Ernest switches to Lantus

Ja'

Ja'

Member Since 2020
@Deb & Wink @Panic @JanetNJ

Continued thread:
https://www.felinediabetes.com/FDMB/threads/continued-help-for-ernests-dosing.235234/#post-2650370

First thread:
https://www.felinediabetes.com/FDMB/threads/ernest-needs-dosing-help-please.234225/#post-2632649

Highlights from the new vet appt today:
* His #1 insulin choice is Lantus - he recommended to switch
- We agreed to switch - he said to start with 2 units twice daily
* He does believe in home testing but doesn't think we need to daily at this point
- We agreed to preshots for the next 2 weeks (don't worry, we'll check more than that LOL)
* He wants a modified curve in 2 weeks - no adjustments until then unless emerg
* He recommends Alpha-Track
- We told him we're going to stick with the Relion for now but we need to figure out the conversion
- Can you guys help with that?
* He took blood today for a comprehensive senior fel/HWC
- Results on Thursday
* He took urine for 2 tests. Urine profile (UA+C&S) and Cystocentesis
- Results in 2 weeks
* Ernest weighed 13.5 pounds - up 2.5 pounds from his 06.24.20 diagnosis date
* Exam was good except for a level 2 heart murmur and some arrhythmia
- He will prob recommend an echo/ultrasound after bloodwork results to check for something...?
* He said if Ernest doesn't eat, test his BG - if 300 or above, give it anyway
* He wants to hold off on testing for Acromegaly/IAA until we give Lantus a chance

So our brand new bottle of Prozinc we opened yesterday is worthless and so are the 900 U40 needles. :banghead:
Boy, sugar kitties sure are expensive! Won't be stocking up on any supplies from now on...
Picked up his Lantus pen at Walgreens and his U100 needles at Walmart and are all ready for his first shot of Lantus tonight!

Wish us luck!! Thank you for all of your guidance...it's much appreciated :bighug:
 
Welcome to Lantus. You will need to test more frequently the first few days. Some cats have a big response. The onset for most cats is +2. If it’s lower than the preshot it’s going to likely be an active cycle requiring more tests. If the same we won’t know until you get data. Leave some space between your prozinc tests and starting Lantus. Please read the stickies snd I suggest looking at the dosing methods to decide which you will follow. Ask as. Any questions as you need. One condo per day on the Lantus forum. Post using our format and keep the title updated so anyone around to help will see if you need it.
 
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Congrats on the switch, how exciting!!

My only thinking is if he DOES have IAA/Acro you'll have to switch again to Levemir ... more money wasted.

There's no conversion between the two meters, ReliOn just runs lower. I would just say you can't afford Alphatrak and are aware that his numbers are slightly higher than they appear.
 
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The C and S should not take two weeks. Heart murmurs can be benign or something else. Max had a benign one for years which an echo determined was not ever a concern. Later he had heart issues not related. The cardiologist was surprised to see me back. Cysto is the method of getting the urine and not a test. So likely a urinalysis and C&S were run. Tge urinalysis will come back in a day or two.
 
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Hello and welcome. My kitty had both secondary endocrine conditions mentioned in your previous thread, IAA (insulin auto antibodies, sort of like allergy to injected insulin) and acromegaly (a benign tumour on the pituitary gland that sends out excess growth hormone and causes the diabetes). Both of those conditions can mean cats need higher doses, though not all do. One in four diabetic cats has acromegaly according to a recent (2015) study. Once a cat gets to 6 units, one or other of those conditions is very likely, Cushings is another possible condition. Hallmark symptoms of acromegaly are polyphagia (starving for food, it's that excess growth hormone like teenage boys), and gaining weight in spite of being unregulated. Acromegaly can cause bony and soft tissue growth and most acros also have well developed muscles. Organ growth can also happen, there can be eventually issues with heart and kidneys. An echocardiogram, even to get a baseline, is an excellent idea.

I would push for the IAA/acromegaly tests - ask him to humour you. My vet thought we needed to get to 10 units, we never got that high but tested positive for both conditions.

My girl Neko also started on Caninsulin (rebranded as Vetsulin in the US to make is sound better), we got up to 5 units, and started Lantus back at 1 unit. Huge mistake! Took me 3 months to get back to where we should have been. So, starting dose on Lantus (should you go with that) is the same as the Prozinc dose. Prozinc should have been started at the Vetsulin dose too. And as Elizabeth stated, Levemir is a much better choice than Lantus at this point. Lantus has an acid base, that can sting at higher doses (and even some lower doses). Both you and your cat will be much happier with Levemir. We find higher dose cats do better on Lev too. The action and dosing are very similar between the two. Lantus and Levemir: What’s the Difference?

Oh, and skip the Alphatrak, stick to what you are using. There is no conversion and it's not needed. High numbers are usually higher on the AT, much closer at lower numbers. We use below 50 on the human meters as the point we feed high carb, 68 on the AT. Other than that, we use the numbers at face value.
 
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