? 29/11/2021 Whiskey - AMPS 232 starting Lantus (previously Caninsulin)

stannarp

stannarp

Member Since 2021
Good day all,

New to FMDB and to the Lantus board.

Whiskey was diagnosed on 19 Oct 2021, and they started her on Caninsulin, she is a rescue cat, and we assumed her extreme thinness was on account of malnourished from her previous home. Turns out she was dumped at a shelter because of issues relating to her diabetes. No history regarding whether she was previously diagnosed and / or treated for it.

She started on 1 unit of Caninsuilin, and because her numbers stayed high, they bumped her up to 2 units as her numbers are high, her numbers started coming down quite nicely, so after the setback below I started her on a much lower dose.

She is exclusively on a wet food diet (Petley's Pate) which is the closes I can get to Friskies Pate in South Africa.

Explanation for weird shot numbers and testing from 20 Nov 2021:
After having a vicious reaction to Revolution Flea and Worm treatment on about 20 Nov 2021 (I think her system has a big issue with it, as I think it is also what caused her to go rapidly downhill at roughly the same time last month). She was vomiting up everything and not eating or drinking, so I stopped dosing her, gave her some Cerenia and then started her again on 0.5 units when she started felling better. In the next few days we had to miss a few doses as her numbers were under 200. Increased to 0.75, but also had to miss doses as we ran out of testing strips and because previous numbers had been under 200 I didn't want to risk dosing without testing.

Recently I see her Caninsulin isn't working too well, I think it has expired; so I have asked for a Lantus script from the vet and am hoping to pick it up today and get it filled at the pharmacy who say they can break up a pen refill set for me. All being well I want to get her started with Lantus tomorrow morning so I can monitor her during the day (instead of overnight when a bad reaction might go unnoticed).

So my question is, he has mentioned starting her on 1 unit of Lantus, twice a day; and I wanted to check with the people who know more than I do whether this is a good starting dose for Lantus for a cat with her numbers?

Spreadsheet is here:

https://docs.google.com/spreadsheet...ouid=113782746861780116040&rtpof=true&sd=true

Regards,

Patricia
 
While I cannot speak to the dosing ad I'm just too new to all this myself. My boy was diagnosed same day as your fur baby.

I will say yes lantus is much more stable than caninsulin(vetsulin)...that's what we started on and it scared me to death! It seems many and probably most cats like to go lower overnight which requires monitoring overnight. I've had to stay up 2 nights in last 3/4 days now to check each hour and feed a bit to slow the drop. Once you find a good dose that they respond to it can be quite a rollercoaster;)

No fear intended here it's just the facts of how this works. Lantus is far superior in cats than vetsulin. Also on a side note regardless of overnights usually being more active. It's important to get spot checks at some of the overnight hours to see how they are responding overall...get the bigger picture :)

Past that welcome the group here is so awesome and I'd be a hot mess without them!
 
Thanks for that :-), meantime I've read the SLGS vs TR thread - at the moment my inclination is to start her on 0.5 of a unit and see how she goes for a week, seeing as she has been holding relatively steady on 0.5-0.75-1 unit of Caninsulin and proceed on the SLGS methodology from there and try for those pretty mostly green numbers for her.

I'm not averse to doing tests overnight, but would rather have a chance to monitor her in daylight, just in case for the first 12 hours on it. As I work from home, it is quite practical for me to do.
 
stannarp said:
Thanks for that :), meantime I've read the SLGS vs TR thread - at the moment my inclination is to start her on 0.5 of a unit and see how she goes for a week, seeing as she has been holding relatively steady on 0.5-0.75-1 unit of Caninsulin and proceed on the SLGS methodology from there and try for those pretty mostly green numbers for her.

I'm not averse to doing tests overnight, but would rather have a chance to monitor her in daylight, just in case for the first 12 hours on it. As I work from home, it is quite practical for me to do.
Click to expand...

If you havent read this: https://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/

It takes a little bit for depot to build with lantus. It also takes their bodies a while to adjust to insulin. As I'm constantly reminded ;) insulin is a hormone not a medication and body needs to learn how to use it properly over time.

