help with switching to Lantus from humulin

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Kathy & Dabey

Kathy & Dabey

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Hi, Dabey was taking 4 units twice daily of Humulin and now going to Lantus. Gave him 1unit to start. checked 3 hrs later and sugar was 491. Checked him next morning before insulin and sugar was 449.
Would you up him to 2 units twice daily? He is starting to drink more water


thanks
 
Lantus works very differently from Humulin, with Lantus it takes about 3-5 days to build up a "shed" or deposit under the skin that the cat then uses, so for awhile with the new insulin Darby's numbers will just be kind of wonky. It is kind of hard to explain, but basically at first with Lantus the insulin is going to build up that shed and not going to the cat, once the shed is built up then it starts being available for the cat to use to start bringing down his numbers. That is one of the reasons that Lantus likes consistant dosing and is given on a fairly strict 12/12 schedule so that shed stays in place and is available for the cat to use.

With Humulin it is short acting so it is immediately available to the body to use, thus the steep drops and rapid rises when it wears off...Hopefully that makes some sort of sense?

Mel, Maxwell, Musette & The Fur Gang
 
Come over to the Lantus forum, where there are several Stickie Posts of basic Lantus unfo and more.
 
Given the 4 units of Humulin N two times a day, I think I would up the Lantus to 2 units at each shot. You must be diligent in checking each pre-shot glucose and also check at +6 hours after getting his insulin (and test any time you think his behavior is "off").

Reminder: as we discussed on the phone, please stop by a pharmacy to pick up some urine ketone test strips (ex Ketodiastix). If you can sneak a largish serving spoon under him when he urinates and test it, you can see if he is producing ketones. Ketones, plus high glucose will be clues for adjusting the insulin dose he gets.

Someone from the Lantus group is usually available no matter what time it is. I posted an introduction to you over there, so you should get some more contacts to provide support.
 
Do you have any home testing data from your experience with Humulin? It would be helpful to see that before making a dose recommendation. In addition, is there any significant medical history -- especially any history of ketones or diabetic ketoacidosis (DKA). And, just as importantly, What are you feeding Dabey?
 
Yes, I did get the keytone test strips to use. Hopefull I can catch him in the act....

No previous history of ketones or problems. He's been really healthy and had all bloodwork done. He's a little overweight. He's eating Fancy Feast Classic wet and with 4 other cats a little dry Blue Buffalo.

On Humulin before insulin high 400-564, then after 6 hrs it could be 439, 205, 265, (one time 70). He did stop drinking alot but just never seemed fantastic.. It's been a challenge getting blood from him in the beginning, but easier now since I have the hang of it and using the ear....So much info to know .


thanks
 
The fancy feast is great, but you may have trouble regulating him if you're still feeding dry food (even if it's grain free dry food). The Blue Wilderness dry is still too high in carbs for a diabetic--is there any way you can eliminate this from his diet?
 
Hi MamaBean and extra sweet Dabey!

You've already got lots of things in place to help get him at least regulated. We started on Humulin back in June but switched to Lantus the last of August.

Let me talk about the differences for a minute. I'm not a medical person so this is my interpretation.

Humulin N is a fast acting insulin that has a single action per injection cycle. It causes sort of a roller coaster effect on the blood glucose level - way down as it's acting then back up the other side because there's nothing left of it to continue doing anything. It takes another injection to start another cycle. It's also unpredictable. Sometimes it works better than other times - the low might be 4 hours after injection one day but 6 hours the next day. That's another reason to hometest as any vet's appt is only seeing THAT number at THAT time on THAT day. Give no picture of the 'health' of the cat.

Lantus is a slower acting insulin. It builds a reserve first then feeds the body from that reserve. Another way to think of it is like a 'timed release' pill. It makes the levels steadier and gets the cat off the roller coaster and onto the kiddy coaster. Even if the numbers are high, the gentler variation of the numbers make the cat feel better. BUT it takes longer for the cat's body to begin responding to the change. You'll probably see higher numbers for the first little bit.

KT's not regulated yet but we get closer each day. His spreadsheet is in my signature - the first part was his Humulin N period, the Lantus beginning is marked.

Hope this helps a little. Hugs,
 
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