Ready to make the change

Status
Not open for further replies.
arozeboom

arozeboom

Member Since 2011
Ruby and I are ready to make the change from PZI to Lantus. The plan is to start with her PM shot tomorrow then I will sit and stare at her non-stop until Monday morning. :smile:

Ru started out on 1 unit of PZI, we bumped it to 1.5 and that went badly so we cut back a few times and tried a sliding scale. Nothing is working.
We've been doing .6 for almost a week now. Despite lots of curves, I've yet to pin down her nadir but more often than not it seems like it comes late in the cycle. Her spreadsheet is up to date.

Last time she was weighed (about 6 weeks ago) she rang in right at 14 lbs. I think she's lost a little since then. She eats 1 can of Fancy Feast, twice a day and I give her freeze dried chicken bits as bribes. I test her pretty obsessively. During the week I'm gone from about 7:15 AM until about 5:45 PM. She tolerates the tests and shot so much better than I ever expected. I tend to shoot her more in the hip area. Am I supposed to aim for the scruff?

I use an AlphaTrak. On Ruby, it tests higher than a Relion Micro. When the Alpha tests in the 300s, it can be up to about 80 points higher than the Relion. When the Alpha tests in the 100s, its about 30 points higher than the Relion. I've got an extra AlphaTrak (don't even ask) and a Relion Micro as backup meters.

I've got the Lantus and U100 syringes. I've got a hypo kit...about 150 test strips, a billion lancets, Gravy Lover's FF, Karo syrup, Rapid Glucose Spray and some Xanax, lots of caffeine, and chocolate for me. I've got a bracelet that says "Breathe" so I remember to breathe. I've got a husband who sometimes looks at me like I'm crazy but will still hug me and tell me that everything is going to be ok everytime I totally lose it (which tends to happen late at night). The past few days she looks like her back legs might be a little stiff so I've got some zobaline on order.

Am I missing anything and what kind of dose should I start with? The vet said 1 unit but that makes me nervous because she hasn't been on 1 unit of PZI for awhile.

Thanks!
Amy & Ruby
 
Hi guys and welcome to Lantus Land! Sounds like you are very prepared and ready to make the switch .. this is a wonderful community and any questions you have should be answered with no problems .. I hope that lantus is exactly what ruby needs and she finds her way to nice steady flat numbers!
 
Sounds like you are fully prepared :cool:

I switched from Caninsulin to Lantus 3 weeks ago, and have to admit that I had to learn the whole thing from the beginning. Don't know how PZI works, so cannot comment what the difference may be.
My Kitty is still on dry food, so his BGs are already high to start with :sad: . For first 2 weeks on Lantus, I did 2U BID and effectively did not get any curve and his BG was consistently in 300's. it was frustrating. A week ago I increased dose to 2.5U (probably a bit high increase, many suggest to do 0.25 increases), and now I have finally got a curve. Still not fully stable, so we are trying to find our ways....

As I am so new to this also, I cannot give you advise on dosing, but am sure you'll get good advise from some of the experts. All I wanted to share our story and that you are not alone :-D

- mia
 
Welcome to Lantus Land! :YMHUG: it sounds like you are well prepared.

Lantus is a lot different than PZI. Lantus is a solution not a suspension, so no rolling or mixing. Are you using a pen or the vial? Pens cost more initially but save money in the long run. We draw insulin from them just like w/ the vials, don't use the attachable needles that are sold for human use. Do not inject air into the pens, they are pressurized. If you have the vial it is fine to inject air in.

It likes to be very consistent in dose and time. Lantus builds up a shed and usually takes 5 to 7 days to show full effectiveness (every shot a little is stored and a little released, so you won't really see what a dose is doing until until the shed is filled). Every time a dose is changed it can take up to 6 cycles to balance the shed out. A 12/12 schedule is very important too, more than 15 minutes early or late works like an increase in dose or a decrease in dose.

I'm not sure why your vet wants to start at a higher dose unless it is because her numbers have not been that low. We generally start lower and try to work up to the perfect dose, less chance of missing it that way. Others will be along to give more dose advice later.

