Allergic to Lantus?

[Justgin]

My kitty Oreo has been on Lantus since May, and near as I can tell he's been having these itchy scabs appear on his back. He's still on 4 units twice a day. Just had his latest curve testing yesterday. All his numbers were in the low 100's.

I asked the vet if it was possible the Lantus was causing the reaction. He said it was rare, which means it's possible.

I asked him if he would consider changing to Levemir to see if that made any difference and he said no. He's not familiar with cats on Levemir. I'm thinking of going to a new vet. What are your thoughts about what I should do?

 

[Justgin]

I forgot to mention this. The vet also ordered PREDNISOLONE for the next 12 days to see if it helps the scabs on his back. Also, he's gained a few ounces since June and continues to be ravenous for food. I've also eliminated salmon which I had started back in April to see if he reacted to that. No difference.

I've also told the vet that I've been feeding them fancy feast chicken, beef, turkey, ocean whitefish and tuna for years without the scabs reappearing. He still insists that Oreo is alleric to one of these proteins. This vet is not listening to me.

 

[FurBabiesMama]

I'm thinking of going to a new vet. What are your thoughts about what I should do?

This vet is not listening to me.

I say fire him. and move on. Or, at least see someone else to get a second opinion if you have serious enough doubts or concerns about the current vet. Maybe even call a few vets in your area with a few questions you have prepared to help you screen them before you even take the time to try them out.

 

[vbc2000]

My Tigger developed food allergies out of the blue several years ago. It presented the same way with the scabs all over his back. My vet put him on prednisolone and switched him to Hills z/d. I believe both contributed to his developing diabetes. We have cut back to 2.5 mg prednisolone every other day and he's on Fancy Feast classic and the scabs have not reappeared. I don't know what to think. I do think he was on that awful food too long and the long-term pred. use caused his diabetes.

Also, when he was on his regular dose, 5mg every other day, we could not regulate him. We even went up to 5 units of Vetsulin twice a day. We cut back the pred. dose, changed foods and blamo! Regulated on 1.25 units twice per day. It really was amazing. I would not expect his numbers to be good while on prednisolone, so don't drive yourself crazy about it.

Get those allergies cleared up and switch foods. There are several limited ingredient foods on the market that use novel protein and carb sources. Check out the food chart at the top of this section. They are not all ideal because of carb count. The ones that come to mind are Natural Balance and Instinct. The fewer ingredients the better. Also explore the grain free foods. They have other sources of carbs like peas and potatoes but it's possible he's allergic to the grains. We never found out exactly what his allergy was to, and I'm astounded that they haven't returned on the Fancy Feast, but I'm so glad!
Good luck.

 

[Maggies Mom Debby]

Cats can get many kinds of allergies. I think food is one of the most common, especially beef and fish, but other things like grass can cause an allergic reaction. I even had a cat who broke out when she sat in the sun. So think of what Oreo is in contact with. Does he roll in the grass outside? Is there a new cat bed? Maybe you started using a new cleaner? A new litter? Fleas or flea meds? If all of this is "no", trying a novel protein food is an easy way to check on the food allergy possibility, though is may take up a while to see results. ( I found this site about cat allergies: http://www.pethealthnetwork.com/cat...thering-your-cat-it-could-be-feline-allergies).

It's been years since my extra-sweet Maggie was around, but she was on Levemir. It is long lasting like Lantus and it worked great for her. I don't think one is necessarily better than the other, except maybe for high-dose cats. Because of the way it works with the body, Lantus can sting at high doses, while Lev doesn't. If you or your vet wants some info about both insulins, check http://petdiabetes.wikia.com/wiki/Main_Page. Though most of this info has not been updated, there is a lot of information about insulin on the wiki, including technical info about Lantus and Lev and how they work.

 

[Meya14]

I think it's probably more likely that your cat is experiencing a localized reaction to the difference in pH of lantus rather than a true allergy. If this is the case, then the pred won't really help. Lantus is acidic which is part of the mechanism of it's slow release. When injected, this can sting under the skin, sometimes for hours. This may cause an inflammatory response leading to the scabbing you see, or it may cause your cat to scratch/groom areas excessively leading to the areas.

Levemir is not acidic and does not have these same side effects. It is a good option for cats who are sensitive to the lantus, works very similarly. Levemir does seem to have a longer duration than lantus, so there are a few differences in monitoring and dose adjustments (ie, I typically shoot on lower numbers than if my cat was on lantus). My cat and others on this board have done well on levemir.

