NEWBIE TO LANTUS ON HEALTH

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Thanks for posting ahead of me. This is actually someone Ive been helping in my hometown...and set her up to see MY vet! :shock:
Dont worry, he is still learning...and a VERY good student, indeed. Open minded and ready to learn. I suggested she post here and thought she might get a bug in her ear to reduce the dose from others. She is still struggling with home testing, so it is most important that she not shoot too much. I will try to revisit the hometesting with her this weekend if she is interested.
 
Hello, it's me, the newbie to Lantus on Health, Sasha's mom. I am concerned that you think he is getting too much Lantus, 2 units every 12 hours. This was the dosage he was previously getting with Novalin N. The assumption that the vet was making is that his blood glucose has been too high for too long, and he needs to get this under control. Once we get the home testing figured out, we will be able to see if the dosage is right, and maybe over time the dosage can be lowered and we can hope the diabetes will go into remission. The problem I am having right now is that is 7 am and I should do a blood glucose test right now before his morning shot, but I am too overwhelmed and scared to do it without help. And my husband probably won't wake up for a few hours. (he is disabled) :sad:
 
seamist said:
The problem I am having right now is that is 7 am and I should do a blood glucose test right now before his morning shot, but I am too overwhelmed and scared to do it without help. And my husband probably won't wake up for a few hours. (he is disabled) :sad:

I can understand that feeling, actually, all of us can. So you take a deep breath, talk gently to your kitty, petting him, tell him it's gonna be ok, and that you're doing this cuz u love him cat_pet_icon you can do this - you've made it this far - I know you can do this! Deep breath.
 
The problem I am having right now is that is 7 am and I should do a blood glucose test right now before his morning shot, but I am too overwhelmed and scared to do it without help. And my husband probably won't wake up for a few hours. (he is disabled) :sad:

Do you mean that you normally give your insulin injection at 7 am? so you would be giving the evening one at 7 pm. Is this a good schedule for you or would it be better to change it to maybe 8 and 8 or something, are you both around then, so you would have help? If you wanted to change the time for giving shots so that you have someone to help you, you can change it back to 7 and 7 (by making little changes each time) after you get comfortable doing the testing alone.
 
"I am concerned that you think he is getting too much Lantus, 2 units every 12 hours. This was the dosage he was previously getting with Novalin N."

Hi Sasha's mom and welcome to Lantus Land! My concern with the starting dose of 2 units is that there is no correlation between the one insulin and the other and I am afraid of another hypo. The vets are still learning on this one...if they are willing...and unfortunately they always seem to start too high.

My Morris has been diabetic for 10 years, the first 9 of them on Humulin N (same thing as Novolin N), and very well regulated actually. The thing is, at one point he was on 10 units of N for almost 5 years....and then he had a very bad hypo and almost died. After re-regulating him, he only required 6 units and was on that dose for another 4 years before he, again, went hypo. My new vet at the time first tried him on Vetsulin, which didn't work at all, and then at my request because I had been reading about it here gave me Levemir (similar to Lantus...we use the same dosing procedures). She started me out at 6 units, based on his weight and that was what he was dosed for N. Fortunately, I was reading here and ignored her advice but did start him out at 3 units...he went hypo within 3 days.

I started over at 1 unit BID (twice a day) and gradually he has been reduced down to .25u (that's 1/4 of a unit) and that's where he is right now and is starting to be pretty well regulated. So you can see, the dosage on Novolin or Humulin N has nothing to do with the dosage on another insulin. As a matter of fact, too much insulin can give you BG readings that are much too high because of rebound.

I hope you will post a new topic here with a title such as "New to Lantus and Need Help"...you will be amazed at the people who will arrive and give you more advice and reading materials than you can imagine. You also have a valuable resource with Carolyn...use her!

I wish you the best of luck with your sweet Sasha and hope to read you on the Lantus board. You have been prescribed THE BEST insulin for the possibility of remission and you found this website...you're almost there.
 
Hi Sasha's mom and welcome!

I just wanted to add my comment on switching from one type of insulin to another.

