Advice on trying a different insulin
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MommaOfMuse
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I can only tell you my exeprience with Musette...she did lousy on Lantus her numbers were all over the place and no amount of chasing up and down the dosing scale made a difference with her. I switched her to Levemir and her curves have smoothed out and she is a happier and less tense kitty on the Lev. I'm still working on finding her perfect dose but it has been definitely easier to figure out if we need to go up or down since she has been on Levemir as well as the plus in her personality change as I no longer need a blood transfusion or reconstructive surgery after trying to test and give her shots.. 
No experience with PZI/Prozinc so hopefully someone with that experience will jump in.
Mel, Maxwell, Musette & The Fur Gang
No experience with PZI/Prozinc so hopefully someone with that experience will jump in.
Mel, Maxwell, Musette & The Fur Gang
Jennifer and Spot (GA)
Member
Where's Carl?
Lisa and Witn (GA)
Very Active Member
Can you answer some questions that can help us advise you?
1) Do you hometest? You said the numbers are all over the place, but are these your readings or at your vets? If you hometest, can you post a chart of your readings?
2) What is your dose? Is it consistent for every shot? When was the last time you changed the dose?
3) What are you feeding your cat? Is it all canned or raw? Do you feed any dry food?
All of these things can affect the BG readings. By answering these questions, this will help us help you.
1) Do you hometest? You said the numbers are all over the place, but are these your readings or at your vets? If you hometest, can you post a chart of your readings?
2) What is your dose? Is it consistent for every shot? When was the last time you changed the dose?
3) What are you feeding your cat? Is it all canned or raw? Do you feed any dry food?
All of these things can affect the BG readings. By answering these questions, this will help us help you.
I do hometest and have done curves on the weekends. She gets her injections every 12 hours. Started at 1 unit of Lantus, 2X day on 3/1/12 and am now up to 6 units. I have gone up 1/2 unit every few days or week as the reading have continued to be high. The insulin does usually seem to work by lowering the BG levels on most days (lowest readings are usually about 5 -7 hours after Lantus, although there have been some days lately when the BG levels have stayed in the 300's all day.
Today, was 392 at time of 1st shot, 117 at + 9 hours, and 357 in the evening at + 2 hours.
Saturday ranged from 315 to 376 all day.
She is not overweight (never has been) and was previously on Friskies pate. Now, she is on 2 cans of Fancy Feast a day.
I am not so much concerned about the reading, but more so about the fact that her behavior seems to be getting worse. She is so ravenous, still drinking and peeing soo much, and has become verrryyy irritable. Not the sweet kittie I have know for years.
I can certainly post the numbers.
Ilene
Today, was 392 at time of 1st shot, 117 at + 9 hours, and 357 in the evening at + 2 hours.
Saturday ranged from 315 to 376 all day.
She is not overweight (never has been) and was previously on Friskies pate. Now, she is on 2 cans of Fancy Feast a day.
I am not so much concerned about the reading, but more so about the fact that her behavior seems to be getting worse. She is so ravenous, still drinking and peeing soo much, and has become verrryyy irritable. Not the sweet kittie I have know for years.
I can certainly post the numbers.
Ilene
C
Carl & Polly & Bob (GA)
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Hi Ilene
how much does Maria weigh?
Carl
how much does Maria weigh?
Carl
I am not quite sure why you want to switch to a different insulin... is it due to the range from shot BG to nadir? Lantus is a good insulin and seems to be working, but I think you may see better reaction and smoother numbers from Levemir.
Both of my cats were on Lantus, and I switched to Levemir due to their higher doses and also having acromegaly. One of my cats, Shadoe, reacted visibly better on Levemir. She was less tense and had a much smoother type of curve with none of the 300 - 100 type ranges. Oliver, on the other hand, acted no differently when switched to Levemir.... he was just fine on both of them.
