Forced to change from prozinc to caninsulin

[C1gar]

Hi

I’m just wondering if anyone has any knowledge or suggestions on my little cats challenge - prozinc to caninsulin due to the ongoing shortage. She was very stable on prozinc with good control.

she was on 3.5 units of prozinc, how much difference is caninsulin to prozinc?
is it stronger? As we have started on 2 units to air on caution.

Any comments would be greatly appreciated

 

[JanetNJ]

Usually you don't really change the dose. If you are worried I would start at 3. Do you have a spreadsheet you can share of the BG numbers?

 

[C1gar]

Thank you for your reply!

I struggle to get any readings from her so a BG curve is always incorrect.

I am hiring it to 2.5 tonight as she was on 3 for one day but went into a very very deep sleep

 

[JanetNJ]

Thank you for your reply!

I struggle to get any readings from her so a BG curve is always incorrect.

I am hiring it to 2.5 tonight as she was on 3 for one day but went into a very very deep sleep

Please don't give up on testing. It truly has saved my cat's life probably a dozen times in the four years she's been diabetic. The first couple of weeks you do it there will be a lot of failed tests... but then new capillaries will grow and make it much much easier. You could also try getting a meter that only needs .3 size sample. I have a video in my signature showing how I test my cat at home.

 

[C1gar]

thank you I am going to look in to the .3 size I have the
AlphaTrak 2 but it seems to want a lot of blood, do you know of the type that requires less?

Thank you!

 

[JanetNJ]

thank you I am going to look in to the .3 size I have the
AlphaTrak 2 but it seems to want a lot of blood, do you know of the type that requires less?

Thank you!

alpha only needs a.3 sample.... it's what I use.

Just to clarify, when you try to get a sample, you are DIPPING the edge so the tiny straw protruding from the side sucks up the drop, right? You aren't trying to scoop a drop in top of one of the dots, correct? This is all the blood you should need to get a sample.... It's literally a drop.

 

[JanetNJ]

you DIP one of the little straw into the drop.... do you see the straws on the edge? It sucks the blood up into the strip.

 

[JanetNJ]

This picture is of a ferret getting tested, but it's a good photo to show you the angle you need to use to DIP into the drop.

 

[Deb & Wink]

One big difference between Prozinc and Caninsulin (Vetsulin) is the much shorter duration with Caninsulin. Usually only 8-10 hours.

Was your vet unwilling to write you a prescription for Lantus or Levemir? Those 2 are nice long lasting insulins in cats.

 

[C1gar]

One big difference between Prozinc and Caninsulin (Vetsulin) is the much shorter duration with Caninsulin. Usually only 8-10 hours.

Was your vet unwilling to write you a prescription for Lantus or Levemir? Those 2 are nice long lasting insulins in cats.

Thanks for the reply

They just reccommned to switch to caninsulin we didndt have a say in it really

 

[Deb & Wink]

Thanks for the reply

They just reccommned to switch to caninsulin we didndt have a say in it really

I'm a bit puzzled here. You are the cat's owner. Why wouldn't you have a say?

 

[C1gar]

Hi

Thanks for your reply

We do not have a clue about what is best for a cat with diabetes and take their advice in good faith. We have just spoken to another vet today (same practice) and she says the that caninsulin is stronger than prozinc and reccomend to lower the dose back to 2 - so we really are at a loss.

We gave her 2.5 units this morning and she seems very sedated - we intend to lower it to 2 and take her to the vet in the morning for a curve.

It is just such a shame she was doing so well on 3.5 * 2 a day but now all she does is lay around

 

[JanetNJ]

Hi

Thanks for your reply

We do not have a clue about what is best for a cat with diabetes and take their advice in good faith. We have just spoken to another vet today (same practice) and she says the that caninsulin is stronger than prozinc and reccomend to lower the dose back to 2 - so we really are at a loss.

We gave her 2.5 units this morning and she seems very sedated - we intend to lower it to 2 and take her to the vet in the morning for a curve.