I started Shadoe of Caninsulin at the direction of my vet, but we got up to 4.5u or something and it was just not working. Shadoe was still getting bad numbers and feeling horrible.
Thank goodness I found this site!

I was told of Lantus which may work much better and so off I went to the vet who agreed it would be OK to switch. She said it was a once a day type, so that told me right there that my vet was not that familiar with Lantus and using it for cats who have a metabolism much different from humans.

When I switched, I started on Lantus at 1u as my vet had suggested and right away, I saw an improvement in Shadoe! I could not believe it! How could I switch from one type to another, and give her way less, and she became way better? How could this be I thought!

Well, it's true. You can't compare apples and oranges, or different types of insulin because they are all different. Some are fast acting and some are slower. And that's why I think others may be concerned about the start of Lantus at such a higher dose.

Now, about the testing. Man, it's frustrating; for you and for Sasha, but just in the beginning. Seriously, once you get the hang of it, and the spots, you will both settle in nicely to the testing. It really will become a bonding time; I know it has with me and Shadoe.
Shadoe jumps right up into the test chair when it is time; she knows that we will do our poke and then she gets a shot that makes her feel very very much better.
Believe me when I say that the day will come quickly when you realize that Sasha is the brighter one when it comes to the routine to treat her!

Try to sit with Sasha and pat her a bit at the testing time; it will help to calm both of you.
I look on the pre shot tests as a check on her temperature. If her temperature was normal, I would not give her meds to lower her temperature, but if it was a high number, I would give her meds. I know it does not seem to be as critical when the BG numbers are all high, but better safe than sorry and know for sure.

The group here is AMAZING! I can't be more serious when I say that I don't know what I would do without the people here, on this board. Shadoe is a brand new cat because of their help and suggestions and guidance. I will never be able to thank them enough. Ever.
 
I took a deep breath and tried doing the blood glucose test myself. I poked the cat 40 times.. He did bleed, but it was never enough to satify the Contour monitor. Yes, I used the warm rice sock and massaged the ear. The cat was fine and let me do it, but I gave up because I was wasting test strips and seeing no result other than error code for not enough blood. :sad:

Sasha's mom
 
Hi Sasha's Mom and welcome from a relative newbie. You have come to the right place.

When I started, I nearly passed out the first couple of times I gave an insulin shot.

When we began testing, it used to take THREE of us, all holding, petting and juggling equipment like something out of a bad Three Stooges movie! But now, we can all do it alone.

The biggest helps for us were:
1) Calm. Lots of calm. Will yourself to relax your body.

2) The magic warm sock. Is yours warm enough? I find quite warm but not hot works best.

3) No ultrafine lancets. We use "fine" and that helped a lot.

4) I switched meters from one that used 1ul blood and had very pricey strips to one that uses 0.6ul blood and has far less expensive strips. We are now using the Wavesense Presto which is much easier than our original One Touch.

5) A nice little massage at the base of the ear is good.

6) Make sure the lancet device is set at a high enough number to penetrate. If you are really having trouble, try poppong the inside of the ear where there is no dense fur. It doesn't seem to make a difference to Basil

Best of luck and don't give up. It makes a tremendous difference in the end when you know what's going on in there.
 
Don't worry, you will get the hang of it. I think also someone told me in the past that the ears learn to bleed which seems to quite true. You get better at poking at the good spot and the bleeding flows better with time, at least that is what I have found with Shadoe.

I looked at pictures of the good spots for testing, along the outer edges; did someone show you those pictures? I wish I could help you more. You said your husband would be awake in a bit; is he better with the testing? If yes, then maybe he can help you with it.

Also, someone mentioned about changing the time for Sasha's shots if your husband would be the better one to do the tests; would a time change work better for the 3 of you? I know I used to do Shadoe's at around 5am, then 6am, and now finally, I have found that 7am is just perfect for all of the rest of my life, what I have outside Shadoe LOL.

As I said, don't worry; everyone here will help you and Sasha along. Lydia made some great points for you and others will come along and add more for you.
 
