Sat is Gracie's first lantus day..positively

[Marje and Gracie]

My wonderful vet spoke with an endocrinologist today (can't remember her name but I'm sure many of you would know her) and she said (as you all did)
that with Gracie hovering around 300, we need to start her insulin. So we are starting in the morning....Gracie weighs 8.6 lbs so at .25u/kg, that would be
almost 1u. We are going to start her at .5u. Do you think I should start her lower...say at .25u? My vet does not think we'll see much movement the
first few days at .5u. I have many, many questions:
1. Grace seems so sensitive to all meds; has anyone ever heard of any type of allergic reaction to lantus? My vet and the pharmacist said anything is
possible but it would be rare. Just want to know what I could expect to see so I know to watch for it.
2. We're still unsure of how this works and I've read all the stickys. I know I get her AMPS, feed her, shoot, and then start monitoring. But if she peaks, say, 9 or 10 hours later and her number is say 150, how do I know whether to shoot at 12 hours and how much since the stickys say to not change dosing for 3-5 days?
3. What if she doesn't peak for 16 hours...I'm assuming she gets no shot until her numbers are coming up. But at what number do you decide it's ok to shoot again the next day?
4. We feed several small (canned, less than 10% carb) meals a day. How long before her evening PMPS should I not feed her...a couple hours?
5. When do you sleep :lol: Seriously, though. Let's say the daytime goes well, and I give her the evening shot at 7pm but she is an 8-hour peaker, I imagine I'll
be up all night checking her numbers.
6. Is it possible that you could give a shot, numbers come down, insulin peaks, numbers start going back up and then numbers come down again before the next shot? Or once they start back up, you're ok??

I appreciate all the help I can get. I read about Heidi's Doodle and I know I'd be freakin' at 25. I think at this stage of the game perhaps I should keep her closer to 90 or 100 until we get the hang of this?

I got my hypo kit ready...one question (have a good laugh at my expense but if someone could then answer, that would be cool ), if you have to give them sugar rectally, do you put the karo in the bulb syringe and inject it and how much?

Thanks everyone. Gracie's spreadsheet is below....we just entered what her numbers have been the last few days without any insulin.

 

[Sienne and Gabby (GA)]

Reactions to Lantus are rare. From what I've read, should a reaction occur, it's usually a rash at the injection site.

Most cats peak around the middle of the cycle -- between +5 and +7. All you can do for now is to monitor and learn where Lantus onset and nadir are and how long the duration is. I wouldn't get ahead of yourself worrying about whether Gracie is a late nadir kitty. You will need approximately 5 - 7 days on your initial dose to get the depot/shed established and for Gracie to actually begin to really benefit from Lantus.

Again, for now, if you have a question about whether it's safe to shoot, post and ask. Change your subject line (in your first post in that thread) and indicate you have a question. We'll help you sort out if it's safe to shoot or what to do. A lot of the questions you're asking don't have a generic answer. A considerable amount depends on having data and on your particular cat.

As for feeding, do not feed within 2 hours of shot time. Otherwise, you risk inflating your pre-shot test information with a food spike.

I do think there are some people here who don't sleep! There are some people who will set an alarm and wake up and test. I tend to stay up because once I'm asleep, I'm asleep. How you gauge what's safe depends on your cat and what you learn about her response to Lantus. Generally, if you see numbers are level or rising over several tests, you'll learn when it's safe to go do sleep. It also depends on where the numbers are -- if numbers are in the 200s or 300s it's easy to go to sleep if the numbers are in the double digits, you'll begin to get a feel for how Gracie is doing and when it's time to turn off the lights.

What you described in #6 is what we call a double dip. If you look on Gabby's spreadsheet on 9/10, at +4 she was 76 was into the 100s later in the cycle and then was at 87 at PMPS. She did the same thing the next day.

Numbers in the 20s are not a recommended place for your cat to be surfing! It's one step at a time. If you want to start at a lower dose and work your way up, that's fine. Our aim is to keep our cats in a normal BG range. At the start of this process, you need to gather data in order to be able to shoot low numbers. You're not there yet nor would anyone expect you to be. For now, remember you can ask questions when you feel like you need more information or don't know what the best course of action is. People are here to help.

 

[Marje and Gracie]

Thanks, Sienne. I've been reading through all the info. Grace is getting subq fluids now to keep her hydrated. I read the info about where to shoot.
For a newbie, is it best to shoot in the flank so she has quicker absorption, quicker to the peak, and shorter duration? I'm not sure where the best
place to shoot is....I hate to be shooting her in the scruff when she's getting subqs there. My vet wants me to keep her on 50 mls subqs until her
number start coming down so we can help keep her bladder flushed of sugar and bring her USG down a bit as her urine is really concentrated.

Thank you.

 

[Kim 'n Shadow]

Hi Marjorie - what has worked for me is collect numbers and post and ask. many gracious and knowledgeable helpers here. knowing that will help keep your stress levels down, trust me.

I've never had to do squids but plenty here have, and they'll be able to help you.

I've always shot Shadow in the scruff, but ECID. I test, feed, shoot while she's eating, she never even looks up.

Read again Jill's most recent sticky. Lantus likes the same dose every 12 hours for 6 cycles, (3 days) minimum, and you will have tested and posted and asked tons of questions during that period and there will be lots of help to carry you and Gracie forward.

Start with a safe dose and begin to compile data for your SS. We tend to be testaholics around here and the more data you collect, the more you begin to learn Gracie's patterns and how she responds to her doses and her eats. Others with tons of experience will look at your posts and Gracie's SS and help you explore every option that will be the most beneficial for Gracie.

It is daunting, when you start out. But you're way ahead of the curve because you already know to come here and ask your questions. You and Gracie are off to a great start.

