Questions about U-100 syringes

Jolie/Rochel

Jolie/Rochel

Member
Hi everyone. I am using a U-100 syringe for Lantus U-100 (orange cap, 29x1/2") and will probably be working with 0.5 U and lower. I did see a post somewhere on this website about how to get a syringe that shows smaller dosing increments but cannot find it. I would like to keep the needle as short as possible and ideally 30 or 31 diametere. Can someone please share the links for 1. the conversions, and 2. any advice as to which exact size/brand I should buy? Do I find these on Amazon or in a local pharmacy? I need to order them asap before my trip! thank you!!
 
Hi Rochel
I copied this from your profile because I think it's important that the members see what's going on with Jolie especially since Jolie had 2 hypoglycemic episodes already and can look at your spreadsheet. You have so many no shots and not testing AMPS and PMPS BG to see if Jolie BG is safe to shoot,. Lantus likes consistency when giving doses.
While you are in vacation will someone be testing Jolie?
Are you still using the Libre?
Would you like someone to take a look at your spreadsheet?



Hi everyone, I'm Rochel introducing myself and my tabby Jolie. I hope I'm following the protocol for posting correctly - will try to complete spreadsheet and start posting soon but wanted to get something published asap. Will review the protocols again!

Jolie is a 14-yo indoor-only adorable kitty and has lived with me and her brother Jacques since 6-mo kittens. They have eaten mostly high-quality canned food their entire lives. (It was low-carb Instinct until February when I changed to high-carb (22%) "novel" meat related to below.) Jolie had prior dx of IBD (2019) with no significant symptoms except vomiting when eating kibble or hard treats.

Current health decline started with weight loss noted back in February and took to vet for exam - noted elevated liver enzymes, elevated glucose. In April 2022 internist dx'd her with triaditis and for a while was on the trail of trying to dx the state of her intestines, pancreas, and liver with multiple tests and ultrasound cytology, at multiple vets. Nothing definitive. The elevated glucose at each visit did not concern any of them - said probably stress-related. One vet recommended Prednilosone (gave daily for about 3 weeks), and the next one suggested replacing that one with Hydrocortisone for less side effects (gave daily for about 2 weeks).

Finally went the Animal Medical Center NYC to see a new internist about more diagnostics for IBD/lymphoma and he suspected instead that DM was primary problem to tackle, esp bc Jolie has been presenting with ravenous appetite, increased water intake, continued weight loss, but no vomiting/diarrhea - so didn't seem like a GI issue to him. Numbers at baseline: BG 300 mg/dL, Fructosamine: 430. Liver enzymes mild/moderately elevated but improved.

Prescribed Glargine 1.0 U 2x a day (started one week ago today), and set up glucose testing via FreeStyle Libre 2 sensor/app. Advised phasing out steroid, which we are almost done doing. Advised changing meal to 2 big meals per day. Recommended Hill's Diabetic Diet (ugh, no.)

First week results:
1. 2 meals a day not acceptable to my little skinny starving cat! So feeding more often than recommended and saving largest meal for pre-insulin.
2. 1.0 2x day insulin was stabilizing her for first few days but then she had an episode of hypoglycemia (to as low as 59 mg/dl). Terrifying for me but she was OK.
3. Vet changed insulin to 0.5 U, 2x per day.
4. Jolie had another hypoglycemic episode subsequently even with lower dose (to as low as 53 mg/dL). Took a break from insulin for 1.5 days. (I thought perhaps the transition to low-carb food plus insulin was too much.)
4. Tried to resume yesterday morning but now she is starting to fight me about the needle, so has not had any insulin in over 2 days. Numbers range from about 250 to 300 (avg 265). Vet still wants me to do 0.5 2x/day.
5. I have decided to change her food TODAY to Weruva Chicken/Pumpkin which should bring down the carb load dramatically (to about 7%) and have continued to pause the insulin to see what happens!! and start an exercise program NOW.
TO BE CONT'D via a post, I guess!
 
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Jolie/Rochel said:
Hi everyone. I am using a U-100 syringe for Lantus U-100 (orange cap, 29x1/2") and will probably be working with 0.5 U and lower. I did see a post somewhere on this website about how to get a syringe that shows smaller dosing increments but cannot find it. I would like to keep the needle as short as possible and ideally 30 or 31 diametere. Can someone please share the links for 1. the conversions, and 2. any advice as to which exact size/brand I should buy? Do I find these on Amazon or in a local pharmacy? I need to order them asap before my trip! thank you!!
Click to expand...

