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Starting dose recommendations please-Starting Lantus Monday
- Thread starter Airway
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Tricia Cinco(GA) & Harvey
Member Since 2011
Hi and welcome to Lantus & Levemir Land - the nicest place you never wanted to be.
Usually when switching insulins, we recommend you start on a dose similar to the dose on the previous insulin. I don't know much about ProZinc, so will defer to those that do regarding specific amount.
Some things I notice, looking at your SS:
You are shooting two different dose amounts at AMPS and PMPS. Lantus does better with consistency, so you will want to try to find a dose that you can comfortably shoot twice a day.
I see you have recently started getting in some tests in the PM cycle. This is very good, as many cats go lower at night than they do during the day.
On 2/26 you got a 32 and there are no follow up tests for the next two hours. Again, I'm not familiar with ProZinc, but with Lantus that would have been an automatic reduction of .25 and you would have needed to test every 20-30 minutes until Orion came up above 50 and stayed there for two hours without food. In other words, it will be a different mindset for you.
Have you read the stickies at the top of the Lantus & Levemir page? There is a lot to learn about Lantus, and it can be overwhelming at first. Don't worry, we'll help you. Just ask lots of questions. You have an advantage over a totally new member, as you have already been dancing the FD dance for 3.5 years.
BTW, Orion is gorgeous!!!!
Here is a post that may help you become more comfortable here: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/
Usually when switching insulins, we recommend you start on a dose similar to the dose on the previous insulin. I don't know much about ProZinc, so will defer to those that do regarding specific amount.
Some things I notice, looking at your SS:
You are shooting two different dose amounts at AMPS and PMPS. Lantus does better with consistency, so you will want to try to find a dose that you can comfortably shoot twice a day.
I see you have recently started getting in some tests in the PM cycle. This is very good, as many cats go lower at night than they do during the day.
On 2/26 you got a 32 and there are no follow up tests for the next two hours. Again, I'm not familiar with ProZinc, but with Lantus that would have been an automatic reduction of .25 and you would have needed to test every 20-30 minutes until Orion came up above 50 and stayed there for two hours without food. In other words, it will be a different mindset for you.
Have you read the stickies at the top of the Lantus & Levemir page? There is a lot to learn about Lantus, and it can be overwhelming at first. Don't worry, we'll help you. Just ask lots of questions. You have an advantage over a totally new member, as you have already been dancing the FD dance for 3.5 years.
BTW, Orion is gorgeous!!!!
Here is a post that may help you become more comfortable here: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/
Tricia Cinco(GA) & Harvey
Member Since 2011
That's great. Can you retrieve those numbers from your meter and put them on the SS now?
Another thing we recommend in that situation is to make notes in the comments section of what you do in response to the low numbers and how kitty responds - for instance - fed 9% at +6; 12% at +7, etc. Then you can refer back the next time you have the same situation to see what worked and what didn't.
I'm going to assume that, if that vet is familiar with Lantus, he or she will know that this doesn't work as well with the long lasting insulins.
Kris & Teasel
Member Since 2016
I've said it before and I'll say it again - Orion is a beautiful boy!!
Welcome to Lantus Land, Angela.
Airway
Member Since 2013
Numbers have been added to the spreadsheet.
I am starting Orion on Lantus tomorrow and need to know what dose to start him at.
When looking at his spreadsheet, please be aware that I was out of town from 3/10-3/12. Orion was under the care of a sitter. Please DO NOT give me a hard time about shooting a 104 this morning. When the sitter was unable to reach me immediately, she gave his shot when she shouldn't have.
@Kris & Teasel @Tricia Cinco(GA) & Harvey @Jill & Alex (GA)
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Bobbie And Bubba
Member Since 2015
Hi Angela and welcome to L& L 
No judgments here, we are here to help you help Airway. Tricia all ready gave you some great advice and TR needs to have test Pre shots and at least one sometime around nadir and more if the numbers are lower though the cycle.
