Asher, 7/2 new to Lantus Board

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donnahc

donnahc

Member Since 2011
Hello everyone!
I would like to introduce myself, Donna, and my sugar cat Asher.
We have been at FDMB for a year and a half and have been on ProZync insulin. Right now we are at 2.8 units BID.
We are making the switch to Lantus and would like to post here. Our spreadsheet is current.

We just haven’t been able to regulate Asher on PZI. He was doing well last year, or so we thought, but we were one of those folks caught up in the Freestyle Meter debacle so we found out he wasn’t regulated after all, for maybe 6 months or a little more from what we can figure out. We had a dental this past January, things looked promising after that, but then bad numbers, and we just can’t seem to shake the 300 preshoots.

We are very consistent with food, we feed only Blue Buffalo Wilderness canned chicken which is 1-2% carb, 1.5 ounces morning and evening right before Asher’s shot. He gets a few snacks during the day and a snack at testing time. These snacks are always boiled chicken cut in 1/4” chunks. Asher gets no other food unless his numbers would would go low in the middle of a cycle and we bring him up with a little Gravy Lovers canned food.

We test for ketones, which he has never shown. He has had no clinical signs of diabetes (excessive hunger, drinking a lot, excessive urination, etc) since he was dx’ed in Jan of 2011 and put on insulin.

My partner Tom and I are self employed so usually one of us can be home with him for the better part of a day, so testing usually isn’t a problem for us. Some days we do have to both be gone mid day, but one of us is always home to feed and shoot. We have not left the house together for more than 12 hours since Asher has been dx’ed.

My vet has advised we start at .25 units of Lantus. I think that is a bit low. (in my vet’s defense we went to him since he was more cautious, my first vet insisted on overdosing Asher and would yell at me when I reduced the dose without her permission) Some folks on other ISGs here have said 1 unit is a good start. I was wondering what you all thought we should do? Somewhere in between? I hate to loose any slight progress we have made but want Asher to be safe too.

We understand we should test often in the first three days so we would like to start him on the new insulin this week since we will be around to watch and test.

I am also in need of some basic info. I have read your stickies but if anyone has any suggestions for things we need to know during this transition time, I am all ears :-D

We will be using the Solostar pens. I have U100 needles and I do understand that Lantus is a U100 insulin so we do not need to use a conversion chart. I have looked over the pics you have of how to draw insulin from the pens. I do understand that we do not roll the insulin in the pens before we draw.

I also wonder if you guys could tell me how a Lantus hypo is different than a PZI hypo. I am confident bringing Asher up from low numbers on PZI. You will see on our spreadsheet we have had to do it a few times. What would I do differently if Asher went low on Lantus? I just want to be prepared. We always have a few cans of gravy food on the shelf, and Karo, although we have never had to use that, touch wood.

So I think that is all of our story. Any suggestions you all might have would be much appreciated. If you have any questions I will try to answer them quickly.

Thanks tons!
Donna and Asher
 

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I also wonder if you guys could tell me how a Lantus hypo is different than a PZI hypo.
Click to expand...

Hey Donna! Hiya Asher! I love that photo.

I've never had to deal with one first hand of course (though I have "sat" through several). Good thing is that the low numbers won't freak you out since you have dealt with them before. The only observation I could make from watching some hypos here is that they can last a lot longer than a P-hypo usually does.
Best of luck, hon. :smile:

Carl
 
Welcome to LL! I've only been here since Dec. 2011. Asher is a beautiful! I don't really give dose advice, but I will visit and see if I can be of any other help along the way. I have an illness that makes it hard to type sometimes..., but I'll try to keep you on my radar. Good luck with LL!!
 
Thanks Daphne :-D

Does anyone have any suggestions for a starting dose for us? I was hoping to start with Lantus tomorrow morning. We shoot around 5:30 am and pm.
If I don’t hear anything maybe we’ll have to wait another day or so. Just want to make sure I don’t do anything stupid nailbite_smile
 
Welcome to LL!

I thought I had read that it's recommended you take a 30% reduction when you first switch. Maybe someone who's gone through a switch can comment though.
 
DONNA!!!! Good to see you!! And, that beautiful picture of Asher!

Since we've been here since June 13th, I'm SURE we're the experts you want advice from. ;-) I look forward to learning as others chime in :-D

Libby (& Hershey, too!)
 
Hi Donna!!

Welcome to Lantus Land. Just a quick response as I have to give squids to a civvie.

While lantus and levemir are less likely to cause hypos if you are following a tight regulation protocol, there are never any guarantees. Low numbers (e.g. 30s) can last over 16 hours with lantus. For some cats, those low numbers could cause symptomatic hypos. However, in this forum, there is almost always someone around and as soon as you start getting into low numbers, you should let us know so we can walk you through quickly getting those numbers up. I've been here for
19 months and haven't seen us have anyone in this forum that had prolonged low numbers anti jinx.

Our goal is to teach you how to handle low numbers so you can keep Asher safe.

I need a little time to look at Asher's SS to help you with a starting dose. However, like I said, I have to do squids now and then do Gracie's insulin. So I will get back to you tonight with a starting dose, ok?

We're so glad you all are here :-D And Asher is one handsome guy!
 
