Monkey's transition from Caninsulin to Lantus

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PH&MonkeyPenPenFaFaTiger

PH&MonkeyPenPenFaFaTiger

Member Since 2020
Please see my previous post for PenPen's situation
HELP! Monkey has bloated belly

How should I transit from Caninsulin to Lantus? I have U100. Monkey is using 3.25 unit of Caninsulin on a U40. However, his BG is above 300 most of the time Fyi,Monkey is eating 9 grams of dry food, I am reducing his dry food, it is possible that he will eat 0 dry food in few days if it is safe. @Deb&Wink @MarjiandGracie
 
Not sure your tags worked-- let's try a do-over: @Deb & Wink @Marje and Gracie

We usually keep the same dose, or close to it, when switching insulins. I'd go on the lower side for PenPen and the higher side for Monkey based on their recent numbers. Monkey, after that one dip down to 70, has been high for days and looks like he needs more juice. I'd suggest starting on 3.5U, unless others have different suggestions.
 
Nan & Amber (GA) said:
Not sure your tags worked-- let's try a do-over: @Deb & Wink @Marje and Gracie

We usually keep the same dose, or close to it, when switching insulins. I'd go on the lower side for PenPen and the higher side for Monkey based on their recent numbers. Monkey, after that one dip down to 70, has been high for days and looks like he needs more juice. I'd suggest starting on 3.5U, unless others have different suggestions.
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yes, but how can i convert u40 3 unit to u100? because i afraid i make mistake if i self learn it
 
I have written in Pen Pens thread and asked a couple of questions.

With Monkey are you also swapping over to canned food? And when do you think that swap over will be complete?
With Monkeys dose I would stick with the same dose he has been having 3.25 units.
Lantus is a depot insulin so you will need to hold the dose for 7 days unless the BG drops under 90 ( I am assuming you are going to do SLGS method at this point?
Test before every shot and try and get a test in during both cycles as Lantus is dosed on the nadir ( lowest point in the cycles).
Always try and get a before bed test in so that you can see what is happening. If the before bed test is lower than the preshot, I would set the alarm and test again later to see the BG has not dropped too low.
 
Bron and Sheba (GA) said:
You don't do any conversions. You just use the U-100 syringes and the Lantus insulin.
Bundle up the U40 syringes and put them away somewhere where you won't get them mixed up or throw them out.
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Can I say, if I use THREE units in U40 for Caninsulin, then I use SAME unit, that is THREE units in U100 for Lantus injection?

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Peter H said:
Can I say, if I use THREE units in U40 for Caninsulin, then I use SAME unit, that is THREE units in U100 for Lantus injection?

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Peter, the U40 syringes are bigger...you can see the bigger barrel.
You need to get rid of them now, so you don't get them mixed up.
PLEASE, bundle up the U40 syringes now and either throw them out or put them somewhere where you won't get them mixed up and CLEARLY mark the outside as U40 syringes.

If you use the U100 syringes that are the correct syringes for Lantus you will be giving the correct dose.
 
Bron and Sheba (GA) said:
Peter, the U40 syringes are bigger...you can see the bigger barrel.
You need to get rid of them now, so you don't get them mixed up.
PLEASE, bundle up the U40 syringes now and either throw them out or put them somewhere where you won't get them mixed up and CLEARLY mark the outside as U40 syringes.

If you use the U100 syringes that are the correct syringes for Lantus you will be giving the correct dose.
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Yes, I understand I need to hide U40 far away to avoid serious mistake. I understand U40 are bigger. Just to double check, if I inject 3 units in U40 for Caninsulin, then now I inject 3 units in U100 for Lantus, is that correct?
 
Peter H said:
Yes, I understand I need to hide U40 far away to avoid serious mistake. I understand U40 are bigger. Just to double check, if I inject 3 units in U40 for Caninsulin, then now I inject 3 units in U100 for Lantus, is that correct?
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If you are swapping over to Lantus you will no longer be using caninsulin AT ALL.
You need to wait 12 hours after the last dose of caninsulin before you start the Lantus insulin.

Peter H said:
He was diagnosed 4 weeks ago. One week ago I ask the doctor if I need to buy testing paper to test for Katone, he said "No need" . Home BG check is enough
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It sounds as if Monkey didn't have any ketones at diagnosis then.
However your vet is incorrect,it is always a good idea to test your cat for ketones especially if he is newly diagnosed and unregulated. I would buy a bottle of Ketostix from the pharmacy and test at home. You don't need your vets permission for that.