Are you talking about U-100 syringes with the half unit markings
If so you can order these
https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct

30-unit-insulin-syringe-markings.jpg



If you ever had to give 0.25 units here is a pic
49822973683_0559ae843a_o.jpg
 
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84ebbd9e955b4348939878c2f671b8ed.jpg

relion-insulin-syringes-png.37311


If you have a Walmart near you they have them, either packages are OK, just check them,you can't order these on line you need to go into the store
You want 0.30 cc/ml (30 units) syringes with half unit markings. Not the 0.5 cc/ml or 1 cc/ml ones.
 
Diane Tyler's Mom said:
84ebbd9e955b4348939878c2f671b8ed.jpg

relion-insulin-syringes-png.37311


If you have a Walmart near you they have them, either packages are OK, just check them,you can't order these on line you need to go into the store
You want 0.30 cc/ml (30 units) syringes with half unit markings. Not the 0.5 cc/ml or 1 cc/ml ones.
Click to expand...
Wow, thanks. I’m in NYC so not sure if I have a Walmart. CVS or Duane Reade perhaps? LMK if you know.

Also - do I need to do any conversion from U-100 dose to a new dose to equal 0.5? I was reading things on this forum about converting dosages when you switch syringe sizes.
 
Jolie/Rochel said:
Also - do I need to do any conversion from U-100 dose to a new dose to equal 0.5? I was reading things on this forum about converting dosages when you switch syringe sizes.
Click to expand...
If you are using lantus which you are you are only buying the syringes with the half unit markings, there is no conversion to do.
I really have no idea what you mean when you said do you need to do a conversion from U-100 dose to a new dose to equal 0.5?
Did you mean that you are using 29x1/2 inch?
It doesn't matter if you get the 31 gauge
If you can't find the Relion syringes then order them from the link I gave you, call them and they will call your vet and she can fax a script over to ADW Diabetes. Give your vet a heads up
Also I have no idea if you have a Walmart in NYC, that's the only place that carries the Relion

I think what you are talking about is
Conversion chart for using a U-40 insulin with a U-100 syringe
 
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Diane Tyler's Mom said:
If you are using lantus which you are you are only buying the syringes with the half unit markings, there is no conversion to do.
I really have no idea what you mean when you said do you need to do a conversion from U-100 dose to a new dose to equal 0.5?
Did you mean that you are using 29x1/2 inch?
It doesn't matter if you get the 31 gauge
If you can't find the Relion syringes then order them from the link I gave you, call them and they will call your vet and she can fax a script over to ADW Diabetes. Give your vet a heads up
Also I have no idea if you have a Walmart in NYC, that's the only place that carries the Relion

I think what you are talking about is
Conversion chart for using a U-40 insulin with a U-100 syringe
Click to expand...

Hi, yes I think I remembered some thing incorrectly about this. No need to do a conversion just looking for a better syringe. I will investigate regarding the Relion type. Thanks so much.
 
Jolie/Rochel said:
Hi, yes I think I remembered some thing incorrectly about this. No need to do a conversion just looking for a better syringe. I will investigate regarding the Relion type. Thanks so much.
Click to expand...
Yes no need to do any type of conversion ,you were just looking for a shorter U-100 syringe with half unit markings, I was just showing you that link to show you what you were thing of that you saw on this site. You don't need to do anything ,just use the U-100 syringes I recommended with half unit markings and just draw up the exact dose you want
 
Hi Rochel, I see on your spreadsheet you are following SLGS which says
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
I see Jolie dropped under 90 last night @+6 , (46) you should have reduced this morning and given her 0.25 units, is there any reason you didn't give her any insulin this morning (6-8-22)?
You might want to read the SLGS dosing method again
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
 
Your previous post
https://felinediabetes.com/FDMB/threads/911-46-and-going-down.264309/#post-2960832
Hi Rochel I saw Jolie dropped to 46 last night @+6, I am pretty sure you should have reduced her dose this morning and should have given her 0.25 units when following SLGS which is on your SS. I am going to tag a few members to confirm that, also is there any reason you didn't give her any insulin this morning with an AMPS of 226?
@Bron and Sheba (GA)

@tiffmaxee

@Bandit's Mom

@Wendy&Neko

@Suzanne & Darcy

@Christie & Maverick

Ladies I know Rochel memtioned that she will be going on vacation soon and I am just concerned about her kitty
Thank you

