Insulin types: how to choose?

Jennifer & Rhubarb

Jennifer & Rhubarb

Member Since 2017
Hi everyone,

I apologize if this information is posted somewhere already; I've had a look around, and can't find anything that quite answers my question.

My question is this: how do you choose the right insulin for your cats?

There are so many different types. Rhubarb is on Lantus because that's what they gave him at the emergency vet when he was first diagnosed. There wasn't any discussion about different types of insulin, how they all work, or what might be best for him. There was no endocrinologist consult, as you would get with a human. It was just: "here's your Lantus!"

My last diabetic cat, Splunk, was on ProZinc, and he did really well on it -- better than Rhubarb is doing on the Lantus. I completely understand that the course of this disease is different for every cat, but I can't stop the voice in my head that asks if I should be trying a different type of insulin. Maybe there's a version of this magic hormone that would put him right into remission! I imagine that testing out different insulins is a terrible idea; I'm sure switching from one type to another would cause very unstable blood sugar levels. So, in the absence of being able to try one, then try another, and another... is there any way to know which insulin is best?

Thanks for any insights. I just want do to the best for my buddy.

(Also, SS not up to date... I have to spend some time importing his data from the FS Libre to the SS... it's on the schedule for later today.)
 
Welcome to FDMB
The best insulin for cats are PrZinc and Lantus they are a12-hour insulin so you have the right insulin both are easy on the cats’ system tge only difference is that Lantus is a Depot insulin with ProZinc you have the advantage to stall the dose up to two hours if BG is low , like right now, Corky uses ProZinc , my alarm did not go off and Corky’s dose was at 6:00 AM I just woke up, he just got his dose at 7:45☹️ but he got his shot, now I just adjust it till he’s back on track I’m not sure if with Lantus this can be done, the protocol for Lantus is a little different, but you’re good to go, I will tag another member that can give you a better insight on the Lantus protocol and dosing advice, you’re in the right place we are here to help you😉
 
Sorry I answered you when I was feeding Corky and Coco sort of blurry and upset I did not hear the alarm, I know we have communicated abut Rhubarb in previous threads, if you can give the name of you original thread title so we can attach it here, we be great. so we don't have to be asking the same questions from the beginning, are you still feeding the Dr Elsy's, I believe we communicated to you the high carb content in that food, some cats as you said all cats are different but a lot of diabetic cats are sensitive to carbs, I know that if I give just a 1/4 tsp of high carbs to Corky he's BG will shoot up at least 30-points so if his BG was 49 and I give him 1/4 tsp of high carbs in a half hour his BG will probably be in the high 70s. Rhubarb can be one of those cats, cats are carb addicts, is a slow transition switching to wet low carb but is best for him, trust me during the day when he's hungry he will eat.
 
Blanche said:
Excellent question indeed!
Click to expand...
Thank you! ❤️ I feel like I have a lot of gaps in my knowledge about feline diabetes, and I'm trying to fill them in. I don't want Rhubarb to be a victim of my ignorance.

My vet floated the idea that Rhubarb might be resistant to Lantus, so I'm not sure if or when I should try a different insulin. But actually I think we're starting to see some progress, so I'm going to hold steady with the Lantus for now.

Blanche is adorable! Please give her a smooch from me and Rhubarb! :)
 
Welcome to the FDMB. Since eating dry food only you would be adjusting the dose at least every 7 days. It is way too soon to talk about insulin resistance. I would go up to 2.75 and check back in 3 days. Some cats need to be fast tracked even if on dry food. You would need to post for dosing advice until you see some bg under 200 and nadirs in the 200's. He is so young. Are the numbers on the ss only from the Libre? When did you start the transition to Dr. E"s? It at least is not as high in carbs as many other foods. That should help.

A different insulin is usually not tried until about 6 months. He is still on a low dose. Will he eat cooked chicken or any protein? If so you could add it to his diet and maybe be able to get him eating less dry food. If not you work with the dry.
 
As others have noted, the two insulins that are recommended by the American Animal Hospital Assn are Prozinc and Lantus. The other insulins. (e.g., Novolin, Vetsulin/Caninsulin) do not have a 12-hour duration which results in swings in the blood glucose numbers. They also tend to be rather harsh -- they can drop numbers quickly. Lantus and Prozinc have a longer duration and are gentler. Because they are gentler, they require more patience on the caregiver's part. It can take longer to get a cat's numbers down.

I truly understand your frustration. I would really wish that Rhubarb was more cooperative about canned food. Given where numbers have been sitting, Tight Regulation would be a good option but one of the issues with TR is that your cat needs to be on a canned food diet. The advantage of TR is that you can increase the dose sooner than with SLGS.

Honestly, you're doing everything right! The dilemma is that we never know how long our kitty has been diabetic. If a cat has been sitting in higher numbers, their body may get used to sitting in that range and it takes longer to get them used to spending time in closer to normal numbers. Just keep chipping away at it. There's really not a formal "rule" about how long a cat needs to be on a particular insulin before switching. I might suggest giving it 4 months and then discuss a switch to Prozinc with your vet.

One FYI, the newer oral diabetes medications (Senvelgo, Bexacat) are NOT indicated. Once a cat has been on insulin, the manufacturer does not recommend a switch to either of these medications.
 
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