Switching from Prozinc to Lantus

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Lisa and Angel

Lisa and Angel

Member Since 2023
Hi all,

I'll be switching Angel over from Prozinc to Lantus. She's currently on 2U Prozinc, my vet is uncertain if we could go straight to 2U Lantus as not many people use Lantus for cats in my country. Can someone look over my spreadsheet and see if 2U Lantus is correct for her?

Some questions...

The pharmacy tech told me that I should refrigerate the unopened vials of Lantus, but that I should keep the one in use out at room temp. Is this correct or should it be refrigerated too?

I'm assuming I should still inject her in different spots with each shot right, even though it's a depot insulin?

I know it can take a few days to build up in her system. How often should I be testing her, especially during the first few days/weeks? I'll be following Lantus' SLGS.
 
It's fine to switch over at the same dose. If you're a bit nervous about switching, you can drop the dose a bit to either 1.5 or 1.75u. Sometimes cats can have a marked response to a change in insulin.

Regardless of the depot building up, please test at least 4 times per day. You want to always test at your pre-shot times. In addition, you want to get a minimum of one additional test during both the AM and PM cycles. Because some cats have a surprising response to a switch in insulin, it's better to test more than less.

Give a shot the same way you've been giving Angel her Prozinc. The location of the shot doesn't differ between Prozinc vs Lantus.

I always kept my opened and unopened Lantus in the refrigerator. If you're using the vials, they should be refrigerated. The pens were developed so they did not need to be refrigerated. However, cats use nowhere near the amount of insulin that a human requires. With my cat, a pen would last around 3 months. Keeping the pen refrigerated ensures the lifetime of the insulin.
 
Sienne and Gabby (GA) said:
It's fine to switch over at the same dose. If you're a bit nervous about switching, you can drop the dose a bit to either 1.5 or 1.75u. Sometimes cats can have a marked response to a change in insulin.

Regardless of the depot building up, please test at least 4 times per day. You want to always test at your pre-shot times. In addition, you want to get a minimum of one additional test during both the AM and PM cycles. Because some cats have a surprising response to a switch in insulin, it's better to test more than less.

Give a shot the same way you've been giving Angel her Prozinc. The location of the shot doesn't differ between Prozinc vs Lantus.

I always kept my opened and unopened Lantus in the refrigerator. If you're using the vials, they should be refrigerated. The pens were developed so they did not need to be refrigerated. However, cats use nowhere near the amount of insulin that a human requires. With my cat, a pen would last around 3 months. Keeping the pen refrigerated ensures the lifetime of the insulin.
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Thank you! I'll definitely test at least 4 times a day. What would be the best times to test in a Lantus day, in addition to the preshots? Is AM+6 and PM+2 okay like with Prozinc, or are other times better?

I've got the vials, I'l keep them in the fridge then. :cat:

I always give a little pat/rub on the shot location after I inject Prozinc. I thought I remembered reading that you shouldn't do this with Lantus because of the crystals, but I can't find it anywhere. So is that actually a thing or is it fine to rub the spot afterwards?
 
I never rubbed any spot using Lantus
Be sure you get the U-100 syringes with the half unit markings for lantus
Don't forget to add when you start Lantus on your signature and on your spreadsheet up too and you can draw a blank line above the date you start Lantus and just type Started Lantus and highlight it
Also can you please add to your signature
Netherlands so members know :cat:
I really think you need to add a new tab for 1-1-24 instead of adding it to your 2023 tab so you have enough room. Do you know how to do that @Lisa and Angel
Here is the link on how to do it
https://felinediabetes.com/FDMB/thr...ase-read-and-keep-bumped.284227/#post-3132495

If you have trouble just ask and a member can do it for you
 
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Good luck with the insulin switch. You might want to read the yellow starred Sticky Notes at the top of the Lantus forum, maybe start with this one:
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing

Humans keep their current in use Lantus vials out of the fridge, but they go through a vial a lot faster than a cat will. Shooting larger doses of cold insulin could be uncomfortable. I held the end of the syringe with the insulin in it between my fingers for a while, to take the edge off. Most of us use Lantus pens or cartridges, which are smaller containers of insulin, typically in a 5 pack per package.
 
Thank you both!

I've got the U-100 syringes with half-unit markings. :)

Updated the spreadsheet and signature since I started Lantus today. I sent Marje a PM yesterday about the 2024 tab since I'm using a World SS.

I've read the stickies. :) One thing I didn't see on there, does the Lantus vial/cartridge need to be protected from light? It comes in a box of 5, so if I put it back in there the other 4 not in use will get jostled twice a day when I grab the in-use one, which doesn't seem good for longevity. But I can prob make a little container or something for the one in use if it can't be left out (in the fridge of course).
 
