PenPen's Lantus dosing

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PH&MonkeyPenPenFaFaTiger

PH&MonkeyPenPenFaFaTiger

Member Since 2020
Please see my previous post for PenPen's situation
HELP! Monkey has bloated belly

As mentioned by you people, I should get U100 with half units. However, only U100 with full unit is available for me. Is that a big problem? I think my vision is sharp enough to adjust for half unit even there is no marking.

How should I transition from Caninsulin to Lantus? PenPen is using 2.0 unit of Caninsulin on a U40. His dosing is reducing these few days because his BG drop too low. Fyi, PenPen is reducing his dry food, it is possible that he will eat 0 dry food in few days if it is safe. @Deb&Wink @MarjiandGracie
 
Bron and Sheba (GA) said:
Hi Peter,
What are you feeding Pen Pen at the moment? I know you are transitioning over to canned food. How much dry is he now eating and when do you think he will be off the dry food?
Was he only diagnosed on 4 April?
How much does he weigh?
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I PenPen eats 6 grams of dry food for breakfast (He did not finish), and a lot of can food (too much he cannot finish). He is diagnosed on 8 April. He weighs 10.2 lb. His weight increase 0.4 lb compare to 6 days ago.
 
Hi Peter,
Bron is giving good advice. Thank you Bron! I'm thinking if you cant get the half increment syringes, maybe you can pre mark the ones you have? Measure with a ruler or something like that, then mark the barrel ? I dont know if this is a good idea but may be better than eyeballing the amount you are going to shoot. If this is a BAD idea I know someone will correct me. ok? Sending many prayers for you and your babies.:bighug:
 
I am assuming you are going to be doing the Start Low Go Slow (SLGS) method with these boys........
You can read about the methods at the top of the Lantus page in the yellow stickies.

With PenPen seeing he is newly diagnosed and has been dropping into green numbers with the three reductions you have done, I think I would start him off on 1 unit of Lantus. Hold the dose for 7 days unless he drops below 90 in which case you would reduce the dose.
Test before every shot and during the cycles as well.
Try and get a before bed test in and if the BG is lower than the preshot, set the alarm to get up and test later.

I used 1 unit syringes only...there were no 1/2 unit syringes here in Australia....I was given some 1/2 unit syringes during Shebas last year but I used to eyeball all the 1/4 unit increases with the help of a magnifying glass and good light with the 1 unit syringes.
 
Peter H said:
Do you mean I cannot draw from the same insulin pen for two cats?
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Yes you can draw from the same insulin pen but you need to have containers marked clearly "Monkey" and "PenPen" and put the correct syringes into the correct containers.
This is no reflection on you. This is a precaution we take here as mistakes have been made before.
I would suggest you draw one cats insulin up and give the insulin dose, and then move onto the other cat and draw up the dose and give it. This will help eliminate the chance of error.

And of course you only use a syringe once then throw it away.
 
Bron and Sheba (GA) said:
Yes you can draw from the same insulin pen but you need to have containers marked clearly "Monkey" and "PenPen" and put the correct syringes into the correct containers.
This is no reflection on you. This is a precaution we take here as mistakes have been made before.
I would suggest you draw one cats insulin up and give the insulin dose, and then move onto the other cat and draw up the dose and give it. This will help eliminate the chance of error.

And of course you only use a syringe once then throw it away.
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I see what you mean. I need to create a system to minimize error. Thanks for reminding me that. We all make mistake;)
 
Update: PenPen average BG is getting lower and lower. I reduce much dose. And tonight since his PMPS is 221 ml/dl, I will skip insulin injection to see his next AMPS BG.

I wonder, howcome PenPen recover so quickly? Perhaps it is because I reduce dry food. Or he may just heal naturally.
 
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Bron and Sheba (GA) said:
Yes you can draw from the same insulin pen but you need to have containers marked clearly "Monkey" and "PenPen" and put the correct syringes into the correct containers.
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This is how I mark my syringes for my thre insulin-dependent cats.
 

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Stick with 1.0U. He hasn't earned another reduction yet, so you want to stick with the same dose for a while.

Is there any way to get any tests at night? Even one "before bed" test would help to fill out the picture.
 
Nan & Amber (GA) said:
Stick with 1.0U. He hasn't earned another reduction yet, so you want to stick with the same dose for a while.

Is there any way to get any tests at night? Even one "before bed" test would help to fill out the picture.
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Hi Nan. I just get "before bed" test. May I ask what is the benefit of night cycle testing if I already have day cycle data?

Also, how can I determine if he earns a reduction? His AMPS and PMPS is pretty close to 200. If his BG is lower than 200, should I still give him a dose? I see other members give their cats dose even the BG is about 100 ml/dl
 
Hi Peter!

Great questions!

Peter H said:
Hi Nan. I just get "before bed" test. May I ask what is the benefit of night cycle testing if I already have day cycle data?
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Do you mean that you shoot, then go to bed right afterwards?