:YMHUG: :YMHUG: cat_pet_icon cat_pet_icon
 
I'm using a vial. I've been using the U100 syringes with the PZI so I need to remember to NOT use the conversion chart. The short, ultrafine needs work much better with her.

I'm not sure why Dr. K wanted to start higher, but I'm very hesitant to do so. I would rather start lower and go up if necessary and I know it will take awhile to build up.

For the most part I'm very consistent with her shots. I get up at 5:00 AM and I get home by 6:00 PM most nights so I tend to go on a 6:00/6:00 schedule. There are occasions I need to stay late at work but, (knock on wood) those don't happen very often. If I want to be able to get at least a +1 AM test in, I would need to shoot her at 6:00. Evenings I can test the heck out of her until about 11:00 PM. She will normally eat most of her food when I give it to her but she leaves some for later. From what I've observed, at least during the day, she likes to eat a small lunch. Evenings she likes a snack before bed. When her numbers are high, she is more likely to finish her whole bowl before the next feeding. If they're in a good range, she rarely finishes all of it.
 
OK, just getting out all the newbie information. ;-)

Next time consider using the pens. Think of it this way, once you start using the insulin the mfg says it is good for 28 days at room temp. this is fine for humans as they use much larger doses, but for cat we often have a lot left after 28 days. Some find they can use the vial longer, others find it starts to lose effectiveness the longer it is opened. W/ the pens you have 5 small 3ml vials instead of one large 10ml on. The countdown doesn't start until you start using a particular pen, so you get at least 5 months out of the pens as opposed to about one from the vial. I had to take a pen in and show my vet how i was planning on using it, you must be sure they specify on the Rx for the pens.Some places will let you buy a single pen, but i haven't found one.

You might consider using the Relion as you primary meter, just from the stand point of cost. Most of us here use human calibrated meters. Also, you can get the strips even cheaper at ADW, go up to the SHOP icon. There is a link. The Arkray Glucocard 01 is the same meter, they make them for Walmart. Testing can be the most expensive part of all this.
 
Hi Amy,

Welcome to Lantus Land! For your hypo kit you only need about 150 lancets, but you'll need a billion testing strips :lol: :lol: Seriously, I think you've got all needed supplies covered. But one of the the most important parts of your hypo kit is made up of the good folks of Lantus Land. There's always someone here to talk you through, hold your hand, or share stories during pajama parties. Let the fun begin.
 
Dr. K said the vial should be good until the expiration date marked on it as long as its refrigerated and doesn't get shaken up. I don't remember what the date is off the top of my head. If it seems like it goes wonky before that, I might try the pens.

I started with the Relion and switched to the Alpha because its what my vet uses at the office. It gives us both a better idea of the numbers we're looking at without having to think about the difference between the meters. The normal 20% variance is too much math as it is! Totally my choice and I've gotten used to the cost of the strips. Right now that's not an issue for me but should it become one, I'm ready to go with the Relion.
 
arozeboom said:
Dr. K said the vial should be good until the expiration date marked on it as long as its refrigerated and doesn't get shaken up.
Click to expand...

The expiration date printed on the label is for the unopened bottle or pen.

Unopened LANTUS vials, cartridge systems and SoloStar device should be stored in a refrigerator, 36°F – 46°F (2°C – 8°C). Discard after the expiration date. http://products.sanofi.us/lantus/lantus.html#section-15.2


Once the rubber stopper has been pierced, the clock start ticking. The following is the info for Human use of Lantus:

Open (In-Use) Vial:

Vials must be discarded 28 days after being opened. If refrigeration is not possible, the open vial can be kept unrefrigerated for up to 28 days away from direct heat and light, as long as the temperature is not greater than 86°F (30°C).

Open (In-Use) Cartridge system:

The opened (in-use) cartridge system in OptiClik should NOT be refrigerated but should be kept at room temperature (below 86°F [30°C]) away from direct heat and light. The opened (in-use) cartridge system in OptiClik must be discarded 28 days after being opened. Do not store OptiClik , with or without cartridge system, in a refrigerator at any time.