 

[Marlena]

I think it's probably more likely that your cat is experiencing a localized reaction to the difference in pH of lantus rather than a true allergy. If this is the case, then the pred won't really help. Lantus is acidic which is part of the mechanism of it's slow release. When injected, this can sting under the skin, sometimes for hours. This may cause an inflammatory response leading to the scabbing you see, or it may cause your cat to scratch/groom areas excessively leading to the areas.

Levemir is not acidic and does not have these same side effects. It is a good option for cats who are sensitive to the lantus, works very similarly. Levemir does seem to have a longer duration than lantus, so there are a few differences in monitoring and dose adjustments (ie, I typically shoot on lower numbers than if my cat was on lantus). My cat and others on this board have done well on levemir.

Brilliant advice!

 

[Maggies Mom Debby]

Is the scabbing localized to where you inject the insulin? That would indicate a reaction, like Meya14 said. If you do switch, you'll have to start again with 1 unit twice a day. Ask for advice when the time comes.

 

[Olive & Paula]

I can not comment on the 2 insulins. However, there seems to be quite a bit of fish in his diet. Don't forget the Ff, beef, turkey probably have some fish in it also. Maybe try eliminating the tuna or whitefish for awhile, one at a time and see what happens. Even though Oreo had no problem in the past, he could now. In some kitties chicken and beef are a problem. It's trial and error.

 

[Justgin]

I think it's probably more likely that your cat is experiencing a localized reaction to the difference in pH of lantus rather than a true allergy. If this is the case, then the pred won't really help. Lantus is acidic which is part of the mechanism of it's slow release. When injected, this can sting under the skin, sometimes for hours. This may cause an inflammatory response leading to the scabbing you see, or it may cause your cat to scratch/groom areas excessively leading to the areas.

Levemir is not acidic and does not have these same side effects. It is a good option for cats who are sensitive to the lantus, works very similarly. Levemir does seem to have a longer duration than lantus, so there are a few differences in monitoring and dose adjustments (ie, I typically shoot on lower numbers than if my cat was on lantus). My cat and others on this board have done well on levemir.

I think this is why the vet wants me to give Pred first and report back to him after 10 days. I haven't started it yet.

The first 2 scabs appeared near the injection site. One actually WAS the injection site and took the longest time to heal but it did heal, but by that time he started getting more scabs down his back. This vet is scared of Levemir because Oreo's dose will be 0.9 u to start and he thinks this will be hard to manage. I am a nurse so I am more aware than the average person how exact insulin dosing must be. Thank you for the info on Levemir. I wish this vet had experience with it. But he told me how one of his patients, a dog, recently had to go to ER because a pet-sitter overdosed him. So he's being extra cautious across the board. <sigh>

 

[Justgin]

I say fire him. and move on. Or, at least see someone else to get a second opinion if you have serious enough doubts or concerns about the current vet. Maybe even call a few vets in your area with a few questions you have prepared to help you screen them before you even take the time to try them out.

It's really hard getting him into a carrier. For one, he's 18 pounds. For another he's feral. He really scratched me good one time. Also I'm almost out of Lantus and I really would rather try Levemir than pay for another bottle of insulin that makes him break out. But I've had a really hard time finding a good vet in this city. This vet is closest to me. When I took Oreo to the ER they recommended another vet far away. That vet put him on ProZinc which did not because I work 12 hour shifts.

Excuses aside, I'll have to bite the bullet and just do it. I'll call around to find out which vet will use Levemir. I really wish I had a vet I could trust.

 

[FurBabiesMama]

Are there any mobile vets in your area? I found one and having her come here was so much less stressful for Mia.

This vet is definitely better than the first one I had, but I cannot say I trust her completely. She wants me to give Mia a consistent dose of ProZinc regardless of her pre-shot test results. That does not make sense to me at all.. not to mention that it can be dangerous. I went along with her instructions for a time but reached a point where I had to go rogue and start doing what I think is right. If is works, I will be able to show the vet the results, and she cannot argue with them. If it does not work, I will try the vet's next recommendation which is to change insulin types. I think it is rare to find a 'perfect' vet since so few seem to know very much about FD. I think it is a matter of finding one that will at least work with you.

 

[Justgin]

My Tigger developed food allergies out of the blue several years ago. It presented the same way with the scabs all over his back. My vet put him on prednisolone and switched him to Hills z/d. I believe both contributed to his developing diabetes. We have cut back to 2.5 mg prednisolone every other day and he's on Fancy Feast classic and the scabs have not reappeared. I don't know what to think. I do think he was on that awful food too long and the long-term pred. use caused his diabetes.

