Lantus to humilin n

[StephyL6]

I have been treating my 10 year old (approximately) male orange tabby Mew for diabetes since I found him in the street 3 months ago. He was on lantus for about 2 months with great progress along with a low carb canned food. He then had a hypo episode and went down to 30, insulin changed to 1 unit twice daily. Still crashed so 1 unit once daily. Still had a hypo event so down to 1 unit every other day. The vet recently changed him to Humilin n insulin 1 unit twice daily. I did a curve yesterday and 4 hours after insulin he was at 164 two hours later he was all the way up to 438. I assume this was because of the symogi effect but am at a loss. Just wondering if others have used humilin n and had any advice. Thank you!

 

[BJM]

Those steep swings are exactly why Humulin or Novolin NPH tend not to work well for cats. There is a primer for using N in the forum for it. I'm on my phone, or I'd link it.

I'm guessing you might have been using a pen for the Lantus. We use a syringe and measure half and quarter units and even drops when weaning a cat off insulin.

If you were using the pen needles, maybe get yourself some U-100, 3/10 mL, short or long needle, 30-31 gauge syringes with half unit markings and consider eyeballing a 0.25 unit dose with the Lantus twice a day, instead of the N.

Depending on what you are feeding, your experience with Lantus suggests you may be able to get him off insulin. We recommend low carb canned or raw, over the counter food such as Fancy Feast Classic Pates or Friskies plain pates (ex. Turket and Giblets, Poultry Platter, Liver and Chicken)

 

[StephyL6]

Thank you so much for your response! I actually have been using vial and u-100 syringes and was also wondering why my vet didn't suggest moving to a lower dose than 1 unit. In general he was doing well on the lantus and his numbers were dropping consistently but the hypo episodes were very scary. I am feeding him ff and the poultry platter currently. I will ask my vet about a lower dose of lantus because this insulin is clearly not a good choice.

 

[BJM]

Check the Lantus forum her and read over the stickie posts at the top, which may give you some ideas.
Also, are you home testing the blood glucose? It will help keep your cat safe when you know what the pre-shot glucose level is and how low he is going in the +5 to +7 hours post-shot when he is likely to be lowest.
All you need is an inexpensive human glucometer, matching test strips, and lancets for alternate site testing (25-28 gauge). Many of us use the WalMart Confirm or Confirm Micro (aka the Glucocard 01 and 01 Mini at www.adwdiabetes.com)

 

[StephyL6]

I'll definitely take a look at that lantus forum. I have been home testing since giving insulin and did a curve on him yesterday, not very fun for either of us! I just spoke to my vet and she agreed that going back to a half unit of lantus was the best choice. Fingers crossed!

 

[BJM]

See my signature link Glucometer Notes for feline-specific reference ranges when using various glucometer types and readings to evaluate the glucose levels.

Also, can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.