Switching from ProZinc to Lantus today

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CatMomWendy

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We adopted Stormy on Saturday. She has had a checked history with ProZinc. I believe she has been on ProZinc since she was diagnosed last Fall. Originally the vet told the owners to inject inter muscularly because she was hard to control. She had been up to 5 units BID but was hospitalized 2 weeks ago with severe pancreatitis. All her organs were swollen and she was in renal and heart failure. She had fluid in her chest and abdomen and that had to be tapped. She was not expected to survive. But through her foster's love, she pulled through and things cleared up.

When released from the ER, they dropped her to 3 units if ProZinc BID because she gave them some low numbers when she was there. When we went to pick her up on Saturday Feb. 25, the foster said at her recheck the night before she had a high BG and she was well into the 500's on Saturday AM at shot time. We had along drive home (6.5 hours) but we kept her calm and she travelled well, eating multiple times along the way. The next AM, she gave me a HI on the Walmart Relion. I did a curve that day and she dropped to 200 at +3 but that was her lowest and she climbed back up into the 500's for the PM shot. I increased to 3.5 units Sunday night.

Monday night we got another HI (gave 3.5 units) and this AM the same. She was laying near the water bowl and peeing pancakes this AM. I increased to 4 units this AM. I have a pet sitter that knows diabetes stopping by to check her BG today. Our plan is to switch her to Lantus which I am much more familiar with tonight. I will get up to test her overnight and the pet sitter will stop by three times tomorrow during the day to check on her. I work during the day and was planning to switch this weekend when I was home but I don't feel we can wait based on her water intake and urination frequency.

My question is what dose to start the Lantus at. We were thinking a minimum of 1.5 units but are entertaining 1.75 to start to build the depot. Any insight and advice is appreciated as I have never done a switch before. I am a case manager for Diabetic Cats in Need so this insight into ProZinc has been a learning experience but with this cat, I just do not feel it is right insulin for her as we can't get in front of her numbers.

She is being kept separate from the other cats and is decompressing from all she has been through the last few months of being bounced around between fosters and boarding at vet clinics and being hospitalized. She is coming out and looking for attention and eating well (current diet is prescription DM and I did not want to change that our house Fancy Feast Classics until things settle down more for her). She is fed multiple times per day (at least 5). She is sleeping on the bed with us (we take turns each night with her).
 
I think I'd start her at 3U since she's been getting 3.5-5 units of ProZinc

If you drop back too much, you just end up fighting glucose toxicity

As long as you can test, you'll be able to keep her safe

Congratulations on your new addition to the family, Wendy!! Stormy's a lucky cat!!
 
I agree with Chris -- I wouldn't drop the dose too much. It's easier to start at 3.0 or 3.5u and fast track upward if needed. It's also likely that when you did a curve, the drop from a HI to the 200s triggered a bounce. It can take roughly 3 days for a bounce to clear. (A bounce occurs if numbers drop into a lower range than the kitty is used to, there's a fast drop, or a drop into low numbers. This causes a stored form of glucose along with counterregulatory hormones to be released that results in numbers spiking upward.) If this is a bounce, you don't want to raise the dose until you know whether the high numbers are the baseline or if Stormy's nadir is really in the 200s.

I'd encourage you to take a look at the sticky notes at the top of the board. There's an overwhelming amount of information there that will help with managing Stormy's diabetes. You will also want to read the directions for how to put together a spreadsheet. This will allow you to keep track of your test data and will allow us to help you with dosing decision. The information is in the New to the Group sticky.

 
Stormy is a very lucky kitty and you are an angel Wendy. We look forward to following Stormy's progress and she settles into her loving new home
 
Welcome, Wendy.

God bless you for taking on this challenge and giving Stormy a home. She sounds like a fighter and it's good she has a team that will fight with and for her. We'll help all we can.

Here is the link to the instructions for setting up a spreadsheet. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ Let us know if you need help - we have people here that can do it for you if you have issues getting it started.

Here is a post we did recently to help new members use this Board successfully: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/ There are lots of tips and links in there that can help with your learning curve.

My most important tip is to ask questions!!! There are many knowledgeable, caring people here (much like yourself) that love to help.
 
3 units of Lantus to make the switch? That sounds very high to me, in my inexperienced insulin switching mind. Isn't Lantus 2.5 times more concentrated than ProZinc?

I do know what a bounce is. We rescued another diabetic (Chip) that was brought in locally for euthanasia on 2/13. I did a curve on him last weekend (Lantus) and discovered a bounce at 1 unit (we started him on insulin on 2/13 when he arrived). He is down to 1/2 unit after that and his curve on Sunday was good.

I will read the Sticky notes. I was reading on the ProZinc links on Sunday. I also know about the spreadsheet but I prefer to do paper and pencil. I know that is old fashioned but it is just easier for me and my husband. He shares equally with the shots and testing. I have rarely posted here. This is our 8th diabetic since 2012 and often we have 2 at a time (we lost one in Nov and Dec of last year, leaving the spots open for Chip and Stormy to fill). ProZinc is just uncomfortable for me as I don't have experience with it and I don't like Stormy's response to it so far.
 
Hello other Wendy. :) Good luck with your new diabetic kitty. I'm agreeing with the others on the starting dose of 3.0 units. The U-40 syringe for Prozinc are different than the U-100 ones you use for Lantus. We've had people accidentally use the U-40 syringes for Lantus, and end up with a dose that was 2.5 more than it was supposed to be.
 
CatMomWendy said:
I also know about the spreadsheet but I prefer to do paper and pencil. I know that is old fashioned but it is just easier for me and my husband. He shares equally with the shots and testing.
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That is absolutely your prerogative, but I just want to let you know that most people here will hesitate to give dosing suggestions without seeing the data. That doesn't mean you can't continue to post when you want and ask question, but just wanted you to be aware of that.

Not trying to argue or convince you, but just FYI, my DH and I shared duties, and we kept a little spiral notebook for each cat with our testing supplies. When one of us tested or shot, we wrote down the date, time, BG, and dose, and then at some point I took the book to the computer and put the info on the spreadsheet. You can spot trends and other things by looking at the data that way, that you miss when you just write it on a piece of paper. But you have to do what works for you.
 
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