Also, when he was on his regular dose, 5mg every other day, we could not regulate him. We even went up to 5 units of Vetsulin twice a day. We cut back the pred. dose, changed foods and blamo! Regulated on 1.25 units twice per day. It really was amazing. I would not expect his numbers to be good while on prednisolone, so don't drive yourself crazy about it.

Get those allergies cleared up and switch foods. There are several limited ingredient foods on the market that use novel protein and carb sources. Check out the food chart at the top of this section. They are not all ideal because of carb count. The ones that come to mind are Natural Balance and Instinct. The fewer ingredients the better. Also explore the grain free foods. They have other sources of carbs like peas and potatoes but it's possible he's allergic to the grains. We never found out exactly what his allergy was to, and I'm astounded that they haven't returned on the Fancy Feast, but I'm so glad!
Good luck.

I'm leery of starting the pred. Thank you for posting about your experience. I have a hunch it's NOT the FF classics but rather the Lantus. He wasn't having this problem on the food before he started Lantus. Oreo has had 2 monthly injections of Prednisone years ago when he had a very bad problem with scabs all over his back. It was worse then. He'd overgroom til he bled. I knew I didn't want to continue giving him Pred shots monthly although it did clear up his scabs as long as he was on it. Toward the end of the month the scabs were coming back though so it wasn't a cure. When Oreo's cousin Nat started having seizures I changed their food to grain-free (not low carb). Then I noticed Oreo's scabs clearing up. He was on FF classics/grilled/chunky/flaky at that time and yet the scabs went away and stayed gone - until he started Lantus.

 

[Justgin]

Are there any mobile vets in your area? I found one and having her come here was so much less stressful for Mia.

This vet is definitely better than the first one I had, but I cannot say I trust her completely. She wants me to give Mia a consistent dose of ProZinc regardless of her pre-shot test results. That does not make sense to me at all.. not to mention that it can be dangerous. I went along with her instructions for a time but reached a point where I had to go rogue and start doing what I think is right. If is works, I will be able to show the vet the results, and she cannot argue with them. If it does not work, I will try the vet's next recommendation which is to change insulin types. I think it is rare to find a 'perfect' vet since so few seem to know very much about FD. I think it is a matter of finding one that will at least work with you.

Wow, I think it's very irresponsible of this vet but I've heard the same thing before as well. Insulin is dangerous, especially if you give it and they don't eat. Oreo has a very good appetite. Too good actually. I think his numbers would start going down if he would lose some weight. After meals he comes and sits at my feet pawing my leg for more food and staring at me hard. You can almost see steam coming out his ears, lol. My current vet is not unhappy that he isn't losing weight yet. He won't even give me a target weight to shoot for.

There is a mobile vet that I sort of like. I'm not sure he's the smartest vet in the world but he's very compassionate, thorough, and expensive. One trip usually runs about $400 and I'm not made of money.

 

[Justgin]

Is the scabbing localized to where you inject the insulin? That would indicate a reaction, like Meya14 said. If you do switch, you'll have to start again with 1 unit twice a day. Ask for advice when the time comes.

The scabs started out near the injection sites. One scab actually was an injection site but it has since cleared. Took a long time though. Since that first scab, it's spread and covered his back.

 

[Justgin]

I can not comment on the 2 insulins. However, there seems to be quite a bit of fish in his diet. Don't forget the Ff, beef, turkey probably have some fish in it also. Maybe try eliminating the tuna or whitefish for awhile, one at a time and see what happens. Even though Oreo had no problem in the past, he could now. In some kitties chicken and beef are a problem. It's trial and error.

Yes I'm concerned about the fish too. I didn't realize there is fish in the beef and turkey. Oh lord, so if he can't eat fish, beef, turkey or chicken, what's left? Jeepers. I suppose the hydrolized proteins and novel proteins are an option.

Just so I'm clear, I stopped feeding salmon and those Purebites treats for 12 weeks without any change in his skin. That was the only new food he had been eating since the scabs appeared, although he'd been eating these for weeks before the scabs appeared.

 

[Justgin]

Cats can get many kinds of allergies. I think food is one of the most common, especially beef and fish, but other things like grass can cause an allergic reaction. I even had a cat who broke out when she sat in the sun. So think of what Oreo is in contact with. Does he roll in the grass outside? Is there a new cat bed? Maybe you started using a new cleaner? A new litter? Fleas or flea meds? If all of this is "no", trying a novel protein food is an easy way to check on the food allergy possibility, though is may take up a while to see results. ( I found this site about cat allergies: http://www.pethealthnetwork.com/cat...thering-your-cat-it-could-be-feline-allergies).

