Jean Luc - Lantus Dosage

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snorton

snorton

Member Since 2012
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Plan to start Lantus tomorrow night. Intital dosage from vet is 2.5U 2x / day. Is this about right or to high?
Little guy is ~12lb and from attached link is having a very hard time regulating on ProZinc. I've been giving him 1.75U ProZinc this week at +5's have been in the mid 300's.

Thanks for you help.
 
There are two considerations with respect to your starting dose. The first is your current dose of PZI. Marje explained that in some detail. The other is your cat's weight. If approx. 12 lbs is an ideal weight for Jean Luc, then the initial dose would be 1.35u (initial dose = 0.25 x ideal weight in kilograms). Since we like to factor if a safe margin given that some cats have a marked response to a new insulin, the 1.25u dose that Marje calculated is a fine place to start.
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I think 2.25u twice a day is high. I would not want to see you giving more Lantus than what you are dosing with PZI. As Marje posted in your previous thread, we tend to have people reduce the overall dose by 30% when changing insulin. Some cats have a marked response to a switch in insulin and the reduction builds in a margin of safety.
 
I am not sure the dose of 1.75u is even working. His nadirs seem to be in the 300s the last couple of days. His urine level is up. He is still active. Actually jumped in dinning room table tonight to watch me mix his food. Is it true the lantus can take up to 3 days to work? I think I may have read too much and gotten confused.
 
Lantus is a depot-type of medication. As such, it need time for the depot to form. You usually hold your initial dose for 5 days to allow the depot to form. Because Jean Luc is switching insulin, we can always fast tract his dose. I would just be very wary of increasing his dose from 1.75u of his current insulin to 2.25u of Lantus.
 
Is it true the lantus can take up to 3 days to work?
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Hi Shannan,
No, it will start working right away, but it may take 3-5 days, possibly longer, for you to be able to tell how well the starting dose is working. Lantus is called a "depot" style insulin, and it can take that long for the depot to become established.

However, as Sienne said:
some cats have a marked response to a switch in insulin and the reduction builds in a margin of safety.
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Some cats do react very quickly to a change in insulin. If you want to see an example of that, check out "Libby and Hershey's" first day after switching from Prozinc to Levemir. Hershey reacted very soon to the change, and that's the primary reason that the advice is to start Lantus or Levemir on a lower dosage than the cat had been on with Prozinc. Your vet is suggesting an increase from the 1.75u Jean Luc is on. If Libby had done that, it may have been way too much insulin for Hershey. You may not feel like his current dose of Prozinc is working well at all (and to some extent, I agree with you), but Hershey's Prozinc dose wasn't working all that well either. You've most likely seen "this is a marathon, not a sprint" and probably way more often than you wanted to. But the primary concern of everyone here is "safety first". Jean Luc would be much better off with 3-5 days of high numbers than 3-5 minutes of "too low" numbers.
I think Marje's post in your other thread said that 1.25u was suggested? I would definitely go with the voices of experience here.

Carl
 
Welcome to Lantus Land! Jean Luc is a very handsome kitty! I agree with Marje's recommendation. Insulin is a powerful hormone and you want to start on the low side since you don't know how Jean Luc will react. It would break your heart (and ours) to have too high of a dose.
Liz
 
I don't have a problem doing something different than the instructions. I just want to fully understand why and possible implications of said action. Thank you for the feedback. I just want kitty to stay at "my reasonable" bg levels for 'reasonable' timeframe. The trampolining and airplane riding is getting old!! ARG....... Yes, I am learning more patience!!
 
Vets have an incredible amount of knowledge about many difference species and diseases. They are amazing. But, quite frankly, most vets do not give very good dosing advice. They haven't lived FD 24/7 like everyone here. And they haven't studied the research in depth like a few folks here. They also aren't available 24/7 like this board. We have a great vet who recognizes that it's a team effort to take care of Zener and she leaves the dosing decisions up to us, knowing we get advice here. Hopefully, you can work with your vet to give Jean Luc the best possible care.
Liz
 
Hey, Shannan -

I've been on vacation the last few days and am way behind, so forgive me if I repeat something you've already heard. Hershey was diagnosed Jan, 2012 and started on ProZinc. Five months later, we switched to Levemir and have just marked two months here. One of the hardest things for me has been trying to 'un-learn' the ProZinc thinking. We signed on for TR because we thought it would give Hershey his best chance at regulation and maybe even remission. He still deals with bounces and up and down doses and may for the rest of his life. And, while that is not what I would wish for him or any other kitty, he is visibly healthier than he has been in a long time. He doesn't run and carry on as much as the 5-year cat (Oreo) but he can jump down from the furniture and his coat is soft and silky, just to name a few improvements. It may help you to look at Hershey's SS and see how quickly things can change when changing insulins. (paha - I just skimmed down and saw Carl suggested the same thing.)

And, Liz is right. Vets are well-educated, but not always the greatest resource for knowing how to dose your kitty's insulin. Mine had never heard of dosing less than 2u bid and has no other patients on Levemir. (Long story :smile: ) This group has some phenomenal people who are an invaluable resource. :smile: It is a large group and sometimes it

I hope all goes well for you with that patience thing...too often my patience pants are in the wash when I need them! :lol:

I look forward to getting to know you better -

Libby (& Hershey, too!)
 
I definitely would err on the side of caution. Ruby dove down to 72 (on an AlphaTrak) on her second dose of Lantus. She did a roller coaster of up and down before she evened out a little.
 
Doug N Libby said:
It is a large group and sometimes it
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Well, there ya' go - clearly not firing on all cylinders! :oops: I was going to say It is a large group and sometimes it may seem overwhelming, especially at first. Visit people when you can and meet a couple of kitties a day... :-D

Sorry about that!
 
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