Lantus - Any Experience with Pain & Rotating Injection Sites?

Baylee & Jack

Baylee & Jack

Member Since 2023
To preface, I'm sorry, I'm new to these forums.

Hello, my name is Baylee and my cat, Jack, is a 5 1/2 years old, sweet maine coon. To put this very quickly, he recently got diagnosed as diabetic (within the past month) and has been taking Lantus. For the first two weeks, he was okay with the Lantus injections, pulling his ears back a bit as I clicked the pen (NOT when the needle pierced his skin: after that, when I actually physically push on the pen top and it clicks, injecting the medication itself, to be very specific), and he was also on a lower dose (approx 1-3 units 2x/d during that time). Now (at 3-4 units 2x/d), he gives out a small pained cry when I click the pen. I was discussing it with someone today who suggested the insulin may be burning to him. I spoke to his vet today and they said that it might be the wrong sized needle or that he's afraid of the clicks, but I'm not entirely convinced.

HOWEVER, I picked up lidocaine today (as per vet instruction to try) and when I applied it to him, he gave out his pained meow, but not when I actually clicked the pen this time, so I'm not sure what to think.

Has anyone else had this experience with Lantus or any of the other injections? Have you had success with switching medications? I really want the Lantus to work, because the vet told me that it has the highest chance of remission that she's seen in cats (don't quote me on that please), but I'm very afraid it may be burning him due to the acidity of the insulin, as it would for a human. I'm also afraid it could get worse for him.

Also, does anyone know if I should be rotating injection sites normally? I will follow up on the vet about this, I just figured I would ask. I've been giving it to him in the scruff of his neck as directed by my vet but I'm afraid of scar tissue buildup for him. I didn't see any information on this when I was scouring the forums, but I was more concerned with finding something regarding my main topic first. I learned today (thanks to you guys!) that I should be putting him on wet food (Purina DM) so I'm going to speak to the vet about that right away. She was originally unconcerned with changing him from his dry food (Hills i/d), but after reading more, I'm more than certain it can do nothing but help him in the long run to get him off of his current food and onto a diabetes-specific food.

Thank you guys for this valuable resource and have a wonderful day :)
 
Welcome to FDMB.

I'm going to respond to your questions but we also ask new members to get started on the Health forum. If you're going to stick around and take full advantage of the resources here, there are some basics that you'll find helpful and we do much of that orientation on Health.

First, we advise against using the Lantus pen. It only dispenses insulin in 1.0u amounts which makes it dangerous when you need to increase the dose. With a large increase, you can easily fly past what would otherwise be an effective dose for your cat to say nothing of plunging your cat into hypoglycemic numbers. . We recommend using a syringe so you can better calibrate the dose. We typically change doses in 0.25u amounts. In addition, you have to prime the pen every time you give a shot resulting in wasting a good deal of insulin. You would want to purchase U-100 3/10cc syringes with half unit markings since these are the best to use for drawing Lantus, Levemir, or the Biosimilars from vials, cartridges, and pens. You may need a prescription to buy syringes. We also recommend home testing your cat's blood glucose. You can get more information about home testing on the Health forum.

With low doses of Lantus, it would be unusual (but not impossible) for a cat to react to the acidity of the insulin. It's more typically an issue if a cat is on a large dose (e.g., over 6u). Most of the high dose cats here switch to Levemir which works in a very similar way to Lantus. The other option would be Prozinc. Your vet is correct. Lantus has an enviable track record for getting cats into remission but you have other good options.

It's fine to rotate injection sites. However, I managed my cat's diabetes for 6.5 years and her shots were consistently in the scruff. I never had a problem.

With respect to food, Purina DM is fine. However, the ingredients are suboptimal for what you're paying for the food. You can buy a much higher quality, low carbohydrate food for what you're paying for the prescription food. You want to use canned foods that are less than 10% carbohydrate -- and most members here feed their cats in the 5% range. Fancy Feast and Friskies pates are much less expensive and are low in carbs. Other brands such as Tiki Cat, Weruva, ZiwiPeak, etc. are higher in price and are great quality. This is a link to a food chart that lists the carb content of most available canned foods.
 
Using syringes with a pen, cartridge, or vial:
  • U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Levemir, or the Biosimilars from vials, cartridges, and pens.
  • BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
  • Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
  • Full and half-unit syringe scales:
49823063143_3437e9e997_o.jpg


You just insert the syringe into the gray rubber stopper that's on the pen and draw out the insulin
 
Thank you two for the prompt replies and the warm welcome! I was checking out the health forum a little bit last night, but I'm definitely going to look more. I want to do as much research as possible to make sure I'm doing everything I can for this cat. I wouldn't know where to continue with this journey otherwise without these forums. You guys are awesome.

