new dx, wonky numbers-Lantus v. PZI, other insulins

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MK + Max

Member Since 2013
Hi, folks,

I used to be on this board all of the time, but my sugarbaby passed and I did not return to the FDMB, but recommended people use it.

But now I'm back because my friend's kitty, Max was just dx'd. She jumped right in to hometesting, he was prescribed 1U/BID Lantus.

Now, back in "my day" I used PZI and always remembered Lantus as an insulin that was used when a kitty was first dx'd, but it was an insulin with big drop and so ppl didn't keep their kitties on Lantus.

Anyway, my friend is getting wonky numbers and we raised to dose to 1.25U/BID, numbers remained high for 2 days, so we decided to go to 1.5. Now his bg is 480 this evening, and I'm concerned that this is glucose dumping because the dose is too high.

She's putting together the bgs from the last 5 days, but can anyone advise if they've stayed on Lantus longterm? I see so many posts with Lantus in the title, is it now the "it" insulin?

Thanks, any feedback will be greatly appreciated. (hoping that this is not too confusing)

Mary Kay + Max
 
My cat was only on lantus for 4 months but lots of cats have been on for several years - you can see the posts in the Tight Regulation forum.
Its considered a gentle insulin as the drop usually starts around +3, with nadir at +6 - it seems to suit a lot of cats.

Once the numbers are on a spreadsheet, start posting in the TR Forum for dosing advice.
Here's a link to the spreadsheet used on the forums - http://felinediabetes.com/FDMB/viewtopic.php?p=179835#p179835

I assume Max is on a low-carb wet food?
 
I think you're confusing Lantus with Lente. Lantus (and Levemir) are long-lasting, depot-style insulins that are much softer on the system. Because of the depot effect, it must be dosed BID with the exact same dose given AM and PM. Dosing changes are based on the nadir/lowest points in the cycle and not the pre-shot. You also don't have to feed with the shot, but it's advised to take up food within two hours of the pre-shot test so as not to increase the pre-shot number artificially (newly diagnosed, it's recommended to not shoot under 200 until it is known how the kitty may react).

We have a forum dedicated exclusively to Lantus users if you want to check it out. It's one of the best insulins to use in getting felines regulated and even into remission.
 
Thank you, thank you, both of you angels.

We're weaning Max off kibble, unfortunately he was very fond of it. I downloaded the low carb chart for my friend, and she's going out today to get some foods for Max.

I did not know about Lantus, and perhaps, in my aging brain, I AM remembering Lente instead.

Ok, off we go! Another try. Will start reading Lantus users and see if we can get Max some healthy numbers. My friend is caring for a small daughter which is why I'm posting for her at the moment.

thanks, guys!
 
Lantus is a depot insulin; it has carry over from shot to shot this is different from PZI

Dose adjustments are based on the nadir, the lowest level between shots.

You give the same dose, every 12 hours.

You start with 0.5 or use this formula:
(Lower of current weight or ideal weight in kilograms) <--- ie lean body weight
* 0.25
= starting dose
(note: pounds divided by 2.2 = kg)

You give the same dose for at 5-7 days before you run a curve .

One thing they note is 'new dose wonkiness' - it seems to take a few days to settle into the dose.

There is a specific protocol posted in the Lantus forum topics on a proven way to use Lantus with a good chance of obtaining diet-controlled status.
 
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