after the shot to see how low he is going.
 
There is no insulin that lasts 24 hours in a cat. Even Lantus needs to be given twice a day. What you want to do is find a dose you can safely give Peyton twice a day, at roughly 12 hour intervals.

What BJM said! Darn, she's fast at typing. ohmygod_smile
 
and I'll make it a third!

Twice a day dosing is required with Lantus...and WOO HOO that he's doing so well so soon! It does sound like he's getting too much too!

Did you get a weight on Peyton? The starting dose is based on weight (most cats start at around 1 unit twice a day, but to know where you should really start, we need his weight...and if he's underweight or at his ideal weight)
 
How is Peyton doing today? How is his mommabean Julie doing with all this new adventure? We recommend not only treats for your cat, but treats for the bean too. My favorite is a piece of Dove Dark Chocolate. ;-)
 
Peyton weighs 8.5 pounds and I believe his ideal weight it about 10+ pounds. I picked him up today and the vet told me 2u Lantus AM and PM. I checked his BG at 5:00 and it was 116, at 9:30 BG was 131. I did not shoot because I didn't want him to go too low. I downloaded the google drive app to my phone and will update my spreadsheet ASAP.
I am starting to feel more confident with this. Especially with the at home testing. Last weekend I cried the entire weeken while trying to test him. Now I know where his best spots are on his ears so I don't have to poke so much. For anyone just starting out...if I can at home test so can you :)
Julie
 
OK...at 8.5lbs, the starting dose per the protocol is only 1 unit twice/day! (actually exactly .9625 unit but rounded to 1 unit)

I'd strongly suggest you just start there, get your testing in so you can start gathering the data that's so important to have, and let's see where he is in several days. IF he were to drop below 50 at any time, we'd want to reduce his dose further

GOOD THINKING! on not shooting last night!! It really does look like 2 units may be too much for Peyton!! We suggest that if you get a number under 200 at pre-shot times, that you "stall", DON'T feed, and post and ask for help. Make sure your subject line says something like "Stalling, please help"

You'll need to get at least 4 tests in per day, but more is ALWAYS better! The 4 most important are:
AM Preshot---test immediately before the morning shot to make sure he's safe to shoot
A mid-cycle test---somewhere between +5 and +7 (5 to 7 hours after the morning shot) We want to try to see when his nadir is (the point in the cycle where he goes the lowest)
PM Preshot
A "before bed" test---a test right before you go to bed at night so if he's running lower than usual, you might want to consider setting an alarm to make sure you get up later on.

Good luck on your first full day at home with Peyton!! Let us know if you have any questions!!
 
Hi Julie,

I'm so glad that Peyton's home with you again - and on Lantus now. I have to agree with the others that 2 units sounds like too much for Peyton. Wendy (and Neko) and Chris (and China) helped me tremendously with dosing for Jersey, so I'll defer to their experience in helping you find the right dose.

I saw in one of your other posts that you're struggling with the spreadsheet.

I am extremely computer illiterate :(
Sign into Google as in google mail?
Access my driver?
Click to expand...

Here are some step-by-step instructions that might help:

1. Pull up google (just the plain old web page). In the upper, right-hand side of the page, you'll see a blue box that says "Sign in." Click on that and enter your login information.
2. Once you sign in, you'll see some new information appear in the upper, right-hand side of the page. You're going to click on the box of little black squares and then click on the little triangle symbol that says "Drive" under it.
3. Once you click on your "drive," you'll see a list of your documents (e.g., Peyton's Spreadsheet). Click on the spreadsheet. That will open it up. From there, you can enter the numbers, comments, etc.

I hope this helps! If you're still struggling with it, let us know.
Shelly
 
Thank you all for the information! I am heading home now to work on the spreadsheet. I gave him 1.5u this morning after checking his BG. preshot BG read "hi" which is 600+. I retested 2 hours later and it still read "Hi". I'll be home soon to retest.
Julie
 
Hi Julie!

Just put "Hi" in the cells when you get that on the meter. We all pretty much know that means 600+ You'll have to color code the cell black yourself though. Up along the top of the spreadsheet is a little icon that looks like a tiny bucket of paint starting to spill. If you click that icon, you can choose the color you want in that cell.

