Starting Lantus Thurs night-2/2-need dosing advice please

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Sarah Mc

Sarah Mc

Member Since 2017
Hi,
I was previously posting in the following thread: http://www.felinediabetes.com/FDMB/...-please-i-made-a-mistake.171651/#post-1881098
Samba was on Lantus, but I shattered the vial and had to give him Novolin temporarily. He will be going back on the Lantus Thursday night. What dose should I give him? I was going to give 1 unit which the vet recommends if you agree based on his #s. SLGS is probably best for us since I cannot test during the day on work days, but if TR is much more likely to promote him going into remission, I can set my alarm to wake up and test at evening +6's.

Thanks,
sarah
 
Sarah Mc said:
Hi,
I was previously posting in the following thread: http://www.felinediabetes.com/FDMB/...-please-i-made-a-mistake.171651/#post-1881098
Samba was on Lantus, but I shattered the vial and had to give him Novolin temporarily. He will be going back on the Lantus Thursday night. What dose should I give him? I was going to give 1 unit which the vet recommends if you agree based on his #s. SLGS is probably best for us since I cannot test during the day on work days, but if TR is much more likely to promote him going into remission, I can set my alarm to wake up and test at evening +6's.

Thanks,
sarah
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I see that he is to be carefully monitored the first 3 days per the sticky. I would be able to test at both preshots and evening +3, +6 & +9 on Friday and all +3,6,9 and preshots on Saturday & Sunday (he would only miss testing during his AM cycle on Friday, and I would otherwise be available to test at any time until Monday morning, and then the same applies as Friday)
 
Wow, they sure took their time getting that Lantus to you. Did you order it from Mark's in Canada? The cartridges are much sturdier than the vials are, so not as much chance of breaking it if it drops. We dropped ours more than once.

The starting dose would be different depending on which method you chose. Under SLGS, since dry food is no longer in the picture, you would start with .5 normally. Under TR it is figured by the cat's weight. Is the weight in your signature block current?

However, since you are switching from another insulin, we take that dosing in to consideration. You currently have him on 1.75 units of Novolin, correct?
 
Tricia Cinco(GA) & Harvey said:
Wow, they sure took their time getting that Lantus to you. Did you order it from Mark's in Canada? The cartridges are much sturdier than the vials are, so not as much chance of breaking it if it drops. We dropped ours more than once.

The starting dose would be different depending on which method you chose. Under SLGS, since dry food is no longer in the picture, you would start with .5 normally. Under TR it is figured by the cat's weight. Is the weight in your signature block current?

However, since you are switching from another insulin, we take that dosing in to consideration. You currently have him on 1.75 units of Novolin, correct?
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Yes, I ordered from Marks on 1/20 and the status still says "inbound out of customs" with no estimated delivery date from USPS yet. I have a nice lady shipping me a pen for $26.45 due in Thursday night to tie me over. That weight is current for Samba, and yes, he is currently on 1.75 u of Novolin
 
Thanks. I've asked some of the other veterans for their thoughts about a starting dose. I'm about to put dinner on the table, but if one of them doesn't chime in, I'll get back to you as soon as I hear from them.
 
I tend to think it's probably best to go back to the 2U dose you were on before and start getting those tests in so we can see what's really going on at that dose

The 1.75 of Novolin hasn't really done much to bring his numbers down so I'm taking that into consideration too

You could probably start back at 1.5U if you think that would be better, but I wouldn't drop back down too much or you'll just allow glucose toxicity to set in and end up fighting high numbers to get back under control later

If it ends up being too much, getting those tests in will let us know pretty soon

If you can test on the PM cycle and get both Pre-shots, you can still do TR

I'd call Marks tomorrow (if you haven't already)....they may be able to help you....it shouldn't have taken that long
 
Sarah Mc said:
SLGS is probably best for us since I cannot test during the day on work days, but if TR is much more likely to promote him going into remission, I can set my alarm to wake up and test at evening +6's.
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The weight based formula for figuring out a starting dose doesn't apply to a cat already on insulin. Given current data, I think Chris is on the right track with her suggestion to restart Lantus at 2u bid. However, I think it's probably best to restart Lantus at the same N dose (1.75u) you're giving now because of your concern about testing. You can always start with SLGS and then switch to TR if you want to give it a few days to see how things go.

Just my thoughts...
 