Just be patient(I struggle with this LOL)...since you work from home going TR would be ideal which is more aggressive but also better shot at remission as well.

I also have a tendency to freak out when we get nights like last night. Although now that I've experienced it a few times last night I was much calmer.
 
Thanks for this, I read about the insulin depot earlier, and it was also a bit of a surprise to learn that it is a hormone and not a medication (but that makes sense in light of needing to keep it so well refrigerated)!

Yes, I've had a few long scary nights with her - especially before we figured out that she reacts so violently to Revolution - not sure what the hell we'll do next time she's due for flea treatment, but I guess it will be the same as our other boy who gets massive sores when you put any topical flea treatment on him ... we brew up a strong batch of chamomile tea and douse him with it weekly. Now I suppose I'll be unpopular with 2 cats and not just one ;-)

Re TR vs SLGS, at the moment I'm not even thinking of remission, just want to get her to a healthy life. With her history, we have no idea how long she was diabetic before we adopted her, she was apparently just dumped at the shelter and they were told 'here is your cat' by the woman who dumped her and left at the beginning of Aug 2021. She was extremely wasted, weighing in at under 3kg (she's about 4kg now), so I suspect she's had uncontrolled diabetes for quite some time.

That said I will consider trying TR and see how we go, but she is not terribly wild about having her ears pricked either, and she is a cat of strong opinions! Testing sometimes degenerates into a round of angry "Hissey" growling Whiskey and frustrated (occasionally weepy) person trying to test her with many many wasted test strips! Testing the paws is not an option, she absolutely hates that.
 
I totally understand and respect the decision to stick with slgs for now. The idea of just stabilizing the babies is a huge driving factor!

I started on slgs and was so nervous to do TR...

Just as a thought...i use freeze dried chicken as a treat for testing...1 small piece before and 1 after. I also will occasionally give 1 small treat at random so he doesnt associate treat with testing all the time. Inhave a female civvie (civilian non diabetic) and frankly i dont think she would tolerate testing quite like little man does haha. Might help might not. Just make sure it's something safe for her to eat. Regular cat treats are a BIG no no. But the freeze dried meats are just meat no additives.

You have time while depot is building anyway to decide on TR vs SLGS. It has to be something you and whiskey are good with either way:cat:

I get the weepy part for sure...my first few tests we were all a mess. He took to hiding from me most of the day way under bed so I couldnt reach him those first few days.
 
Hi Patricia! Welcome to FDMB and the Lantus forum.

Thank you for rescuing Whiskey! Lantus is indeed a much better insulin than caninsulin for cats.

When switching insulins, the starting dose is determined based on the dose of the prior insulin. 0.5U may be too less. I see she had good numbers at 2U on Caninsulin and the Lantus dose needs to be decided keeping that in mind. I am going to tag a couple of senior members for their inputs on dosing:

@tiffmaxee
@Wendy&Neko

Btw, has Whiskey been tested for ketones? How is her appetite these days? Any food changes recently? Is Petley's Pate low carb?

A small housekeeping note. Please set-up your Signature? It's basically a summary of the information we need about your cat to give you advice. The spreadsheet and signature are the things we look at when asked for advice. It saves us asking you the same questions again and again especially when the question is time critical like stalling or low numbers. It also saves you the effort of giving us the information every time you post!

Here's how you can set-up your Signature:
  • In the Menu, under your user name, click on Signature.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
  • There is a limit of two lines. You may separate info with commas, dashes, | etc.
  • Be sure to click the 'Save Changes' button at the bottom.
If you look at the Signature at the bottom of our posts, you will get an idea of what I am talking about. :)
 
Thanks for the idea of random treats not just at test time, she definitely associates treats with test time, and waits for the testing on the chair but then gets properly grumpy with me if it takes too long for the treat to happen, then the growling happens (and when Madam Whisk growls, the entire house know about it). Shout out to the person on the FB group who suggested catching the blood drop on a finger nail instead of trying to hold the test strip to the ear of a 'testy' cat!
 
Bandit's Mom said:
Hi Patricia! Welcome to FDMB and the Lantus forum.