Open (In-Use) SoloStar disposable insulin device:

The opened (in-use) SoloStar should NOT be refrigerated but should be kept at room temperature (below 86°F [30°C]) away from direct heat and light. The opened (in-use) SoloStar device must be discarded 28 days after being opened.

Most people find that the bottle poops out in a month or two and that they're throwing away a barely used bottle all the time. The SoloStar pens are much more economical and you throw away less when it does poop out.
 
Hmmm...good to know! I wonder if PZI is the same. Ru was diagnosed 3 months ago yesterday. Maybe that's why she's been extra high the past week or so. That never occurred to me. I didn't realize it was that long ago until this morning.
 
squeem3 said:
Unopened LANTUS vials, cartridge systems and SoloStar device should be stored in a refrigerator, 36°F – 46°F (2°C – 8°C). Discard after the expiration date. http://products.sanofi.us/lantus/lantus.html#section-15.2


Once the rubber stopper has been pierced, the clock start ticking. This is the info for Human use of Lantus:

Open (In-Use) Vial:

Vials must be discarded 28 days after being opened. If refrigeration is not possible, the open vial can be kept unrefrigerated for up to 28 days away from direct heat and light, as long as the temperature is not greater than 86°F (30°C).

Open (In-Use) Cartridge system:

The opened (in-use) cartridge system in OptiClik should NOT be refrigerated but should be kept at room temperature (below 86°F [30°C]) away from direct heat and light. The opened (in-use) cartridge system in OptiClik must be discarded 28 days after being opened. Do not store OptiClik , with or without cartridge system, in a refrigerator at any time.

Open (In-Use) SoloStar disposable insulin device:

The opened (in-use) SoloStar should NOT be refrigerated but should be kept at room temperature (below 86°F [30°C]) away from direct heat and light. The opened (in-use) SoloStar device must be discarded 28 days after being opened.

Most people find that the bottle poops out in a month or two and that they're throwing away a barely used bottle all the time. The SoloStar pens are much more economical and you throw away less when it does poop out.
Click to expand...

I was going to wait until next week to make my appearance in the Lantus forum, but I saw this post and had to comment. Just to make it clear, UNOPENED Solostar pens go in the fridge, OPENED Solostar pens are at room temperature? Does anyone know the actual reason for this? Just curious.
We'll be switching to Lantus the weekend of March 4th, wish we could have started right after we got the script for the pens from the vet but we're moving this weekend and both Morlei and I don't need the stress, especially her, poor thing will probably hide under the couch for a week.
 
I just found this in the info, proper handling, & storage sticky...I'm a little confused now
In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
 
Are you going to be making the switch to Lantus too?

Becky & Morlei said:
I just found this in the info, proper handling, & storage sticky...I'm a little confused now
In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
Click to expand...
 
arozeboom said:
Are you going to be making the switch to Lantus too?
Click to expand...

Yep, we've gotten nowhere with ProZinc, we've given her doses ranging from 0 to 3.5 and her cycles are relatively flat...in the beginning we got somewhat of a curve and with a high dose we got a little curve, but she isn't even close to getting into the normal range at her nadir. Now it seems like her numbers just want to hang out between 220-280 all day long. Can't figure out why so off to Lantus Land we go!
I'm not too sure what dose we'll be starting at, if I go by the weight formula she should start out at 1.5u. It seems like the standard starting dose is 1u though so we might go with that. My kitty has tolerated high doses of ProZinc with basically no effect on her numbers so we're ok in that department I think. In regards to your Ruby, my opinion would be to maybe start at a lower dose because you said 1.5u of ProZinc was too much...however I would get the advice of experienced Lantus users since Lantus works differently than ProZinc. Good luck to you and Ruby!
 
ladies, forget the instructions for human use!

here's what you need to know for feline use:

--- store opened and unopened lantus/levemir vials and pens in your refrigerator at 36 to 46 degrees F (2 to 8 degrees C). it lasts longer that way!