Also can you add SLGS to your signature, what does
If would be a good idea since you are posting on the lantus board to do a new post every day
You would do it like this
Date, then Jolie , then AMPS# whatever is is and then any tests after that, then PMPS#
If you don't know how to go back and add the additional tests look to the right you will see Thread Tools tap on that, tap on Edit Title and add the tests then tap Save
Always link the previous days post to it
Curious what does
Co-morbs mean that is in your signature?
@Jolie/Rochel
 
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Hi all,
I will add on to this thread for today bc I am rushing through my day, on almost no sleep, and can't figure out quickly how to follow the protocol. There is so much learn and everyone has so many questioins and I'm exhausted and very frustrated with my vet:
1. No, I couldn't give insulin this morning because I was so stressed from last night and the last time this happened vet told me to take a day off the insulin. We also had an appointment at the medical center to replace her Libre2 and that was a big rush too and she is very difficult with the injections! I have watched countless videos and am trying something new: using elevated surface with block of cream cheese to engage her, and counter-conditioning approach. Did not work yesterday - she jumps when she feels the needle - but will keep trying.
2. I even hired a tech to come over last night and help me/teach me better how to do the injection. I hope I get this down today - because she is not free to come by in the mornings.
3. This tech is a senior-level tech at a major practice in NYC, and she is going to be boarding Jolie at her apt while we are gone for 10 days with close all day monitoring, BG checks, insulin, etc. It will probably be for the best for Jolie to get into an insulin routine, although I'm probably going to try again tonight.
4. Having said that, yes I agree the .25 is correct. My vet today disagreed (via short email). Said it was "impractical" and was reviewing the data to help him plan what to do. Asked me how much food I was giving, and when. I feel like I'm going against him (he who is so busy he can't call, just sends short emails) and trying to absorb everything on these forums and not seem completely non-compliant. He's not cooperating with me partially because I don't always follow his instructions.
5. I want to switch to a different U-100 syringe that was recommended by someone here/FB that might be easier to use for smaller dosing. He should have written prescription by now in order for me to get it overnighted for tomorrow. He has not.
6. How can I measure .25 U in that little syringe I have with the orange cap?? (3/10 mL Monoject 29 G x 1/2")

thank you so much for your input, time, and patience!

 
I'm glad that Jolie will be staying with the vet tech at her house and will be checking her BG. Hopefully she will get Jolie used to everything. When are you leaving for vacation
Rochel are the monject syringes you have do they have the half unit markings?
Which ones do you have
30-unit-insulin-syringe-markings.jpg



Curious what does
Co-morbs mean that is in your signature after lc wet?
Do you have any med and high carb wet food for your hypo kit in case Jolie drops to low
What brand low carb wet are you feeding?
Med and High Carb food and some honey, you might want to pick up some of these and leave them with the vet tech while you're away



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs or you can look for other med and high carb foods on the food chart

Here is the link:http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

@Jolie/Rochel

49822973683_0559ae843a_o.jpg
 
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Thank you everyone- for sure I will not give her 0.5!! It will be a challenge to get the amount right as it's so close to the top of the needle. Wish it wasn't clear liquid! But I have a tech coming over any minute to help me tonight.

I have the syringe with the 1/2 U's shown (left picture), but there is so little clearance, as I said.
Co-morbs = co-morbidities, like other diagnoses she also has
I have high carb (RAWS 22% carb) and will get some medium tomorrow. Thank you for that list of the Fancy Feasts!!!
Currently feeding Weruva Who Wants to be a Meowinnaire? (chicken/pumpkin) = around 7% carbs
Not following vet's advice about using Hills. Also not following his advice about only 2 meals a day. I do biggest meals right before insulin and 2-3 smaller meals at other times. He seems to not be liking me not following his directions, as he has not reached out to me today about a new plan since .5 is not working. I got quite upset (crying!) at the hospital today when we were changing the Libre and probably turned everyone off!! Very little sleep last few days.
And yes, I will leave all these things with the tech. Thanks again!
 
While you are waiting for the tech, let's try a little experiment. Draw up a little more than 0.5u since that line is visible, then take the syringe and go to your fridge. Open the door, stand in the doorway and hold up the syringe against the light from the fridge, then gently turn/squeeze out a couple of drops until you get between 0.5u and the zero line. Give it a try, you might be surprised at how well you can see with the fridge light as a back light :)
 
Hey Christie - perfect timing. Thank you! The tech and I liked this technique. I don't know how 0.25 otherwise could be done. Jolie was on to us (despite the block of cream cheese on the towel on the counter approach)so it had to be a 2-person operation in the end (we coaxed her out from under the table, I held, she shot). The trick will be learning to do it by myself - let's see how tomorrow morning goes. (and hopefully no 4 am hypo episode...!!)
 