I think many have had that experience. Heck I've used a meter 100's of times and one day I wasted 2 strips and was furious. Then I found a trick....Place the strip into the meter but not all the way (the meter should not spring to life ;-) ) if you push to far and it beeps or turns on just remove the strip (it is still good) place it in again so it just stays there. After you have poked and got some blood (some people put a smudge of vaseline or something on the spot so the blood beads up instead of sinking into the fur) make sure your drop is big enough (more than you need) then pick up the meter (I sit on the floor and have the meter next to me) push the strip all the way in so the meter turns on and shows it is ready (the contour is quick and will show the strip and blood drop meaning it is ready) I actually push the srtip in on my leg (one hand is holding the ear, and the other the meter, so I just press it against my leg or arm to push the strip all the way in) then just hold the strip close to the edge of the blood drop, as soon as enough blood is there (tenth of a sec.) it will start counting down, set the meter down and wipe the blood away with a tissue pinching the spot for a sec. or 2. Now you should have a reading.

Make sure to give kitty a treat after, even it doesn't work, and get one for yourself too!
 
Thank you for your kind words. Sasha started Lantus 2 units twice a day last night, and this morning he seemed healthier than I have seen him in a while. I just wish I could test his blood glucose to confirm my observations.

Sasha is a male, by the way. Our hunter. In Russia, Sasha is the nickname for Alexander, and I named him this because he reminded me of a Siberian Tiger.

Two questions:

1. Which glucose meter requires the least amount of blood and is still accurate?

2. Which lancet is best at getting a good drop of blood from the cat's ear?

Sasha's mom
PS, I really have not thought of myself as Sasha's mom until now, since he is my husband's cat. However, now that he needs help, I guess I am his mom.
 
I think the tough thing here is that the protocol sheets from Queensland for lantus and levemir do say that one can start with the same dose as a previous insulin. It's just that different cats can respond so differently to different insulins, it may be best to start as though the cat has never been on insulin. I imagine the vet was just following protocol. People here have learned that particular bit of protocol may not be the most efficient path to your correct dose.
 
I love that name Sasha!

The meter I use is One Touch Ultra mini and it does not require much, but sorry I don't know how little. I also put the strip only halfway into the meter, then once I have got the drop of blood on the ear tip, I push the strip in further and then wait for it to be ready for use.

There is another meter that some others use as the strips are quite inexpensive; only Reli-on comes to mind, but the others can say what they use to help you.

It's a really good feeling when you see your kitty almost coming back to life.
Best of luck in getting the hang of successful testing.
 
We use the Reli-On mini from Walmart...about $11 for the meter and around $21 for 50 strips. Uses an amazingly small amount of blood, about a pinpoint, really. Reads very fast and almost never malfunctions...I think maybe twice in the last 6 months I got no reading because of too little blood.

If you are not getting enough blood, I bet it is because your lancets are TOO fine. Hard to believe, but the really fine ones don't make the ear bleed enough. I bought 31 or 32 gauge thinking it would be less painful but couldn't get any blood to come out (and Morris bleeds almost on command after 10 years!) I went and got 28 gauge lancets and no problem.

Please don't give up...you are so lucky your cat will sit still for this....give him a big hug and chin skritches for that!
 
i am on my lunch break and just wanted to stop in and say I AM SOOO PROUD OF YOU! We will get the testing worked out. I can for sure stop by on saturday. If there is any way I can get there sooner I will.
 
Welcome! :smile: So happy to hear that Carolyn is helping you - she is wonderful!

Sasha was diagnosed with ketones initially, correct? That may also be a deciding factor in determining the correct starting dose. Ketones are formed from lack of insulin, so starting with a dose too low may also be as much of a problem as starting with a dose too high. Please keep that in mind when coming to a conclusion on dose, and please do also try and test daily for ketones as you have been.

I do see that Sasha has recently tested negative for ketones, but some cats are more prone to them than others, and if they have recently tested positive for them (such as at the diagnosis that was only 3 weeks ago) then that really does factor into treatment.
 
Ok, Sasha got his second Lantus shot of 2 units at about 9 am this morning. (HIs first ws last night.) I finally got enough blood for the meter to read at about 1 pm, so four hours after the shot. The result was 360. Now I am supposed to call the vet and give him the result. I am afraid he will increase the dose if I call him. What should I do?