--- unopened refrigerated pens/vials will last at least until the expiration date stamped on the box.

--- pens do not last longer than vials and vials do not last longer than pens. the reason we recommend pens is they're more economical in the long run.

--- once you pierce the top of a vial or pen the pen or vial has been known to last for approximately 6 months. however, i urge you to visually inspect the pen or vial before every use. floaties (crystals), discoloration, and or frozen insulin is toast. discard it.

--- please view julie's video in the STICKY: LANTUS & LEVEMIR - INFO, PROPER HANDLING, & STORAGE about how to correctly draw a dose from a pen or vial (insulin is drawn differently from a vial than a pen).




amy, happy to see you're making the switch now! i'm on the run. will get back to you about dose after studying ruby's spreadsheet.
 
Becky & Morlei said:
I'm not too sure what dose we'll be starting at, if I go by the weight formula she should start out at 1.5u. It seems like the standard starting dose is 1u though so we might go with that.
Click to expand...

hello and welcome becky!
we do not use the weight based formula nor do we recommend a standard starting dose of 1u bid for those switching from another insulin. instead we give a whole lot of consideration to kitty's performance on the insulin used prior to the switch.

when you're ready to switch, please start a thread asking for recommendations.
 
amy, one quick question and then i have to be out the door. i'll look for your response as soon as i get back.

has ruby ever had ketones or been in DKA?
 
Jill & Alex said:
Becky & Morlei said:
I'm not too sure what dose we'll be starting at, if I go by the weight formula she should start out at 1.5u. It seems like the standard starting dose is 1u though so we might go with that.
Click to expand...

hello and welcome becky!
we do not use the weight based formula nor do we recommend a standard starting dose of 1u bid for those switching from another insulin. instead we give a whole lot of consideration to kitty's performance on the insulin used prior to the switch.

when you're ready to switch, please start a thread asking for recommendations.
Click to expand...

Thanks Jill! I saw in the protocol that the starting dose is different when coming from another insulin...I hope you all can figure it out for me because I don't have a clue, that's why I assumed I would just start at 1u. I'll get her spreadsheet updated with all her numbers and will start a new thread soon.
 
No.
She was a bit dehydrated and had a nasty bladder infection (with rod bacteria) when she was first diagnosed in December. She took a round of Baytril and it cleared up. She's always been pretty healthy other than a terrible habit of neurotic over grooming.
 
She has looked a little stiff the past couple of days so I have some Zobaline on order, just in case.
 
Listen to Jill! :-D :-D She is one of our Gurus here. Keep you open vial or pen refrigerated. The reason for the human instruction saying to keep at room temp for the pens is the pressurization. Cold effects the pressure in the pen and the pressure is what make the dialed-in, auto injection possible. Since we don't use the auto inject feature, but just draw with regular syringes, it does effect our dosing and the refrigeration keeps the insulin fresh longer.
 
Hi Amy, I'm glad you posted for a starting dose suggestion. Welcome to the group!

I know it may seem like 1.0u is a lot compared to what Ruby is getting now, but keep in mind that Lantus is less potent than PZI, so kitties often end up needing a higher dose of Lantus to get a similar response. What I'm seeing on Ruby's SS is that the current dose of 0.6u of PZI is not high enough, she has room for more insulin, so the lowest I would suggest that you start at is 0.75u, and 1.0u might be better. She has been seeing mostly high numbers for the last two weeks, I'm sure there's some glucose toxicity to break through, so 1.0u would probably help her start seeing some better numbers sooner rather than later. If Ruby were my cat, I would start at 1.0u....but that's me, with the benefit of hindsight.

Take a look at our SS when we switched....Mr Tinkles was seeing a good response to 1.4u of PZ, 1.5u was a little too much. We started Lantus at 1.25u, and had to go up to 1.75u to start seeing good numbers again, and that took over a week. While that's not too bad, if I had it to do over, I wouldn't have started any lower than 1.5u.