Thanks everyone, I appreciate it! I’ll be here Marjorie :-D Appreciate you takin’ the time to have a look later.
 
OMG!! Asher is adorable!

Reagan remembered correctly. With switching insulin, we generally recommend that you reduce your current dose by 30%. In round numbers, that would make your starting dose around 1.75u.

When you're asking about a "hypo," do you mean a symptomatic hypoglycemic episode or low numbers? If a cat is well over dose on Lantus, the duration of the episode is longer than you might expect with PZI since PZI has, overall, a shorter duration than Lantus. I've not had experience with a cat that's been over dose on PZI. Rumor has it that with the shorter acting insulins, the drop can be impressive and they are harsher acting than Lantus or Lev. However, if you're talking about low numbers, I suspect there is minimal difference. We still use food to bring the numbers up. There is information in the sticky on Shooting and Handling Low Numbers.

If you could put together a Profile on Asher when you have a chance, that would be great. The Profile will contain much of the info in your introduction along with his medical history and other relevant info.

Please let us know if you have questions.
 
Thanks Sienne.

I was talking about low numbers, feeding the drop, etc. Touch wood, we have never seen hypo symptoms in Asher even when he has gone low into the greens.

My vet recommended we start at .25, so I am guessing that is because he has never used Lantus before and is being overly cautious. (He only has used PZI in his practice)
I should also mention our vet is moving out of state within the next month, so I will be changing vets at some time in the near future too. (nothing like all the excitement at once @-) )
 
Hi Donna and Asher and welcome to Lantus Land!

Marje will figure out a good starting dose for you and you will certainly be able to start with Lantus tomorrow morning. (Edited to say that I see that Sienne has just given you a good ballpark figure). How much does Asher weigh? That will be a factor in the starting dose, as will his present PZI dose. Lantus is a gentle, long-lasting insulin. It builds a "depot" or "shed" that must be filled before the insulin begins to work effectively. This building-up of the shed usually takes a few days, so don't worry if you don't see results immediately. We test, feed, and give the shot all within 10 minutes or so. Lantus takes usually about 2 hours before it begins to onset, so you have to figure that into your schedule. Many people find that a test at +2 will be a good indication of how the cycle is going. If the +2 number is lower than the pre-shot number, it may be an "active" cycle and you will want to be on your toes.
Dosing changes with Lantus are based primarily on the nadir (the lowest number of the cycle, often occurring at around mid-cycle--+6 or thereabouts, but every cat is different and nadirs are known to change). This is a big difference from PZI, where, as I recall, dosing is based on the pre-shot number. You will get to know the protocol very well!! :smile:

We are all here to help you, so ask as many questions as you need. Welcome!

Ella & Rusty
 
Right now Asher is between 17 and 18 pounds. He is a big dude.

He has been on a diet since Jan of this year (used to get 3/4 can of food at a meal, now he gets a half).
Before he got diabetes a year and a half ago he was 21 lbs.
 
Just for some clarification...

When it comes to the initial dose of insulin for a cat that has not been on insulin, there is a weight based formula for calculating the initial dose of Lantus or Lev. However, when a cat has been on insulin previously and is switching, you could start with the same dose you've been using with your "old" insulin. What we've seen, though, is that in some cases, the cat has an initially strong response to the new insulin. As a result, the suggestion is to start at a reduced dose -- that's where the 30% reduction comes from. I'm erring on the side of a slightly smaller starting dose than the actual 30%. Dosing with PZI is based on pre-shot whereas Lantus is based on nadir and I'm not that familiar with how a PZI spreadsheet "should" look. I'd rather see you start at a slightly smaller dose and if necessary, we can fast track the dose up. (Starting slower is a littler easier on the beans nerves!)

While I tend to be a huge fan of the +2 test, since you and your DH are home, I'd rather see, all things being equal, that you test at pre-shot, +3, +6, and +9 per the TR protocol. The advantage of getting a mini-curve is that it will begin to give you a sense of when Lantus onset and nadir are and how much duration you're getting. While nadir can shift around, it's really good information to get.

And, finally, just to tweek Ella's note, if the +2 is the same or lower than your pre-shot value, it may be an active cycle.
 
Hi Donna

I'm glad Sienne got back to you on the dose sooner than I was able to. I also agree that 1.75u looks like a good place to start. We can fast track him if we need to.....by that, I mean, increase the dose a little faster than usual if he seems a little slow getting started. We'll help you :-D

Let me know if you have any questions about the profile instructions. They are long but it's fairly simple.
 
Sounds good. We'll start him tomorrow then. Thanks again for everyone's help tonight.
I'll report in tomorrow and will try to get a profile up this week sometime.
G'night folks! I-)
 
Hi Donna - after 4 weeks, several of us are seeing some really good looking numbers on the Ls... hoping Asher does the same! GREAT pic of him (not that I'm surprised!!!) ;-)
 
Welcome to LL Asher, Donna and Tom! I think you are well prepared and have tons of good advice.

Asher is so handsome and he looks like a character too!
 
Welcome Donna and Asher!
great to see you 2 over here!
wishing you nothing but luck and good numbers!
my vet had recommened that we start shakes on .50
but I thouhgt that was too little so I did start at 1 unit
good luck and I am praying for the 2 of you!!!
 
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