Intro - George

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George’s Mom

George’s Mom

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Hi! New to posting to this forum. Been getting advice from other posts for a while now.

George, 17.5 year old otherwise healthy kitty, has been diagnosed as diabetic for about 10 mos now. He was on 4 units 2 x a day but the PZI was only lasting about 6 hours and then his BG was shooting up to >500. We have had him consistently on a Libre sensor for about 2 months. His PZI nadir was not going below 200. So he was bouncing mostly between 300 and 500 and rarely below 200 (maybe twice in 2 mos).

So we have switched to Lantus. Vet recommended 2 units 2x a day. His numbers are much flatter which is good (no big bounces liked it did with PZI). However, we are not getting readings below 350 now. Nadir is 350-400 and rest of the time it’s >400.

Feeding him low carb wet food only - Beyond Trout and Catfish (1%) or Duck (3%). He free feeds and eats often.

I after 6 cycles, I bumped him up to 2.5 units 2x a day. That was yesterday morning and then moved to 2.75 because he’s so high. Kitty doesn’t feel good and is very lethargic. He also has some neuropathy. *I bumped him to 3 tonight.*

I’ve read the guidelines on tight regulation Lantus administration and have been using this. I’m just wondering if I should bump him up more aggressively since he is so high and doesn’t go low at all?

***I just created the spreadsheet and figured out the signature etc. Let me know if I missed something but I think I am following all forum guidelines for info provided now*** Also, my spreadsheet has a tab with curve pictures in it.

Thanks! This message board is amazing btw!

Rachel

link to my original post:
https://www.felinediabetes.com/FDMB/threads/lantus-bg-too-high.265716/
 
George’s Mom said:
Hi! New to posting to this forum. Been getting advice from other posts for a while now.

George, 17.5 year old otherwise healthy kitty, has been diagnosed as diabetic for about 10 mos now. He was on 4 units 2 x a day but the PZI was only lasting about 6 hours and then his BG was shooting up to >500. We have had him consistently on a Libre sensor for about 2 months. His PZI nadir was not going below 200. So he was bouncing mostly between 300 and 500 and rarely below 200 (maybe twice in 2 mos).

So we have switched to Lantus. Vet recommended 2 units 2x a day. His numbers are much flatter which is good (no big bounces liked it did with PZI). However, we are not getting readings below 350 now. Nadir is 350-400 and rest of the time it’s >400.

Feeding him low carb wet food only - Beyond Trout and Catfish (1%) or Duck (3%). He free feeds and eats often.

I after 6 cycles, I bumped him up to 2.5 units 2x a day. That was yesterday morning and then moved to 2.75 because he’s so high. Kitty doesn’t feel good and is very lethargic. He also has some neuropathy. *I bumped him to 3 tonight.*

I’ve read the guidelines on tight regulation Lantus administration and have been using this. I’m just wondering if I should bump him up more aggressively since he is so high and doesn’t go low at all?

***I just created the spreadsheet and figured out the signature etc. Let me know if I missed something but I think I am following all forum guidelines for info provided now*** Also, my spreadsheet has a tab with curve pictures in it.

Thanks! This message board is amazing btw!

Rachel

link to my original post:
https://www.felinediabetes.com/FDMB/threads/lantus-bg-too-high.265716/
Click to expand...
I can tag a few members for , can you please remove the GA from your title it means Kitties that have gone ahead passed away
Look to your right tap on Thread Tools , then tap on Edit Thread remove GA and tap Save

@tiffmaxee

@Bron and Sheba (GA)

@Wendy&Neko
 
Hello and welcome Rachel and sweet George. When people switch from a non depot style insulin to Lantus, we have them switch at about the same dose, depending on how the original Prozinc/PZI does was doing. Given that you didn't see anything under 200 (and had a Libre so would know if you saw it), I'd suggest bumping him up to 4 units. At that point, hold the dose for 5 days at least. We hold initial Lantus doses 5-7 days. Provided of course, he doesn't go low on that dose. You will have to be patient, sometimes the first couple cycles of a new dose on Lantus can have some wonky numbers, which we affectionately call New Dose Wonkiness.

I removed the GA. ;)

You might want to head on over to the Lantus/Levemir/Biosimilars forum, if you haven't been there already, and start reading the Sticky Notes on the top of the forum.
 
