My vet recommends Insulin Humulin R instead of Lantus

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Gozde Yildirim

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Hi,
I have introduced myself and my diabetic cat sisi before. She is 11 years old, first diagnosed diabetic 1 month ago. We have used Glipizid for one month. Her glokose level decreased from 470 to 330 in last 2 weeks after I started feeding her with low carb - high protein diet with your recommendations. Thanks a lot for introducing me with Isıl (she is a member of this forum from Turkey). I use now Fancy Feas canned food like her.

This week, my vet wanted to start Insulin and she wants to use Humulin R. I know that you have great experienced with Lantus, however she insisted on Humulin R (short and fast effect insulin).
Do you have any experiences with Humulin R?

I checked 4 times during a day at the weekend and the results were very close to 330. One problem I have is that, I will be injecting Insulin maximum twice a day during day as I will be at office. I would prefer to make injection one time in a day.

I would appreciate any of your comments and advices. Many thanks, Gözde
 
Humulin R is basically a "rescue" insulin it is extremely fast acting and wears off even faster...it is not IMO an insulin to use for daily maintance of a diabetic cat. R is usually used for a cat in DKA when blood sugar has to be brought down extremely fast. Not only does it work very quickly it only lasts about 3-4 hours max.

All cats need even the longest lasting insulins such as Lantus twice a day, there are very few cats that can maintain the proper blood sugar levels on a single injection a day, and those that are only recieving one shot a day are those that are on tiny doses and headed for remission.

Mel, Maxwell, Musette & The Fur Gang
 
Humulin R is NOT a regular insulin.... sorry but it is very harsh on the cat and yanks down the numbers so it's used if a cat is in very high dangerous numbers.... It lasts only 4hours, if that! Ask the vet how often you have to give shots, How long does R last, and what dose you would give, then post here. The answers will be very telling about your vet's knowledge about insulin and feline diabetes.
Does the vet plan for you to give shots every 4 hours?

Ridiculous. You could seriously harm your cat with R; it's an emergency type of insulin, not a normal one.

Lantus, Levemir, or Prozinc are longer lasting insulins.
 
Is it possible that the vet meant Humulin N or NPH? Some vets still use N, although it is also a faster acting insulin and not a good insulin for diabetic cats.

Please read and share this American Animal Hospital Association treatment protocol for cats with your vet, which was issued in 2010. Both Prozinc and Lantus are more appropriate than N. And using R is not acceptable treatment except in an emergency.

http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf

Regarding insulin dose frequency, cats need twice daily insulin dosing. That can be done even on a rough work schedule. When I began insulin treatment for Gandalf I also thought I could only do shots once a day. When I learned how to home-test and what the blood glucose values meant I felt more in control and somehow managed to do shots as close to every 12 hours as I could.

Dosing every 12 hours in the beginning is very important and will give you a much better possibility of getting him diet controlled and in to diabetic remission.
 
I would ask your vet what his success rate is with Humulin? Has he ever gotten a cat regulated on it or into remission? If not, would he be willing to experiment with you with another insulin.

Once a day just won't work. You can experiment within that 12 hour window to make a schedule that works. (I have no idea but 4:30am and 4:30pm if that works, or whatever)
 
Many thanks for all your replies. I have sent my vet the tight regulation document of Lantus and some more documents. I will never start Humulin R ( I am sure she says Humulin R, but I see that none of the Humulin insulins work fine with cats).
I have seen that there are good stories of PZI as well. After all your comments, I am sure I will start with Lantus.
As I mentioned above, my cat sisi has Blood Glocose around 330 , I will not give a dose if she is under 250, do you think it make sense?
 
We recommend that without lots of data, not to shoot below 200. With lots of data, knowing how your cat responds, that number may be lowered to 150.

Also, we recommend starting with a low dose of 0.5 - 1.0 Units (not mL) of insulin, every 12 hours,
Always test before you shoot to make sure it is safe.
When possible, get a before bed test (some cats go lower at night).
When you can, get some mid-cycle tests around the probable nadir (lowest glucose level); usually from +5 - +7 hours after a shot.
 
Welcome Gözde :-D
I agree that Humulin R is way to harsh and fast acting and dangerous to give as a regular insulin.
I wish you the Best Of Luck in getting the Lantus and in finding a vet that will work with you.

We're always here for you.
 
Eeeeps! Humulin R is used in cases of medical emergency - like DKA- and is never used on a day-to-day basis to treat feline diabetes. Not only does it hit the system fast and hard, it's completely worn off within a couple of hours, so needs to be given about 6 times a day!

Lantus, Levemir, or even PZI if you can get it, are the best options. And now that you have made the food switch, it is a good time start the insulin - with a nice low starting dose, remember ... no more than 1u, preferably twice a day. Unfortunately, once a day shooting rarely works - but if that's all you can do, then you want something that lasts (which R does not!) and which carries a lower risk of the BGs dropping dangerously low (again, a concern with Humulin R).

Good luck!!
 
Gozde

It the vet means on Humulin N, it may require dosing 3 times a day (every 8 hours) or 4 times a day (every 6 hours), in order to achieve any decent control. That is tough on most folks schedules.

A real benefit to Lantus, Levemir, ProZinc, and PZI insulins is the owner's ability to have a life outside of checking and dosing the cat!
 
Humulin R is just not safe. When it is used by vets, it's usually when the cat is in the hospital and being continuously monitored. In addition, there is usually an IV of glucose running. R is not safe to use as your base insulin. Some people will use it with special needs cats but that is very much the exception vs. the rule. Unless you are able to continuously monitor your cat, R is not an appropriate basal insulin. If your vet insists on R, my heartfelt suggestion is to find another vet. (We have a couple of members who are from Turkey and I know this suggestion may not be easy. The two other members have had multiple issues with veterinary care in your country.)

If you are planning on using Lantus, the starting dose is based on your cat's ideal weight. (Initial dose = ideal weight in kilograms x 0.25). This usually works out to a dose in the neighborhood of 1.0u.

You may want to get started on learning how to home test. Home testing is very important so you can manage your cat's insulin dose.

In addition, if your cat is not already on a low carbohydrate, canned food diet, this is also essential for diabetes management. The website written by Lisa Pierson, DVM on feline nutrition is very informative.

You may want to get in touch with our other Turkish members: Isil&Tifil and Pallid. You can send them personal messages via the message center here.
 
Hi Sienne,
Many thanks for your suggestions. I will defnitely not use Humulin after the the answers I recived at this forum. I am in contact with Isil from Turkey, she has provided me all information about Lantus and gives me support.
I will share my experiences with Lantus here.
Thanks a lot to everyone who takes cares and answers me. Gözde
 
just a note that R is short for regular. That doesn't meant it should be used as a normal insulin for cats...it shouldnt!!!
 
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