New Member Kokkinoulis/dose of insulin

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Kokkinoulis

Kokkinoulis

Member Since 2023
Hello, I have a male cat 8 years old, newly diagnosed with diabetes. He is a few days in low carb diet. Hill's weight now is 6.900 gr and it was 7.300 gr. When he diagnosed 1 week before his glucose was 495 mg/dl and today in the morning before food was 411mg/dl. Should we start insulin and which dose? I will visit the vet tomorrow. I buy some ketone strips but it is difficult to use them. He drinks less water now.
 
Welcome to FDMB.

How the starting dose of insulin is determined can vary based on the insulin and what dosing method you're following. There are a number of insulins that vets prescribe. However, the only insulin that is recommended by the American Animal Hospital Association is either Lantus (glargine -- Lantus is now available in a generic/biosimilar) or Prozinc. Other insulin such as Vetsulin (also called Caninsulin) is no longer recommended due to its short duration and harsh method of action. However, in some countries outside of the US, the vets are restricted in what they can prescribe.

We also recommend that you are home testing. If you are not already doing so, we can link you to information on how to do this. Most of our members use a human meter since the cost for strips is far less than with a pet specific meter.

It would also be helpful to know what you are feeding your cat. Many of the prescription foods are actually not low in carbs.

Also, are you sure the weight you noted for your cat is correct? We tend to use pounds and ounces (most of us are in the US) and 6.9gr is only a few ounces.
 
If you can please answer the question about food, that would be helpful.

Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

With a diabetic cat you need:
  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • It sounds like you’re already home testing…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions!
 
Sienne and Gabby (GA) said:
Welcome to FDMB.

How the starting dose of insulin is determined can vary based on the insulin and what dosing method you're following. There are a number of insulins that vets prescribe. However, the only insulin that is recommended by the American Animal Hospital Association is either Lantus (glargine -- Lantus is now available in a generic/biosimilar) or Prozinc. Other insulin such as Vetsulin (also called Caninsulin) is no longer recommended due to its short duration and harsh method of action. However, in some countries outside of the US, the vets are restricted in what they can prescribe.

We also recommend that you are home testing. If you are not already doing so, we can link you to information on how to do this. Most of our members use a human meter since the cost for strips is far less than with a pet specific meter.

It would also be helpful to know what you are feeding your cat. Many of the prescription foods are actually not low in carbs.

Also, are you sure the weight you noted for your cat is correct? We tend to use pounds and ounces (most of us are in the US) and 6.9gr is only a few ounces.
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Hi again, I live in Athens, Greece. My cat's weight is 6.9 kg (15.21 lbs). He is a neutered male cat. I started feeding him royal canin diabetic wet food and after I joining your forum I switched to Purina pro plan veterinary diets cat dm diabetes management mous since 3 days ago.
His initial glucose value during diagnosis before 2 weeks ago was 495 mg/dl and yesterday it was 411 mg/dl. I went to the vet to initiate him insulin today but the vet was not familiar with lantus and shoot him 6 units caninsulin and told me to make this units twice a day. I tried to test him at home 3 times with human meter accu-check instant but without sucess so, I am waiting a friend to do it together as he help me the other days to test him at home. The cat is ok, without hypoglycemia. I will not shoot another insulin dose as I thing that the units are two high and also before I test him for blood glucose. Moreover, I would like to switch the insulin to lantus as it is more peakless and last more hours than caninsulin but I will need your help because here in Greece most vets are not familiar with it. I also read the instructions for the creation of the spreadsheet but I cant understand which one of them to use and how to share with you. Could you please help me with the insulin dose and the spreadsheet?
 
Starting a cat on 6 units of Vetsulin is way too high and I would not do that if I were you. I wouldn’t start any higher than 1 unit. Also, Vetsulin is a very harsh and fast acting insulin and you need to make sure you cat has eaten at least 30 minutes before giving the shot.

I know it’s tricky to get other insulins in Europe, but the fact your vet has never heard of Lantus, is a huge red flag that he’s no at all familiar with feline diabetes. Prozinc is also a good insulin for cats and I hear is a little easier to get over there. Can you ask about prozinc too? Your instinct are 100% right. Vetsulin is also called caninsulin because it was created for canines which have a much slower metabolism than cats so it does not last a full 12 hours so your cat is not protected all day.
 
You want to use the World version of the spreadsheet. You enter your test data on the World tab. The numbers are automatically converted to the US format on the other tab.

@Ale & Bobo & Minnie (GA) - I would not jump to the conclusion that her vet is not familiar with feline diabetes. Lantus is a human drug. Consider that in the UK, vets were not able to prescribe any other insulin except Caninsulin. It's only recently that they can prescribe Prozinc. The pharmacology of glargine (Lantus) is considerably different than other insulin and it would be unethical for her vet to not prescribe a drug he/she is not fully comfortable with.
 
Ale & Bobo & Minnie (GA) said:
Starting a cat on 6 units of Vetsulin is way too high and I would not do that if I were you. I wouldn’t start any higher than 1 unit. Also, Vetsulin is a very harsh and fast acting insulin and you need to make sure you cat has eaten at least 30 minutes before giving the shot.

