Making the switch

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arozeboom

arozeboom

Member Since 2011
The vet recommended that I switch to Lantus this weekend.
Ruby's been on PZI and had a really good day yesterday but this morning, thru the roof again this morning. She's all over the map.

I'm still very tense about making the switch and I'm thinking about giving her another week with PZI, taking next Friday off from work and making the switch then. That would give me all of Friday, Saturday and Sunday to hover over her.

Can some of you experienced folks take a look at her spreadsheet and tell me what you think about dosing on the Lantus? The vet said to start with 1 unit twice a day but I'm wondering if I should start with .5 and move up from there if needed.

During the week I can't test her throughout the day. I can give her the shot in the morning and test about about 90 minutes after it. Then I won't be home again until her PM shot is due. I can usually get a +4 or +5 reading at night before I go to bed.
 
Hi guys and welcome to lantus land from us! I don't have any dosing advice myself, but others with much more experience/knowledge will be along soon and can help figure out the right starting dose for you. We started mocha out at 1u I believe and got as high as over 3u .. some cats need more, some cats need less .. Ruby will let you know :-D hang in there, and never be afraid to ask questions!
 
:lol: I know the feeling! You can check out mocha's SS and see she was anything but predictable! We had lots of ups .. and ups .. and a few downs .. with several more ups .. well, you get the picture! :lol: There were days I seriously wanted to throw her meter right out the door .. but didn't .. cause I always knew, tomorrow was a new day .. and I could always toss it then :lol:
 
Using a weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
  • ** the formula is 0.25 unit per kg of the cat's ideal weight
    ** if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
    ** if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
Click to expand...

This is the initial dosing info from the TR protocol. I'm not very familiar w/ PZI, but since Ruby is only on .5u I would tend towards a lower dose for safety sake. Especially since she went low on that dose. What does she weigh? That has a big influence on where you start.

When I switched Tess from Lantus to Levemir I reduced her dose and still had big drops, others have switched and noticed no difference, ECID (every cat is different!)

I think the bottom line is it is much safer and effective to start lower and work you way up to the proper dose than to start too high. You could miss the ideal dose that way and too much insulin can look very similar as too little.

This should at least bump you up to keep you at the top of the list to be seen more easily. Go to your first post and put the "?" by the subject. That should help get more attention.

BTW Ruby is absolutely gorgeous! :-D :-D :-D
 
Thanks! I think so too. I've always loved how her face is half black & half orange and her chest below it is the opposite.

When we were at the vet a couple of weeks back she was right at 14 lbs. She might be slightly under that now, but not much. She didn't lose any weight before her diagnosis. I think we caught it on a fluke because of the bladder infection.
 
True , Jesse. And you did mention that Ruby is a td chubby.

Well, doing the calculations on her current weight it would be 1.5u for a 14 pound cat so you vet may think the 1u is being conservative. I would still hesitate to give that much. I think others recommended a lower dose in you previous condos too. The thing is you can always increase the dose once the shed is filled.
 
hi amy. as much as i love both lantus and levemir, i'm surprised your vet wants to make a switch to lantus given ruby's recent response to pzi.

that high ps # this morning could very well be influenced by the partial fur shot last night (loss of carryover). i know pzi isn't considered a "depot" insulin, but all insulins offer some carryover when you're close to an optimum dose. as stated in the pet diabetes wikia:

"Because no insulin injection is immediately 100% absorbed by the body, the yet to be used insulin stays under the skin, the system drawing on this "reserve" as needed. Any such insulin effects that last after the insulin's expected action is over are also known as carryover in some literature."
http://petdiabetes.wikia.com/wiki/Insulin_depot

because pzi does not require consistent dosing, it affords you the luxury of adjusting the amount of the shot based on preshot numbers while at the same time giving consideration to nadirs. i have no hands on experience with pzi, but i bet there are others in the pzi group or even on Health who can help you develop a sliding scale.

as i mentioned in my first post to you, i think starting lantus at 1u bid would be a mistake based on the action you're seeing on a lower dose of pzi . when a cat is switching from another insulin we do not use the weight based formula. instead, we give a whole lot of consideration to kitty's response on the insulin used prior to the switch. based on current data, i wouldn't start out at any more than 0.5u of lantus. you may even want to try starting with 0.25 unit. it all depends on your comfort level with the possibility of steering low numbers as well as your availability to monitor closely this weekend.

hope this helps...


edited to add:
i just read thru your current thread on the pzi forum and saw the 401 @ +1.5. this definitely looks like a bounce.
i wouldn't be surprised if it clears soon.
 
Dr. K was going on the numbers from Jan 22 to Feb 6, if that makes any difference.

My gut is telling me to wait a week and its hard for me to ignore my gut. I'm thinking if last night wasn't at least a partial fur shot, she probably would have still been pretty good this morning. Its not that I don't trust Dr. K - she's got two diabetic cats at home and one who lives in the office. They're a cat only clinic so I'm pretty confident that she knows her stuff. But she doesn't know Ruby like I do. When her numbers are in the blues and high greens, her eyes get clearer and more sparkly and she gets the energy that she had 5 years ago.
 
i wonder if dr. K might feel differently if she was aware of ruby's numbers over the last few days.
amy, obviously the decision is yours to make. i don't want to dissuade you from using lantus because it's a great insulin, but sometimes it pays to go with your gut. holding off for a week isn't much in the general scheme of things.

i'm only saying this because it looks like ruby has turned a corner on pzi. :mrgreen:

i sent a PM to sue/oliver asking her if there was anyone in pzi land who has experience with sliding scales. sliding scales were used successfully by many pzi users in the past. not sure if any of them are around any more...
 
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