It is just such a shame she was doing so well on 3.5 * 2 a day but now all she does is lay around

It's stronger in that it will lower the number quickly but does not last add long.

 

[JanetNJ]

Hi

Thanks for your reply

We do not have a clue about what is best for a cat with diabetes and take their advice in good faith. We have just spoken to another vet today (same practice) and she says the that caninsulin is stronger than prozinc and reccomend to lower the dose back to 2 - so we really are at a loss.

We gave her 2.5 units this morning and she seems very sedated - we intend to lower it to 2 and take her to the vet in the morning for a curve.

It is just such a shame she was doing so well on 3.5 * 2 a day but now all she does is lay around

Did you see the info about using the alpha track I posted above? You may have been trying to get the sample wrong if you were needing a lot of blood. Another thing you can do is scrape the drop onto your nail and test from there.

 

[C1gar]

Did you see the info about using the alpha track I posted above? You may have been trying to get the sample wrong if you were needing a lot of blood. Another thing you can do is scrape the drop onto your nail and test from there.

yes thank you

We tried unsuccesslfy to get readings or we got extemely low which could not be correct as (my cat) was up and around.

I am going to try the finger nail idea, thank you!

 

[JanetNJ]

yes thank you

We tried unsuccesslfy to get readings or we got extemely low which could not be correct as (sugar - my cat) was up and around.

I am going to try the finger nail idea, thank you!

When you say extremely low what do you mean? My cat had been as low as 37 with no outward symptoms but it's still life threatening

 

[C1gar]

I believe the reader was saying 8

this happened to the vet as well who got a reading of 8mml but took it again and she was in the 500 mg ml

 

[C1gar]

Just got a true reading

22 mml - so she is high but the vet maintains to keep her on 2 units *2 a day for three weeks and get a fructosamine test.

any thoughts would be much appreciated

 

[Deb & Wink]

22 mmol/L times 18 = 396 mg/dL
No too horrible, but could be better. At least it's not in the black color range, over 500 mg/dL (27.7 mmol/L).

Do you home test the BG levels? It gives you more of a real time understanding of the BG levels.

It soundslike you do, but you don't have a spreadsheet setup in your signature. That would really help you and us see what is going on. Setup instructions for the spreadsheet (SS) are here >>>>> FDMB Spreadsheet Instructions

And what it all means is here>>>>> Understanding the Spreadsheet/Grid

A fructosamine test will give you an average blood glucose over the past 2 weeks. But it can't tell you if your cat dropped really low or was really high, over 500 mg/dL(27.7 mmol/L)

What food is your cat eating? That can make a big difference in the BG levels.

Adding information to your user id signature is really helpful too. Editing your Signature, Profile, and Preferences

 

[Elizabeth and Bertie]

Just got a true reading
22 mml - so she is high but the vet maintains to keep her on 2 units *2 a day for three weeks and get a fructosamine test.
any thoughts would be much appreciated

Hi there, are you in the UK? Just wondering because you're saying you're having to switch to Caninsulin because of Prozinc shortage. ...I'm in the UK, and am waving to you from Surrey!

she was on 3.5 units of prozinc, how much difference is caninsulin to prozinc?
is it stronger? As we have started on 2 units to air on caution.

There are some little differences between Caninsulin and Prozinc.
Caninsulin isn't 'stronger' than Prozinc (it has the same number of units of insulin per ml as Prozinc), but it 'typically' has a faster action and so can drop the blood glucose faster and more steeply in some kitties. Also, it 'typically' has a shorter duration, and may not last the full 12 hours.

A lot of UK kitties will probably be switched (by vets) to Caninsulin because of Prozinc not being available at the moment. Hopefully this will only be a temporary issue (fingers crossed).
If Caninsulin doesn't work well enough for your kitty then your vet can prescribe an alternative insulin. Since Prozinc isn't currently available that would mean switching to a human insulin such as Lantus or Levemir. There are now quite a few UK kitties on these insulins. ....However...since your vet hasn't actually suggested that you switch to one of these it seems reasonable to suppose that your vet has no experience of these insulins. That is not unusual in the UK. A vet's willingness to prescribe human insulins varies a lot. Some vets are keen to prescribe them, some vets totally refuse, some don't even know they have the option to prescribe them...

