Rhubarb's First dose Lantus (11/26) PMPS 227 +2 175 +4 103 +5 79 +6 88 +7.75 104

majandra

majandra

Member Since 2018
Likely a stupid question.
My planned shot times are 730/730. I see the vet at 1030 tomorrow and will start insulin after that. I want as much time tomorrow to monitor as I can. Could I shoot tomorrow afternoon or early evening, and then shoot at my planned 730 the following morning? Or would it have to be earlier and work up to 730 slower?
 
You only want to move at most 30 minutes a day. So either 15 minutes each shot or 30 minutes once a day. Example: You shoot earlier by 15 minutes in AM and then another 15 minutes earlier at PM shot time.

Hopefully someone with more experience can chime in as to what a good plan would be for tomorrow. Do you already have some lantus or will you be going to the vet to get it? As well, I've read many posts here where vets prescribe a "high"-ish dose of Lantus when other members felt it was better to start low. So I would keep that in mind at your vet appointment tomorrow. I personally wished I was able to start low but heh... I didn't get to do that and it was... rough.
 
I have the Lantus already (thanks to a no longer insulin dependent friend), and plan on no more than 0.5 units bid. My appointment will be showing me how to give the shots, and discussing future follow up. I'd hoped for a first thing in am appointment so I could give the shot in office, but 1030 is way too late. So will have to start the cycles later.
 
majandra said:
Could I shoot tomorrow afternoon or early evening, and then shoot at my planned 730 the following morning?
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She hasn't been on insulin before, right?

If so, you could shoot at 7:30pm tomorrow night and then start your 7:30am/7:30pm shot schedule.

It can take 5-7 days before the depot is full and you'll see how well the starting dose is going to do. Once in awhile, we'll have a cat that reacts sooner, but generally, it'll be several days before you'll know how she's going to do on the dose you start at.

I second @Crista & Ming's statement.....Most vets start out at too high a dose. Most cats should be started at around 1U.….no higher

And there's no such thing as a "stupid" question!! We've all been at the beginning of this dance and understand how confusing it can be!
 
My vet is awesome! Through my dedication, I have earned his trust. He knows plenty about feline diabetes, and although Lantus isn't typically his first choice due to vet practise standards, he said there is no reason I shouldn't start with it, as long as I am confident and comfortable. We dicussed insulin, and I showed him on syringe how much I would be giving. I asked for him to show me how to give the shots, and I gave a saline shot to practise technique.
I feel completely supported and comfortable with my vet. We both want the best care for Rhubarb. I am glad that I earned his trust and respect, and he has confirmed mine in him.
 
That’s a great report on the vet visit, being able to practise the shots really does build the confidence. Good luck with starting the Lantus.
 
I think I will do 7pm tonight to give me the little extra time to get a +4 in before bed, and I can get a +2 before work tomorrow. Already got the ok from boss that we can leave work to check on Rhubarb tomorrow if we think she needs it too. I can worry about shifting slowly to the 730 times later this week.
This make sense?
 
Oh, and should I be checking every hour after tonight's shot?

Edited title to reflect today start date.
 
majandra said:
Oh, and should I be checking every hour after tonight's shot?
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Testing every hour isn't necessary unless the cat is running low.

If you can get a +2, that's a pretty good test to try to always get because it can act a lot like a crystal ball in a lot of cats and give you a good idea of what the rest of the cycle might be like.

But again, this is your first shot, so usually we don't expect it to make a big difference until they've been on Lantus for at least several days
 
Good plan starting at 7:00 so you can get a little more data. Even testing every three hours to start is probably OK.
 
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Sounds like your vet will be a good partner for you and Rhubarb (LOVE the name!) My vet did the same thing and had me practice with saline solution. AND, it sounds like you have a great boss too!

Oh and Welcome to the L, B, and L forum! Keep asking questions, that is how we all learned. :)
 
I'm crossing my fingers that things don't go too wonky in the first few days- work can be flexible, but sometimes it is absolutely not. I figured tonight is best to start since I can easily get in tests, and at least a +2 tomorrow and all my jobs are within half hour from home just in case. Wednesday is going to be a mostly full day, but can likely still get +2. I am off this weekend so can do a curve at 5 day mark.