So just to confirm, Monkey has been on insulin for a month, is that correct?
And what dose did he start out on? (Can you answer quite quickly please Peter as it is very late here and I have to head to bed, but I want to help you first.:)
 
Bron and Sheba (GA) said:
If you are swapping over to Lantus you will no longer be using caninsulin AT ALL.
You need to wait 12 hours after the last dose of caninsulin before you start the Lantus insulin.


It sounds as if Monkey didn't have any ketones at diagnosis then.
However your vet is incorrect,it is always a good idea to test your cat for ketones especially if he is newly diagnosed and unregulated. I would buy a bottle of Ketostix from the pharmacy and test at home. You don't need your vets permission for that.

So just to confirm, Monkey has been on insulin for a month, is that correct?
And what dose did he start out on? (Can you answer quite quickly please Peter as it is very late here and I have to head to bed, but I want to help you first.:)
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Yes of course I do not have to inject Caninsulin again after I change to Lantus.

So the statement "if I before inject 3 units in U40 for Caninsulin, then now I inject 3 units in U100 for Lantus, is that correct?

Sorry that I ask repetitively, I just want to make sure.

For the first 3 weeks of treatment, I was not taking care of Monkey, my family member was taking care of him and fail in many ways (not knowing 12 hours cycle)

It caused Monkey's health deteriorating quickly (lose muscle, fur, skin problem, neuropathgy. After I started to take care of Monkey, Monkey is recovering quickly, he is 1lb heavier in one week

He started with 3 units of U40 Caninsulin, that was decided by the vet
 
Peter H said:
Yes of course I do not have to inject Caninsulin again after I change to Lantus.

So the statement "if I before inject 3 units in U40 for Caninsulin, then now I inject 3 units in U100 for Lantus, is that correct?

Sorry that I ask repetitively, I just want to make sure.

For the first 3 weeks of treatment, I was not taking care of Monkey, my family member was taking care of him and fail in many ways (not knowing 12 hours cycle)

It caused Monkey's health deteriorating quickly (lose muscle, fur, skin problem, neuropathgy. After I started to take care of Monkey, Monkey is recovering quickly, he is 1lb heavier in one week

He started with 3 units of U40 Caninsulin, that was decided by the vet
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Thanks for answering quickly Peter!
Ok thanks, I just wanted to establish how much insulin he has been on during the month.
That is wonderful he has put on a lb in weight!
So according to the spreadsheet Monkey has been getting 3.25 units....
If you would be more comfortable starting with 3 units instead of 3.25 units that would be OK.
Usually when a cat is swapping over to another insulin, we do a straight swap, unless something tells us other wise.
(With PenPen he is newly diagnosed and that is why I suggested a lower dose for him and the fact he was dropping low on higher doses)
For Monkey....What are you comfortable with...3 units or 3.25 units?
 
Bron and Sheba (GA) said:
Thanks for answering quickly Peter!
Ok thanks, I just wanted to establish how much insulin he has been on during the month.
That is wonderful he has put on a lb in weight!
So according to the spreadsheet Monkey has been getting 3.25 units....
If you would be more comfortable starting with 3 units instead of 3.25 units that would be OK.
Usually when a cat is swapping over to another insulin, we do a straight swap, unless something tells us other wise.
(With PenPen he is newly diagnosed and that is why I suggested a lower dose for him and the fact he was dropping low on higher doses)
For Monkey....What are you comfortable with...3 units or 3.25 units?
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Yes Monkey is generally doing great:cat:. I hope to end his suffering as soon as possible.
I am comfortable with higher dose such as 3.25 and 3.75, since his BG is higher than 300 at all time. What I am scared about is transiting to another insulin.
I think I will start with 3.25 Lantus U100 tomorrow morning.

Btw I am taking him to the vet to check his bloated stomach. Please see the bloodwork of monkey. What do you think about it He has higher than normal white blood cell, particularly
MONOCYTES, EOSINOPHILS, BASOPHILS, . According to All Feline Hospital:

1. MONOCYTES are a less common type of white blood cells of the immune system that can indicate stress or chronic inflammation.
2. EOSINOPHILS are a type of white blood cells of the immune system. An elevation in absolute or total eosinophils can indicate allergy disorders, parasitism,and some skin and intestinal disorders.
3. BASOPHILS are a less common type of white blood cells of the immune system. Elevations in these can indicate allergy disorders, parasitism, and neoplastic states.

I do find that Monkey has tumor on his skin (neoplastic), skin inflammation, bloated belly, and super huge appetite. Also, Monkey is a bit in CHOLESTEROL, do you think I need to feed less organs(high cholesterol) and more chicken breast (more protein and less cholesterol, I guess)?