In reply to Sienne and Gabby,
I didn't know that about the solo pen; I just bought another, too. I'll see if the vet has any in a vial that I can swap the solo pen for, and if nothing else, order the vials. Finding a sweet spot with the dosage sounds a lot better for him in the long run using that method, and testing his glucose a bit more regularly. It'll take a bit to save up for everything, though, because I'm in a rough spot financially right now--was not expecting this diagnosis.

That's interesting about the Lantus really only doing that at high dosages, but I wonder (spitballing here) if he has ketones right now and that's affecting his insulin because they're both acidic in his blood, but I'm clearly not a vet so I have no idea. I'm definitely going to try to keep him on the Lantus as long as I can, but if it starts making him more uncomfortable, I'm going to have to make that switch to Levemir.

Thank you for the food recommendations--that's a lot easier on my budget. Thank you for the direct links as well to those forum sites in your post, including for the food. I'm going to check them out and try and decide on something. He's having stomach problems, though, which the vet thinks could be because of the diabetes. Do you have any recommendations on making his food swap a little easier? We tried doing a transition a little while ago to Hills w/d when he was first diagnosed (I know, dry food again; not making that mistake again) and it really upset his stomach. Wouldn't eat for a few days. That sort of thing makes me concerned because he needs food, especially with the medication.

Thank you so much for your help!

In reply to Dianne,
Thank you for those links to the syringes--that makes it a lot easier on me to bring it up to the vet for a rx! The diagram is also super helpful, as are your instructions. Thank you.
 
Baylee & Jack said:
I didn't know that about the solo pen; I just bought another, too. I'll see if the vet has any in a vial that I can swap the solo pen for, and if nothing else, order the vials. F
Click to expand...
Hi Baylee there is no need to ask your vet for the vials or order them
Just use the pen and order the syringes
You mentioned you are in a rough spot financially at the moment
The next time you need to order another lantus pen you can get the generic form of lantus instead ,it's much more affordable. I'll give you a link rather than write the whole thing out for you to read about it .I would stay with the pens instead of the vials
Many members use the generic

https://felinediabetes.com/FDMB/threads/looking-for-spreadsheet-insight.273978/#post-3043828
Read post #4 , the numbers are to the right of each post :cat:
@Baylee & Jack

Edit about the U-100 syringes with half unit markings a lot of members like the sure comfort ones
https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct

Here is a coupon for them
DIA10
adw-coupon-dia10.jpg


You can just call them and tell them what you want and they will contact your vet and have her fax over the script , ask your vet for refills also so then you can just call in and get them
They are very nice people to deal with
 
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We recommend using a syringe and drawing the insulin out of the pen. The pen has a rubber stopper at the tip. It's the same as you would use if you were drawing insulin out of a vial. You also have options with regard to Lantus. The brand name Lantus is very pricey. However it's now available as a generic/biosimilar (it's called Semglee) at a fraction of the price. You may need to call around to a few pharmacies to see whether they stock it. Alternatively, many people here purchase their insulin from Canada. Mark's Marine Pharmacy in Vancouver sells Lantus at about 1/3 of the price is costs in the US.

I'd also take a look at our Supply Closet. Members will often have items to sell or give away. FWIW, if you talk to a pharmacist at whatever place you go to buy items, ask if they have any free glucometers. Often, the manufacturers will give away the meters since it's the strips that become the basic cost. If there are no specials, the Walmart brand, Relion glucometer is inexpensive as are the strips. If money is an issue, do NOT buy a pet specific meter. The cost for the strips is outrageous ($1.00 per strip) vs the Walmart strips which are the cheapest around.

I would dearly hope that your cat does not have ketones. They can be life threatening. Jack would be very lethargic and if the ketones were at a high level, his breath would smell like acetone/nail polish remover. If you are concerned about ketones, you can get Ketostix at any pharmacy. The strip is dipped in your cat's urine stream and you compare the strip to the color guide on the container.

Typically, the major effect that diabetes has on food is that your cat is ravenous. It's not a cause for an upset stomach. On the other hand, a rapid transition to a new food can cause a GI upset. It's best to make a slow transition. This is a post on transitioning a cat from dry to canned food. If Jack is already eating canned food and you're switching brands, just do so gradually - maybe a teaspoon or two at a time.
 
Hello and welcome. As Sienne suggested, the Feline Health forum would be a better place to start. This forum is a little more advanced and we expect people to have a spreadsheet up and running with test values in it before posting here. That way we can help you better. A post with more details:
New? How You Can Help Us Help You!

Having said that, I am one of those people whose cat responded negatively to the Lantus sting. She did get to higher doses at times, but even on the lower doses it was bothering her. Switching to Levemir helped. Levemir is another long acting insulin with similar action to Lantus.

I would first suggest switching to syringes to draw the insulin from the pen, as we have had reports of pen needles hurting the cat. I'd recommend reading all the starred Sticky Notes at the top of the forum, especially this one with regards to syringes, how to draw and brands:
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing
 
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