There are differences between Lantus and Levemir, and more cats are switching over to Levemir and having improvements in their BG numbers. I would tell your vet you want to switch over to Levemir, not PZI which is not as long lasting as Lantus and Levemir. Another change you may see on Levemir is a later nadir; instead of in the 5-7 hr, you may see more around 6-8 hr for the nadir/low point.
I don't think weight has anything to do with the issue at hand.
Both of my cats were on Lantus, and I switched to Levemir due to their higher doses and also having acromegaly. One of my cats, Shadoe, reacted visibly better on Levemir. She was less tense and had a much smoother type of curve with none of the 300 - 100 type ranges. Oliver, on the other hand, acted no differently when switched to Levemir.... he was just fine on both of them.
There are differences between Lantus and Levemir, and more cats are switching over to Levemir and having improvements in their BG numbers. I would tell your vet you want to switch over to Levemir, not PZI which is not as long lasting as Lantus and Levemir. Another change you may see on Levemir is a later nadir; instead of in the 5-7 hr, you may see more around 6-8 hr for the nadir/low point.
I don't think weight has anything to do with the issue at hand.
C
Carl & Polly & Bob (GA)
Guest
Thank you Ilene,
Now I can explain why I asked the question, which contrary to what Gayle might think, I think it is important to the discussion.
You said that she gets 2 cans of FF a day, and I was trying to figure out if that was enough food for her weight. That is roughly 180 calories, which is appropriate for a 9 pound cat or smaller provided she isn't very active, and isn't diabetic. Given that she is diabetic, and that you said that she is so ravenous, it is likely that she needs at least another half can a day to hold her over.
Also, you said that she is getting 6u twice a day? Another reason I asked the weight question. At 12 units a day, she falls into this description from Cornell University's Feline Health Center:
So it could be possible that she is insulin resistant, or may have a "high dose" condition that needs to be checked on.
So that is why I asked about her weight, and why I believe is does have something to do with the "issue at hand".
Carl
Now I can explain why I asked the question, which contrary to what Gayle might think, I think it is important to the discussion.
You said that she gets 2 cans of FF a day, and I was trying to figure out if that was enough food for her weight. That is roughly 180 calories, which is appropriate for a 9 pound cat or smaller provided she isn't very active, and isn't diabetic. Given that she is diabetic, and that you said that she is so ravenous, it is likely that she needs at least another half can a day to hold her over.
Also, you said that she is getting 6u twice a day? Another reason I asked the weight question. At 12 units a day, she falls into this description from Cornell University's Feline Health Center:
So it could be possible that she is insulin resistant, or may have a "high dose" condition that needs to be checked on.
So that is why I asked about her weight, and why I believe is does have something to do with the "issue at hand".
Carl
C
Carl & Polly & Bob (GA)
Guest
Ilene,
Did your vet explain why he wanted to switch to Prozinc? Is he more familiar with it than with Lantus? Has he had other cats that have done better when switched to Prozinc?
Prozinc is very different from Lantus or Levemir. It isn't a "depot" type insulin, and it usually lasts 10-14 hours, although occasionally you can get overlap like with the "L" insulins.
We all have our preferences, and naturally we like what worked for our cat(s). I didn't use any of the above. I used PZI, which is not the same as Prozinc.
There is no "best" insulin. The "best" insulin is the one that works best for YOUR cat. The problem is, there is no way to know for sure which insulin that is up front.
Carl
Did your vet explain why he wanted to switch to Prozinc? Is he more familiar with it than with Lantus? Has he had other cats that have done better when switched to Prozinc?
Prozinc is very different from Lantus or Levemir. It isn't a "depot" type insulin, and it usually lasts 10-14 hours, although occasionally you can get overlap like with the "L" insulins.
We all have our preferences, and naturally we like what worked for our cat(s). I didn't use any of the above. I used PZI, which is not the same as Prozinc.
There is no "best" insulin. The "best" insulin is the one that works best for YOUR cat. The problem is, there is no way to know for sure which insulin that is up front.