Do persist with learning to hometest blood glucose. 'Hometesting' is enormously helpful in managing diabetes. And if you can test at home you will be able to 'see' how the insulin is working in your kitty's body. If it's not working well then that blood test data could be very helpful in persuading your vet to prescribe an alternative insulin.
Janet has given you some great advice on hometesting (and some fab pics!). In addition to that here are a few things that I wrote for someone else that may be helpful. If you need more help, just shout out!

HOMETESTING TIPS & TRICKS
1. WARM EARS. Probably THE most important thing. Warm ears bleed very much more easily than cold ones. You can warm an ear by massaging it, or by holding something warm against it; ie a pill bottle filled with warm water, or a ‘rice sock’ briefly warmed in the microwave.

2. MASSAGING immediately below the ear prick, with finger and thumb, can ‘milk’ more blood out. I almost always do this, if only for a second or two.

3. VASELINE. A teensy weensy smear of Vaseline on the outer edge of the ear will enable the blood to ‘bead up’ and stops it disappearing into the fur. This also makes it easier to see the blood droplet if the kitty has dark ears.

4. RESISTANCE. The lancet needs something to ‘resist’ otherwise it can push the ear away rather than pricking it effectively. Some folks use a piece of cotton wool or folded tissue. I use one of my fingers, but sometimes do accidentally take a blood sample from myself that way.

5. TWO EAR PRICKS close together can often produce enough blood for a test when one ear prick might not.

6. SCOOPING THE BLOOD DROP ONTO YOUR FINGERNAIL. Doing this is a game-changer for some people. If you can get that drop of blood on your finger or thumb nail you can then let the kitty go and finish the test without her/him.

7. TREATS. It is important to reward the kitty for each attempted test, whether the test was ‘successful’ or not. Cats very soon learn to associate tests with treats. And some will soon come running for their tests. A ‘treat’ is usually a food reward of some kind, but some folks reward their kitties with a cuddle or a grooming session. I actually crumble a few treats for my cat and test him while he’s hoovering up the crumbs.

Remember to reward yourself too. Chocolate is good…

8. GET COMFORTABLE. If you are physically comfortable you’ll be more relaxed, and also less likely to try to rush the process. Some people like to test their cats on a counter top or a desk, maybe next to a desk lamp. Some people prefer to hold their cats on their laps when they test. Some folks incorporate testing into a grooming session. You’ll find what works best for you. And once you get used to home testing you’ll quite possibly be able to do it anywhere, and maybe even while the kitty is asleep.

9. RELAX. Cats pick up on our moods. The more relaxed and ‘matter of fact’ we are, the more relaxed and confident the kitty is likely to be. Some people chat or sing to their cats while they test him. Try it. It might help you too.

10. PATIENCE. Be kind to yourself. You’re learning something new. (And you’re learning something wonderful!)

For sensitive cats who really resist testing it's possible to use the pleasure association of food to make the process easier. This really good little video shows the principles of 'desensitisation and counter-conditioning'. The vet in the video is getting a cat used to injections, but the same principles can be applied to testing:

 

[Deb & Wink]

The "Sticky" or pinned posts at the top of this forum have just been updated. So you might want to take a look at them.

 

[C1gar]

Thank you all for your guidance! I am based in the uk.

I am still struggling to get readings from my cat but she has just drunk 10 mins straight - so she must be high and I think I need to higher the dose and pray that she doesn’t go to low

as living in a water fountain is no life for her.

 

[JanetNJ]

Thank you all for your guidance! I am based in the uk.

I am still struggling to get readings from my cat but she has just drunk 10 mins straight - so she must be high and I think I need to higher the dose and pray that she doesn’t go to low

as living in a water fountain is no life for her.

