Caninsulin to Lantus dosing

Kathy1980

Kathy1980

Member Since 2016
Hi

My cat is on his 3rd bought of diabetes. It usually goes away fairly quick with insulin, but I don't like the up and down of the caninsulin, and cranky in the am. I got my vet friend to order me Lantus solostar, but she is works with rodents and is not sure about cat diabetes.

My cat gets 2 units of caninsulin right now, twice a day. How much of the Lantus should I give? I would prefer to do it once per day. Of course, I home monitor the BG. Thanks!
 
Can you link current BG's to your spread sheet which will help with giving dosing advice.

Lantus works better to be dosed every 12 hours, so finding a dose that can safely be given every 12 hours is optimum. When did Jack get DX again this time? Do you know what is causing him to lose remission?
 
Since you are in Canada, you can pick up Lantus in any pharmacy without a prescription. Don’t forget to get the BD Ultrafine II syringes with half unit markings too. You need to use U100 syringes and the half unit markings help with smaller doses that cats need. Lantus lasts 24 hours in humans, but not cats.

As Bobbi said, if you could up date your spreadsheet with the last couple weeks of test data on Caninsulin, we can help you figure out a Lantus dose,
 
I will update the spreadsheet when I get home. Basically his bg is around 24 in the morning, then 5 hours after insulin it goes down to about 14 and then by 12 hours it’s back in the 20s. He gets 2 units. I bought the needles that go with the pen, are these ok? I just got the Lantus today so will be trying to figure it out when I get home.
 
Kathy1980 said:
I bought the needles that go with the pen, are these ok? I just got the Lantus today so will be trying to figure it out when I get home.
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It's best if you use the U100 syringes with the pens instead of the pen needles for 2 reasons. The pen needles are very awkward to use while shooting and you will not be able to micro dose using the pens with the needles. We raise and lower the doses in increments of .25 and with the pen / needle set up you can only give 1 unit increases. You could go over the best dose that way.
 
Additional reasons syringes are better, from the Sticky Note on Insulin Care and Syringe Info:

When dosing cats, there can be more negatives to using pen needles with an insulin pen than positives:
  • Inability to administer doses in increments of 0.25 - 0.50 units with pens.
  • Forgetting to "prime" the pen prior to each use will result in a smaller dose than intended. Priming the pen involves wasting 2 units of insulin for every shot.
  • One must keep the pen needle in for 5 - 10 seconds after the shot or you'll run the risk of not administering a full dose (can be tough with some cats).
  • Manufacturers do not recommend refrigerating an in-use pen. Therefore, shelf life may be shortened to 28 days (Lantus & Basaglar) and 42 days (Levemir).
  • Some FDMB members have reported shots administered from insulin pens are more uncomfortable than from a syringe
Note that pens can be used to the last drop if stored in the fridge and used with syringes. In Canada, cartridges, which are like pen refills, are the better price option.
 
Ok thank you! I will get the syringes tomorrow. I just updated the spreadsheet. There has been little improvement over the week with the Caninsulin. I hope Lantus will work better. Any recommendation on starting dose?
 
Any chance of getting some mid cycle tests the rest of this weekend? By which I mean both day time and night time? It's hard to tell from mostly preshots as to what is happening. What day did you start back on Caninsulin? Has it just been the week?
 
It's only been the week. I am only able to do preshots when I work, more on days off. I am off Monday but I wanted to start Lantus since I will be able to monitor all day. Is 1 unit too low for Lantus?
 
Lantus dosing is quite a bit different from Caninsulin. We dose based on the nadirs, or how low the dose is taking the cat. That is why I asked if you could get some tests in the middle of the day or evening cycles, so we have an idea what Caninsulin is doing. Even getting tests at +2 or 3, especially at night, are really good to get. Many cats go lower at night.

Typically when people switch from one insulin to another, we take the dose of the existing insulin into mind. But that means we need a good picture of what Caninsulin is doing first. 1.0 units may be too low, but I'm not sure.
 
Based on the numbers and my cats weight (8kg, but a few pounds overweight) I'm thinking of a starting dose around 4U? The current regime only takes him down to about 13-14BG. I'm planning to start on Saturday.
 
Kathy1980 said:
Based on the numbers and my cats weight (8kg, but a few pounds overweight) I'm thinking of a starting dose around 4U? The current regime only takes him down to about 13-14BG. I'm planning to start on Saturday.
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I’m fairly new here but I can say that 4iu is WAY too high to start on! Don’t start on that! 1iu is a safe starting point, you could possibly do more but I am sure that you wouldn’t expect to begin on more than even 2iu.

For a tiny example; I switched my kitty from caninsulin to lantus just two days ago. 1iu of caninsulin was bringing my girl down to only 14-15 sorta level. But 1iu of lantus which we began on, meant we had to skip her shot last night because she had a PMPS of only 8.2!! Haha. So she has a reduced dose today to trial that. 4iu is way too much to begin on.
 
Kathy1980 said:
Based on the numbers and my cats weight (8kg, but a few pounds overweight) I'm thinking of a starting dose around 4U?
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I have to say I agree with Amy, 4u BID would be to much of a dose to start safely on, especially when we look a the information you have provided.

Even if your kitty was completely new to insulin and 8kg was his ideal weight (starting dose for a kitty new to lantus is based on ideal weight) 8*0.25=2u BID (2u am and 2u pm) That would be if you were aiming to do TR, but this would require a little more monitoring on your part as the TR protocol is a little more aggressive. I would also reiterate Bobbies comment in that Lantus needs to be dosed twice daily in cats, it only lasts about 12 hours in cats. Dosing 4u once a day would not be the same as dosing 2u twice a day.