Many cats go lower at night than during the day. And just in general, every cycle is different, so what they do during the day doesn't tell you what they might be doing at night. So you are missing half the story if you don't test at night-- even just one test between the PM and AM shots would be helpful in filling in the missing history!

Peter H said:
Also, how can I determine if he earns a reduction? His AMPS and PMPS is pretty close to 200. If his BG is lower than 200, should I still give him a dose? I see other members give their cats dose even the BG is about 100 ml/dl
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In the Lantus forum stickies, there are two dosing methods described: Tight Regulation (TR) and Start Low, Go Slow (SLGS). They have different rules for when you take reductions, and different rules for testing frequency, etc.

Because you are still feeding some dry food, you would have to use SLGS, which uses 90 as the reduction point. Any time Monkey or PenPen go below 90, reduce the dose for that cat by 0.25U.

Full instructions here: Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

As for your no-shoot number, 200 is a good starting point, but after getting some data you can start moving that number down. The Lantus forum actually uses 150 as the initial no-shoot number, and most people are able to move the number down quite a bit. Under SLGS, eventually you can shoot anything over 90.

Ideally, you want to move your no-shoot number down gradually. When you hit a number you are unsure of, you can always stall without feeding and post for help, but also use your judgement on what you feel comfortable with shooting. It may depend on the situation, too-- for example, you might be more comfortable shooting low numbers during the day when you can monitor than at night when monitoring is more limited.
 
Peter, that looks like a 39.6 at +4 today. Did you feed Pen Pen some high carb food get another test in 30 minutes later?
You need to reduce PenPens dose down to 0.75 units from the next dose.
To get the 0.75 units you draw up to insulin to half way between the 1/2 unit mark and the 1 unit mark. If you don’t have 1/2 unit marked syringes and I don’t think you do, try and imagine where 3/4 of the 1 unit is and draw it up to there.
Ask questions if you are unsure.
 
Update: Yes, PenPen got 39.6 today and I gave him high carb food immediately. He looked completely fine and active. As suggested by Bron, his dose will be decreased to 0.75 U.
Maybe I will draw a mark for 1/2 units using a cutter. Let's see if it works;). Btw, may I ask how to make use of the BG result of the night cycle, as named by you "missing cycle"? Like for example, how the result influence the dosing decision if there is a clear curve for day cycle?

Monkey and PenPen are so fortunate to get help from this community. Thank you all:bighug:
 
Peter H said:
Btw, may I ask how to make use of the BG result of the night cycle, as named by you "missing cycle"? Like for example, how the result influence the dosing decision if there is a clear curve for day cycle?
Monkey and PenPen are so fortunate to get help from this community. Thank you all:bighug:
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Good question Peter.
Every cycle is important and gives us good data. Because cats often drop lower at night, it is important that we test during the pm cycle as well as the day cycle. Think of the cycles of the SS as a puzzle. If you only test during the day cycle, you are only seeing half the picture.
Lantus dosing is based on the nadir, or the lowest point in the cycle. If for example your cat didnt drop during the day but dropped low at night, you would miss totally that you may need to reduce the dose and could put your cat in danger by continuing with a higher dose.

If I were you Peter, I would get a before bed test in every night for both Monkey and PenPen. If the before bed test is lower than the preshot, it usually means an active cycle and I would set the alarm and get up later and test again to check that the BG has not gone down too much
 
Peter H said:
Unfortunately my Mom feed half hour ago already.:eek: i did not know i should stall. Whats the purpose of stalling?
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If you get a lower than normal number, you can stall for 20 minutes and see if the BG is coming up higher.
If your mother fed half an hour ago and the number was 66 after that I would skip the dose and not give any insulin
 
Also Peter, last night you got a +2 of 142 after a PMPS of 181.
That +2 of 142 is telling you that Pen Pen is going to drop lower that cycle and you need to set the alarm and get up and test later if you have gone to bed. Pen Pen would have dropped a lot lower Last night if he came up to 66 at AMPS.
 
Peter H said:
@Bron and Sheba (GA) Btw how would stalling for 20 minutes significant enough to influence the BG? 20 minutes is a short period
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It doesn’t always work but it is worth trying. Remember we are at the end of a cycle at shot time so the insulin is wearing off. Sometimes if you stall and wait for 20 minutes without feeding the BG will come up enough to shoot. Sometimes you have to wait another 20 minutes without feeding.
But until you get enough BG data, you would not want to be shooting a number much under 150 at the moment without advice from someone.
 
Peter when you get any BG under 50 you need to immediately reduce the dose by 0.25 units.
Also please feed low numbers. It looks like you did not test for 3 hours after getting 43 at +3. That is very very risky.
You need to feed some high carb food to Pen Pen when the numbers drop below 50 and test again in 30 minutes and keep testing until the numbers are up over 50.
Please start posting over on the Lantus forum from now on where there are more eyes to help you,
 
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