Changing insulin

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angela&jimmycat

Member Since 2010
Hello all, The vet who did Jimmy's dental procedure wants to change him from Prozinc to Lantus. She believes using Lantus could lead to remission. Jimmy has been on Prozinc for 1 1/2 years, well regulated. Has Lantus brought such great results that long into treatment? What do you all think?
 
Well, we all like it a lot here. :lol: I don't know about remission rates for cats changed over at this point in treatment, but there have been several long term cats going OTJ.

You say Jimmy is well regulated , what dose and what kind of numbers? I don't see anything on your SS recently.

Lantus is becoming the magic bullet among vets lately, but a lot of them don't really understand it and want to treat it much like other insulins. There are some very big differences. You will have to learn new procedures and forget a lot of what you are used to doing now. Since it builds a reserve (we call it a shed or a depot) in the body dosing is always held for several days before another change. A very regular schedule is important too. We hve a lot of stickies at the top of the forum, w/ tons of info. Start reading through and post any question you may have.
 
Hi Angela and Jimmy

Welcome to Lantus Land. There have been several PZI/ProZinc users in FDMB who have switched to lantus or levemir. Ann gave you some good info; one of the biggest adjustments you and your vet will need to make is
dosing based primarily on the nadir and not the PS. That's a big one but it's not a difficult one.....we can help you with dosing.

Also agree with Ann that since there isn't any data on your SS for several months, it's hard to see how regulated he is. On your current SS, he isn't.

Lantus and levemir are much longer duration insulins so instead of the bell curve you typically see with PZI/ProZinc, you "should" see something much, much flatter with lantus and levemir.

Please let us know how we can help.
 
Every situation will be different and, depending on other things going on, remission chances will be different. In the reading I have done, I have seen that remission on newly diagosed runs up to as high as 85%, where long term users of other insulins may be lower in the 30% range. Still a fairly good chance at almost 1 in 3 cats and if you are testing and monitoring, feeding low carb, and just got some dental work done (a big cause of high BGs in cats) you might be a step ahead already.
 
To be completely honest, I don't know of any studies that have looked at Lantus remission rates in cats that are longer term diabetics or that are longer term diabetics and switched insulin. We have had several cats go into remission who have been diabetic for over 2 years.

There are some realistic issues that others have mentioned. The biggest of these issues is that dosing is based on nadir, not on pre-shot numbers. Depending on your schedule, this may or may not be easy.That said, most of us do not get nadir checks every day. We do suggest that you get a minimum of 4 tests (your pre-shot tests and one spot check per cycle) per day once you have a feel for how Lantus is working with your cat.
 
Thanks for the info everyone. I dont keep the ss just a paper chart. Jimmy is usually ps< 250 . Nadir about 100. There are the occasional bg300, usually during travel, overnight, or end of a vial. We are at .75 to 1.25. Every once in awhile he doesn't need a shot for hours after the +12 time. A couple months back it was over +24! Hoovered around 130, then back to his regular schedule. Jimmy had several teeth removed week before last, seems to feel better. We are at the end of his vial and I dont think it is at full potency. I'm giving 1.5 - 1.60. I would like to have a more "normal" unit amount before switching insulin, if I switch. I'm still not sure if the odds of remission for Jimmy are very good......."should I rock the boat?" keeps going through my head. I have to order insulin this week......... nailbite_smile
 
usually people drop a dose back a little bit when switching insulins, just to make sure you're not giving too much. then they adjust the dose. with lantus, unless you see numbers that are less than 50, you hold the initial dose 5-7 days so that the shed (reserve) can build and stabilize.

mr tinkles went OTJ a couple of weeks ago and he's been on insulin for almost 2 years. so obviously, it happens. no one can predict on a particular cat.

and just wanted to say welcome! nothing ventured, nothing gained! :-D
 
Good morning, Angela!

Mr Tinkles was on ProZinc for 3 months, and then we switched to Lantus. He was on Lantus for 15 months before going OTJ. Please feel free to take a look at his SS, our first year is on the second sheet.

My personal opinion is that ProZinc is a very good insulin, but Lantus is better. Just from the standpoint of behavior, Mr Tinkles obviously FELT much better once we switched to Lantus. The steep curves we had on PZ must have made him feel pretty crummy....Lantus is much more gentle. He learned how to play (at 14 years old!) after we switched. He had a chronic URI that would not go away....the wild swings in BG were feeding the infection. Once we got him on Lantus, the AB could do it's job and the infection cleared up.

IMHO, I don't think there is anything to lose by switching, and everything to gain. Even if Jimmy doesn't go into remission, I doubt you will be sorry you switched. The hardest part of switching is learning how Lantus works, the shed makes it more complicated, and dosing strategy is very different. It's hard to "unlearn" PZI thinking....but I did it, and so did many others here, so don't worry...we'll help you!

As far as dosing, if you do decide to switch, I would encourage you to put your recent data on your SS. Jimmy's current dose on PZ can be taken into consideration when deciding on a starting dose....that would help his transition go more smoothly. We hardly missed a beat when we switched, since our starting dose was very close to the dose Mr Tinkles ended up needing. I would post here and ask about a starting dose a day or two before you start.

Whatever you decide to do, I wish you good luck!

ETA: Please don't freak out about all of the testing I did....I'm a testaholic! I did a lot of testing even when Mr Tinkles was on PZ. Most people don't test as much as I did.
 
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