I can give you my opinion and explain why I feel that way, but you are the one holding the syringe, so it's ultimately your choice. Are you willing to take the plunge and see Ruby get into better numbers as quickly as possible, or would you prefer to take it slower, even if that means Ruby will sit in higher numbers for longer? There's no right or wrong answer, it's a matter of your comfort level. What do you think?

Hopefully others will share their opinion as well.
 
Laurie and Mr Tinkles said:
I know it may seem like 1.0u is a lot compared to what Ruby is getting now, but keep in mind that Lantus is less potent than PZI, so kitties often end up needing a higher dose of Lantus to get a similar response. What I'm seeing on Ruby's SS is that the current dose of 0.6u of PZI is not high enough, she has room for more insulin, so the lowest I would suggest that you start at is 0.75u, and 1.0u might be better. She has been seeing mostly high numbers for the last two weeks, I'm sure there's some glucose toxicity to break through, so 1.0u would probably help her start seeing some better numbers sooner rather than later. If Ruby were my cat, I would start at 1.0u....but that's me, with the benefit of hindsight.
Click to expand...
I see the same thing Laurie is seeing, and I would suggest 0.75u to 1u. If you're starting on Friday night and can monitor over the weekend, starting at 1u might give the boost Ruby needs to help bring the numbers down sooner. If you're more comfortable with 0.75u, then that is great too. There's no wrong answer.

Welcome to LL!
 
hi amy - and becky too!

amy, i hope you won't be terribly disappointed this weekend - there might not be anything going on at first. :-D seriously, though, if it were as crazy as you're anticipating we'd all be a little insane from it! you'll be fine - and yes, linda's right, there's nearly always someone on here that will help if you need it. everything will be fine.

regarding the dose - jill & laurie are so experienced - i would trust their advice completely. in fact, i have and they haven't steered me wrong yet. :-D
 
I was just over on the PZI board saying that the thing that kills me about this disease is that I KNOW the insulin works. I see how she feels when she's in the lower range. When I got home from work tonight she was obviously feeling crappy and was giving me big sad kitten eyes. Now its 4 hours later and she's rolling around on the floor, rattling her favorite toy and swatting at Midgie (our civvie). So it works. Its just not working right. I want to get it right and I want to do it as quickly as long as its safe. I haven't tested her yet but she's probably in the 200s right now. By the time we get up in the morning we'll probably be back to the sad kitten eyes.

I've said before that right I don't know if its possible for her to ever go OTJ. If its not in the cards, I can handle that. My goal is to get her in a good range and keep her there because I know what she's like when she's feeling good. I miss my happy Ru.

Do I worry about a hypo? Yes, I do. Especially in the middle of the night. But am I prepared to lose as much sleep as I need to so we can get her feeling good? Hellz yeah I am.

So here's a question...let's say she dips into the blues or greens tomorrow night and on Saturday morning, she under 200. What do I do then? I know she spikes quite a bit when she eats. So do I go with the idea that I know she's going jump way up and shoot for that or do I hold off? I think the lowest I've shot into was 145, and that was .5 unit, after she had been on the PZI for a month.
 
Wow...you all jumped in while I was typing that!

I know I probably won't see much of a change for the next week. I sat her down after dinner and told her that she's got 5 more days to be a slacker, then she's got to get to work and help me fix this nonsense!
 
people who are experienced will shoot 50's at preshot. shooting a low number is an entirely different game than shooting a high number. not suggesting you do that at first, just saying. you are experienced, you just aren't experienced at lantus. probably your best game plan is going to be to post here and ask for help.

when you're waiting don't feed her. often they'll go up quickly in numbers at the end of a cycle. basically you're going to have a number in your head that you feel ok shooting. complete newbies usually don't shoot less than 150.

if you look at spreadsheets for some of the other cats new to Lantus who are doing great, you can see that shooting a lower number will flatten out a cycle and bring the overall numbers down. Check out spreadsheets for daphne, sam siam, atticus - hmm, those are the ones popping into my head immediately that have recently learned to shoot lower numbers. specifically, look at their preshot numbers and then look across at the middle of the cycle - the numbers are relatively flat. their cats are having a great response to it.

