5/13 Switching from Caninsulin to Lantus

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kimouette

kimouette

Member Since 2012
Hi everyone,

I am helping someone who will switch her cat to Lantus tomorrow. When you see her spreadsheet you'll understand why we want to switch! The poor cat has very high values at every preshot. We can barely get his nadirs under 300.
Please look at the comments we've add, they mention all the changes in the cats food.

The cat's name is Kabaret, he is 12 years old and has been diagnosed with diabetes on March 19th. Since he was eating dry kibbles we suspect the cat has black values ever since that day :(
Kabaret has been tested for ketones every day for the last 3 days. The results are negative.
He weights 16 pounds.
The owner is Sylvie. She lives in Paris and doesn't speak or understand English.

https://docs.google.com/spreadsheet/ccc ... cslist_api

As you will see, even at 3.5U his nadirs were high (including today while the cat was eating a mixture of Almo canned food and boiled chicken.
Three hours ago we started a low carb food (1.5%), but because of that we also decided to lower the dosage to 2.5U... But im sure the results are going to be as high as usual.

What would you recommend is a good starting dose of Lantus?
I know we have to let the cat build a depot, of course we do not want an hypo, but if the dosage could help the poor kitty spend couple of hours at least in the "yellow values" it would be appreciated!

Thanks all for your help!
Kim and Sylvie
 
Kim --

I don't think the numbers are as bad as you think. Those high pre-shots look to me to be due to the size of the drops. A drop from 516 to 263 by +3 is definitely going to cause a bounce. It's likely the ugly pre-shot numbers are reflecting bounces. This also doesn't surprise me with Caninsulin. If you suggested the switch to a longer acting insulin, it was a good suggestion.

If you base starting dose strictly on the weight-based formula, the starting dose would be between 1.75 and 2.0u. However, with a cat that's been on a different insulin, the dose on that insulin is taken into consideration. I certainly wouldn't suggest anything less than 2.0u. I'd be more inclined to suggest a ose of 2.5u. I'll be curious what others have to say.
 
I'd probably go with a 2-2.5u dose also, maybe leaning towards the 2.5u Lantus. Although the two insulins work slightly differently, if he needed a 5u dose before, you don't want to reduce so far that he sits in high numbers any longer than necessary. Of course, you've got the food carb reduction in the mix as well. It's always tricky when more than one variable is changing at the same time. One thought might be to give a full 24 hrs on the Caninsulin, after the dry food is all gone so the high carbs are out of his body, to see what that 2.5u dose is doing and that might help us know a little better about the Lantus dose.

Once she makes the switch, make sure she understands to hold the dose for 5 days unless she sees a number under 50. If the reduction in carbs means the dose is too high, we may be able to tell in those first few days as the depot is filling with Lantus. She's doing a good job of testing.

I'm completely rusty at speaking, but i did major in French in college so if she posted, i would be able to get the gist of it. Just let her know as a back-up plan if she needs help. Are you able to translate the Low Numbers sticky for her so if he does go low she will know what to do? or did the vet advise her on that?
 
The sheet is updated... https://docs.google.com/spreadsheet/ccc ... _web#gid=0

As you will see, we might not start Lantus tomorrow morning (it's the afternoon right now for us), cuz the cat doesnt like the 3 new low carb brands she bought! Bad kitty misses his carbs! He did eat a little this morning so I was not affraid to tell her to give the shot of 3U, but then the cat decided he would take a little bite and nothing else. He goes to his food, smells all three choices he has (like a little king!) and goes away. With Caninsulin I dont care, but since we were hoping to have him on a low carb food that he would be able to eat all day long (in small portions instead of bigger meals) when we start Lantus.. well we cant start now.

Oh by the way he stopped eating kibbles on May 9th.. but until yesterday was fed cheap canned food (no idea what the carbs are cuz they specify everything in "min and max").
Today is officially his first day on low carb the 3 choices he has are 1.5%, 2.8% and 3.3% carbs.

Since we will be holding the first dose of Lantus for 5 days (and I dont want him to be stocked in high values for such a big period of time), and looking at the new infos on his spreadsheet, you guys still agree that 2.5U of Lantus would be a good starting dose? I mean safe? but still enough?

Oh and by the way I have already translated the low number and protocol for Sylvie. She has printed both documents. I think she is ready (even though nervous cuz she is so used to these high numbers, getting closer to a hypo still scares her a little)... but not me! What scares me is that kitty having very high preshots and not a big fan of the food that could cure him :(
 
Sienne and Gabby said:
If you are able to contact the manufacturer of the food, you may be able to get the "as fed" values and calculate the carbs.

I don't know if you have this list of canned foods and carb%s that are available in Europe.
Click to expand...
Yes I do, since I'm the one who started that sticky :mrgreen:

That company is Almo. The values I have are not even stated as "min and max".. it is only my deduction since the nutriment's total is over 100%!
http://www.zooplus.co.uk/shop/cats/cann ... bel/264637
He was eating "Skip Jack Tuna Fillet ".. it contains 1% rice so I'm not convinced it is super low in carb
 
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