Dandy Wants to Switch to Lantus

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theruss

theruss

Member Since 2012
Hi all,

This will be a double-post, both here and in the ProZinc forums. I had a previous post in the general health forum, but once I got my act together with home testing, someone kindly suggested I create a new one here in hopes of getting expertly fine-tuned advice on Dandy's situation. This board has been wonderful!

Dandy is a 7 year old, 16lb puss. He was put on the juice (ProZinc) exactly a year ago.

Prior to this past week:
- No Home Testing, only monthly BG checks at the vet
- 6u BID ProZinc (started at 1u and moved up to 6u over 6 months or so)
- 3 oz Purina DM wet food at shot times.
- 1/2 cup Purina DM dry food to eat whenever (while I am at work / sleeping)

Starting this past week:
- Home testing as much as I can, certainly AMPS, PMPS, and a read at lunch time. In the midst of a weekend-long BG curve.
- 1.5u BID ProZinc (due to dropping dry food...better safe than sorry)
- 3oz Purina DM (or equivalent low carb wet food) at shot times
- 1.5oz Purina DM (or equivalent low carb wet food) at lunch and as a late evening snack.
- Misc. low carb treats for being a brave boy when I'm poking at his ears like a vampire.
- Tested for Ketones a couple times late in the week. Negative.

The intention here is both to get used to home testing, and switch over to Lantus (for procurement and financial reasons). The vet was totally cool with us switching over to Lantus (in fact, he admitted Dandy was the only patient he had on ProZinc), and suggested 2u BID (based on the 6u ProZinc that was being administered). It was also suggested to me on the board that 6u may have been too much, and since I dropped dry food, maybe even more so, so I'm afraid that a 2u starting dose of Lantus may now be too much.

That being said, I've taken a 'better safe than sorry' approach this week. I've dropped the dose to 1.5u (ProZinc), and have just been taking BG readings as frequently as possible. The numbers don't seem crazy high, but they're also not at 'normal' levels. You can look at my SS, but be aware that the first few reads were using the FreeStyle Lite meter, which I'm told could have been reading a bit low. I've since switched to a ReliOn Confrm (which is great because the strips are way cheaper :)).

I guess at this point, I'm just looking for some advice on go-forward strategy. Should I just go ahead and make the switch to Lantus at a lower dose and monitor closely? Or, do I stay on ProZinc for a little longer until I'm sure he's 'stablized' from the diet change, then switch?

Any advice would be greatly appreciated...but when you do respond, please whisper...Dandy's napping right next to the computer...

Thanks!

Russ & Dandy
 
Hi Russ and welcome to you and Dandy!

To be honest, how and when you proceed is entirely up to you and what you're comfortable with. Typically, when someone switches from another insulin to Lantus we suggest reducing the dose by 30%. Some cats have a marked response to an insulin switch so it's a bit of built in protection. Right now, it doesn't look like Dandy is getting enough insulin but with a cat that's been diabetic, we could consider "fast tracking" the dose once you make the switch.

If you've transitioned Dandy to low carb, canned food for a week, chances are that you're not going to see much more change. Usually, the drop in numbers is within a few days. Given that you dramatically reduced the insulin dose, it makes sense that you didn't see any big drops in numbers with the food switch.

I would suggest you take a look at the starred, sticky notes at the top of the Board if you've not done so already. They will help to familiarize you with much of what you'll need to know about Lantus.

Please let us know if you have questions. The people here are very generous with their time and their information.
 
Thank you for the quick response! What you're proposing definitely checks out with everything I've been reading, and other posts in the ProZinc forum.

Since I still have a good amount of ProZinc left, I think I'm going to step up the dose little by little over the next few weeks / month to see where his numbers start to drop to a reasonable level. I'm thinking once I get to that point, I can switch to Lantus per your suggestion, starting at a more appropriate dose. That will also give me time to read all about Lantus, as suggested :).

Obviously, I would monitor each bump closely for at least a few days (per increase) before deciding whether to hit or stay. I know I've read a lot of advice about going slow, but when I changed his diet, I also reduced his insulin from 6u to 1.5u to be safe, so I'm thinking it's okay to proceed a little more aggressively than one would with a newly diagnosed kitty puss (especially with the numbers seeming like the insulin is having little to no effect).

Oh...one more question...(and this might be in the Lantus sticky)...since ProZinc is U40 and Lantus is U100, is there additional math that goes into that 30%? Or are you saying if I was giving 10u of ProZinc, I should give 3u of Lantus (without any additional conversion)?

I'm happy to hear thoughts and suggestions!

You guys are wonderful.

Thank you,
R
 
Hi Russ,
The adjustment to current dose would be less 30%, so in your 10u scenario, it would be 7u when switching, (although I doubt the numbers will be anywhere close to that high :smile: )
Carl

edit: no additional math due to the u40/u100 issue. Just new syringes that are for U100 insulin.
 
Like Carl indicated, you'll need different syringes that are appropriate for the concentration of the insulin. Lantus is a U100 insulin so you need U100 syringes (unless you really want to do the math but it does increase the likelihood of a dose error). You will want to get syringes that are in half unit increments. Te vast majority of dose adjustments are made in 0.25u increments. Walmart's Relion syringes come in half units. I use Monoject syringes that I purchase online.

Since you're not going to make an immediate switch, I'd suggest you also read any of our condos (it's what we call a thread) to get a feel for Lantus and this Board. It may also help you to identify questions. Feel free to ask those questions either in the condo/thread or open a new one.
 
Thanks Sienne!

I'm all set up with the Lantus and the new U100 syringes (they are the ReliOns), just haven't started using them yet :). You saw how good I was with simple Math in my last post, so I definitely do not want to do conversions at 6am. I was just making sure there was not an initial conversion necessary that I was missing when I switch from U40 to U100...but it seems like a unit is a unit is a unit.

Soon enough we'll be playing for team Lantus, so I will definitely check out the condos in the meantime.

Thank you,
Russ
 
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