it's logical to think that if you shoot a 300 and the BG drops to 100 by the nadir you've seen a 200 point drop - so if you shoot a 100 you'll have a dead cat by nadir - but it's like there is one game when you shoot a high number and an entirely different game when you shoot a low number. strange but true! :lol:
 
hi amy. sorry i'm getting back here so late. just finished working.

i see laurie has already posted the outcome of some back channel discussion. we're all in agreement about starting with a dose no less than 0.75 unit. you're coming from a different place than you were a few weeks ago when you were contemplating switching to lantus when we talked about a lesser dose. since then, i'm seeing some glucose toxicity. you'll want to break through that before too long.

every once in awhile we see a lantus/levemir kitty experience a big response sometime in the first 3 cycles. this initial response usually does not mean the starting dose is too high. it's just something that happens... and not with every kitty. when you're prepared, it no big deal. considering you'll be starting friday night and have the weekend to monitor, i'd start with 1u bid if ruby were mine. however, there is nothing wrong with taking a slower approach. i know switching insulins can be a little scary. starting with 0.75u or 1u bid is up to you.

one more thing i'd like to cover because i saw it mentioned a few times in your pzi threads is inverse curves.

inverted curves can be signs of:
--- too much insulin
--- not enough insulin
--- a late nadir

when a kitty is taken up the dosing scale in the systematic and methodical manner we use in LL we do not give much thought to an inverse curve until kitty is very, very close to going OTJ.

late nadir kitties will also have inverted curves. inverted curves do not always mean the dose is too high.


so, what do you think?


i'm a slooooooooow typist (never learned how to type properly) and saw your question:

So here's a question...let's say she dips into the blues or greens tomorrow night and on Saturday morning, she under 200. What do I do then? I know she spikes quite a bit when she eats. So do I go with the idea that I know she's going jump way up and shoot for that or do I hold off? I think the lowest I've shot into was 145, and that was .5 unit, after she had been on the PZI for a month.
Click to expand...

post for help. we can talk you through the next steps based on the numbers and your availability.
 
julie & punkin said:
it's logical to think that if you shoot a 300 and the BG drops to 100 by the nadir you've seen a 200 point drop - so if you shoot a 100 you'll have a dead cat by nadir - but it's like there is one game when you shoot a high number and an entirely different game when you shoot a low number. strange but true! :lol:
Click to expand...
take a look at 2/21 on alex's ss. alex is tightly regulated so her range is low, but you'll get the idea. i have more concerns about shooting 90s or low 100s than i have shooting 50s or 60s with her because she'll drop lower from 90s than she does with preshot numbers that are lower. it took me a long time to wrap my head around that phenomenon.
 
You all say 1 unit and Dr. K said 1 unit, so I'll go with 1 unit. Just keep in mind I might just freak out if I think she's dropping too fast! :smile:

So how often should I test her over the weekend?
 
one more thing...
you're shooting for what happens around 2 hours past shot time. +2 is the typical onset with lantus.
you'll figure hers out pretty quick.
 
i haven't experienced that yet with punkin, but i gotta say the light bulb really went on when i finally "got it." i'm looking forward to getting to that point.

ya hear that, punkin?! :-D
 
arozeboom said:
You all say 1 unit and Dr. K said 1 unit, so I'll go with 1 unit. Just keep in mind I might just freak out if I think she's dropping too fast! :smile:

So how often should I test her over the weekend?
Click to expand...
protocol suggests testing at preshots, +3, +6, and +9 for the first 3 days.
 
Ok, see this makes sense to me. That's one thing I didn't get with PZI.
At 5:00 AM she tests at 200, I know I'm going to feed her and I know she's going to spike to over 300 within an hour, yet I'm supposed to shoot as if she's still at 200. That doesn't make sense to me.
I know her previous shot is running out (or already has) and I know she's going even higher with the food, so it makes sense to me to want to match that rise to keep it from going to high.

Am I understanding that correctly?