Thanks for posting here. GA means guardian angel and that a cat has gone ahead to the rainbow bridge so you will want to remove that. The original depot takes about 7 days to build. I do think you started on too low a dose. I would stick with 3 units for at least 3 days now and let the depot build. See what Wendy thinks as to whether you increase any sooner. We would have started on 3.5 or 4.0.
 
Wendy&Neko said:
Hello and welcome Rachel and sweet George. When people switch from a non depot style insulin to Lantus, we have them switch at about the same dose, depending on how the original Prozinc/PZI does was doing. Given that you didn't see anything under 200 (and had a Libre so would know if you saw it), I'd suggest bumping him up to 4 units. At that point, hold the dose for 5 days at least. We hold initial Lantus doses 5-7 days. Provided of course, he doesn't go low on that dose. You will have to be patient, sometimes the first couple cycles of a new dose on Lantus can have some wonky numbers, which we affectionately call New Dose Wonkiness.

I removed the GA. ;)

You might want to head on over to the Lantus/Levemir/Biosimilars forum, if you haven't been there already, and start reading the Sticky Notes on the top of the forum.
Click to expand...

Thanks! I have looked around a bit in the Lantus section and understand the depot nature. I am going to bump him up again tomorrow to 3.5 or 4 depending on how he does with 3 tonight. Assume he’ll still be way above 200. Thanks to both for the quick responses! No idea how I set the post as GA but thanks for fixing!
 
Wendy&Neko said:
Hello and welcome Rachel and sweet George. When people switch from a non depot style insulin to Lantus, we have them switch at about the same dose, depending on how the original Prozinc/PZI does was doing. Given that you didn't see anything under 200 (and had a Libre so would know if you saw it), I'd suggest bumping him up to 4 units. At that point, hold the dose for 5 days at least. We hold initial Lantus doses 5-7 days. Provided of course, he doesn't go low on that dose. You will have to be patient, sometimes the first couple cycles of a new dose on Lantus can have some wonky numbers, which we affectionately call New Dose Wonkiness.

I removed the GA. ;)

You might want to head on over to the Lantus/Levemir/Biosimilars forum, if you haven't been there already, and start reading the Sticky Notes on the top of the forum.
Click to expand...
Well, we certainly have some new dose wonkiness going on. I am holding steady now at 4 units but poor guy is suffering through these high numbers. He is still eating often, so that’s good. I haven’t gotten to read ketones yet but planning to isolate him from other cats today to see what’s going on in that regard.

I am planning to stay the course at 4, but let me know if you have any other thoughts. I will keep my spreadsheet (and curve pictures) up to date.

thanks!

Rachel
 
It'd be great to see date up to today on the spreadsheet. ;) Now it's time to stick with this same dose for several days. As we say, Lantus can teach you patience.
 
Wendy&Neko said:
It'd be great to see date up to today on the spreadsheet. ;) Now it's time to stick with this same dose for several days. As we say, Lantus can teach you patience.
Click to expand...

Whoopsie! I am up to date but I misdated (had two 7/11/22s) Fixed now. Also working on updating this afternoon now. Ketones picture is in with Libre curve. Seems like he’s okay (minus his high glucose).
 
Okay, we got some #s in the 200s last night. Sadly, he spiked back into the 400s pretty quickly. Dang it.

Question: recommendation for syringes? I am using the Ultracare VetRx syringes, but I keep getting air bubbles that won’t exit the syringe. I flick the syringe and the move to the top (where needle is), but the bubble(s) just sit there until I completely empty the syringe. I didn’t have this problem with U-40 syringes with PZI (same brand) but now it seems like every dose I am guessing the volume of the air bubble to ensure I am properly dosing 4 units. Is there a suggested best syringe? I saw the post with about 5-6 recommendations for syringes. Which one is best? I am going to purchase and prob throw away these VetRx syringes. They really suck… Thoughts?
 
Hi Rachel I see a lot of members love these syringes
Call then and they will contact your vet to fax over a script ,so give the vet a heads up and ask for refills you can then just go on line and order them

https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct
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Diane Tyler's Mom said:
Hi Rachel I see a lot of members love these syringes
Call then and they will contact your vet to fax over a script ,so give the vet a heads up and ask for refills you can then just go on line and order them

https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct
:bighug::bighug::bighug::bighug::bighug::bighug::bighug:
adw-coupon-dia10.jpg

10% off your next order
Click to expand...
Do you have to get a prescription for these? I ordered the VetRx ones on Amazon and didn’t need a prescription. I’ll definitely try these either way. They’re cheaper too. Bonus!
 
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