Will you be home tomorrow to monitor after you start the Lantus ? With a new insulin it would be a good idea to be around to see how he will react. As far as the dose, as Tricia said, it usually is similar to what you were using on the previous insulin. Today's dose was too much and on 12.24 he went too low on 2.5u and then a few days after that there wasn't any testing other than pre shot test so it is hard to say what that dose did after the bounce from 12.24 cleared So, I am not really sure where you shoud start with Lantus but I am incined to say to start at 2 units and hold that dose for one week unless he goes below 50 but, I am going to tag a few peeps to see what they think @Wendy&Neko ,@Sienne and Gabby (GA), @Chris & China
No judgments here, we are here to help you help Airway. Tricia all ready gave you some great advice and TR needs to have test Pre shots and at least one sometime around nadir and more if the numbers are lower though the cycle.Will you be home tomorrow to monitor after you start the Lantus ? With a new insulin it would be a good idea to be around to see how he will react. As far as the dose, as Tricia said, it usually is similar to what you were using on the previous insulin. Today's dose was too much and on 12.24 he went too low on 2.5u and then a few days after that there wasn't any testing other than pre shot test so it is hard to say what that dose did after the bounce from 12.24 cleared So, I am not really sure where you shoud start with Lantus but I am incined to say to start at 2 units and hold that dose for one week unless he goes below 50 but, I am going to tag a few peeps to see what they think @Wendy&Neko ,@Sienne and Gabby (GA), @Chris & China
Kris & Teasel
Member Since 2016
I think that 2 u is a good place to start. Have you decided which protocol to try, TR or SLGS?
Hi, Angela. Welcome to the group.
You won't hear me give anyone a hard time about shooting low numbers. I would shoot anything above 50 but I was also a committed testaholic and had tons of data on my kitty and was using the Tight Regulation protocol. You want to be data ready. We can also help you with instructions for a pet sitter (e.g., giving a "no shot" number, making sample syringes to avoid misunderstandings) since many of us have good and not so good experiences to share.
I agree with Bobby -- I think 2.0u is a safe amount to shoot. You can always start lower if that will make you more comfortable. Since you're gone for the day, do you have a timed feeder? It may help your nerves by insuring that Orion has access to food throughout the day. There's also good information for working caregivers in the sticky note at the top of the board that pertains to working full time and using the Tight Regulation Protocol. I work full time and managed my diving diva for 6.5 years using Tight Regulation. Getting a +2 was essential for me but Gabby also had an early nadir.
BTW, your kitty is gorgeous!
You won't hear me give anyone a hard time about shooting low numbers. I would shoot anything above 50 but I was also a committed testaholic and had tons of data on my kitty and was using the Tight Regulation protocol. You want to be data ready. We can also help you with instructions for a pet sitter (e.g., giving a "no shot" number, making sample syringes to avoid misunderstandings) since many of us have good and not so good experiences to share.
I agree with Bobby -- I think 2.0u is a safe amount to shoot. You can always start lower if that will make you more comfortable. Since you're gone for the day, do you have a timed feeder? It may help your nerves by insuring that Orion has access to food throughout the day. There's also good information for working caregivers in the sticky note at the top of the board that pertains to working full time and using the Tight Regulation Protocol. I work full time and managed my diving diva for 6.5 years using Tight Regulation. Getting a +2 was essential for me but Gabby also had an early nadir.
BTW, your kitty is gorgeous!
Airway
Member Since 2013
I don't have a timed feeder. The challenge I have is I have a CKD kitty who eats low phosphorous food that is too high in carbs for Orion. I feed them in separate rooms when I'm home. I'm not sure I'd want to keep them separated all day.
It's not often I am gone, and the one time I was gone longer than a weekend I had the boys stay with the vet.
I would like to do TR if I can. For medical reasons, I am only awake 12-14 hours per day so I do the best I can to collect data with that limitation. I also work 4 days per week.
It's not often I am gone, and the one time I was gone longer than a weekend I had the boys stay with the vet.
I would like to do TR if I can. For medical reasons, I am only awake 12-14 hours per day so I do the best I can to collect data with that limitation. I also work 4 days per week.
Ozzy Pawzbourne
Member Since 2016
Hi Angela, welcome to the group. I hope Orion does better on Lantus. Orion is stunning gorgeous..omg those eyes!!! I'm swooning over him!
No one will criticize you for shooting a 104 PS number. The motto here is shoot low to stay low and many of us have shot numbers much lower than that. Orion went down to 47 which earns him a reduced dose going forward according to the protocols used here. I see you are considering starting him on 2u of Lantus. I'm not an expert and don't feel qualified to give dosing guidance but this does sound reasonable since it's less than the dose you were on previously on prozinc and you can try to test the waters and see how he does with this longer acting insulin. There are lots of knowledgeable members here who can help you. Wishing you the best of luck.
Do you test Orion's urine for ketones? This is the only recommendation I can suggest to you right now. Because he has such high blood sugars, you will want to make sure he doesn't develop ketones which could put him into a life threatening situation called Diabetic Ketoacidosis (DKA). If you don't test for ketones and would like to learn how, please let us know and we can give you additional information. It's very easy to do and a very inexpensive way to make sure your kitty is safe and to know to intervene early if needed.