I know it’s tricky to get other insulins in Europe, but the fact your vet has never heard of Lantus, is a huge red flag that he’s no at all familiar with feline diabetes. Prozinc is also a good insulin for cats and I hear is a little easier to get over there. Can you ask about prozinc too? Your instinct are 100% right. Vetsulin is also called caninsulin because it was created for canines which have a much slower metabolism than cats so it does not last a full 12 hours so your cat is not protected all day.
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Hi!

We can easily purchase Lantus in Greece without prescription. The problem is that vets here prefer caninsulin
Another problem is that they use u100 syringes when administering Caninsulin
So, it's very likely that the vet gave Kokkinoulis 6 units of caninsulin using a u100 syringe . That would be about 2.5 u if he used a u 40 syringe.

Gabriella, can u confirm the instructions your vet gave u regarding syringes?
 
Red & Rover (GA) said:
Tagging @Yanna and @Carol & Rico who live in Greece.
Welcome to the forum. Waving from Canada.
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Hi, I am already in
Yanna said:
Hi!

We can easily purchase Lantus in Greece without prescription. The problem is that vets here prefer caninsulin
Another problem is that they use u100 syringes when administering Caninsulin
So, it's very likely that the vet gave Kokkinoulis 6 units of caninsulin using a u100 syringe . That would be about 2.5 u if he used a u 40 syringe.

Gabriella, can u confirm the instructions your vet gave u regarding syringes?
Click to expand...
Hi, I really did not pay attention in syringe that moment but i thing it was a u100 syringe and the problem is that we can buy syringe form pharmacie and not from a pet shop so I bought u100 syringe. According to this it was 2.5 unit. I didnt shot a second dose at night and two hours after the night food the blood sugar was 420mg/dl. I would like to start Lantus but my program is very busy as most of the days I am at work from 9.am to 7.30 pm and only some days i work remotely. So, I think to work remotely this week on Wednesday and Friday and start lantus on Wednesday in order to have 4 days at home for close monitoring.
 
 
Could you please advise how I can start Lantus in a 6.9 kg cat? Which initial dose you recommend (0.25 per kg BID)? What about close blood sugar test monitoring in the first days?
 
Sienne and Gabby (GA) said:
You want to use the World version of the spreadsheet. You enter your test data on the World tab. The numbers are automatically converted to the US format on the other tab.

@Ale & Bobo & Minnie (GA) - I would not jump to the conclusion that her vet is not familiar with feline diabetes. Lantus is a human drug. Consider that in the UK, vets were not able to prescribe any other insulin except Caninsulin. It's only recently that they can prescribe Prozinc. The pharmacology of glargine (Lantus) is considerably different than other insulin and it would be unethical for her vet to not prescribe a drug he/she is not fully comfortable with.
Click to expand...
Dear @Sienne and Gabby (GA), Could you please advise how I can start Lantus in a 6.9 kg cat? Could you please see my speadsheet? Which initial dose you recommend ? What about close blood sugar test monitoring in the first days? I will have an opportunity to work remotely Thursday and Friday so I will try to test Kokkinoulis more often in case I start Lantus these days and during weekend.
 
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tiffmaxee said:
Welcome to the FDMB. We use two dosing methods here. It would probably be best to start with SLGS until you are familiar with lantus and testing. @Yanna can help you get supplies. I’d start with a .5 dose since you are feeding low carb now and evaluate after 5-7 days.
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Hi @tiffmaxee, Do you mean 0.5 iu /kg BID ( ideal weight or current weight)? What do you also mean to evaluate after 5-7 days? To change the initial dose? What is the SLGS protocol about dose adjustments as well as test monitoring?
 
tiffmaxee said:
Yes, 0.5 units. Lantus is a depot insulin so takes 5-7 cycle for the initial depot to build. Then we decide if the dose needs to be increased. Switching from high carb to low carb food can havena huge impact. Head on over to the Lantus forum and read the stickies on depot insulin and our dosing methods.

https://felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/

https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
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Hi Elise!
I've sent Gabriella a photo of the syringes she needs to buy. Just to clarify. You mean the starting dose of Lantus should be 0.5 u
 
Kokkinoulis said:
Hi @tiffmaxee, Do you mean 0.5 iu /kg BID ( ideal weight or current weight)? What do you also mean to evaluate after 5-7 days? To change the initial dose? What is the SLGS protocol about dose adjustments as well as test monitoring?
Click to expand...
Gabriella I think tiffmaxee means starting dose 0.5 u (not per kg). Don't start Lantus until you confirm the dose. After a week you will do a curve and then you will adjust the dose (increase or decrease). Keep posting and asking questions before you make any changes in the dose.
 
Yanna said:
Gabriella I think tiffmaxee means starting dose 0.5 u (not per kg). Don't start Lantus until you confirm the dose. After a week you will do a curve and then you will adjust the dose (increase or decrease). Keep posting and asking questions before you make any changes in the dose.
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You are correct. I was suggesting a dose. With SLGS the starting dose is not based upon the cat’s weight if that is what you were asking. I’m suggesting starting with that becasuse if tge change in food to lc and not having data or enough prior information. She can always switch to TR a little later.
 
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