Is it absolutely essential that she has no access to food for 2 hrs prior to PS? Her sugars have typically lowered with food. And usually she doesn't have much if any left by next feeding.
 
majandra said:
absolutely essential that she has no access to food for 2 hrs prior to PS
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Until you figure out (you will; data!) if Rhubarb is a food sensitive- glucose “spiker” from food... be careful. Couple tablespoons max, is ok 2+ hours before PS, until you know better.
Nelli for example is not a food induced spike-ER.
ECID- Every Cat Is Different. You’ll hear this again ;)
 
Her first shots are going to be from an opened Lantus pen. It has been stored properly, and is perfectly clear. I would really hate to waste a nearly full pen if I don't have to. If there is no response, then I will know it's no good, right? I do have an unopened one as well in case it's no good.
 
I got some larger gauge syringes from vet since I was having trouble with bending the thin one. They don't have half unit marks and it is ridiculously difficult to measure. Is this 0.5 U? I may have to use the thinner needles for accuracy sake.
 

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I used the thinner needle and definitely easier. That went better than I thought, though it is so hard to tell when needle goes in- if she didn't flinch, I wouldn't have been able to tell.
 
Chris & China said:
You will develop a "feel" for it.....I can tell when the needle "pops through" China's skin but I've been doing this dance for over 5 years!
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I think there's a few things here to develop a feel for!
I keep watching the minutes pass, trying to occupy my time until +2 (it's +1 now). Fighting the urge to test way more than I need to!
 
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That's a pretty good drop....you might want to go ahead and give her a teaspoon or two of her regular low carb food to help encourage her to surf.

I think you could wait to test again at +4....but if that's too much for you, there's no reason you can't test at +3 ;)
 
Chris & China said:
That's a pretty good drop....you might want to go ahead and give her a teaspoon or two of her regular low carb food to help encourage her to surf.

I think you could wait to test again at +4....but if that's too much for you, there's no reason you can't test at +3
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I gave her some food as you suggested, a while ago, an she just tested at 5.7 (103). Is it possible she hits nadir early? Should I be setting alarm for +6?
 
I would suggest going ahead and getting a +6 in since she's still dropping and we don't have any experience with her.

103 is still a very safe number, but since we don't have any data on her, it's better to be safe
 
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I'm too wired to sleep, so will be grabbing a +5 in about 10-15 min.
Really glad that my vet was on board with me starting her low!
I need to get strips for my old One Touch Ultra meter to see how it compares. My Freestyle reads on the low range.
Thank you for checking in :)
 
Still a safe number, but if you have something a little higher in carbs, you might want to give her some.

I have to get off here, but I've asked @Bron and Sheba to keep an eye out for you.

We don't leave anybody alone

With her responding so quickly to her first dose, it might be a good idea to drop her down to .25 tomorrow and start even lower
 
Hi Majandra, Chris has asked if I can keep an eye on you now.
I will be around for the next several hours.
Looks like Rhubarb is responding really well to the insulin !
Have you given Rhubarb some food a little higher in carbs as Chris suggested?
As Chris said 79 is a safe number but as we don't know how Rhubarb responds to insulin yet, we are suggesting giving him a spoonful of the food.
Can you get a +6 please?
Bron
 
Bron and Sheba said:
Hi Majandra, Chris has asked if I can keep an eye on you now.
I will be around for the next several hours.
Looks like Rhubarb is responding really well to the insulin !
Have you given Rhubarb some food a little higher in carbs as Chris suggested?
As Chris said 79 is a safe number but as we don't know how Rhubarb responds to insulin yet, we are suggesting giving him a spoonful of the food.
Can you get a +6 please?
Bron
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I gave her 0.5 oz DM savory selects (10-14% carbs) about 10 min ago. About half hr to +6 now
 
I really need to get some sleep- is it safe now to leave out food (low or mid/high carb) and get some rest?
 
majandra said:
I can give it a shot. Should I put out more food?
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Because he is such a new FD kitty I would leave out a tablespoon of the higher carb food but still get up at +7.5. Once we have more data we will be able to see better how he reacts to the insulin.
He is doing amazingly well how he is responding.
 
She had the spoonful of the higher cal food, didn't quite eat it all, right after last test. I just put down a small spoonful of friskies pate for her to tide her over to when I get up
 
I would post the blood sugar level in the morning if the level is under 200 (11.1) and ask for help. We usually suggest that in the beginning you don’t shoot under 200 especially if you can’t monitor the blood sugar levels. Write something like ‘Rhubarb AMPS 150 ( write what bsl is ) do I give insulin.? Or similar. If you have to go to work tomorrow and can’t test you might need help with deciding what to do. Does that make sense?
 
Hm didn't catch your edit there- low carb with the little bit of leftover high carb is on the floor now. Will set alarm to pick it up and then sleep again after till shot time.
 
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