No one will criticize you for shooting a 104 PS number. The motto here is shoot low to stay low and many of us have shot numbers much lower than that. Orion went down to 47 which earns him a reduced dose going forward according to the protocols used here. I see you are considering starting him on 2u of Lantus. I'm not an expert and don't feel qualified to give dosing guidance but this does sound reasonable since it's less than the dose you were on previously on prozinc and you can try to test the waters and see how he does with this longer acting insulin. There are lots of knowledgeable members here who can help you. Wishing you the best of luck.
Do you test Orion's urine for ketones? This is the only recommendation I can suggest to you right now. Because he has such high blood sugars, you will want to make sure he doesn't develop ketones which could put him into a life threatening situation called Diabetic Ketoacidosis (DKA). If you don't test for ketones and would like to learn how, please let us know and we can give you additional information. It's very easy to do and a very inexpensive way to make sure your kitty is safe and to know to intervene early if needed.
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Airway
Member Since 2013
Yes, I do. I have strips that test for both sugar and ketones. He has always been negative for ketones. I hope to get him negative for both.
Ozzy Pawzbourne
Member Since 2016
Angela, there are several types of kitty food that are both low in carbs (for the diabetic kitty) and low in phosphorus (for the CKD kitty). They probably both could benefit from eating a low carb low phosphorous food.
Weruva brands top the list. You might want to check into them. There is a great food list on this site that was put together by a vet. It breaks down the nutritional content in the foods and you can shop by what is most important for you (low carb low phosphorous). You can find it here.
If you decide you want to feed them both the same low carb, low phosphorous food, you can then use a timed feeder that both kitties can benefit from and if you wish you might not have to separate them in different rooms during feeding time. Since you mentioned that you are only able to be awake for 12-14 hours per day, this would really help you with your schedule as well and most importantly help Orion make sure he has food available if his blood sugar numbers start to plummet when you are not home or not awake.
The automatic feeder that most of us use is called the petsafe 5 and you can get it at Amazon for $35
This has been a major game changer for me, especially since I work full time and am only able to maybe get a +1 or +2 before I leave the house and have no ability to check in on my kitty until I get home from work.
Ozzy Pawzbourne
Member Since 2016
Wonderful, this is great news. You might want to add his ketone tests to your SS when you do them. Folks on this board will always look to your SS first before offering guidance and if they see you are regularly testing for ketones, they won't ask. Because trust me...we ask! Especially me- my kitty almost died from a serious case of DKA so I always try to help others know about the dangers if they are not testing.
Tricia Cinco(GA) & Harvey
Member Since 2011
I found it best to use one feeder per cat. I put each in the spot where that cat was accustomed to eating and tried to set them to go off about the same time, so both cats were occupied eating and couldn't steal from each other. I left the last slot empty and set the feeders to turn to it two hours before the next shot time, so the cat with FD would not eat in that time frame and the shot time test would not be food influenced.
Kris & Teasel
Member Since 2016
Good luck, Angela! There's a lot of great help and guidance here. The timed feeder idea sounds like a good one for you.
ETA: When you have time, could you add a dividing line on your SS showing the switch to Lantus?
Bobbie And Bubba
Member Since 2015
Good luck Angela! What was the +2 number ?
Airway
Member Since 2013
Yup, going to take care of that after work today. Will add his numbers from today as well.
His +2 is 227.
Bobbie And Bubba
Member Since 2015
When a +2 is lower than the Pre shot numbers, it indicates it could be an active cycle. Since you can only get a+2 before you leave for work, it might be a good idea when he is low yellow before you leave to give him a snack to help slow him down a bit, maybe you did I didn't look at the SS . It will be helpfu when you get a feeder so that you can time it to open and give him LC or MC according to the numbers you get before you leave for work.
Looking forward to seeing his +10 and PMPS
One housekeeping thing, since this is such a big forum, we start a new thread each day so the threads don't get to long . Use the same thread every time you post on that day We title them: 3.13 Orion AMPS 299 ,+2=227 and so on with each number you add to the title .
Looking forward to seeing his +10 and PMPS
One housekeeping thing, since this is such a big forum, we start a new thread each day so the threads don't get to long . Use the same thread every time you post on that day We title them: 3.13 Orion AMPS 299 ,+2=227 and so on with each number you add to the title .
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Phoebes (GA)
Member Since 2017
Just stunning!!!!
Airway
Member Since 2013
I fed him after I got the 227 at +2. I don't have access to his spreadsheet at work so I will update it when I get home.
Lisa & Nacho
Member Since 2016
Very pretty kitty!
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