Carl
Carl:
I took her to the vet on Monday and he is doing some blood and urine culture to figure out if there is another underlying problem. So far, the blood came back as pretty good....the white blood cell count was a little high, but the vet said not high enough to suggest an infection. Other blood numbers indicated no problems with kidneys, etc.
I am still waiting on the urine culture.
The vet and I are wondering if she is insulin resistant.
I don't think it is a problem with the adminstration of the insulin....I've got that down very well.
Ilene
I took her to the vet on Monday and he is doing some blood and urine culture to figure out if there is another underlying problem. So far, the blood came back as pretty good....the white blood cell count was a little high, but the vet said not high enough to suggest an infection. Other blood numbers indicated no problems with kidneys, etc.
I am still waiting on the urine culture.
The vet and I are wondering if she is insulin resistant.
I don't think it is a problem with the adminstration of the insulin....I've got that down very well.
Ilene
Carl:
Regarding the food, I will try giving her extra....in fact, I gave her an extra can of FF tonight because I figured she might need it. I just thought about that. I did not think to give her more food before (even though she is ravenous) because I thought she would gain weight on it.
Ilene
Regarding the food, I will try giving her extra....in fact, I gave her an extra can of FF tonight because I figured she might need it. I just thought about that. I did not think to give her more food before (even though she is ravenous) because I thought she would gain weight on it.
Ilene
C
Carl & Polly & Bob (GA)
Guest
You can keep a close eye on her weight, but usually a diabetic kitty will require more food than "normal". Until her numbers are a little more regulated, she most likely won't add weight from an extra 50-80 calories a day. You can also space that food out if your schedule permits, like feed her a little bit in between shots. Just not in the couple of hours leading up to the next shot.
Carl
Carl
coconut8 said:
If she does be found to be insulin resistant, then for sure you don't want to find yourself on Prozinc or PZI. You will need a longer lasting insulin WITH the shed/depot for the needed overlap. If you have that concern in the back of your mind, and you have the choppy numbers as on your ss, then she may well be similar to my Shadoe who was positive for acromegaly and had the same issues with Lantus but NOT with Levemir.
Levemir is a much gentler insulin, and you will see much flatter curves than you are currently seeing on Lantus.
Melanie and Smokey
Very Active Member
It sounds like your vet is on the right track looking for something that might work better for Maria. Lantus is a good insulin, but sometimes some kitties just don't do well on it. Lev isn't on every vet's radar yet so your vet may be recommending the next best thing in his arsenal. You could tell him you like to look at Detemir (drug name of Levemir) instead and find out what he knows about it.
coconut8 said:
Many people use an auto feeder so they can spread out their cat's daily food over several feedings as smaller frequent feedings help to level out the BG numbers.
Also, until you have the cat's numbers regulated, they often eat more because their body's are not able to extract the nutrients from the food needed. My two cats were eating close to 24oz and 30oz but dropped way down to 8 to 12oz a day when they got to their good dose and decent BG numbers.
It will not do any harm to feed more until you have her numbers more settled, but split it into maybe 6 feedings.... put small mini meals between her normal feedings.
Lisa and Witn (GA)
Very Active Member
6 units is a very high dose unless there are other medical conditions going on. Most diabetic cats only need between 1 - 2 units twice a day. You may be dealing with Somogyi rebound. What this means is that in order to protect itself from becoming hypoglycemic when too much insulin is given, the body produces extra glucose and that is why you have high readings. However, eventually though your cat will become hypoglycemic.
My suggestion is before switching insulins, try starting over first. Go back to 1 unit twice a day and keep it at that dose for at least one week. When your cat was first diagnosed, you probably were going through a lot of changes - diet, learning to hometest, giving insulin, etc. It is very possible that with all of the changes and increasing the dose so frequently, that you missed the optimal dose. By starting over with 1 unit, you can slowly increase the dose again over a period of weeks to find the dose that works best.
