? Lantus drop outs and /or others that have changed insulin, looking for information

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apple

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Anyone a Lantus dropout? If so what insulin did you move to?

I'm not at all convinced this is a positive thing for my cat, nor am I convinced it's helping him. I reflected on his feeling crummy for sometime and discovered I hold insulin in a different category of drugs and that is incorrect thinking. If this was a different class of drugs, he'd have been removed and on something else by now.

I've got enough anecdotal evidence that it is the Lantus that makes him feel ill.

30, 45, 60 minutes after injection he goes from a happy, active, motoring around, interacting, participating in love cat. To a car that lays down, sunken eyes, painful to the touch, growls, doesn't want to participate in life.

I've tried experimented with timing, letting his injections slide back if he's low enough and every time, his response is the same.

I chalked it up to feeling ill with high bg, then nausea from high bg, then antibiotics messing with his tummy and on and on.....

He now gets antibiotics and all other meds spaced 3 to 4 hours after insulin.

He has allergies to many things. I don't see why and he can't be allergic to Lantus. I've have him react to other drugs or a filler so, i don't see why dvms and others are giving Lantus a pass. I've decided Lantus is getting a pass because it's insulin.

I've removed all the other cause/effect items that could have been used to explain the change of behavior/ looks. The only thing left, the constant is the Lantus.


If I described the above misery stated on how he looks, acts and feels, to the vet, on any other drug or food, the vet would yank it and prescribe something else. The same should apply to Lantus.

So, anyone switch from Lantus to another insulin?

To those who may have switched to Lantus, you can also provide insight. Why did you switch?

Anyone have cat/s feel fine and the after injecting insulin, feel miserable?

He doesn't mind getting his bg tested, he purrs and helps to the point that I worry I may poke his nose. He has to see what I'm doing. He rubs and loves the meter, lancing device, test strips, et al. He doesn't mind his other injections (dex, bup). No hiss, grr.... When it's time for Lantus, he voices his opinion. I think he figured out the cause and effect before I did.

So, who has changed insulin and why?

Thank you in advance for taking the time to reply and helping me gather information.
 
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I know @Kris & Teasel first used Lantus for some time before switching to prozinc. She has recently gone back to using Lantus again. I believe Teasel is doing much better on the Lantus the second time around. Kris, can you offer any insights on your experience?
 
Teasel was started on Lantus and had it for two months. However, the standard vet dosing method of hold the dose a week, do a full curve, then evaluate the dose didn't work. He bounced early on then got stuck high and every curve was high and flat. The vet suggested I stop the insulin for 48 hours in order to restart him. After 24 hours he was in DKA and spent three very expensive days in the ER ICU.

I switched to ProZinc insulin then and worked at getting him on a good dose following my vet's method (hold dose a week, do a curve) for a solid four and a half months - no luck. Every curve showed a lot of bouncing up high. I got him up to 3.6 u and finally decided to test before a shot and found him very low. I realized what I was doing wasn't working so I came here to FDMB, started the testing and spreadsheet regimen and discovered why I hadn't been successful: Teasel is a major bouncer and his last a long time. Every curve I'd done had captured bouncing but never captured the odd lows he was having. I had no clue until I built up all the data on a spreadsheet.

I spent five and a half months trying to get ProZinc to work - with moderate success. He still bounced like crazy but I learned a lot about fractional dosing, how to read his spreadsheet and, most of all, how to use what I knew to make my own dosing decisions. He was generally quiet for a number of hours after each dose, feeling the onset of the insulin was my guess. He was livelier as a dose wore off.

I toyed with the idea of going back to Lantus over the course of a few months because I knew tons more about his responses and wanted to see if I could make Lantus work the second time around. I was very worried about switching but got up the courage to do it anyway. He's been on it about 3 months now and is doing (his version of) much better: more good BG runs, less "insulin effect" after a dose because of Lantus' gentler action. He still bounces and I still have to do things his way for dosing but I think I made the right decision by going back.
 
Kris & Teasel said:
Teasel was started on Lantus and had it for two months. However, the standard vet dosing method of hold the dose a week, do a full curve, then evaluate the dose didn't work. He bounced early on then got stuck high and every curve was high and flat. The vet suggested I stop the insulin for 48 hours in order to restart him. After 24 hours he was in DKA and spent three very expensive days in the ER ICU.

I switched to ProZinc insulin then and worked at getting him on a good dose following my vet's method (hold dose a week, do a curve) for a solid four and a half months - no luck. Every curve showed a lot of bouncing up high. I got him up to 3.6 u and finally decided to test before a shot and found him very low. I realized what I was doing wasn't working so I came here to FDMB, started the testing and spreadsheet regimen and discovered why I hadn't been successful: Teasel is a major bouncer and his last a long time. Every curve I'd done had captured bouncing but never captured the odd lows he was having. I had no clue until I built up all the data on a spreadsheet.