Sasha's mom
 
just remember, you are the one that draws up the dose, not the vet.

if they know much about lantus they will know not to raise the dose based on one number. and if they don't know (since it's fairly unknown to a lot of vets still), just explain to them that you are uncomfortable raising it so fast and would prefer to monitor for a few more days and then decide. it's not a race doc. :-D
 
I agree with Cindy. As long as you are getting consistent negative ketone readings, then upping the dose right now based on one reading is not the solution. Many vets do not understand the way Lantus works. Just keep working on the BG testing (you're doing great so far! :smile: ), and try and shoot as close to a 12/12 (every 12 hour) schedule as you can. A late shot, even by just an hour, can change the way the insulin works. The same goes for an early shot.

This Sticky on the shed action of Lantus and Levemir may help: viewtopic.php?f=9&t=150
 
Blood Glucose 11 hours after morning Lantus dose of 2 units, 331. It is only the second day on Lantus, will this number get lower in a few days?

Sasha's mom
 
We used to use the One Touch Meter but switched to the Wavesense Presto which we all like much better. It is faster, uses half the blood, doesn't need calibrating to strips and the strips are far less expensive. One place even had a special--buy 4 boxes of strips and get the meter free--American Diabetes Wholesale.
 
Just tested Sasha 6 hours after 2 units of Lantus. Blood Glucose 533 ! It has never been that high that I know of. What should I do? The cat seems fine.

Sasha's mom
 
Did you get a preshot test this morning? Have you been able to get another ketone test in?

Lantus has a cumulative effect. It has to build up in the system in order to work. If you read the Insulin Depot/Storage Shed sticky, it explains this. High numbers in the beginning when the shed is filling are normal. It is best to keep BG testing before each shot and whatever spot checks during the cycle you can do, and keep ketone testing as often as you can.

Has someone helped you with setting up a spreadsheet to track the numbers you are getting?
 
Seamist: start a new condo (thread) with today's date and cats BG then maybe type - help - in the subject line. I think you will get more responses more quickly that way.

Sorry I cant answer your question. Hang on a little longer!! Or when in doubt call the vet!
 
Until someone comes along who knows more, let me say that high blood glucose in cats is not an immediate emergency. If you look at basil's ss, you;ll see he was at 568. Not that it's a good thing, but it isn't spmething you need to worry about correcting instantly. Hope you get help soon and meanwhile, hang in there.
 
First I want to say Welcome to Lantus Land. You are in the right place to do the best that you can for Sasha! These people have been a god send to me and Indy.

I know first hand how scared you are about all the "poking". My hands wouldn't stop shaking the first time I tried to test Indy. What I have found to work is:
1) using a lancet "pen". It actually does the sticking for you and you can set it for the amount of force needed to get his ear to bleed. ( I was WAY to chicken to have to actually do the sticking myself.)
2) I put a tissue or paper towel behind the place on his ear that I am going to test. Then, I FIRMLY press the pen against his ear and push the trigger button. This way his ear doesn't move away from the point of the lancet when it is trying to go in his ear.
3) Then, I massage his ear below where I poked him to get the blood to flow. Sometimes it takes a while and sometimes at first I can't even see where he was poked, but after a few seconds of massaging the blood drop appears.
4) I re-use my lancets. My husband made the observation that when the lancet has been used before it must get a little dull and makes a bigger hole, so he bleeds more. I usually only change the lancet every 4 or so uses.
5) Remember that this WILL get easier with time. You will get more comfortable with the process and Sasha will get more comfortable with being poked. And once he starts feeling better he will thank you for having poked him. :mrgreen:

Hang in there. We all started out where you are and know how frustrating it is in the beginning. Just remember that you have a good resource in the people here and someone will be here to help you when you need them!
 
I forgot the all important:
6) Vulcan death grip. When you finally do get that drop of blood, hold tight to that ear like it was made of gold. There is nothing more frustrating than getting that elusive drop of blood only to have him shake his head - sending the blood hurling onto you instead of the test strip. :roll:
 
I called the vet, and he said not to panic. He told me to keep track of the blood glucose, and let Sasha get used to the new insulin.
 
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