 

[Sienne and Gabby (GA)]

I honestly don't think it makes a huge difference where you shoot. For me, it's more comfortable to shoot in the scruff. It's what I'm used to. I've tried flank shots and I'm more apt to give a fur shot than get the insulin in. BUT, you make a very good point about squids. I think that the people here who also give squids and who shoot in the scruff used the opposite sides.

Just one thought re. squids. Fluids can drop BG numbers. Granted, you're not giving a large amount of fluids but it is a consideration with respect to the timing of when you give squids. When you're making notes on your spreadsheet (SS), please make a note as to when (i.e., what + hour -- +1, +2) that you're giving fluids so we can assess whether it's effecting numbers.

 

[mybuddybinks]

and there you have the proof...it's like having your own team of experts, angels, guides, cheerleaders, and a couple of goofs thrown in just to lighten the mood! trust me, you will not find yourself alone or without guidance, and NO question is silly or too small to ask. not only is the answer available almost instantly, but they will spot the things we never thought to ask...and get us back on track quickly. oh, and it comes with personal shoppers, too!

I'm not overstating the situation when i tell you that if it weren't for this forum and Venita and her organization, I wouldnt still be blessed with my companion. He was terribly ill, and i was temporarily in a financial bind...i had reached the point of desperation for his health that i was willing to give him up if someone could just help him ...and he means the world to me. I was so heartbroken, i could barely read the computer screen thru the tears, and that's when i stumbled onto the FDMB...

call it whatever fits into your frame of reference, but whatever led me to this forum was our miracle. Our financial situation turned around within about a month, but that period of time could have been the end of my relationship with my guy, and the folks here kept us from that.

(geez...the header says "gracie's first day, not celi's testimonial) so i'll stop with the proselytizing, but i hope that it turns out to be as beneficial for you and your girl!
celi & binks

 

[Blue]

First off, you've got a bunch of good questions there, and I am positive you will get a ton of good answers and replies.
There are a couple things I'd like to mention.

1. ECID - every cat is different, so in the beginning, all data you can gather, especially the numbers from hometesting for your spreadsheet will be invaluable. Those numbers will tell you many things:
a. how long your cat takes to react to a dose change
b. how well your cat is reacting to a dose
c. where is your cat's nadir, earlier, mid-cycle, or late
d. is your cat a bouncer, dropping low and then bouncing high
and much more.

I have 2 FD cats, each very different from the other.
Shadoe is sensitive to change of dose, and BG drops with SQuids, and has a mid-cycle nadir.
Oliver is sensitive to nothing, reacts slowly to shots, and has a very late nadir, almost just before his shot time. If I did not know he was a cat, I'd say he was part 3-toes sloth!

The way that I discovered the above was by my frequent home testing for both earlier on.
Now, I know that Shadoe could react by +2, but Oliver is not likely to change until closer to +4, so I don't really need to bother testing Oliver around +2 as it will be a waste of a strip.

For SQuids, I cannot give to Shadoe if she is already low in numbers because she is very sensitive and will go much lower if I give her SQuids, so I have to wait till she is rising and at a higher number. I may wait until the end of her cycle, maybe +9 or so, then give SQuids because she her numbers are rising. Oliver was the opposite and SQuids showed no change on his numbers. It's just a good idea to watch closely and know how your own cat responds.

Flank shot! YIKES NO! I tried once with Shadoe and she freaked. Oliver does not like his sides touched so no way I am trying flank shots on the big guy.
There have been tons of discussions on it, and some have done tests to see how their cats respond, but in my mind, I would prefer an insulin that is slow and smooth and long lasting, not something that is fast and likely jerky. Why want something to act faster and then you run out of gas before the next shot is due? There are other ways to bring a very high number down quickly, many people will use R, but that's another topic for another day.

When I give SQuids, the needle I put in the center scruff but about 2inches farther down the back.
The insulin shots I give higher up the scruff and for Oliver, his dose is quite high, I split it half on one side of the scruff and half on the other side. I try to keep at least 2 inches between injection spots. I don't know what others are doing though.

Responding to dose changes - my Shadoe responds within 3 or 4 shots, sometimes even sooner; Oliver sometimes takes 6 or 8 or more to respond, and that's with their shed in place. It's very important to hold the same initial starting dose for at least 5 days, 10 shots/cycles, so that you know the shed has been filled and you know how your cat is responding to that dose. In the beginning, most of the insulin is going to filling the shed under your cat's skin and not much is going to your cat - I like to think of it as their spare tank of gas in the trunk. If you are ever late or something with a shot, your cat will be OK because it's got that spare tank of gas it can use. Just know that there will be some adjustment later because that spare tank has to be filled all the time to match your current dose.
If you give .5u shots, that's how big your tank is.
If you decrease your dose to maybe .25u, then the tank has to be decreased too and so your decrease won't show in your numbers because the tank is dumping the excess .25u.

Anyways, it's important to stick to that first 5-7 days at the start and get a good shed in place.

I try to take up the foods during the 2hrs before shots. You want all the foods out of the system, that way the BG number you get is not reflecting food. Food does not last long and in a couple hours after eating, you would see numbers dropping again. By having no food on board, you are getting more true BG numbers.

During the day, I spread out the foods as the foods should help to keep the numbers more level. Many people use auto feeders to space out the total daily food - I have a 5 section auto feeder I use for Shadoe.

You can look at my spreadsheets for Shadoe and Oliver to see how I have been recording my numbers, meds and SQuids. All are important because they affect one another and could explain the numbers you are getting when you test.

I am sure you will feel like you are drowning in info from everyone all at once, but don't worry, it's easy peasy before you know it.
If you have any questions, just ask away.

 

[Anonymous]

hey marjorie, when you gonna add the #'s on your subject title? did i miss your most recest condo???