I spent five and a half months trying to get ProZinc to work - with moderate success. He still bounced like crazy but I learned a lot about fractional dosing, how to read his spreadsheet and, most of all, how to use what I knew to make my own dosing decisions. He was generally quiet for a number of hours after each dose, feeling the onset of the insulin was my guess. He was livelier as a dose wore off.

I toyed with the idea of going back to Lantus over the course of a few months because I knew tons more about his responses and wanted to see if I could make Lantus work the second time around. I was very worried about switching but got up the courage to do it anyway. He's been on it about 3 months now and is doing (his version of) much better: more good BG runs, less "insulin effect" after a dose because of Lantus' gentler action. He still bounces and I still have to do things his way for dosing but I think I made the right decision by going back.
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This isn't about bouncing, this is about taking a happy cat, at any bg number and after injecting insulin, he feels miserable. He goes from normal interactions and activities to laying down, clearly in pain, tender to the touch, none of the usually 'make him happy' distractions work. He goes from being very animated to painful.
 
apple said:
This isn't about bouncing, this is about taking a happy cat, at any bg number and after injecting insulin, he feels miserable. He goes from normal interactions and activities to laying down, clearly in pain, tender to the touch, none of the usually 'make him happy' distractions work. He goes from being very animated to painful.
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All I was doing was sharing my experience with two insulins in my cat. You'd asked who has changed insulins and why.
 
Maybe you could try another type of insulin as suggested by a few other members. Smoky was prescribed vetsulin and displayed similar symptoms. He was very depressed and would run from me during shot times. I switched to Prozinc and the change was immediate. His vet thinks because vetsulin is pork based he may have had an allergy to it for some reason.
Smoky has much better BG numbers now.
He has severe food allergies and pancreatitis too. I understand how difficult it is to treat a cat with various health issues. My cat was afraid of me while taking vetsulin. It is possible for them to respond poorly to certain types of insulin I think.
 
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Kris & Teasel said:
All I was doing was sharing my experience with two insulins in my cat. You'd asked who has changed insulins and why.
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Yes, after I posted my reply, I figured out you weren't implying my cat was bouncing.

My apologies if my reaction was gruff. It wasn't meant to be. I want my little happy back and it's hard seeing him unhappy. If I shot the messenger I didn't mean to and I apologize.

Thank you for sharing.
 
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Lisa and Smoky said:
Maybe you could try another type of insulin as suggested by a few other members. Smoky was prescribed vetsulin and displayed similar symptoms. He was very depressed and would run from me during shot times. I switched to Prozinc and the change was immediate. His vet thinks because vetsulin is pork based he may have had an allergy to it for some reason.
Smoky has much better BG numbers now.
He has severe food allergies and pancreatitis too. I understand how difficult it is to treat a cat with various health issues. My cat was afraid of me while taking vetsulin. It is possible for them to respond poorly to certain types of insulin.
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He's started a new behavior, sniffing needles. Never, has he done that before. If it's dex or bup, he sniffs, I inject and we move on. When he gets a whiff of Lantus, the grrrrrr or hiss starts.

At first I wondered if the insulin was stinging or burning and the other meds were not. Now, I think he plain doesn't feel well after Lantus.
 
apple said:
He's started a new behavior, sniffing needles. Never, has he done that before. If it's dex or bup, he sniffs, I inject and we move on. When he gets a whiff of Lantus, the grrrrrr or hiss starts.

At first I wondered if the insulin was stinging or burning and the other meds were not. Now, I think he plain doesn't feel well after Lantus.
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Lantus can sting because it's acidic and it's definitely true that some cats do better on one insulin versus another. You could try ProZinc or compounded PZI. It's amenable to sliding scale dosing.
 
Kris & Teasel said:
fractional dosing.
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How are your doses divided?

The vet has proposed two options and divided the dose out. It may not be the same idea of fractions.

Idea 1. Divide the dose into 3 injections vs two

Idea 2. Divide the dose am heavy. 1/ 3 of the 24 hour dose in the am. 2 /3 of the dose in the pm.

I see pros and cons to both. Right now I see more cons. The idea was to build up his depot in a different manner and see if that helped.
 
apple said:
Idea 1. Divide the dose into 3 injections vs two
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This TID dosing scheme puts you up against three nadirs instead of two along with more dose overlap because Lantus is a long acting insulin. You'd still have the three nadir issue with another insulin so it requires more testing to make sure it's safe to give the second dose only 8 hours after the first. TID is very hard on the owner.

apple said:
Idea 2. Divide the dose am heavy. 1/ 3 of the 24 hour dose in the am. 2 /3 of the dose in the pm.
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Not sure I understand. Do you mean the evening dose would be 2/3 of the total or vice versa? This is a sliding scale of a sort but it could be too large a dose differential AM to PM. Many cats run lower at night so heavy dose PM might be a problem. Heavy dose AM could mean a low BG while you'e away at work during the day.

