Switching to Lantus

[flyingduster]

so I stopped posting for the past week or so as I just wasn’t able to follow the recommended protocol (“feeding the curve” to try slow down her bouncing), nor was I able to switch insulin as my vet wanted to keep trying caninsulin longer.

But it’s now been like five weeks since diagnosis and she’s still sitting at similar levels (the caninsulin brings her down, but she just goes right back up again as it wears off!) so I hit up my vet, again, about changing, and this time she has agreed and has ordered a lantus pen for me today! It might be tomorrow before I can get it, but YAY for switching over finally. Finally!

So now I am reading up more on lantus info and I’m doing another curve on Jazz today (on caninsulin) too before hopefully switching over tomorrow.

Any support on that is welcomed! Should I post in the lantus forum??

 

[Bron and Sheba (GA)]

Amy I am delighted to see that you have finally been able to change over to Lantus.
Didthe vet say what dose to start with.? See what the curve tells you today but I would not give more than 1 unit Lantus to start with and if you need to increase, increase in 0.25 unit increments. Depending on the lowest point of the curve today, you might need to reduce the dose to 0.75 unit Lantus.
But you need to stay on the starting dose for at least 5 to 7 days to let the depot fill.........it is a depot insulin and acts differently to the caninsulin..

You mention the vet is ordering you a Lantus pen. They only go up in 1 unit increments but you can take the cartridge out of the pen and use it with a syringe. Just store it in the frig, not the door, in a container. It will last up to 6 months.
The syringes you need are the ultrafine BD U/100 0.3ml 31 G 8 mm. You might have another brand in NZ but they must be a 0.3ml U/100 syringe. Any other syringe will give the wrong dose. Please check back here before using ........you would be surprised how many people are given the wrong syringes.
Have a look at the two protocols tight regulation and SLGS to see which would suit you better.

Read all the yellow stickies at the top of the Lantus page and I would recommmend you start posting over on there now.
Bron

 

[flyingduster]

My vet has recommended starting on 1U, and of course barring a hypo, remaining on that dose for a good week.

Her curve today didn’t bring her down all that much so I’m inclined to agree with 1U?

I only have u100 0.3ml syringes. I’ve not had any u40 syringes ever, so there’s none in the house. I bought my own, none supplied by the vet.

I said pen, but I mean just the pen cartridge! Lol. It’s just the wee 3ml vial thing.

I have gone and picked it up just now, so my question is; do I start on it tonight or am I better to wait until tomorrow? I will be home (mostly) for the next four days.

 

[Bron and Sheba (GA)]

My vet has recommended starting on 1U, and of course barring a hypo, remaining on that dose for a good week.

Her curve today didn’t bring her down all that much so I’m inclined to agree with 1U?

I only have u100 0.3ml syringes. I’ve not had any u40 syringes ever, so there’s none in the house. I bought my own, none supplied by the vet.

I said pen, but I mean just the pen cartridge! Lol. It’s just the wee 3ml vial thing.

I have gone and picked it up just now, so my question is; do I start on it tonight or am I better to wait until tomorrow? I will be home (mostly) for the next four days.

That’s good you are all sorted.
You can start tonight if you feel ready. But I would make an effort to get a +4 or +5 if you can, just to make sure she isn’t going to drop too much.
The onset of Lantus is usually later than caninsulin... around +2... and the drop should be more gradual. But every cat is different. If you can get some mid cycle tests over the next four days that would be very helpful. It will take a few days for the depot to fill and the full effect of the dose to be seen so don’t be disappointed if she doesn’t drop as low as you had hoped in the beginning.
Good luck! Exciting for you.
Bron

 

[Chris & China (GA)]

I agree with @Bron and Sheba …..most of the time, the first several days on Lantus is uneventful, but some cats respond quickly.

If you want to start tonight, you can, but I'd try to get at least a +2 and be prepared to get more tests later on if necessary.

If you don't want to take the chance of being up most of the night, there's no reason you can't start tomorrow.

Most likely, it would be totally fine, but since ECID, we never say "never"

 

[flyingduster]

I have ten mins to decide right now. Haha!

I am thinking that the first dose is “unlikely” to have much of a change to her, and I can test overnight if I have to, so that maybe I will just do it tonight. I’m slightly worried about the “what if”, but I think we will be fine.

 

[flyingduster]

Done! She’s got lantus on board now. And I’ve updated her spreadsheet to say her insulin at the top as well as to show where the switch was done for ease of looking at it later.

I will do a +2 and set my alarm to do a +4-ish one too.
What sort of readings at those times would mean needing to watch closer? I’m used to the caninsulin dropping her quite a bit! So I don’t want to think it’s fine if it’s actually too much too fast for lantus. I will test her as much as needed in the night.