Jill & Alex said:
one more thing...
you're shooting for what happens around 2 hours past shot time. +2 is the typical onset with lantus.
you'll figure hers out pretty quick.
Click to expand...
 
with lantus we adjust doses based upon the nadir - the lowest point of each cycle.

the purpose in getting the preshot test is to make sure it's safe to shoot.
 
you got it! :mrgreen:
by the time the insulin begins to work ruby's much higher.

ok, a couple of basics which may or may not have been mentioned...
--- you want to test, feed, and shoot all within a matter of minutes.
--- with a kitty who experiences horrific food spikes, you don't want to feed after nadir if you can help it. feeding after nadir only serves to grind whatever action is left to a halt.
--- try not to feed within 2 hours of shot time. if you feed within that 2 hour time frame you'll be shooting a number artificially inflated by food. this is especially important with a kitty known to spike after eating.
 
If Ruby's pre-shot is 200, that's her pre-shot. She may experience a food spike by +1 but, with an "ideal" curve, by +2 her numbers should be back at around her pre-shot level and Lantus onset would be beginning. (There's a description of an ideal curve in the New to the Group sticky.)

What I would suggest is to not over think this. Every cat is different and if Ruby is like many of the cats here, as soon as you think you understand how she's responding to insulin, she'll be a cat and try to confuse you by doing things differently. One of the many lessons I've learned while attempting to manage Gabby's FD is that she's the one leading the dance.

I posted this in another member's condo who's switched from PZI:
The most challenging part of this adventure, since you're a seasoned hand at testing and shooting, is going to be wrapping your head around the differences between Lantus and PZI.
  • dosing is based on the nadir and not on pre-shot values
  • there are no sliding dose scales -- Lantus likes consistency so the dose is the dose unless there's a drop below 50 in which case the dose is reduced.
  • doses are increased initially after 5 - 7 days and thereafter, the wait is 3 days (6 cycles)
  • doses are typically changed in increments of 0.25u. Having syringes that are in half unit increments will help
  • it's important to test before each shot and to get at minimum, one spot check during the AM and PM cycle whenever possible
  • with Lantus, the effects of the doses are cumulative and there is overlap between shots. This gives Lantus its duration.
  • it is also a depot-type of medication. There is information about this in one of the stickies.
Click to expand...
 
I can handle the test, feed, shoot. No trouble there.

Right now I still don't have a grasp on her nadir. I've seen it at +4 and I've seen it at +11.
I think what might push her up in the afternoon/evening is because she has a late afternoon snack, not long before I get home. She's less likely to get up in the middle of the night and snack than she is to snack during the afternoon. The husband works at home so I'm going to get him to start taking the bowls up around 3:00 PM. That would be around +9, does that work?
Unfortunately the husband is too much of a chicken to test or shoot, so I'm on my own on that.
 
you don't have to know all of this ahead of time. the nadir may be (i would think would be) different on lantus than on PZI. their action isn't the same. a lot of what you're doing at the beginning is gathering data to learn how ruby responds to lantus.

as you get into this, post and ask questions about whatever seems unclear. it gets easier. truly!
 
eh, since you don't know when she'll nadir on lantus yet... initially, i think i'd just make sure the food bowl was picked up by +10. however, within the next several days we might find that it'll help if the food bowl is picked up earlier.
 
Alrighty...my head is spinning now so I'm going to head off to bed. Thank you all for so much information!

I see you all tomorrow!
 
Welcome to LL Amy, you are in the very best of hands with all the experts on board tonight! There is so much to learn, it will take time and no doubt, you will do great.
 
Good morning!
Should I go ahead and start a condo thread for her, with her AMPS, or wait until tonight?
 
i'd go ahead and start a thread for her. we all watch the "news" in the subject line to see if the bean is asking for advice/help and watch how the kitter's BG is doing.

long threads get hard to wade through and find questions or what's been said. you can copy the URL in this condo and post it in the new one so that if someone needs to look for more of The Story they can find it easily. if you need help doing that, just ask in your new LL condo!

so i'm thinking this makes it official! welcome!
 
Status
Not open for further replies.
Back
Top