Starting Lantus on Saturday

kurikitty

kurikitty

Member Since 2019
So on Saturday, I plan to start using Lantus instead of Glipizide for my cat and I was wondering if anyone has any advice on doing a curve while using Lantus? I have read about peak times and such, but I have also read that Lantus is slow reacting. So any advice or links to advice would be greatly appreciated! I am very nervous, heh heh.
 
Hello and Welcome,
Grey and Grey's Mom

I'm glad you're going to be starting on Lantus, Glipizide doesn't work in cats, my vet started on that route too.

Great Job getting the spread sheet up and running. I can't see any test result there yet. Is this because you are having trouble testing?
Here is a link to home testing
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
Have you got a glucometer yet? Is it a human one? or pet Specific? the dosing methods we follow recommend the use of a human glucometer since they were developed using human meters, there's also the great advantage that the strips for the human meters are easier and cheaper to get hold of.
Some vets are more supportive than others of home testing, my vet encouraged it, but it's not unusual for others to actively discourage regular testing and monitoring.
To give you an example over here on this site it is usual for everyone to always test before shooting insulin, we never shoot blind as we want to be sure it is safe to give our kitties insulin, yet some vets would discourage this, I've no idea why, since if you think about it even human diabetics check their Blood Glucose before having a shot of insulin.
Most of us, if our schedule allows try to get at least one other test midcycle anytime, and I would encourage you to do this, dosing with Lantus is based on how low the dose get's kitty, so we want to know what the low point is (nadir) this can occur at anytime during the cycle, but more commonly at around +5 +6. My cat for instance, usually nadired around +5 but he has had a nadir (lowest number in the cycle) as early as +2 and as late as +13.
I would encourage you to read the stickies at the top of the forum if you haven't already.
Start here with the new to the group sticky
http://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/

Some info on the proper handling of Lantus and how to draw a dose
http://www.felinediabetes.com/FDMB/forums/health-links-faqs-about-feline-diabetes.14/

And some info on how Lantus works http://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/

Also this will be worth a read too it's the dosing methods we follow and includes the methods we use to determine a starting dose
http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/
Again do read this section above before you give the first dose, it is not uncommon for vet's to start kitties off on too high of a dose, this can lead to a very stressful few days fighting low blood glucose numbers.

On your ss you mention a change to wet food, that's a great move, has Grey taken to the wet diet well? Or are you transitioning him slowly? (I swapped my boy overnight, but others have trouble getting kitty to accept the new food) When did you do that change? and what were you feeding? and what wet food are you feeding?

We try to feed wet food that is below 10% carbs as their regular meals, anything higher than that will work against your FD kitty.
Please note that many of the 'Prescription' Diets even the ones that are for diabetics are way to high in carbs, and usually of poor quality ingredients, even though they are expensive read more about it in the links below.
Here is a list compiled by Dr Lisa's sortable food Chart Food Chart (here's a link to her feline nutrition website)
The reason I am asking about the food change is that for some cats the change in food can have a dramatic change in blood glucose (BG) levels but it is not something that happens overnight, the dry food can have an effect on the BG for a few days.

I would suggest that you start practicing testing, be sure to treat your kitty, warm up the ears, and stay calm and positive while doing the tests, I talk to my boy when I am testing him, tickling his chin and cheeks, he usually purrs right through it all. At first it can be a little tricky to get a decent blood drop, but it does get easier once the capillaries form, and it helps if you warm up the ear a bit. I do this just with my warm hands and rubbing his ears, George likes his ears rubbing, in fact I got him used to me rubbing handling his ears, before I started poking him, I would rub his ears for a bit and then give him a freeze dried treat. This meant that when I went to get the first test he was calm as can be and was eager to get his treat (it helps that he is food motivated) though for some kitties the affection/attention is more than enough reward.

As for the curve you can run either a 12 hour (testing every 2 hours) or 18 hour curve (testing every 3 hours), whatever fits in best. When you get that if you post up the results we can help you with any decisions/questions you may have on a starting dose.

One last thing, if you decide on a dosing method, could you add that on to the signature, it will stop us asking the same question again and again. It is also very useful, especially to anyone that may be offering help or suggestions to know of any health issues that Grey may have, when he was diagnosed, what food he is getting his age and weight. Also knowing where in the world you are, just from the point of view of having someone with experience look out for you when you are getting ready to shoot, especially in the early days, your name or what you would like us to call you even if that's just Greys Mom, I'm Gill and I live in Europe/Spain for instance.:)

You're off to a good start posting here before you've started shooting it will give you an opportunity to get informed and prepared, which will make the whole thing less stressful.
I remember feeling very relieved to have the whole of this community supporting me when I started on this journey, and who still continue to support and care nearly four years on.