Jill & Alex (GA) said:
The weight based formula for figuring out a starting dose doesn't apply to a cat already on insulin. Given current data, I think Chris is on the right track with her suggestion to restart Lantus at 2u bid. However, I think it's probably best to restart Lantus at the same N dose (1.75u) you're giving now because of your concern about testing. You can always start with SLGS and then switch to TR if you want to give it a few days to see how things go.

Just my thoughts...
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If I test at AM and PM preshot every day plus at +2 and +4 every week night plus at any time you like on the weekends, is that enough for TR?
 
Sarah Mc said:
If I test at AM and PM preshot every day plus at +2 and +4 every week night plus at any time you like on the weekends, is that enough for TR?
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It probably will be, but you might want to see how things go for a couple days since there's not a lot of Lantus data to go on.
It's up to you.
 
Chris & China said:
Is there any chance your schedule would let you shoot earlier in the morning and get a +2 before you have to leave? (and still be home 12 hours later to shoot again?)
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No, I don't think so...I leave for work around 8 and get home around 8 everyday. I work 9-5 full-time, and then I get paid to go see a woman at a nursing home in the opposite direction of my home from 6-7. Work & nursing home are both an hour from my home. I took the 2nd job because I am broke right now. Earliest I can get home is 8.
 
Sarah Mc said:
No, I don't think so...I leave for work around 8 and get home around 8 everyday. I work 9-5 full-time, and then I get paid to go see a woman at a nursing home in the opposite direction of my home from 6-7. Work & nursing home are both an hour from my home. I took the 2nd job because I am broke right now. Earliest I can get home is 8.
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I could wake up early to get a +10 if that would be helpful, but the only way to time the shots that I can see is 8 & 8
 
Sarah Mc said:
I could wake up early to get a +10 if that would be helpful, but the only way to time the shots that I can see is 8 & 8
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I'm not sure I could improve upon my schedule much even if I was just working one job. At my FT job, I am on call until 5 and could potentially have to meet a client at 4:59. As it is now, I go see Carolyn if I get off on time, and if I'm stuck at work late, I just book it home. Tonight I had to work until almost 7. It is just the nature of my job...I work on a mobile crisis team. I've thought about moving closer to work, but I can't afford to live in that area.
 
Sarah Mc said:
I'm not sure I could improve upon my schedule much even if I was just working one job. At my FT job, I am on call until 5 and could potentially have to meet a client at 4:59. As it is now, I go see Carolyn if I get off on time, and if I'm stuck at work late, I just book it home. Tonight I had to work until almost 7. It is just the nature of my job...I work on a mobile crisis team. I've thought about moving closer to work, but I can't afford to live in that area.
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This sounds crazy, but I might be able to swing bringing Samba to work with me on a Wed, Thurs or Fri if necessary because I work out of a satellite office with only a few staff members that probably wouldn't mind... he could have his own room because the building is practically vacant. If his numbers were of concern on one of those days, I could probably pull that off without stressing him or anyone else too much, but I wouldn't be able to make a routine out of it. Not sure if that's helpful or not
 
Since your normal schedule is tight, it might be better to start out with SLGS with the intention of switching to TR once you have a little more data accumulated, but it's up to you. If I were in your shoes, I'd also make sure there was food available for Samba to nibble on while you're gone all day.

Just my thoughts... others may have different ideas.
 
Sarah Mc said:
This sounds crazy, but I might be able to swing bringing Samba to work with me on a Wed, Thurs or Fri if necessary because I work out of a satellite office with only a few staff members that probably wouldn't mind... he could have his own room because the building is practically vacant.
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It's not crazy at all! Many of our members have brought their cats to work (if they can).
 
Jill & Alex (GA) said:
Since your normal schedule is tight, it might be better to start out with SLGS with the intention of switching to TR once you have a little more data accumulated, but it's up to you. If I were in your shoes, I'd also make sure there was food available for Samba to nibble on while you're gone all day.

Just my thoughts... others may have different ideas.
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Thanks. I know I got a bit snappy in the other thread about the food, and I'm sorry. We have a pest problem here that is really bothering me. I'm sure I make it sound worse than it actually is, but IMO there should be no pests. I have a timed feeder and could try leaving him wet food in that and see what happens... is the reason for that (other than his enjoyment and comfort) because if his numbers go low the food would bring them up?
 
Sarah Mc said:
I could wake up early to get a +10 if that would be helpful,
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I think a +11 would be enough. It would help you see if Samba is going up or down at AMPS, and give you some hint about whether you need to leave LC or MC when you go to work. Do you have an autofeeder? If not, I suggest you get one. A lot of us use the Petsafe 5 Meal Feeder, available online and at some Petcos and Petsmarts. Remember that Lantus is a long lasting insulin, so you need to have food available at least until the middle of the cycle. You can put an ice pack under the food tray to keep the food fresh.

