Help and advice needed for a newbie re:Lantus

[jamesp]

This is my first post, although I have been checking in frequently and going through the back archives. Reading the archives has truly been like going to school and I commend the good people who frequent this board for their spirit of generosity and open-heartedness toward our cat kingdom and cat caretakers everywhere!

Here is my dilemma: My 10-year-old Teddy was diagnosed as diabetic a couple of months back. I have not begun home testing, and have been working with the local vet (a few steps out the door here in my New Jersey neighborhood) to get the cat's blood glucose under control. I have also been dealing with a couple of other issues the cat has had. It's been an expensive and stressful couple of months, but we are all hanging in there and taking it one day at a time. Teddy has responded well and has gained back the weight he lost before being diagnosed. Here is the specific problem I would like to bring here today:

On top of all this, once a week I travel 75 miles to assist with my 80-year-old mother's caretaking. All winter I have been making day trips so that I can get back in time for the cat's insulin shot. It would be much better all around, though, if I could spend the night at my mother's place and return the next day. I would thus have to entrust to someone else the administration of the insulin shot while I am away. Right now the person available to do this would be the teenager who lives in the upstairs apartment here. He owes me many favors and says he would be willing to help out; he and the cat know and like each other.

The thing is, I would be a lot more comfortable if the kid were to give the shot with one of those click-pen devices, which seem to be a lot easier to work with. The idea would be to make giving the shot as easy as possible for him. I have been checking out the latest technologies and see that Solo-Star pens and Opti-Click pens are available for this purpose.

I have been giving him 3 units of ProZinc with U-40 syringes. But Lantus, not ProZinc, is available for use with these devices. I would have to make the switch, then, from one to the other. Do you think this would pose a big problem? Any feedback from persons with similar experiences in these areas would be welcome.

JamesP

 

[MommaOfMuse]

The problem with that is that ProZinc and Lantus work very differently. ProZinc is a 'one shot" insulin in that you give the dose it does its work and it wears off by the time the next shot comes up. Lantus on the other hand has to build up a shed or depot under the skin, so you give a shot, it goes to the shed (if not previously on Lantus) then it isn't until the next shot after the shed is full for the insulin to become available for the cat to use to bring down their blood sugar. Plus it can take 3-5 days initially for a Lantus shed to fill.

3units is going to be a large dose for Lantus, most cats do really well on either .5u b.i.d. or 1u b.i.d of Lantus because of that carry over, about the only way I can see for you to switch over to Lantus from ProZinc is to make the switch competely and find what is the right dose for your cat, but then again that doesn't guarantee that you could use the pens to give the shot since you may find that the ideal dose for him on Lantus would be less than a full unit and the pens only allow for full units. If your cat is doing well on ProZinc the other option since you are talking about short trips with only a single overnight stay would be if possible to take your cat with you, if he travels resembly well. Or possibly look into broading kitty overnight at the vets.

My husband is a muscian and often has to travel overnight for gigs, we simply take Musette with us and have a neighbor stop in a couple times a day to let the dog out and take care of the other cats. My neighbor is even a nurse but she still doesn't feel comfortable testing Musette and I don't feel comfortable with her giving shots without testing so our answer is to just travel with Musette.

Mel, Maxwell, Musette & The Fur Gang

 

[Catannc]

You can always pre-load your syringes and leave them in the fridge, label them even if you dose on a scale.

I don't know anything about how to switch insulins, but I do know that the vast majority of lantus users do not dose from the pen as they do half unit or less adjustments all the time: most cats will not be on even units. They also choose their dosage based on nadir, so your sitter would have to be able to test at +6 or +7. It seems like a great insulin, but I wouldn't switch my cat just because I thought it would be easier to give him the shots....

Cathy

*and if your sitter is right upstairs, have him come down and teach him how to test/inject before you leave....if he gives a week of injections with you watching I"m sure you'll feel better about it.