When I said fractional dosing in my post above, I was referring to the fact that ProZinc, which is a U40 insulin, can be drawn up with U100 syringes (and a conversion table) so that the dose can be divided into fractions as small as 0.2 u. Some cats are responsive to extremely small dose changes - mine is one. I was dosing every 12 hours though on a fairly rigid schedule.
 
I switched from Lantus to Levemir and have been very pleased. When Dakota arrived here (already diabetic and on Lantus), he only tolerated his shots. He flinched, he wanted to hide but he knew he wasn't supposed to - as soon as I gave it, he'd quickly run. He also didn't seem to feel well - I chalked it up to all the changes, the new home and other new 'brothers'. KT was still with us then, I had KT on Levemir. After a couple of months, I changed Dakota. It was a VERY good decision for him. No more flinching or wanting to avoid shots and I also found that his numbers, even when bouncing, are much more steady than ever on Lantus.

Another issue I had with Lantus with KT - KT wasn't healthy his last year. Lantus works on the ph balance of the body - when given it creates more or less a lump under the skin then precipitates. When his ph was off due to illness, meds, whatever, the Lantus didn't precipitate properly leaving high numbers. When his ph balanced, all those lumps began precipitating driving numbers WAY too low. Unfortunately we didn't have him long enough for the Levemir to get a good handle on things.

Hope this helps a bit...HUGS too 'cos it stinks when our babies don't feel well.
 
Kris & Teasel said:
This TID dosing scheme puts you up against three nadirs instead of two along with more dose overlap because Lantus is a long acting insulin. You'd still have the three nadir issue with another insulin so it requires more testing to make sure it's safe to give the second dose only 8 hours after the first. TID is very hard on the owner.


Not sure I understand. Do you mean the evening dose would be 2/3 of the total or vice versa? This is a sliding scale of a sort but it could be too large a dose differential AM to PM. Many cats run lower at night so heavy dose PM might be a problem. Heavy dose AM could mean a low BG while you'e away at work during the day.

When I said fractional dosing in my post above, I was referring to the fact that ProZinc, which is a U40 insulin, can be drawn up with U100 syringes (and a conversion table) so that the dose can be divided into fractions as small as 0.2 u. Some cats are responsive to extremely small dose changes - mine is one. I was dosing every 12 hours though on a fairly rigid schedule.
Click to expand...

Numbers made easy for the example.
Total 24 hour dose =3u
Am=1u
Pm =2u
 
Squeaky and KT (GA) said:
I switched from Lantus to Levemir and have been very pleased. When Dakota arrived here (already diabetic and on Lantus), he only tolerated his shots. He flinched, he wanted to hide but he knew he wasn't supposed to - as soon as I gave it, he'd quickly run. He also didn't seem to feel well - I chalked it up to all the changes, the new home and other new 'brothers'. KT was still with us then, I had KT on Levemir. After a couple of months, I changed Dakota. It was a VERY good decision for him. No more flinching or wanting to avoid shots and I also found that his numbers, even when bouncing, are much more steady than ever on Lantus.

Another issue I had with Lantus with KT - KT wasn't healthy his last year. Lantus works on the ph balance of the body - when given it creates more or less a lump under the skin then precipitates. When his ph was off due to illness, meds, whatever, the Lantus didn't precipitate properly leaving high numbers. When his ph balanced, all those lumps began precipitating driving numbers WAY too low. Unfortunately we didn't have him long enough for the Levemir to get a good handle on things.

Hope this helps a bit...HUGS too 'cos it stinks when our babies don't feel well.
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I'll have to check for lumps. He's getting injection site reactions and hyperpigmentation.
 
I couldn't feel the lumps easily but if I paid attention to where I shot, I could - they're very small as you give the injection. The more you describe, the more I second your thoughts and suspect you may want to change to another insulin. Levemir would be a good choice if you want to stay with a depot insulin, ProZinc would be a good choice for a duration but still 'in and out' insulin. I wouldn't suggest Vetsulin or NPH right now as those may cause too hard of drops/raises.

I don't think trying to go TID is going to give you the relief he's needing right now....
 
Was taking insulin with my dad.....

He told me interesting info about lantus. One lantus side effect is that it can spike blood glucose. A family friend was removed from lantus because it spiked his bg.

That also fits my cat. When diagnosed, he was a firm 200s boy. His bg at time of dx was 200s. Since going on insulin he's a 300s boy.

Monday will start conversations about changing his insulin.

Same thing happened tonight. Sniff the needle, hiss, grouch, pain........
 
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