Was the zinc based insulin called Prozinc? If so, when someone switches from Prozinc to Lantus we typically switch to around the same dose, giving consideration to how low the first insulin dose is taking the cat.
More questions, sorry! Did you start out giving 4 units of Prozinc? That's a lot larger dose than we normally start with. And was Jan 29 her first day of insulin?
When you switched from Prozinc, did you also switch to U-100 syringes? Prozinc uses U-40 syringes but Lantus is a U-100 insulin. The reason I'm asking is that 4 units in a U-40 syringe would be 10 units of Lantus.
Your vet did have you increase by larger amounts than we would have and in some cases much faster. That means there are two possible scenarios. First is that you've overshot a good dose, but with all the data the Libre is giving you that seems unlikely as too high a dose will eventually cause numbers to dive. Second possibility is that she's a cat that needs larger doses of insulin. Once a cat gets to 6 units, we recommend getting a blood test for acromegaly (IGF-1 test). The Royal Vet Clinic will do the testing, and they are probably the best place in the world to deal with this condition.
One minor housekeeping thing, could you put a blank line after the last day of the previous insulin, and before starting Lantus, so it's more obvious to those of us looking at spreadsheets. You can label that line "start Lantus" or something like that.
Hi Wendy, thanks for the message, no worries on the questions, more than happy to answer as I am sure it will help.
Sooo.
Yes, Prozinc is the name. I was told to minimize the dose back to 3 by the vet.
we started with a dose of 2 units of prozinc, I 'll have to check my data again as I realise the chart starts at 4. 29th was definitely the start date though or the night before when we got her home. She was in the vets for a couple of weeks whilst they dealt with the liver/jaundice etc
We switched to U100 syringes, via pen, needles are 31g 4mm, but was concerend it wouldnt go through the skin layer so using 31g 8mm.
4 prozinc = 10 lantus, I am surprised I thought it was the other way around, which suggests we have backed off her dose significantly?
I am aware of the possibility of Acromegaly, but no clinical symptoms and again the vet dismissed it when asked, possibily as they had tested for it, (possibly by scans looking for growths) which they said were all clear. but will have to double check. When I get a mo I will add both the original and the latest blood tests (everything standard was back to normal) and add them to her chart.
Chart updated for housekeeping
Looking at a timeline chart and some other data I put together (both attached) showing food, insulin timings and amount plus BG it looks like her levels are on average, getting higher, despite the increasing doses, which makes me think there is a bounce thing going on, especially as there is a sharp increase in BG straight after her dose, although that could be just the timing of the previous dose running out, I dont know!
Looking for some opinions (obviously will make the final decision ourselves) on what protocol we should follow going forward, not convinced continuing to just increase is right, but not sure!
Should we hold at 3 for a day or two more (6 cycles) should we go to equivalent, ie 10 units (although this would put her at the max of 1.5 units per kg) at a loss, really, just hoping we havent been patient enough and things will become clearer.
To add to the worries, the local vet (not the specialist) broke the first sensor, then fitted the second one right over her shoulder blade, so it wobbled itself off, so I cant get readings today until the new one is fitted tomorrow.
At a loss on where to go next, as I am sure everyone here can understand, very stressful and frustrating.
Any thoughts, would be very much appreciated.
Thanks again Wendy for responding and the information, its much appreciated.
Chris, Claire, Sarafina and Simba!