Are you planning on shooting at 9:30am/9:30pm for your shooting schedule? It's important that the shots be as close to every 12 hours as possible.

How's his appetite today and what are you feeding? The A/D the vet had him eating is still a little too high in carbs at 12%

Since you gave 1.5 this morning, you should probably go ahead and give the same tonight and for the next several days and get a lot of tests in. It's especially important to get some tests mid-cycle since Lantus dosage is based on the nadir (the lowest point in the cycle) and NOT the pre-shot test. The pre-shot test is just to make sure they're high enough to give insulin at all.

IF he drops below 50, it means it's too much insulin and you'd want to reduce. Don't freak out on the higher numbers at Pre-shot. It takes a little time for the Lantus to really show you what each dose will do for him

Don't know if we've told you this...You don't want him to eat for the 2 hours prior to Pre-shot tests. That way the Pre-shot test isn't influenced by food.

Good luck and welcome to the sugardance!
 
Hi Chris, thank you for the prompt reply :) My vet had said to space them out 12 hours apart but it didn't have to be exact. Even said an hour late would be ok. Thought I had more flexibility so I will definitely have to fix that! If it's midnight now does that now mean I can't shoot again until noon tomorrow? How can I back my time up? I would like to shoot around 7:30am/7:30pm.

His appetite has been the same as usual. He likes to eat several small meals throughout the day. He has been eating the Hill's AD but I am slowly transitioning him to the Friskies Pate.
His morning BG Hi
3:30 BG 380 (no food for 2 hours)
11:00 BG 334 (no food for 2 hours)
I did not know not know to wait to check BG 2 hours from food. Luckily I keep a journal and see that he had not been fed for 2 hours.

So go ahead and shoot 1.5u tonight?
 
To back up to a schedule of 7:30/7:30, you have these options

Shooting 15 minutes early every cycle until you're where you want to be.

Shooting 30 minutes early ONCE per day

Skipping one shot and then you can restart at any time (we don't really recommend this, but if there's a good reason to not shoot, that's the best time to make a big adjustment)

Yes, I'd shoot the 1.5 tonight and get a "before bed" test to give you some idea of where he might be going later in the cycle and to see if you might want to set an alarm to wake you up to get a test later in the cycle. Most cats go lower at night, so getting that before bed test is important.

If you need someone to help you and you're in kind of a hurry, "Edit" the subject line from your first post (the one that now says "Newbie Peyton is now on Lantus")....the only way we can scan the board looking for people who need help is if that first subject line indicates there's a question, so you could change it to say something like "How much to shoot tonight?" There's also a little ? icon you can use on that first post that will help let people here know you have a question.

If it's a medical emergency, you'd use that 911 icon
 
thank you sooo much!!!! I shot 1.5 and he ate...again :) To get a PreBed level I would have to stay up til 2:30 since he ate. I'll definitely have to set an alarm.
I will pick one of those options and start to back up his time. I need to find a moment to read up on nadir etc. I'm sooo confused now. lol
Julie
 
Nadir is just the point in the cycle where the insulin is working it's best! The problem is that it can move around!

In most cats, the nadir is around +5 to +7 (5 to 7 hours after the shot)....that's when their blood sugar is the lowest it's going to be for that cycle. We don't care so much what their pre-shot numbers are when we talk about dose...We want to know how EFFECTIVE the dose is..How low does it take them?

As you get more tests in, you'll start to learn how Peyton responds to Lantus and where in the cycle he "usually" nadirs.
 
Now I'm staring to understand...a little :)
Tomorrow I will test at +5 and +7
He's resting peacefully and I'm about to take a short nap and then get up and test him in a couple hours. Thank you so much for your help. Wish I had understood better how the Lantus works and had started him on 1.0u instead 1.5u. The hi number scared me and made me think he needed more. I definitely don't know much but something's are stating to make sense. Tomorrow I will take some time to read through the site. You all are wonderful!
Julie
 
Re: Newbie Peyton's post bed level

I woke up at 3:45am to check Peyton's BG and it was 192. He had 1.5u at 12:30am. He seems to be walking better now that we are getting a lower reading but drinking more. I'll test again in the morning and update his spreadsheet again.

My app on my phone is not showing what looks like a can of paint tipping over. I can change the background color so where his level read "hi" I colored the box black :)
Julie
 
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