Thank you for rescuing Whiskey! Lantus is indeed a much better insulin than caninsulin for cats.

When switching insulins, the starting dose is determined based on the dose of the prior insulin. 0.5U may be too less. I see she had good numbers at 2U on Caninsulin and the Lantus dose needs to be decided keeping that in mind. I am going to tag a couple of senior members for their inputs on dosing:

@tiffmaxee
@Wendy&Neko

Btw, has Whiskey been tested for ketones? How is her appetite these days? Any food changes recently? Is Petley's Pate low carb?

A small housekeeping note. Please set-up your Signature? It's basically a summary of the information we need about your cat to give you advice. The spreadsheet and signature are the things we look at when asked for advice. It saves us asking you the same questions again and again especially when the question is time critical like stalling or low numbers. It also saves you the effort of giving us the information every time you post!

Here's how you can set-up your Signature:
  • In the Menu, under your user name, click on Signature.
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
  • There is a limit of two lines. You may separate info with commas, dashes, | etc.
  • Be sure to click the 'Save Changes' button at the bottom.
If you look at the Signature at the bottom of our posts, you will get an idea of what I am talking about. :)
Click to expand...

Hi there, thanks for the dosing info, will wait on input from other members on dosing.

They tested her for ketones when she was first diagnosed and didn't find any issues (she was tested for absolutely EVERYTHING then).

Thanks for the housekeeping note, signature now all set up :)

Petley's is the closest equivalent of the Fancy Feast Pate that many others are using, and is low carb, it was recommended to me by other people on the FB forum who live in South Africa. Her numbers improved dramatically when I moved her to that from any form of dry food.

Her appetite is generally very good, with the exception of the scary Revolution episode, when it was non-existent; the two of them go through 1.5 cans of Petley's Pate in a day (about 600g food).
 
Rainbow Conti said:
Just dont overdo treats..even pure protein too much of a good thing.... well you know the saying haha
Click to expand...
LOL, indeed, our George managed to get into the treat tin one day while we were out, fortunately he couldn't get to too many as it all rolled under something too low for him. Now the treat tin requires opposable thumbs to open!
 
Welcome! When switching to lantus from caninsulin you start at the same dose or a little less. Since you were not seeing the kind of numbers you want to see, I would start with .75 or even 1.0.

Some cats get a strong response to the initial shots so I would switch when you can monitor closely for the first few days. I remember my vet actually had me leave Max for a curve after his first shot but he was just diagnosed and I wasn’t testing. It was the only curve he ever had at the vet as I tested enough at home. If you can’t monitor closely then start with .75.
 
tiffmaxee said:
Welcome! When switching to lantus from caninsulin you start at the same dose or a little less. Since you were not seeing the kind of numbers you want to see, I would start with .75 or even 1.0.

Some cats get a strong response to the initial shots so I would switch when you can monitor closely for the first few days. I remember my vet actually had me leave Max for a curve after his first shot but he was just diagnosed and I wasn’t testing. It was the only curve he ever had at the vet as I tested enough at home. If you can’t monitor closely then start with .75.
Click to expand...

Thanks so much, my syringes will measure 0.5 but 0.75 is a bit of guesswork. My vet is saying start her on 1 unit, so I think I will do that, and as my work is home based I can test regularly tomorrow, after I start her on the Lantus dose (last dose of Caninsulin tonight for her) if I don't manage a curve then will test at least three times during he day and will definitely observe her closely.
 
tiffmaxee said:
Perfect! They don’t make syringes with less than half unit markings and we increase and decrease by .25. You do have to eyeball it. I bought digital calipers so I could be exact and would have been lost without them as Max needed 1/8 increases and decreases at times. Here’s a video about them.

https://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/#post-862835
Click to expand...
Thanks for that, the calipers are a good idea - my father was an engineer, and I remember seeing those in his desk quite a while ago, will ask if my brother still has them, or if he disposed of them! When I was trying to do 0.75 unit of Caninsulin I eyeballed it, but was never 100% confident that I had it right.
 
You must log in or register to reply here.
Back
Top