What size lancet are you using

 

[Elizabeth and Bertie]

I am still struggling to get readings from my cat but she has just drunk 10 mins straight - so she must be high and I think I need to higher the dose and pray that she doesn’t go to low
as living in a water fountain is no life for her.

Aw, sweetie. Take a few deep breaths... And be kind to yourself. We all understand how difficult and stressful this can seem at first. But it honestly does get easier.

It can take time to get the hang of testing. And every cat is a bit different when it comes to what works for them.
I'd been dealing with my first diabetic for 11 and a half years when I adopted my second diabetic. And I thought testing her would be a 'piece of cake' and that I'd be able to do it the same way that I did with my old diabetic boy. But....she was very different, and it was a humbling reminder that every cat has their own specific needs and preferences... I will confess that, even having tested for many years, I felt lost, and I really cried at one point, feeling that I was failing the cat that I'd adopted... But, then I took a step back and re-approached things in a different way....

My first diabetic (who I initially swore to people here was "impossible" to test) was quite food-motivated. So, I found that I could pop him on a table top, crumble a few treats for him, and then test him while he was hoovering up the treat crumbs. That 'distraction' was key in being able to test him, because he was a big powerful kitty, and there was no way I'd be able to test him if he didn't 'agree' to it.
My adopted diabetic girl isn't particularly food motivated, so treats didn't distract her sufficiently to be able to test her. But, I found out that she loved to be brushed, and so I managed to sneak tests into a little cuddle and brushing session, and she barely notices the test... She still gets a food treat at the end. But the treat is a small part of the whole thing.

With both my diabetics I spent quite a lot of time just getting them used to the sensations and sounds involved in testing. So, at various times during the day I'd go to where they were, stroke them, hold or massage an ear for a second or two, and then immediately give them a treat, and just walk away.
Similarly, I'd rattle the test strip container, or click the lancing device (it can be used a bit like a training clicker), give a treat, and then walk away.
It's also helpful initially if you can test in the same spot in the house so as to establish a routine. So, I'd pop the kitty on a chair or table top, and give a treat and lots of praise.
If you can get the kitty to your 'testing spot', hold or massage an ear for a second or two, and then reward with a treat, you are most of the way to being able to test....

It's also important to remember that cats pick up on our moods. If we are stressed, they pick that up. So, taking time to take a few deep relaxing breaths prior to testing can help a lot. ...Also, and this is probably going to sound really daft, some folks sing to their kitties while they test them. I've done this myself, without even thinking about it! But, strangely, if you hum or sing a tune, it can be relaxing for both human and kitty... Strange but true....

 

[C1gar]

Thank you all for your input

she went back to the vets to day her blood sugar was 28mmol so now we are getting into dangerous territory. Frutosemine test done we are awaiting there guideance

We left her in for 2 sepatre days to get a curve. They said - both times - there were able to get a curve as she is far too stressed to see a correct reading :-(

 

[Deb & Wink]

They said - both times - there were able to get a curve as sugar is far too stressed to see a correct reading :-(

Do you mean they could NOT get a curve, either of the two times you left Sugar at the vets?

 

[C1gar]

Do you mean they could NOT get a curve, either of the two times you left Sugar at the vets?

Sorry, yes they have been unable to get a curve.

We have left her again today at the vets, for a curve. I pray it goes ok

 

[Deb & Wink]

Have you thought about using a CGM (continuous glucose monitor) like the Freestyle Libre? They last about 2 weeks on average but give you data every 15 minutes.

It's something to consider. Probably no more expensive than having your cat stay at the vet for a curve.
If I were you, I'd ask my vet about the Libre.

 

[C1gar]

Have you thought about using a CGM (continuous glucose monitor) like the Freestyle Libre? They last about 2 weeks on average but give you data every 15 minutes.