Jolie/Rochel said:
I got quite upset (crying!) at the hospital today when we were changing the Libre and probably turned everyone off!! Very little sleep last few days.
Click to expand...
Aww don't cry Rochel , I feel that the members here know more about diabetes than most vets do. I'm glad you are feeding multiple times during each cycle.
We are all here to help you and very little sleep doesn't help

If would be a good idea since you are posting on the lantus board to do a new post every day so we can see what's going on
You would do it like this
Date, then Jolie , then AMPS# whatever it is and then any tests after that, then PMPS#
If you don't know how to go back and add the additional tests look to the right you will see Thread Tools tap on that, tap on Edit Title and add the tests then tap Save
Always link the previous days post to the new one

You can also buy freeze dried treats for Jolie ,get her to associate getting one after you test her BG and after giving her the insulin
 
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Hi - I changed the title. Hope I'm supposed to be adding the new day's post to the bottom of this thread. LMK if I should be writing this post elsewhere.
Question: AMPS is in normal range (157). Was 123 +5 last night PMPS. SHOULD I GIVE 0.25 this morning? I'm assuming so. Last night had a successful first run of 0.25 U - with help of tech. Jolie is very crafty and picks up on any attempt to do anything "fancy" with her. But we accomplished it. Today it's me alone. But have caught up on sleep so feel more ready!
UPDATE: her number was lower (154) right AFTER am meal! Waiting 15 more minutes and will test again before deciding about morning insulin. Hope you're getting this!
 
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Jolie/Rochel said:
Hi - I changed the title. Hope I'm supposed to be adding the new day's post to the bottom of this thread. LMK if I should be writing this post elsewhere.
Question: AMPS is in normal range (157). Was 123 +5 last night PMPS. SHOULD I GIVE 0.25 this morning? I'm assuming so. Last night had a successful first run of 0.25 U - with help of tech. Jolie is very crafty and picks up on any attempt to do anything "fancy" with her. But we accomplished it. Today it's me alone. But have caught up on sleep so feel more ready!
UPDATE: her number was lower (154) right AFTER am meal! Waiting 15 more minutes and will test again before deciding about morning insulin. Hope you're getting this!
Click to expand...
Hi Rochel copy this and go to
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
to the right it will say Post New Thread and then paste what you wrote above
This is where you will start a new post everyday and link the previous days post to it
Can you do this now and I'll go over there and tag more experienced members for you about the dose.
When you do today's post do it like this
6-9 Jolie AMPS-157
You can go back and change the title above to what you had before like Questions about U-100 syringes
 
Jolie/Rochel said:
Hi - I changed the title. Hope I'm supposed to be adding the new day's post to the bottom of this thread. LMK if I should be writing this post elsewhere.
Question: AMPS is in normal range (157). Was 123 +5 last night PMPS. SHOULD I GIVE 0.25 this morning? I'm assuming so. Last night had a successful first run of 0.25 U - with help of tech. Jolie is very crafty and picks up on any attempt to do anything "fancy" with her. But we accomplished it. Today it's me alone. But have caught up on sleep so feel more ready!
UPDATE: her number was lower (154) right AFTER am meal! Waiting 15 more minutes and will test again before deciding about morning insulin. Hope you're getting this!
Click to expand...
@tiffmaxee
Hi Elise I'm trying to help out Rochel ,she is new to this and I told her to start a new thread and put it on the lantus board. Her title before this was different. Question is with a AMPS of 157 should she still shoot 0.25 , she just started giving this dose last night Thanks Eluse
 
Diane Tyler's Mom said:
@tiffmaxee
Hi Elise I'm trying to help out Rochel ,she is new to this and I told her to start a new thread and put it on the lantus board. Her title before this was different. Question is with a AMPS of 157 should she still shoot 0.25 , she just started giving this dose last night Thanks Eluse
Click to expand...
it's not 157, it's 124 now! Not going to based on a lot of feedback already. Thank you. sorry about the confusion about posting, it's complicated!
 
Bron and Sheba (GA) said:
@Diane Tyler's Mom this conversion chart is not for using with Lantus. It is a conversion chart if you are using a U40 insulin and want to use a U100 syringe.
Click to expand...
Hi Bron, yes I know that I was just telling her that I think this is what she was thinking of
She thought she had to do something different just because she wanted to use a different gauge syringe for the U-100 syringes :cat:
@Bron and Sheba (GA)
 
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