Kathy1980 said:
The current regime only takes him down to about 13-14BG.
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Based on the information you have provided on the SS it is impossible for you to say this with any certainty, there's simply not enough data. In the last 20 cycles you have only been able to grab a midcycle test for 5 of those cycles, that means that 75% of cycles you have absolutely no idea how low he may or may not have gone. The lowest he has seen on this dose is actually 10 (180) just 3 days ago, and I wouldn't be surprised if he went lower 2/22 when you shot yellow (16) 288 in the pm cycle, the fact that he was red the next morning makes me suspicious he dropped lower than usual that night.

Before making a decision on dose I would second Wendy's suggestion of grabbing some midcycle tests, between now and saturday, wherever you can. If that's only a before bed test in the evening (anything between +2 and +6 in the evening not suggesting that you stay up late) even that will be helpful.
Can you grab a test in the am cycle just before you leave for work? even if that's a +1 or +2 or +3, at this stage any data would be really useful to help you with a good dose for Jack.

I would also suggest that as you have been used to using Caninsulin and the dosing method is somewhat different to what you have been used to that you start by reading the following information posts.

flyingduster said:
1iu of caninsulin was bringing my girl down to only 14-15 sorta level.
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Actually the 1u of caninsulin got Jasmin as low as 7.2 130. The reason you might not have seen that happen every cycle is that she was bouncing from some of those fast drops and the liver was counteracting the insulins action by 'panicking' and dumping glucose into the system. But you are right in that you can experience a strong reaction when we swap insulin types, and it seems jasmine experienced that on her second dose. So yes it pays to be a little cautious and alert.



 
Occasionally they can have a strong reaction to a change in insulin, can you start by grabbing a +2 or +3?

Hope you start to see some progress with Lantus.
 
Yes, I plan on taking many reading today! Thanks. I wanted to add that yesterday in the PM (caninsulin) his reading was only 15 after almost 17 hours with no shot. So I never gave him a shot last night.
 
How is it going? I'm about to switch my cat, Andy, to Lantus, so I'm trying to learn everything I can about what to expect.
 
Seems work slower than caninsulin, which is expected, but, now over 12 hours later and his BG is 11. I can not give him the PM shot and I don't know if that's a good thing? I hope it won't get too high overnight, but then, it did that on Caninsulin anyway. So I guess so far so good.
 
I had to drop the dose of my girl pretty quickly; I was doing 1iu of caninsulin and she still had highs, so started at 1iu of lantus. That lasted for two cycles and then she was too low to shoot so dropped it to 0.75, which lasted another two cycles before she went low and now she’s sitting much steadier on 0.5iu. It may well still have to be increased or decreased again as the depot fills and levels off and she might stop bouncing so badly!! But I’m only five days in now so it’s early!

But if your kitty is too low to shoot then you might be needing a dose reduction? But is 11 too low? I guess it is if you don’t know how low it’ll take him yet!
 
This morning his BG was 18. He didn't get a shot last night. I reduced the dose the to 1U and will monitor today. It seems to be helping
 
BTW I think I got air into the solostar pen. Is this bad? It gets air into the syringe but I just fix it by flicking
 
Have you decided which of the dosing methods you wish to follow?
http://www.felinediabetes.com/FDMB/threads/dosing-methods-start-low-go-slow-slgs-tight-regulation-tr.210110/

Although skipping was a reasonable choice, because you haven't got data to support you shooting that low, remember that with Lantus because it is a slower acting insulin thatn caninsulin we eventually work up to shooting much lower numbers than you will have done on caninsulin, it's a different mindset.

On TR you would eventually with enough data you learn to shoot anything over 50 (human meter) and on SLGS anything over 90 (human meter)
 
I see he was green at +6

They can continue to drop after +6, please carry on monitoring.

When did you feed today?
 
What was he at pmps? Did you shoot? Or skip?
What dosing method do you want to follow?
On SLGS that drop below 90 earned him a reduction to 0.75.
Are you able to monitor on Monday?
 
Looks like an exciting switch from Caninsulin to Lantus. FWIW, I ended up going to a much higher dose of Lantus than we were on Caninsulin. ECID.

Any chance you could put a blank line in your spreadsheet after the last day of Caninsulin and before the first day of Lantus, and then put something like Starting Lantus on that line. That'll make it easy to see when you did the switch.
 
Last night I skipped the dose. This morning he was 21. I gave 2 units but now at almost 12 hours later he is at 7. I think I should give only 1 unit in the morning? I work and don't get home until almost 12 hours later, but my mom is home to watch him. Or maybe 2 units once per day will be good enough for now? I can only do full curves on my days off. And, I will fix the spreadsheet to show the switch.
 
Why did you go back to 2iu? You need consistent dosing as much as possible, and not to be shooting based on preshot numbers but the nadir. And holding a dose for a few days to settle the depot in most cases.
 
Once a day shots seldom work in Lantus for cats. Better to do a smaller dose twice a day. How about trying 0.75 units twice a day. Remember, we determine dose based on the lows, not the highs or preshots like you did with Caninsulin.
 
I will stick to 1U, see how it goes. I'm not home to monitor nadirs most days. This morning he was pretty high, but I only gave 1 U and now over 12 hours later he is still at 9.
 
If you cannot get daytime nadir tests, then night time before bed tests are what will tell you how he is doing on a dose. Also unless you are gone 12 hours a day, in or out the door tests are helpful.

If you are having to skip half your shots, that is a sign the dose is too high.
 
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