WRONG! Lantus is longer lasting, but it does not produce anything like the hard drops that are characteristic of Caninsulin. I've treated my cat with both. Saoirse was first treated with Caninsulin (as is legally required in the UK). Shortly after her change to low carb wet food, even though she was not in remission I suspended Saoirse's insulin therapy
as her numbers got lower because it became too dangerous to give her Caninsulin. She held OK numbers for about a week and then her numbers started climbing right back out of regulation - her pancreas had not had enough time to heal. I managed to get a Lantus prescription for her and I was able to continue to safely treat her with insulin for several months until she became diet-controlled. (Have a look at Saoirse's numbers on Caninsulin and on Lantus to see the difference.)
The trickiest aspect of managing a cat on Lantus is when a dose is too high and the cat drops to low numbers. Because of its depot nature, intensive monitoring for many hours may be needed to ensure that a cat remains in safe numbers. Caninsulin as an in-out insulin may be out of a cat's system faster than Lantus, but Lantus typically has a gentle lowering effect on blood glucose levels whereas Caninsulin can cause much bigger drops - even on a microdose - and that is not a characteristic you want in an insulin when treating a cat who is at quite low numbers to start with.
I've just looked at Terry's numbers. If it were Saoirse and she was at those numbers, frankly I'd rather stick my head in a hornet's nest and then ask someone to give the nest a good kicking than give her ANY Caninsulin. In fact, I would not give her
Lantus at those numbers unless there was some
major overriding clinical need to give it to her (e.g. if she was having a pancreatitis flare). Even then I would only be prepared to do so with extreme caution. I would need to ensure I could monitor her 24/7 until I had enough data to make sure she was safe and I would work on a tailored dosing protocol with our vet with a significant number of safety checks in it.
As far as the available data can show, Terry looks to be very well regulated. FDMB often quotes a BG reference range of 50-120 mg/dL as measured on a human meter as being acceptable for a diet-controlled cat. Terry's well within that range. Other members may have different opinions but I would really question whether blood glucose regulation has anything to do with Terry's pee volume. I'd recommend hanging fire on any insulin decision until:
1. the results of the diagnostic tests are in. (Did your vet book a fructosamine test, by the way?)
2. I had completed a period of secondary monitoring of fluid intake (from food and water in dish), urine output, and home urine testing (especially specific gravity).
I'd also post here to discuss things before making any decisions about insulin treatment.
Just because someone is a specialist, it doesn't stop them being human and, like the rest of us, they don't always get it right. With every respect to your own vet (who is obviously very conscientious and caring) if the specialist has told your vet that Caninsulin is safer for cats at lower numbers than Lantus then s/he doesn't know the action profiles of both of those insulins well enough. (Again, see Saoirse's spreadsheet for a real world comparison of the two.)
To give you an idea of how badly wrong FD specialists can be, in August of last year our vets, in good faith, referred Saoirse's curves for interpretation to a diabetes specialist at a highly respected university veterinary hospital over here. Said specialist pronounced Saoirse a true diabetic who had little or no hope of ever achieving remission. Saoirse obviously didn't get the memo because she officially went into remission at the beginning of December. Saoirse has not had any insulin since mid-November of last year. Specialist schmecialist.
If it's a help, I'd be happy for you to send the link to Saoirse's 2014 spreadsheet to your vet so she can have a look at the difference in action of the two insulins in a clinical setting. Saoirse was a dream to regulate and she's not a bouncy cat so it's quite easy to understand her data and her (fairly text book) pattern of response to both insulins.
I'd very much like to hear how you both get on and it would be great if you could update us with your vet's findings.
Mogs
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