It's something to consider. Probably no more expensive than having your cat stay at the vet for a curve.
If I were you, I'd ask my vet about the Libre.

thank you for your input! I will ask my vet this when they open at 11!!!

she was in all day again yesterday and the vet was unable to get a accurate reading due to stress.

so they want us to bring her down every few every hours for a spot check on a day to see if that can get a better reading

 

[Deb & Wink]

so they want us to bring her down every few every hours for a spot check on a day to see if that can get a better reading

That just sounds like she would be stressed again, and again and again from the ride to the vet and back.

Please, do ask your vet about the CGM. Not cheap, but should be worth it.

 

[C1gar]

Just a quick update

Are vet is not being at all helpful with regards to CGM she says her pratice would not consider it - nor change to a new insulin (human one). So regrettably we have taken her down every 2 hours for 2 days now and have a curve of sorts - and need to re up the insulin accordingly and back to praying that it will be ok.

 

[Elizabeth and Bertie]

I’m just wondering if anyone has any knowledge or suggestions on my little cats challenge - prozinc to caninsulin due to the ongoing shortage.

Hi, Prozinc is currently available at Viovet if you can get a prescription from your vet.
https://www.viovet.co.uk/ProZinc-Insulin/c35418/

 

[C1gar]

ThAnks for the input

sold out atm :-(

 

[Deb & Wink]

Just a quick update

Are vet is not being at all helpful with regards to CGM she says her pratice would not consider it - nor change to a new insulin (human one). So regrettably we have taken her down every 2 hours for 2 days now and have a curve of sorts - and need to re up the insulin accordingly and back to praying that it will be ok.

Only 2 words for you.

New vet. Second opinion. Different practice.

Pray hard. Pray the dose is not too much.

p.s. Ok, that's more than 2 words.

 

[Pabs&Ro]

thank you for your input! I will ask my vet this when they open at 11!!!

she was in all day again yesterday and the vet was unable to get a accurate reading due to stress.

so they want us to bring her down every few every hours for a spot check on a day to see if that can get a better reading

I hope things are settling down for you. My cat was on prozinc and stable at the start of lock down but because of covid the supply dried up in the UK and we went on can insulin. We have tried for four months to get the right dose and still struggling. He was on 2.5 units of prozinc twice a day and we are on 3 units of caninsulin twice a day and it is not enough. Today in the low 20's all day. Also I notice that with caninsulin the effect is great for the first few days of a new vial but thereafter it is not as effective. Vets don't believe me! Also not all companies were storing caninsulin properly and I have been supplied with completely ineffective bottles. It has been a nightmare. I would be interested to know what dose you have settled on in comparison to prozinc dose.

 

[C1gar]

I hope things are settling down for you. My cat was on prozinc and stable at the start of lock down but because of covid the supply dried up in the UK and we went on can insulin. We have tried for four months to get the right dose and still struggling. He was on 2.5 units of prozinc twice a day and we are on 3 units of caninsulin twice a day and it is not enough. Today in the low 20's all day. Also I notice that with caninsulin the effect is great for the first few days of a new vial but thereafter it is not as effective. Vets don't believe me! Also not all companies were storing caninsulin properly and I have been supplied with completely ineffective bottles. It has been a nightmare. I would be interested to know what dose you have settled on in comparison to prozinc dose.

Hi, we are currently still chasing high blood sugar, unfortunately caninsulin is just simple not working for our cat.

We were on 3.5 prozinc - we are currently at 4.5 caninsulin and still climbing in dosing. Caninsulin is clearly less affective than prozinc.

However, our vet is now saying our cat my have become insulin resistance, so comparison might be invalid; but I personally dont beleive it and think its more to do with malpractice, but I need to bite my tounge untill we get our cat settled.

 

[Pabs&Ro]

Hi, we are currently still chasing high blood sugar, unfortunately caninsulin is just simple not working for our cat.

We were on 3.5 prozinc - we are currently at 4.5 caninsulin and still climbing in dosing. Caninsulin is clearly less affective than prozinc.

However, our vet is now saying our cat my have become insulin resistance, so comparison might be invalid; but I personally dont beleive it and think its more to do with malpractice, but I need to bite my tounge untill we get our cat settled.

