First day on LANTUS... :)

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RockStar033

RockStar033

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so we had our new vet appointment yesterday, it went sooo awesome, i love the vets at this new place. They took 3 hours with us just to talk to us about everything and answer questions etc. It was so wonderful. i'm so much more hopeful now then with the other vet. They switched us to Lantus to start this morning, they told us to skip her evening shot last night to give her a bit of a break, then start with Lantus this morning at 2u once a day. they also gave us some potassium and injectable b12 for her. The b12 is started at once a week for 6 weeks, then once every 2 weeks for 6 weeks, then once a month after that.

any info on lantus right now would be appreciated greatly. :)
 
Welcome!

You should come over to the Lantus board. There is a huge amount of information there.

I'm not an expert and this should not be taken as dosing advice, but I know everyone will tell you that you shouldn't be giving the insulin just once a day and that 2 units is a lot to start with. Insulin usually needs to be given twice a day because of the way cats metabolize it.

I will defer to the experts from here...
 
that's what i've read but also, this vet is very experienced with diabetic cats, and specializes in cats in general. maybe he's starting like this just to see how it goes for a couple weeks?
 
You might just ask him if 1u every twelve hours is more logical than 2u every 24 hours? His answer will tell you how well he understands how lantus works in cats. He might understand feline diabetes and just not be up on the scientific current dosing protocols?
Carl
 
2u once a day is not the way Lantus works for a cat. Because of the shed factor it needs to be given twice a day. While this vet sounds better than the other one, he may not be up to date with how Lantus works since it is a human insulin and the use of it in cats is still considered "off label'

Giving Lantus once a day is like taking you car on a trip with only enough gas to get to your destination without enough gas to get you back home again.

When you look at a typical Lantus curve the numbers will start rising again around the nadir at about +6ish or so (some cats sooner and some cats later). So what is going to happen by only giving it once a day is the cat's BGs are going to drop from preshot to nadir then rise again until the next morning, when they get insulin again. That is going to keep you spinning your wheels on trying to get the cat regulated.

A better plan would to be give 1u in the morning and then another 1u in the evening 12 hours after the first shot, that way the cat can use that insulin to keep its sugars down. Plus Lantus builds up a shed or depot under the skin that is like a spare tank of gas, that you want to keep topped off so all the insulin you are giving is going to the cat to use to lower its bloodsugar. if you only give insulin once a day you will constantly drain that spare tank and the insulin give will send most of it to that spare tank to top it off before the cat will be able to use it to lower his bloodsugar.

That just is how Lantus works for felines.

Mel, Maxwell, Musette & The Fur Gang
 
i appreciate the feedback, i will call him today and express this to him and go from there.

i think he just wanted to see how annie takes to the new insulin, and then he was gonna do it BID, but i will call and discuss it with him.
 
Think about it this way...

Let's say you have horrible allergies, and they're killing you 24 hours a day. You go to the doc and say "please, you gotta help me. I can't work, I can't sleep, I'm miserable all day and all night long." So the doc prescribes a perfect 12 hour time-release allergy medicine. But he says "here, this is the best thing on the market. Take 2 each day with breakfast, and call me in a week and let me know how you're doing".
So, you do. After 3 or 4 days, you call him back and say "help me out, doc. I'm doing just what you said, but it's still killing me. I'm going to get fired because these pills make me feel like a zombie all day, and I can't function at work. I'm not sleeping, haven't slept in three nights, and I'm going through two boxes of Kleenex a night!"

Not only would your doc have put you through 4 days of needless misery, but he also would not be able to tell you one way or the other if the meds are actually working for you or not and you'd be right back to square one, questioning your doc's judgement to boot.

The vet is basically advising you give two 12 hour doses at one time. And the results at the end of the week or two won't tell him anything useful.

Carl
 
RockStar033 said:
...i think he just wanted to see how annie takes to the new insulin, and then he was gonna do it BID, but i will call and discuss it with him.
Click to expand...

CAUTION: 2 units at once might be too high for Annie and might result in a hypo! Safety first! Once a day dosing at 2 units is old school. If he wanted to see how she reacted to it, he should have tried 0.5 units - 1.0 units, every 12 hours.

This, by the way, is documented in a number of articles by world feline diabetes expert, Dr Rand of the University of Queensland Centre for Companion Animal Health http://www.uq.edu.au/ccah/index.html?page=41544 Please share the link with him, and see if he is receptive to it. That will give you a clue as to how willing he is to update his knowledge.
 
well i just talked to the vets, they said they will adjust it accordingly, they said to keep checking her bg throughout the day, and to call them later and they will adjust it accordingly to probably twice a day if her numbers are still too high at her pm feed time tonight. she was at 342 pre shot, gave her insulin and food at 11am, then at +1 she was at 360. i am going to test her at 2pm to see again.
I go to work at 2:30 and my hubby won't be home till 7. he will test her when he gets home.
 
Please print out the linked file and give it to your vets asap. Also read it over yourself.
Glargine & BG control-Roomp & Rand_2009-JFMS
Lantus brings the glucose down s l o w l y, not quickly.

And each shot builds on the previous one, so dose changes are done very, very carefully, following an established protocol. Do NOT change them every 12 hours !!!!!

Miss-dosed insulin can kill your cat.

The lowest glucose level is usually somewhere between 4 to 8 hours after the dose.


Think of walking up an escalator going down.
You want to get halfway up, then stay there.
You adjust your speed so that you get where you want, you step at a speed that keeps you there.
Go too fast, and you can get off at the top.
Go too slowly, and you are back at the bottom again.

This is what dosing with Lantus is like.
 
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