Timing of Shot

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judy

Member Since 2011
Hi,
I have a question, tomorrow morning we have to 1 hour earlier then normal. Is it okay to give Annie her Lantus shot 1 hour earlier or will there be a problem?? She is getting 1 unit in the morning and we added 1/2 unit in the evening. Her spreadsheet is listed below.
She has bee doing really well. She is moving around alot more and we bought a new toy called THE BIRD she is playing like a kitten.
Any suggestions are greatly appreciated.
Thank you
Hugs
Judy and Annie
 
I'm glad Annie is feeling better.

Shooting early acts like a dose increase. It is feasible to do IF Annie's numbers are above 300 AND if someone will be home to monitor. I'm presuming that if you need to shoot early, you won't be home. I wouldn't do it if you can't be there to keep an eye on Annie's BG numbers.

Also, you mentioned not shooting the same dose at AM and PM. Lantus is not a type of insulin where this approach works particularly well. This is due to it being a depot-type of medication. When you shoot a different amount at AM and PM, you are repeatedly effecting the level of insulin in the shed (depot) and numbers generally get worse, rather than better. As a rule, Lantus likes consistency -- a consistent dose at a consistent time.
 
Hi Judy,

Welcome to Lantus Land.

I believe and early shot is like giving a dose increase.

I took a quick look at your spreadsheet and usually we dose the same amounts twice a day, so it makes it really difficult to say if shooting an hour early is safe.

Have you seen:

This one explains why consistent dosing is important with Lantus
STICKY: LANTUS & LEVEMIR - INSULIN DEPOT -AKA- STORAGE SHED

And this one explains our protocol
STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL

Perhaps some more experienced members can address you real question though.
 
Hi Judy. With Lantus and Levemir, it is best to stay as close to a 12/12 schedule as possible.
Please remember that an early shot is like giving a dose increase,, and a late shot is like a dose reduction.

I'm sorry, if I haven't read all your posts, but we normally give the same dose every 12 hours, and I see that you are giving 1.00 units at AMPS and 0.50 units at PMPS. Has anyone discussed this with you?

:oops: I see that I posted the same time as Sienne.
 
Oh no I did not realize that about Lantus. Am I making things worse for her?? No one ever said anything, even the vet. What should I do?? Go back to the one shot in the morning and nothing in the evening for a few days to see how she is doing?? Or do I give her one unit at night , please please please help me.
Thank you
Judy
 
judy said:
Oh no I did not realize that about Lantus. Am I making things worse for her?? No one ever said anything, even the vet. What should I do?? Go back to the one shot in the morning and nothing in the evening for a few days to see how she is doing?? Or do I give her one unit at night , please please please help me.
Thank you
Judy
Click to expand...
I don't think anyone meant that you should only give ONE shot a day. They meant shoot the SAME dose every morning and every night.

Until someone else chimes in... if this was my dilemma, I might try a dose of .75u in the morning and same thing at night. What do you think?
That is basically the same amount of insulin you have been using - only it is dosed evenly within the 24 hour time frame.
 
Hi CD,
That sounds pretty good, but what do I do about tonights shot. I should be giving it to her in about 15 minutes. Do I give her the .50 or 1.00 or nothing??? I am so confused...........
Help
Judy and Annie
 
Well, hmm. If it was my kitty and you have this struggle with the hour early tomorrow... I definitely would NOT increase it tonight.

Annie's numbers are not very low ... being in the pink and yellow territory. Taking that into consideration too... One option might be to shoot the .50u tonight just like you always do and tomorrow start shooting the .75u Morning and Evening.
If you must shoot early you have decreased a little to make up for that.

When will you be home to check on Annie if you do shoot early?
 
Hi CD and Sienne,
Thank you for your help. I did give her the .50 shot this evening. I will start tomorrow just as was suggested doing equal amounts at both the AM/PM hour of .75. How will I know when to increase it to 1.00 for the shots?? I thought you have to go slow to build it up alittle bit in her system. I will read those two thread that were suggested. You ladies are angels!!!!
Thank you for always being there
Hugs
Judy and Annie
 
Regarding increasing, Blue (her name is actually Beth), linked the info on the Tight Regulation Protocols and our modified version.

This snip from the protocol may help:
* Report this post
* Reply with quote

STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL

Postby Jill & Alex » Thu Jan 07, 2010 3:37 am
Those of us who have been around for awhile have been familiar with two tight regulation protocols associated with the use of Lantus or Levemir.
However, the German Tight Regulation Protocol with Lantus or Levemir for Diabetic Cats and Rand's Protocol (from Queensland University) are now one and the same. This was recently published in the Journal of Feline Medicine and Surgery and based on a collaborative study.

The tight regulation protocol was tested in 55 diabetic cats for Lantus/glargine and in 18 diabetic cats for Levemir/detemir from the
German-Katzen Forum. Owners measured blood glucose an average of 5 times daily and adjusted insulin dose based on the protocol. An overall remission rate of 64% was achieved in the cohort. Significantly higher remission rates were observed if good glycaemic control was achieved soon after diagnosis: 84% for cats started on the protocol within 6 months of diagnosis went into remission, and only 35% for cats that began more than 6 months after diagnosis.

Links to protocol guidelines:
Tight Regulation with Lantus or Levemir for Diabetic Cats
Dosing Protocol for Cats on Lantus/glargine or Levemir/detemir Using Daily Home Monitoring of Blood Glucose Concentrations to Adjust Insulin Dose


WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR...

* Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.

* It will be necessary to test kitty's blood glucose levels multiple times per day.

* Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.

* Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).

* Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.

* Feed a high quality low carb canned or raw food diet.

* Feed small meals throughout the day. Some kitties adapt well to free feeding.



Many Lantus and Levemir users in this forum have been successful following a somewhat modified version of this Tight Regulation Protocol for the last few years. These "general" guidelines are based on anecdotal evidence and personal experiences of laypersons frequenting the forum.

"General" Guidelines:

* Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

* Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

* Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


Increasing the dose...

* Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

* After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

* After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...
 
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