Starting Lantus

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Sarah/Nancy

Sarah/Nancy

Member Since 2014
Hello Fdmb
Just got a new insulin from vet. I will be going from Humulin to Lantus. Question do i just start with it on the next shot time and is am or pm the best time to start.
Do i still feed before shot and do i still need to wait about an hour after feed to give shot? Vet said to start at 1u Sarah weighs 8.4lbs she needs to gain weight. The Humulin was just not working numbers were staying high. Toughts just want to get it right.
Nancy
 
Hi Nancy,

Since I'm a newbie, I won't give you any specific advice. I just wanted to let you know that you aren't alone - we switched from Humulin to Lantus last week. :smile: I gave Jersey Humulin that morning and then gave her Lantus that evening (12 hours apart since Lantus requires a 12/12 schedule; we wanted to go ahead and get used to that schedule). For Lantus, I test Jersey, feed her, and typically give her the shot while she's still eating.

Others with more experience will be along soon to give you more detailed advice. I just wanted to welcome you to the board Lantus!

Shelly
 
Thanks Shelly
It has only been a few weeks for me also. Sarah seems normal except for the peeing. she wont use her litter box anymore but other than that she is fine. Just couldnt get her numbers down with Humulin. so im excited to see if this will help. Her low point was always +2/+3 hours in and then it was high by the time I got back home for test.
 
Welcome to FDMB!

Lantus is very different from Humulin. You may want to take some time to read the sticky notes at the top of the Lantus board.
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal version -- the “Tilly” Protocol developed by the counterpart of this group in Germany, which was also published by Kirsten Roomp & Jacqui Rand, DVM in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.

With Lantus, you do not need to have food on board prior to shooting. With Humulin, the onset is very quick. With Lantus, onset of the insulin's action takes at least one hour, more typically 2 hours. Most of us test, feed and shoot while our kitty is eating -- all usually within the span of a few minutes.

Lantus dosing is based on the nadir (lowest point of the cycle) and not the pre-shot numbers. As a result, it's important to do what you can to get at least one spot check during both the AM and PM cycles. My guess is that Sarah's numbers have been bouncing around with the Humulin, but there's no way to know that for sure without some spot checks.

Just to check, what are you feeding Sarah?

Please let us know if you have questions. The people here are incredibly generous with their time and knowledge. We're here to help.
 
With Lantus, you test, feed, and shoot within 15 minutes.

Starting dose should be LOW
take the lower of weight of your cat now vs the ideal weight
Convert to kilograms (pounds divided by 202)
Multiply by 0.25
round down to nearest quarter unit.
 
just wanted to say hello to nancy and shelly. me and my kitty switched from N to lantus last wed. am. looks like there r 3 of us here doing the same thing :) good to see u all.
good luck!
larry says hi to ur kitties :)
 
BJM said:
With Lantus, you test, feed, and shoot within 15 minutes.

Starting dose should be LOW
take the lower of weight of your cat now vs the ideal weight
Convert to kilograms (pounds divided by 202)
Multiply by 0.25
round down to nearest quarter unit.
Click to expand...

so if she weighs 8.4 how many units would that be
sorry not good with math
 
IloveLarry said:
just wanted to say hello to nancy and shelly. me and my kitty switched from N to lantus last wed. am. looks like there r 3 of us here doing the same thing :) good to see u all.
good luck!
larry says hi to ur kitties :)
Click to expand...

Hey back Larry i have been watching your posts hope things go well for you :-D
 
thanks, likewise!
i had an inlaw named sarah. she has juve. diabetes.
kinda tickled me ur cat is sarah :D
 
Hi Nancy and sweet Sarah

8.4lb/2.2=3.8 x .25=0.95units

As 8.4lb is lower than her normal weight, you don't want to give more than 1U to start. You want to test frequently. Before giving the shot (don't give the shot or feed her if she is under 150. Post and ask for advice). Two hours after the shot +2 (if kitty is the same bg or lower you will want to test frequently as she is dropping. If the same or higher, try for a +6). Do not feed for the 2 hour period before her shot as it will influence her bg numbers.

Different insulins take different size syringes. Lantus is a U100. Not sure what humulin is but I have U40 in my head? If so, you can NOT use the same syringes. They give a very different dose as U40 is larger.

Please read all the links Sienne sent you. They are full of amazing and necessary info to help you and to keep Sarah safe!
Welcome to FDMB! We are so glad you found us! :-D
 
Kim & Twice said:
Hi Nancy and sweet Sarah

8.4lb/2.2=3.8 x .25=0.95units

As 8.4lb is lower than her normal weight, you don't want to give more than 1U to start. You want to test frequently. Before giving the shot (don't give the shot or feed her if she is under 150. Post and ask for advice). Two hours after the shot +2 (if kitty is the same bg or lower you will want to test frequently as she is dropping. If the same or higher, try for a +6). Do not feed for the 2 hour period before her shot as it will influence her bg numbers.

Different insulins take different size syringes. Lantus is a U100. Not sure what humulin is but I have U40 in my head? If so, you can NOT use the same syringes. They give a very different dose as U40 is larger.

Please read all the links Sienne sent you. They are full of amazing and necessary info to help you and to keep Sarah safe!
Welcome to FDMB! We are so glad you found us! :-D
Click to expand...

Thanks for the help the vet put her on 1.u bid so thats 2 u total is that to much? and it was Humulin N short acting insulin but the syringes were the same u100 I posted her bg#s on ss tonight. I can only come home and test +6 during the day due to work so im getting in 4 tests aday.
 
Great job Nancy :-D

One unit twice a day is a good place to start :smile: We give Lantus every 12 hours. So if you give the morning shot at 7am then you would give the evening shot at 7pm. I hear you on the work and testing conflict. Can you grab a +2 in the evening tho? It's a pretty important test to try and get at least once/day. The +6 is great and a before bed will help you sleep ;-)

We have a Lantus tight regulation board that you should take a look at since you are now using Lantus. It is a very busy board and full of amazing, supportive and well versed people. We would love to see you there and you would just start a new thread with the date, Sarah, AMPS (morning amps). We start a new condo every day and link the previous day's condo to it. It helps everyone stay up to date on what is happening with each other's kitties, and the advice and good wishes are very helpful. I think you would be very happy there :-D
 
Thats great you have started Lantus.. i hope you have had a chance to review all the stickies and info on the lantus board. But i just wanted you to be aware than Lantus is a depot insulin which means it takes time to build up in the cats system. This means it can take 2-3 days before you see how a dose is really working.. and for your first dose you want to hold it 5-7 days unless she drops under 50 which means an immediate decrease of 0.25 units.

Also I usually recommend 3-4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 150 ( or 200 depending your board and comfort level) but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low her blood sugar is going. The low point "nadir" is what you base dose changes on since you don't want her dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what the her overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Wendy
 
Thanks everyone for the great advice. Its nice to have someone to go thur this with. Question I noticed on my prescription is said that once I opened the lantus pen that i should not put it in the fridge. But everything I have been reading here says keep in the fridge. I have been keeping it in the fridge but was wondering why the instructions say different.
 
The insulin pens have a bit of pressure in them, that helps when you use the dial a dose feature and the pen needle tips to "push" the insulin out of the pen. Since we strongly recommend using regular insulin syringes, to get those tiny doses our kitties need, we have no problems with storing the pens in the fridge. The pressure does not matter if you are withdrawing with an insulin syringe and refrigeration helps the insulin to last longer, "to the last drop" for many people.
 
Humans get through the insulin a lot faster at higher doses so fridge doesn't matter. With cats, we can use a pen for 4-6months and so fridge makes them last that long.
 
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