It's been years since my extra-sweet Maggie was around, but she was on Levemir. It is long lasting like Lantus and it worked great for her. I don't think one is necessarily better than the other, except maybe for high-dose cats. Because of the way it works with the body, Lantus can sting at high doses, while Lev doesn't. If you or your vet wants some info about both insulins, check http://petdiabetes.wikia.com/wiki/Main_Page. Though most of this info has not been updated, there is a lot of information about insulin on the wiki, including technical info about Lantus and Lev and how they work.

Oreo is completely indoors and has been since 2004. No new cleaners or flea meds. The only thing new was the Lantus, the salmon and the treats. Thank you for the links!

 

[Justgin]

Update:

Oreo's vet has agreed to consider Levemir after talking to an Internal Med Vet and let me know by tomorrow or the next day. At least he's willing now to consider it!

 

[Justgin]

Just heard from the vet today. He agreed to start Oreo on Levemir at 2 units twice a day. He was on 4 units Lantus twice a day.

 

[Chris & China (GA)]

That's a pretty big drop

We usually suggest starting at 70% of the "old dose".....so closer to 3U

Hopefully Oreo will be one that really likes the Levemir!!

 

[Justgin]

I'm hoping so too. Man it's expensive! I've called a number of different pharmacies. The highest is almost $400! The lowest is Walgreens - around $244 with a RX card and a discount card. This is an awful lot to pay not knowing how he will react to it, but I don't have much choice at this point. I'm almost out of the Lantus.

Re: dosing. I've heard to "start low, go slow". Which interpreted by the scale I've seen is 0.25 units to start with.

 

[Chris & China (GA)]

This is an awful lot to pay not knowing how he will react to it, but I don't have much choice at this point.

If you have the time, you might want to order your Levemir from Canada.....that's where most of us are buying our Lantus and Levemir from because it's so much cheaper

Re: dosing. I've heard to "start low, go slow". Which interpreted by the scale I've seen is 0.25 units to start with.

If he's been on 4U of Lantus twice a day, you'd want to start the Levemir at 70% of his current dose...that would be 2.75U twice a day

You do not want to start over at .25.....that could lead to a lot of wasted time working your way back up

 

[Justgin]

Thanks, but I already bit the bullet and paid $279 for it this afternoon, since I'm almost out of Lantus. I could order it from Canada? Would it come packed in a cooler? How much does it cost and what is the website I would use?

One question. The Lantus supposedly lasts only 28 days, yet for me it lasted almost 4 months. It sounds like a marketing ploy to get more money. I was told Levemir lasts a bit longer than that. What is your opinon on that?

 

[Meya14]

I've kept vials of lev for 6 months and they were still active. It's mostly a marketing ploy, the FDA requires them to put an exp. date/use by date on things and test if it is good only up to that date. Choosing a very small window allows companies to sell much more insulin.

 

[Justgin]

I've kept vials of lev for 6 months and they were still active. It's mostly a marketing ploy, the FDA requires them to put an exp. date/use by date on things and test if it is good only up to that date. Choosing a very small window allows companies to sell much more insulin.

So you did note that the Lev was still effective after 6 months?

 

[Meya14]

yup, worked just fine

 

[Maggies Mom Debby]

One question. The Lantus supposedly lasts only 28 days, yet for me it lasted almost 4 months. It sounds like a marketing ploy to get more money. I was told Levemir lasts a bit longer than that. What is your opinon on that?

The expiration dates are for humans, who are told it doesn't need to be refrigerated since they use higher doses and will use up the pens around the expiration date. Since we use so little, and keep it refrigerated, it can last a really long time.

 

[Justgin]

The expiration dates are for humans, who are told it doesn't need to be refrigerated since they use higher doses and will use up the pens around the expiration date. Since we use so little, and keep it refrigerated, it can last a really long time.

Makes perfect sense to me! And it takes the pain out of the total cost since it'll last several months.

 

[Justgin]

So far, Oreo has been on Levemir 5 days and it seems like there are fewer scabs on his back, but he's still licking and scratching. I wonder how long it will take before I know for sure Lantus was not to blame for these scabs?

 

[Meya14]

I would give it a couple weeks to allow all the inflammation to settle down and the open areas to heal. If there is still issues with the licking and scratching, you may want to look into if something else like ear mites (which can cause rashes on face and neck too), fleas, ringworm or feline hyperestesia might be an issue.