It seems we are on the same path. We went onto prozinc a few years ago because caninsulin did not work for Pabay and now we are back in the same situation. My vet wants to investigate resistance and or moving onto glargine. The problem I have with the resistance argument is that we get good readings for the first three or so days after opening an new vial. I store it well (having bought a new fridge, insulin wallet and digital thermometer). I have been advised that if we move to glargine I will still need to top up with caninsulin. I really hope humans have better luck with the products they use to control diabetes. How much does your cat weigh as a matter of interest. In march mine weighed 5.3kg but now 4.7.

 

[Elizabeth and Bertie]

My cat was on prozinc and stable at the start of lock down but because of covid the supply dried up in the UK and we went on can insulin.

Prozinc is now available in the UK again, the supply has apparently been restored.
This is from the Boehringer UK website:
"ProZinc 40 IU/ml suspension for injection for cats and dogs
Normal supply has been restored – vets can place orders via their usual process (updated 11 August 2020)"


@Pads&Ro, I also posted this on your thread (enquiry about lantus cost in UK), but am posting here in case others in this thread may have missed this info.
@C1gar

 

[Elizabeth and Bertie]

I have been advised that if we move to glargine I will still need to top up with caninsulin.

Um, no.... That's just nuts... Sorry... Why does your vet think this is the case...?

 

[C1gar]

It seems we are on the same path. We went onto prozinc a few years ago because caninsulin did not work for Pabay and now we are back in the same situation. My vet wants to investigate resistance and or moving onto glargine. The problem I have with the resistance argument is that we get good readings for the first three or so days after opening an new vial. I store it well (having bought a new fridge, insulin wallet and digital thermometer). I have been advised that if we move to glargine I will still need to top up with caninsulin. I really hope humans have better luck with the products they use to control diabetes. How much does your cat weigh as a matter of interest. In march mine weighed 5.3kg but now 4.7.

Hey

our cat is 8kg.

just come back from the vets and are suggesting 5 units * 2 a day.
They also say they can’t get prozinc and suggest keeping on cannisulin until there is a steady supply.

 

[Elizabeth and Bertie]

just come back from the vets and are suggesting 5 units * 2 a day.

5 units is very high dose of a fast-acting insulin like Caninsulin...
Are you managing to test your kitty now? What sort of numbers are you seeing before insulin, and at the lowest number of the cycle..?

And some vets are managing to get stocks of Prozinc... Is it possible that other vets in your area may have some...?

 

[C1gar]

we were getting to the mid 20's with 4.5 units at its peak.

So that why we have been pushed again to up the dosage. We have explored all vets within a wide area - they say prozinc is a no go atm :-(

With 3.5 prozinc we were at 9 at at its peak so there is a huge difference it would seem!

 

[Julie & steve j]

Hi, we had the same issue with Prozinc in the UK. Fortunately for us, my vet was open to the idea of using glargine as an alternative but after a few days of trying they did manage to get hold of 6 vials of Prozinc that they said were coming from the US. I must have been very fortunate that my vet persevered in his quest for tracking some down. I did see the other day that there was limited supply available from Viovet but didn't try to purchase any as I now need a new prescription.

 

[Elizabeth and Bertie]

Prozinc supply has now been restored. Boehringer say that vets can order through their normal channels.
And it is being shown as in stock at Animed:
https://www.animeddirect.co.uk/prozinc-40-iu-ml-suspension-for-injection-for-cats-dogs-10ml

 

[Critter Mom]

I have been advised that if we move to glargine I will still need to top up with caninsulin

Please can you let us know who advised you of this. Whoever it was is giving incorrect and extremely dangerous - possibly lethal - advice.


Mogs
.

 

[Pabs&Ro]

Hi, It is a specialist vet: specialises in internal medicine in the UK. This is one reason I have been cautious about changing to a long acting insulin. The vetinary advice was that the dose on a long acting insulin must be below what is required to avoid hypo and then top up as required with a faster acting insulin. Vets in the UK do seem to be reluctant to use long acting insulins. Judging by the number of posts it seems that long acting insulins are used more often in the USA.