Hi Lisa, what light are you talking about. I just kept the pens in the box and when I had to take the one I am using out and gave the insulin I just put it back in the box. I would just mark the one I was using with a magic marker so I knew I was grabbing the same one. The other 4 will be fine if they move a little when you take out the one you're using .Just be sure to keep the box on the middle shelf of the fridge
@Lisa and Angel
What a gorgeous kitty :cat:
 
The Lantus pens are mostly encased in plastic. There's a "window" so you can see how much insulin is left in the pen. Like you described, I kept Gabby's unopened pens in the box in a spot where it didn't get banged around. I kept the pen I was using in a spot on the refrigerator shelf. some members will put the pen in a container to keep it from being bounced around. I never had a problem with the longevity with keeping on the shelf. (The only time I ever had a problem was with a pharmacy tech who dropped the box of pens into a bag, went to put the paper bag into a plastic bag and bounced everything on the counter for 6 - 10 times with me screaming at him to stop. I ended up having to bring at least one pen back to the pharmacy.)

As for test times, to a degree this will depend on your cat. Ideally, testing mid-cycle to catch the nadir is what you would want to do. However, nadirs can and do change so it can be somewhat of a guessing game. From your spreadsheet, it looks like you were seeing this with Prozinc. The other consideration is that you don't yet know where Angel's nadir will be with Lantus. Some cats have early or late nadirs. My cat's nadir was generally at around +3 (except when it wasn't). I tested a lot especially during the early part of the cycle because Gabby was prone to rather dramatic drops in her numbers. Once the depot is more stable (i.e., 5 - 7 days), getting a couple of curves over the first few weeks will help you to get a sense of when Angel's nadir is. Testing at +2, especially in the PM cycle may tell you if numbers are dropping. Lantus onset is usually 2 hours after shot time but again, this can differ from cat-to-cat. A very popular saying here is "ECID -- Every Cat Is Different."
 
Diane Tyler's Mom said:
Hi Lisa, what light are you talking about. I just kept the pens in the box and when I had to take the one I am using out and gave the insulin I just put it back in the box. I would just mark the one I was using with a magic marker so I knew I was grabbing the same one. The other 4 will be fine if they move a little when you take out the one you're using .Just be sure to keep the box on the middle shelf of the fridge
@Lisa and Angel
What a gorgeous kitty :cat:
Click to expand...

Just the light from opening the fridge. The box is on the middle shelf yes! And thank you:bighug:
 
Sienne and Gabby (GA) said:
The Lantus pens are mostly encased in plastic. There's a "window" so you can see how much insulin is left in the pen. Like you described, I kept Gabby's unopened pens in the box in a spot where it didn't get banged around. I kept the pen I was using in a spot on the refrigerator shelf. some members will put the pen in a container to keep it from being bounced around. I never had a problem with the longevity with keeping on the shelf. (The only time I ever had a problem was with a pharmacy tech who dropped the box of pens into a bag, went to put the paper bag into a plastic bag and bounced everything on the counter for 6 - 10 times with me screaming at him to stop. I ended up having to bring at least one pen back to the pharmacy.)

As for test times, to a degree this will depend on your cat. Ideally, testing mid-cycle to catch the nadir is what you would want to do. However, nadirs can and do change so it can be somewhat of a guessing game. From your spreadsheet, it looks like you were seeing this with Prozinc. The other consideration is that you don't yet know where Angel's nadir will be with Lantus. Some cats have early or late nadirs. My cat's nadir was generally at around +3 (except when it wasn't). I tested a lot especially during the early part of the cycle because Gabby was prone to rather dramatic drops in her numbers. Once the depot is more stable (i.e., 5 - 7 days), getting a couple of curves over the first few weeks will help you to get a sense of when Angel's nadir is. Testing at +2, especially in the PM cycle may tell you if numbers are dropping. Lantus onset is usually 2 hours after shot time but again, this can differ from cat-to-cat. A very popular saying here is "ECID -- Every Cat Is Different."
Click to expand...



I'm using vials/cartridges that look like this:
csm_lantus7_aa_f4cdb8d771.jpg
the outside is mostly clear so I am unsure if it's a problem with light.

Thanks for the info on test times! I think I'll just test at random times during these next few days, and then do a curve next weekend.
 
In the US you can't get the cartridges. I'd just be careful since they are glass and breakage may be more the concern. Look on the packaging. If it's light sensitive it would say so. Or, you can call the pharmacy and ask.
 
I used cartridges by preference in Canada. Smaller and less plastic waste, plus cheaper. I had a small plastic cup that I kept the current in use cartridge in. Never had a problem with breakage. You can always store it in a little nest of bubble wrap if you want to stabilize it. I took cartridges, and cat, on long car rides (3 days each way), plane trip, and car+ferry rides, all inside a cooler with a gel pack inside. The bubble wrap or paper towel wrapped cartridge in a plastic container with lid kept it stable.
 
Basic's Mom said:
Angel is absolutely beautiful.

I will let someone else answer your dosing and testing questions. I'll tag others for you. @Suzanne & Darcy @Wendy&Neko @Marje and Gracie @Sienne and Gabby (GA)
@tiffmaxee @Christie & Maverick @Larry and Kitties
I keep all of my pens in the refrigerator. I do not leave any at room temperature. I have them on the middle shelf. I no longer keep them in the door, directed by the forum not to.
Click to expand...
Same here. I refrigerate everything and keep my Lantus on the middle shelf after reading that on this forum.
 
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