It might also help to heal them by taking a very very short course of steroid (3 days or less) to just get it under control but I would try to avoid longer courses if I could due to the effect on BS.

 

[Justgin]

I was afraid that there would be no change and I'd wasted money on a much more expensive insulin. So far it's hard to tell but will wait it out. Oreo is a nervous kitty. I think he eats for comfort sometimes, bless him. And again it could be one of the proteins he is still eating but it now not tolerating like he used to

 

[Meya14]

I'm guessing you'll see some improvement. Lantus can really have a bad effect on some kitties if they have skin sensitivities to it. I have a cat with seizures/FHS and the lantus was causing his seizures to be like 10 a day (a few a week is ave. for him) due to the irritation in the skin, and he had a really bad attitude when on lantus because I assume it was causing him discomfort.

Some cats seem to be more sensitive than others.

Was your cat having odd behaviors with the scratching? Kinda like this:

 

[Justgin]

I'm guessing you'll see some improvement. Lantus can really have a bad effect on some kitties if they have skin sensitivities to it. I have a cat with seizures/FHS and the lantus was causing his seizures to be like 10 a day (a few a week is ave. for him) due to the irritation in the skin, and he had a really bad attitude when on lantus because I assume it was causing him discomfort.

Some cats seem to be more sensitive than others.

Was your cat having odd behaviors with the scratching? Kinda like this:

Awww poor kitty! No Oreo wasn't doing that. He just licked and licked and licked. Today I've noticed real improvement in his skin! It's a lot less scabby!!! I sure hope it's going away for good now, and I will be happy about that. So that's some good news!

But now Oreo has another problem. He started limping right before, maybe about a week or 2, he was diagnosed with DM. The limping went away. First it was the front right paw, which is where one of my other kities injured him in a fight years ago. But now it's his left back paw. When he gets up to walk it's really bad, but as he walks his walk improves, so it's not constant. He's due to go back to the vet for a recheck anyway so I hope it's nothing really serious. I wonder if it's because the vet stuck his paw for the curve testing? I've only tested his ears.

 

[Meya14]

When he gets up to walk it's really bad, but as he walks his walk improves, so it's not constant.

This sounds like my old lady kitty who has arthritis. Sometimes I'll see her limping very slightly as she gets up from a long nap, but it goes away after she moves around a bit. Diabetic neuropathy can happen in cats too, so it's something to keep in mind.

 

[Justgin]

Yes, That's what I was thinking. I first noticed his limp about a week or two before diagnosis but it went away, came back went away again, and now it's back. I spoke prematurely about the scabs getting better Going to see if I can take him in to the vet today. Man, when it rains it pours. Had to go to the dentist this morning which costs $200 + for full xrays and cleaning. Insurance pays a part but they reimburse. I need it to rain money into my account for a little bit.

 

[Justgin]

I'm a little bit frustrated right now. I took Oreo back to the same vet who now has him on Levemir to check out his limp. He suggested Cosequin twice a day. I've been trying but it's difficult to get that dose in him. Will just have to keep on trying. Winners never quit... So yesterday I took him to another vet for a 2nd opinion about the limp. She said he might need surgery if it turns out to be due to a torn ACL, and she gave him a shot of pain medicine. It made no difference at all, he has limped worse since the exam, and I'm aware it could be because of the exam too. My poor baby. He badly needs Pred but he can't have it because of his diabetes. Btw now he's down to 1.5 units Levemir twice daily, well controlled. He needs another curve testing to see if we can go down further but because I don't have unlimited finances, it'll have to wait. <sigh> Anyone else have a guess about what this limp could be?

Also, was frustrated with the new vet because she too (like the previous one) doesn't seem to want Oreo to lose weight because she is afraid of fatty liver. So what then? Let him continue to be fat on the outside chance that he might lose weight too fast and develop problems from that? That doesn't seem to be a good approach especially when she says that his joint problems are not helped and probably even caused his limp.

I do not know who else to take him to. God, this is so exasperating. I needs some guidance on how to proceed. She did say to give him sardines as a treat and even salmon because they both have Omega 3 fatty acids in them.

Also, one of my other kitties Honey has been losing weight fairly steadily since the diet change in April. In April she was 12 pounds something. Just last week she is down to 9.15, so down a little over 2 pounds in 6 months. Labs were perfect. Liver, kidneys, thyroid, sugar - all normal. So she didn't get fatty liver. Just sayin..