One last link for you to Health Links and FAQ's may hold the answers to other questions you may have
http://www.felinediabetes.com/FDMB/forums/health-links-faqs-about-feline-diabetes.14/

But please any further questions don't hesitate to ask.
And lastly look after yourself, and breath, there's a lot to take in and it can be very overwhelming we've all been there so we know how your are feeling, we are here to support you through your journey.

Gill:bighug::bighug::bighug:
 
@Gill and George
Thank you so much for taking the time for your reply, it helped a lot.
I am testing him sometimes with a human glucose meter, ReliOn Prime to be exact. I have tried it out here and there, but I've only been successful with it 2 times. I'm hoping by the time I start giving him insulin, I have it nailed down (heh).

I am only feeding him the wet food. Before he was eating both wet and dry, so it hasn't had that much of an impact on him. He really loves that Fancy Feast. I also give him Delectables as a treat, the one for senior cats 15+. It's the only way I can think of to get him to take his Glipizide pill.

I decided to do the Start low, go slow method. I give him half a pill of Glipizide every 12 hours, so I think I will do 0.5u when I start the Lantus, since I also feed him only wet food.

As for more questions, I am trying to decide on when to start his insulin I have an 8-5 job, mon-frid and I was thinking of starting the Lantus this Saturday. I read to do a curve a week after giving him the Lantus when using this method, so I thought I could do the curve on the next Saturday without missing work, but do you think I should actually do it on a weekday since my vet is only open on weekdays? If something goes wrong, such as hypoglycemia, I would only be able to take him to a vet that's an hour away. Is it a common thing to happen when first starting insulin?
 
Hi sorry I missed your reply.

Could you pop any tests that you have got with the Relion prime onto the ss, doesn't matter how sporadic they are, the meter has a memory so you will be able to scroll back to recover the info.

What time do you leave for work in the morning? What time do you get back?
If when you say it's 8-5 that's the hours you are out of the house then I would shoot at 6 am and 6pm that would give you time to squeeze in a +2ish test (which can be a good indicator of how the cycle would pan out and let you perhaps get a couple of test in the pm cycle after you have fed and shot him in the evening.

This is a very good thread to read and although it pertains to TR the logic applies to SLGS as well.
http://www.felinediabetes.com/FDMB/...ion-possible-with-a-full-time-job-yes.129378/
Personally I find that just relying on a curve once a week can be tricky, so getting some spot checks regularly through the week will give you a much better picture and a better safety margin than just doing PS and a weekly curve, which is the minimum for SLGS

If you start him saturday, I would run a curve when you first shoot, just occasionally they can have a strong reaction to starting insulin. So it's best if you start when you can monitor.

kurikitty said:
If something goes wrong, such as hypoglycemia, I would only be able to take him to a vet that's an hour away. Is it a common thing to happen when first starting insulin?
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My vet is also an hour away and no ER vet, I've been able to manage George's BG at home, the guidelines with both dosing methods have in built safety mechanisms so as long as you take your reductions when they are earned and take the dose up methodically as per the guidelines, always test at PS and get curves weekly (with slgs) and spot checks when you can you will be minimising the risk of hypoglycaemia. I haven't seen anyone that has been following the dosing methods we use here properly loose their kitty due to hypoglycaemia, we have however seen folk either following a vets instruction or some other method or none at all turn up on the site already in a state of emergency a lucky few are caught in time but sometimes, sadly, it has just been to late.
 
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kurikitty said:
I also give him Delectables as a treat, the one for senior cats 15+.
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I would imagine this is really high in carbs and even a few bits can impact his BG tremendously.

The only type treat (which most if not all of our kitties go wild for) are freeze dried pure meat treats. I use a brand called cosma snackies (but I think that might be a european thing) Orijgens freeze dried treats also go down very well and they are available in the US and Canada
https://www.orijen.ca/us/foods/cat-food/#fd-cat-treats

Sometimes I get the orijen and I buy the dog version it's exactly the same just pure meat, the chunks are bigger but I break them up and they work out morre economical than the cat ones. It's good to have a treat that won't impact BG, it's what got George to be a complete angel about being tested, it got to I just rattle his treats and he would come and sit on my lap. Sadly he's deaf now so I have to wave the treats in his line of sight to catch his attention.
 
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