 

[C1gar]

Prozinc supply has now been restored. Boehringer say that vets can order through their normal channels.
And it is being shown as in stock at Animed:
https://www.animeddirect.co.uk/prozinc-40-iu-ml-suspension-for-injection-for-cats-dogs-10ml

Out of stock

 

[Elizabeth and Bertie]

Out of stock

It's in stock at Weldrick's now..... Someone here bought it there yesterday afternoon, and it's still showing as in stock now...
https://www.weldricks.co.uk/products/prozinc-insulin-for-cats-40iuml-vial-10ml

 

[Critter Mom]

Hi, Vets in the UK do seem to be reluctant to use long acting insulins. Judging by the number of posts it seems that long acting insulins are used more often in the USA.

Vets in the UK are legally required to first prescribe medicines licensed for use in the species they are treating. Only when licensed treatments are proved ineffective are they free to consider prescribing other treatments under drug cascade rules. Currently only Caninsulin and Prozinc are licensed for treatment of feline diabetics. Vets have to treat with these first. They need to have evidence that they aren't working well for their patients (e.g. spreadsheet BG data, adverse reaction to the treatment) in order to issue an Rx for the likes of Lantus or Levemir (although Eliz advised recently that the depot insulins are gradually gaining more traction over here in the UK).

OK, that's the easy reply done.


Mogs
.

 

[Elizabeth and Bertie]

Hi, It is a specialist vet: specialises in internal medicine in the UK. This is one reason I have been cautious about changing to a long acting insulin. The vetinary advice was that the dose on a long acting insulin must be below what is required to avoid hypo and then top up as required with a faster acting insulin. Vets in the UK do seem to be reluctant to use long acting insulins. Judging by the number of posts it seems that long acting insulins are used more often in the USA.

I must admit I'm baffled.... And I honestly think you have been misinformed somehow... Perhaps there was some misunderstanding somewhere along the line, because this just doesn't make sense... I've never previously heard any suggestion to use lantus (or any other long-lasting insulin) like this to manage feline diabetes...ever... And I've been on this forum since 2007... This advice seems to relate more to how humans might use insulin... But the metabolism of humans and cats is very different... ...There are certain clinical situations in cats that may, as an emergency measure, require the use of both a longer lasting (basal) and faster acting (bolus) insulin, but these are very specific situations, and nothing to do with the routine management of feline diabetes...

A number of esteemed vets and researchers have investigated the use of lantus in cats, including some quite recently in the UK. It has a pretty long history of use in cats, and has proved to be a good insulin for them.
The RVC in London trialled lantus alongside Prozinc, and found that their remission rates were comparable. Some members here have even managed to get help from the RVC in persuading their vets to prescribe lantus in situations where the veterinary insulins haven't worked well for their kitties...

As Mogs says above, the requirement in the UK is that vets first prescribe an insulin that is licensed for cats. If that's not sufficiently effective they can prescribe an alternative under the 'cascade' system. Those in the US generally have much more freedom to choose what insulin they want. This is why they are used more frequently there... Things seem to be changing here though, albeit slowly; and on feline diabetes forums more UK kitties are using the human insulins now than was the case just a few years ago...
...I think the RVC's research may have begun to influence change here. And the more that vets keep up to date with changes in the prescribing guidelines for insulin the more likely they are to prescribe longer lasting insulins. (The international ISFM guidelines recommend the use of longer lasting insulins for cats (Prozinc, lantus and levemir), and with no mention of the need for a bolus insulin to be used as well....) ...Incidentally, my own current (cat-only) vet favours lantus, saying that she considers Caninsulin to be - in her words (and somewhat shockingly) - "not fit for purpose"....

I should also say (for balance) that there certainly are cats on the forum for whom Caninsulin works just fine. And there are cats who have gone into remission on it too. It even has an advantage that the longer lasting insulins don't have in that it can be used with 'sliding scale' dosage in cats who suit that dosing method.

Eliz