My suggestion is before switching insulins, try starting over first. Go back to 1 unit twice a day and keep it at that dose for at least one week. When your cat was first diagnosed, you probably were going through a lot of changes - diet, learning to hometest, giving insulin, etc. It is very possible that with all of the changes and increasing the dose so frequently, that you missed the optimal dose. By starting over with 1 unit, you can slowly increase the dose again over a period of weeks to find the dose that works best.
hmjohnston
Very Active Member
Sneakers was on ProZinc for about two months and while it was working somewhat (constant roller coaster ride from Hades) she was starting to need a LOT of it. I switched her to Levemir and she is doing so much better now with softer curves and is starting to be a little like her old self.
I will also tell you that if you 'reboot' her dose- check for ketones if you are not already doing it. They showed up in Sneakers, always trace to small because I did a reboot from 3u bd to 1u- mainly because I felt the vet didn't really do a curve to start and was feeding her dry cat food at the same time even though I sent in canned :evil: .
Your kitty will be HUNGRY until the insulin has had a chance to work and her bod is finally getting the nutrients it needs out of food and will slowly (or not) start to decrease intake. Sneakers was eating 12-15oz per day at diagnosis. She slowly lowered it herself to 10-12 over the course of 2 months and then dropped to 6-8 one morning from breakfast to supper- scared the bageebees out of me for the DKA factor.
And don't let her have dry as Sneakers sneaked some from a neighbors house when she got to feeling better and we have had to start the WHOLE process over again- and she was eating MORE than the first time around :shock: . She has only just now started to come down off of that one.
Well, that is my experience. PZI is great, but doesn't stay. Levemir is a whole lot better .
I will also tell you that if you 'reboot' her dose- check for ketones if you are not already doing it. They showed up in Sneakers, always trace to small because I did a reboot from 3u bd to 1u- mainly because I felt the vet didn't really do a curve to start and was feeding her dry cat food at the same time even though I sent in canned :evil: .
Your kitty will be HUNGRY until the insulin has had a chance to work and her bod is finally getting the nutrients it needs out of food and will slowly (or not) start to decrease intake. Sneakers was eating 12-15oz per day at diagnosis. She slowly lowered it herself to 10-12 over the course of 2 months and then dropped to 6-8 one morning from breakfast to supper- scared the bageebees out of me for the DKA factor.
And don't let her have dry as Sneakers sneaked some from a neighbors house when she got to feeling better and we have had to start the WHOLE process over again- and she was eating MORE than the first time around :shock: . She has only just now started to come down off of that one.
Well, that is my experience. PZI is great, but doesn't stay. Levemir is a whole lot better
.Well, the urine culture came back as Maria having a urinary tract infection, so this may be affecting her insulin results.
So, she is going to be on an antibiotic to take for a month, and the vet said that if it is the infection affecting the effectiveness of the insulin, it will become apparent in a week or two.
If the infection has nothing to do with it, I think I will try the Levemir.
Hope its the UTI though......
Thanks to everyone for their help!
Ilene
So, she is going to be on an antibiotic to take for a month, and the vet said that if it is the infection affecting the effectiveness of the insulin, it will become apparent in a week or two.
If the infection has nothing to do with it, I think I will try the Levemir.
Hope its the UTI though......
Thanks to everyone for their help!
Ilene
C
Carl & Polly & Bob (GA)
Guest
Good that they found something! Infections, can cause higher BG (so can the pain from the infection). Once the anitbiotic starts to work, her BG may drop, in which case you want to keep an eye on her numbers. It can mean her dose needs to be lowered. Also, keep an eye on her appetite (in case the AB makes her feel like not eating), and on her LB "deposits" because some ABs can cause diarrhea. If she does, then you want to make sure she's getting plenty of water, either straight up or mixed in with her food, so she doesn't become dehydrated. It's all tied together...
Carl
Carl
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