Sarah Mc said:
This sounds crazy, but I might be able to swing bringing Samba to work with me on a Wed, Thurs or Fri if necessary because I work out of a satellite office with only a few staff members that probably wouldn't mind... he could have his own room because the building is practically vacant. If his numbers were of concern on one of those days, I could probably pull that off without stressing him or anyone else too much, but I wouldn't be able to make a routine out of it. Not sure if that's helpful or not
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NOT crazy. A lot of member wish they had this luxury. If Samba is having an active cycle, you might not feel safe leaving him home alone. He'll just have to cooperate and do that on the right day! ;)

 
Sarah Mc said:
Thanks. I know I got a bit snappy in the other thread about the food, and I'm sorry. We have a pest problem here that is really bothering me. I'm sure I make it sound worse than it actually is, but IMO there should be no pests. I have a timed feeder and could try leaving him wet food in that and see what happens... is the reason for that (other than his enjoyment and comfort) because if his numbers go low the food would bring them up?
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Thank you. I accept your apology.
Yes, most cats will look for food if they feel their blood sugar dropping.
 
Tricia Cinco(GA) & Harvey said:
I think a +11 would be enough. It would help you see if Samba is going up or down at AMPS, and give you some hint about whether you need to leave LC or MC when you go to work. Do you have an autofeeder? If not, I suggest you get one. A lot of us use the Petsafe 5 Meal Feeder, available online and at some Petcos and Petsmarts. Remember that Lantus is a long lasting insulin, so you need to have food available at least until the middle of the cycle. You can put an ice pack under the food tray to keep the food fresh.


NOT crazy. A lot of member wish they had this luxury. If Samba is having an active cycle, you might not feel safe leaving him home alone. He'll just have to cooperate and do that on the right day! ;)
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I have the pet safe 2 meal feeder, but it sounds like that won't be enough with me being gone for 12 hours, so I can order the 5-meal feeder & ice pack tomorrow. Thank you for the links

And a +11 would be no problem
 
Sarah Mc said:
I have the pet safe 2 meal feeder, but it sounds like that won't be enough with me being gone for 12 hours, so I can order the 5-meal feeder & ice pack tomorrow. Thank you for the links

And a +11 would be no problem
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I do associate food with testing though, so will that be a problem? I.e., I'd like to feed him after his +11, but I thought he's not supposed to have food for two hours before the AM &PMPS? I think he'd be really pissed at me if I pricked him without food involved
 
Sarah Mc said:
I have the pet safe 2 meal feeder, but it sounds like that won't be enough with me being gone for 12 hours, so I can order the 5-meal feeder & ice pack tomorrow. Thank you for the links

And a +11 would be no problem
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*I can order the ice pack tomorrow to use with my two meal feeder (looks like the same ice pack is compatible with both). I will have to wait to order the 5 meal feeder until I get paid next week.
 
Tricia Cinco(GA) & Harvey said:
I think a +11 would be enough. It would help you see if Samba is going up or down at AMPS, and give you some hint about whether you need to leave LC or MC when you go to work.
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I know that low carb is less than 10%. What would be considered the ideal option or range for medium carb? I don't think I have any of that here so would need to get some. Just some high carb in case of hypo
 
There is a slight chance that I might have the Lantus for his AM shot today. Apparently, there was all kinds of activity for my Canada package beginning at 2 AM today, and it is out for delivery now. If not, I should have it for his evening shot tonight. Confirming that I should start at 1.5 u or 2?
 
Sarah Mc said:
There is a slight chance that I might have the Lantus for his AM shot today. Apparently, there was all kinds of activity for my Canada package beginning at 2 AM today, and it is out for delivery now. If not, I should have it for his evening shot tonight. Confirming that I should start at 1.5 u or 2?
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I think that I will go with 1.75 u of Lantus to start unless I hear that I should do otherwise since I won't be at home with him during the day tomorrow or Friday. Fingers crossed that we can start tonight. I am still waiting for the delivery.
 
I have been testing at +3 in the evenings and am now adding +11. Since my evenings are more flexible, what are the ideal times I should test? Should I continue with +3 tonight or do a +2 and +4 instead? After reading the tips for TR when working full-time, it looked like +2 and +4 were recommended in addition to AM/PMPS, but this is all a bit confusing to me. Thanks
 
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