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Peter,when you swap over to Lantus you will need to put a thick coloured line across the SS of both cats and write "changed to Lantus" across the thick line.

Yes start at 3.25 units. You don't want to increase the dose when you are starting a new insulin.

I am goimg to tag @Marje and Gracie to look at the path results for you.
You are doing a great job with Monkey!
I'll look in tomorrow when I wake up.
 
Peter

The only issue with the labs that really stand out to me is that it looks like he’s got some kind of infection because his white blood cell counts are so high. Beyond being able to tell you that, there are so many things that can cause elevated WBC counts and I am not a vet. I would definitely get your vet to address this and don’t let him say, “don’t worry, it’s ok”. They shouldn’t be that high without a good reason. If it was just one of them it might be ok to say that but not for all of these.

i wouldn’t worry about high cholesterol. It seems to be common in diabetic cats but can also be influenced by when he last ate and what he ate.
 
Peter what are you actually feeding Monkey? I know you are transitioning over from a dry food but what is the new food?
You mention chicken breast and organs. They are great but they are not a complete food on their own. If you are going to feed a raw diet it will need supplements. If you are only giving some extra chicken and organ but feeding a canned food diet then that is ok.
Also with organs .... what are you feeding? With liver and kidney you should only be giving a small amount each day ... around 5 to 10 grams only.
With heart, if it’s chicken heart only give about 3 or4 hearts a day and the equivalent amount if it’s beef or lamb heart.
 
Bron and Sheba (GA) said:
Peter what are you actually feeding Monkey? I know you are transitioning over from a dry food but what is the new food?
You mention chicken breast and organs. They are great but they are not a complete food on their own. If you are going to feed a raw diet it will need supplements. If you are only giving some extra chicken and organ but feeding a canned food diet then that is ok.
Also with organs .... what are you feeding? With liver and kidney you should only be giving a small amount each day ... around 5 to 10 grams only.
With heart, if it’s chicken heart only give about 3 or4 hearts a day and the equivalent amount if it’s beef or lamb heart.
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Thanks for telling me exact numbers. I will remember that. Currently i am feeding 4grams of dry food, a lot of can food from Feline Natural, a lot of chicken breast. I decide not to give raw organs since i am not sure how much i should give. I give extra raw cooked chicken breast only because i think it wont be dangerous even o gcie too much
 
Peter H said:
Thanks for telling me exact numbers. I will remember that. Currently i am feeding 4grams of dry food, a lot of can food from Feline Natural, a lot of chicken breast. I decide not to give raw organs since i am not sure how much i should give. I give extra raw cooked chicken breast only because i think it wont be dangerous even o gcie too much
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It is quite safe to give raw organs if you don’t give too much. Liver is full of nutrients and a small piece each day (6 grams) or a couple of times a week would be fine. You give the same amount of kidney as you do liver a day or you can feed it a couple of times a week.
With chicken hearts it is quite safe to give three a day.
I feed my cats a completely raw diet and they get several different varieties of meat each week and a small price of liver, kidney and 3 Chicken hearts a day. One of them eats bones as well but the other can’t as she has few teeth but I supplement the calcium for her.
 
Update: Tonight is the first time and PenPen and Monkey do not eat any dry food. Also, I find that Lantus is just better than Caninsulin. Their insulin peaks are similar level, but on average Monkey on Lantus has on average lower BG, and the level is a lot more stable. (i.e. less fluctuation). Of course reduction of dry food maybe a factor.

Tomorrow I may see if I want to increase the dose for Monkey. Thank you for your love to Monkey and PenPen.:cat:
 
Peter H said:
Update:
Tomorrow I may see if I want to increase the dose for Monkey. Thank you for your love to Monkey and PenPen.:cat:
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Peter,
With Lantus, it is different to caninsulin. It is a depot insulin and you need to hold the same dose for 5 to 7 days in the beginning, for the depot to fill and stabilise. If you chop and change the dose at this point you will mess it all up and get wonky numbers. The only reason you would change the dose is if Monkey drops too low and you had to decrease the dose.
It takes up to 5 days for the full effect of the dose to take effect in the beginning.
And then later as you change the dose you need to hold the dose for three days for the depot to fill and the full effect of the dose to take effect.
If you rush in and change the dose too early you will not have success.
With Lantus you need patience.
 