 

[nwnews]

HI James, I agree with previous posters - it would be easier, especially since your cat is already regulated on Prozinc, to stay with Prozinc and find a petsitter who is experienced with diabetic cats (some petsitting services employ veterinary technicians) and can give the shots. My cat is on Lantus and she needs half unit dose pretty regularly when her shed fills up and she has a lower then normal blood sugar reading. Jan

 

[Blue]

This is my first post, although I have been checking in frequently and going through the back archives. Reading the archives has truly been like going to school and I commend the good people who frequent this board for their spirit of generosity and open-heartedness toward our cat kingdom and cat caretakers everywhere!

Here is my dilemma: My 10-year-old Teddy was diagnosed as diabetic a couple of months back. I have not begun home testing, and have been working with the local vet (a few steps out the door here in my New Jersey neighborhood) to get the cat's blood glucose under control. I have also been dealing with a couple of other issues the cat has had. It's been an expensive and stressful couple of months, but we are all hanging in there and taking it one day at a time. Teddy has responded well and has gained back the weight he lost before being diagnosed. Here is the specific problem I would like to bring here today:

On top of all this, once a week I travel 75 miles to assist with my 80-year-old mother's caretaking. All winter I have been making day trips so that I can get back in time for the cat's insulin shot. It would be much better all around, though, if I could spend the night at my mother's place and return the next day. I would thus have to entrust to someone else the administration of the insulin shot while I am away. Right now the person available to do this would be the teenager who lives in the upstairs apartment here. He owes me many favors and says he would be willing to help out; he and the cat know and like each other.

The thing is, I would be a lot more comfortable if the kid were to give the shot with one of those click-pen devices, which seem to be a lot easier to work with. The idea would be to make giving the shot as easy as possible for him. I have been checking out the latest technologies and see that Solo-Star pens and Opti-Click pens are available for this purpose.

I have been giving him 3 units of ProZinc with U-40 syringes. But Lantus, not ProZinc, is available for use with these devices. I would have to make the switch, then, from one to the other. Do you think this would pose a big problem? Any feedback from persons with similar experiences in these areas would be welcome.

JamesP

hi James,
I put my vote on switching to Lantus or Levemir because of the shed, the carryover that may help you when shots are delayed or something. I would also encourage you to start home testing, even if it's just before shots.... I also agree that the dose you are giving seems on the high side and I don't know how Prozinc works if a lesser dose is given by your neighbour.

Speaking of your neighbour, I would not have a person who knows nothing about the cat's health issues and is not familiar with shots, and also likely has no info on what to do in the chance of a HYPO situation with your cat. What if your cat's BG is low, the neighbour gives a shot you have prefilled for him, and the cat has a hypo attack? You need to have your sitter/shot giver prepared ahead of time.

I think I like the sounds of the idea to switch to Lantus or Levemir, and you can have the sitter give a half dose instead of a full dose, and you would lessen that chances of a HYPO and you could deal with the higher numbers later.

Home testing is easy peasy. Just pick up a Relion meter and some test strips, lancets, and start practicing.
Testing on cat’s ear

I am guessing from your readings on the board, you have heard how testing can alert you to a low number and often, shots are skipped because the cat's numbers are too low for insulin shots.

Another BIG selling feature for home testing is that you will know if your cat is ready to go off insulin. Just imagine that the pancreas has healed and is able to function on its own, and does not need insulin, but you just keep giving shots anyway ... because you don't know.

By home testing, you can work towards getting your cat OFF insulin so that you don't have to worry about shots being given once a week by others.

The test numbers obtained at the vet are notoriously higher than the animal's normal numbers. I have one cat who always tests higher at the vet office and another who often tests lower there. I get them both home and within 30min, tests confirm that they are back to their REAL and TRUE numbers.

With the Lantus in the pens, I would like to say that nobody uses the pen needles for their cats' shots as it's not possible to dial fractions of units. There are several cats who are getting only .5units for their shots and the pens dial in whole units. When a cat is getting close to going off insulin, you will need to drop down to as low as a .1u dose or just one drop! No way the pens do that.
The pens are used but with the U100 syringes to extract the dose you need.

 

[jamesp]

To Mel, Cathy, Jan and Gayle -

Thanks very much for taking the time and your advice will be well-taken.