making the switch from PZI

[millerb]

Hi everyone. I'm relatively new to these forums and have already gotten a ton of (overwhelming) information.

Brief background: Skipper (male, 15.5 yrs old) diagnosed with diabetes Dec. 3, 2011. He has been on Prozinc ever since, but we were never able to get his BG under control (lowest ever reading at the vet was 450). He also has CKD, hyperthyroidism and anemia. Our vet sent us to see an internal medicine specialist, whom we saw March 5 and again March 12. She switched us to Lantus, and I gave the first dose last night at 5 p.m. I tested his BG at 9 p.m., and it was 405. At 4:30 this morning, it was 393. Both of these numbers are on the low end of what I got on a curve at home March 10 (see spreadsheet via link below).

My question is, how long does it take to determine if the Lantus is working? Will it happen right away, or is there any ProZinc remaining? Is there a buffer period where things have to get reset? Since the vet started us at 3 units 2x a day, and I've seen many posts say that is too high, I want to know if I should look for low BG right away. So far, he seems to be fine.

Thanks for the continued help!

 

[MommaOfMuse]

Before I answer if 3u is too high or not what is he eating?

Normally with Lantus we recommend starting at 1u b.i.d. but since he has been on PZI before this and has underlying conditions it is hard for me to tell you if it is too high or not. The bad part is that too much insulin and too little insulin can look exactly alike, if it is too little then their BGs remain high, if it is too much the body tries to protect itself from going to low and will release counterreglatory hormones and stored sugars which will drive the BGs up again.

Lantus isn't, however, an "instant' insulin like PZI it has to build up a shed or depot under the skin, which can take anywhere from 3-5 days to settle. So that you end up with kind of an overlapping effect the next dose is coming on right as the old dose is fading out. Lantus is all about patience, it is also based on the nadir or lowest point in the cycle as opposed to the preshot values. The three most important tests to try to get when you can are the preshots as well as a mid-cycle as close to the nadir as possible when trying to determine if the dose is a good one or not.

I wish I could give you more advice but I have no experience with any of Skipper's underlying health issues or how those might or might not effect his insulin dosage, hopefully others will weigh in and give you a little more direction in that department.

The Relaxed Lantus Forum can be pretty slow around here as there aren't many of us around. If you want additional information fairly quickly I would suggest posting over on the Lantus Tight Regulation forum as there are a lot more people around over there all hours of the day and night. So they might have more folks that has dealt with cats that have the other health problems that Skipper does.

You are always welcome to post here of course but just trying to think where we can find you the information you need to get Skipper feeling like his old self as quickly as possible.

Mel, Maxwell, Musette & The Fur Gang