Update: Monkey is feeling well. He starts to show curiosity about things, just like before. One thing is when I pet him in my bed, he suddenly pee on my bed. That's strange because he had never been like that. Thanks for reminding me of the difference between Lantus and Caninsulin. I would forget the difference if you did not mention it.:) I think that the way how Lantus work is not intuitive to me. I was wondering how to scientifically explain that Lantus needs to hold same dose for five days, like how would it mess up if I increase the dose by 0.5 U on the second day.

As advised by you, I should stay 3.25 U for Monkey for 5 days. Although some part of me wants to quickly improve his BG by increasing the dose, he is having decent BG that is lower than before.
 
From what I understand Lantus is a GOOD insulin for cats. You do have to be patient and let it do its job. By using lantus you are building a better foundation (not to mention all the experts here know it inside and out) You will get a lot of help. Heck you are already on your way and have already started building that foundation. Monkeys numbers should start improving soon . It cant happen over night but trying to follow the instructions you get here will help tremendously.
Sustained higher numbers can cause damage but give lantus time to do its job. ;)

We need more cheerleaders to get you through this tough time!
 
Peter Monkey is looking better on the Lantus. I’m glad you are sticking with the 3.25 dose!
Don’t forget to take some tests in the evening cycles as well. Cats often drop lower at night and the pm cycle is half the puzzle.
 
jt and trouble (GA) said:
From what I understand Lantus is a GOOD insulin for cats. You do have to be patient and let it do its job. By using lantus you are building a better foundation (not to mention all the experts here know it inside and out) You will get a lot of help. Heck you are already on your way and have already started building that foundation. Monkeys numbers should start improving soon . It cant happen over night but trying to follow the instructions you get here will help tremendously.
Sustained higher numbers can cause damage but give lantus time to do its job. ;)

We need more cheerleaders to get you through this tough time!
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Yes, I can say cheerleaders is so important. I cannot imagine what would Monkey and PenPen be without this community. This forum really help me to have a clear head to be confident to make informed decisions, which cannot be learned from just information that is without interaction:rolleyes:
 
Bron and Sheba (GA) said:
Peter Monkey is looking better on the Lantus. I’m glad you are sticking with the 3.25 dose!
Don’t forget to take some tests in the evening cycles as well. Cats often drop lower at night and the pm cycle is half the puzzle.
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Yes, I am so glad that I change to Lantus. Monkey reaches a new record of 121 ml/dl BG today. I am planning to increase his dose by 0.5 after the depot period that two days later. What do you think?
 
Peter H said:
Yes, I am so glad that I change to Lantus. Monkey reaches a new record of 121 ml/dl BG today. I am planning to increase his dose by 0.5 after the depot period that two days later. What do you think?
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Peter, Monkey is doing really well so far on the Lantus. Please don’t try and rush things.
With that 122 today I would highly recommend you hold the dose of 3.25 units longer than the next two days.. You can see how the numbers are lowering as the depot fills and when you hit low blue numbers it is recommended to hold the dose longer.

And when you do increase....and please don’t just go ahead and increase....please Wait until we recommend you increase....you should only increase by 0.25 units.

Monkey could well bounce from the blue number today, don’t let that worry you. He will come back down. Don’t be tempted to increase with a bounce.
 
So, he has already eaten his dinner? When did he eat the "can food + chicken breast", relative to the 153 test? I am just trying to figure out how much of an influence of food there was on that number.

How about a re-test now, to see where he is? There will definitely be some food influence now, but we can take that into account when interpreting the number.
 
@N
Nan & Amber (GA) said:
So, he has already eaten his dinner? When did he eat the "can food + chicken breast", relative to the 153 test? I am just trying to figure out how much of an influence of food there was on that number.

How about a re-test now, to see where he is? There will definitely be some food influence now, but we can take that into account when interpreting the number.
Click to expand...

Monkey has finish his dinner which was a lot of meat 10 minutes ago. He wants more so I am going to feed him 1 hour later. Before dinner, he eats 9 hours ago. We usually give him many meals per day. But today we are out, so he may eat less today.

I test his BG 1 minute ago, it is 201. @Nan & Amber (GA)
 
Hey Jeanne, regarding to the tagging problem, I find that if you type this on a post, you can tag people without needing that tagging box to come out.

For example:
@Nan & Amber (GA)
@Bron and Sheba (GA)
@jt and trouble (GA)

upload_2020-4-20_22-17-44.png


You can type the text in above to tag people, I have tested it. What I have not tested is if spacebars are not applied corrected. Once you have the correct text, you may copy down to your clipboard.

Hope this can help you
 

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I think that tagging trick is ingenious! You can see the userid numbers if you quote-reply, it's part of the text.

As for the highlighting, I have no idea, lol!
 
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