Novolin N vs Lantus

Status
Not open for further replies.
Amber & Meadow

Amber & Meadow

Member
I'm trying to figure out which is better. My cat was on Humilin N at 4 units bid with #'s in the 200-300's. Specialist switched her to Lantus a month ago. We started at 2 units bid and increased to 5 units bid. Neither made a difference, BG was always over 500, even with curve. Does anyone have any ideas? Should I start all over at a lower dose? And which one? How long after feeding should I inject?

Amber & Meadow
 
Are you testing at home? if you started at 2 and nade it to 5 in one month then you were increasing too quickly...other considerations are diet..

Lantus in the vast majority of cats is waayyy more suitable than N; for more details see petdiabetes wikipedia

Jen
 
You did not go about dosing with the lantus properly and now you are switching to another insulin....impatience will not help you get this solved...
 
Well.. I'm still waiting for someone on this forum to explain to me how to dose properly because obviously this expensive specialist doesn't have a clue. She's the one that told me to go back to Novolin. Will someone give me some advice?
 
Constant high numbers can indicate 2 things: too little insulin or too much insulin. The common protocol for starting Lantus is to start at 1 unit twice a day, and many cats are regulated with fairly small doses. My guess is that 2 units may have been too much and kitty's body is protecting itself and pushing numbers high (symogi rebound - sp?). Other things that it could be - acromegaly, which is an over excretion of growth hormone by the pituitary which acts as an insulin inhibitor; or IAA (insulin auto antibodies) where the body produces antibodies that attack the insulin you give because it sees it as foreign to the body. In these last two scenarios, you will end up seeing very little curve until you give enough insulin to overpower the growth hormone or antibodies, and then all of a sudden you will see results. Most kitties in the "high dose" part of this forum fall into one of those two categories, and you will typically see doses of 8-12 units each shot in these instances.

Regardless, it is important to know that Lantus works with a "shed" which is a build up of insulin just under the cat's skin. Once that shed is filled, then the body can use the remainder for sugar processing. It will take 1-2 weeks for this shed to build up, so if you up the dose too much too quickly, you can very quickly fill the shed and send the body into rebound.

Others will chime in, I am sure, but if you didn't see results on Lantus, it is likely that switching insulins will not help your situation that much. Lantus/Levemir and ProZinc are the most common insulins that work the best with kitties. I would recommend cutting back down to 1 unit of Lantus twice a day with home monitoring and not upping the dose for a week while the shed fills up. Then up the dose by 0.5 units every 3-4 days maybe.
 
dosing is usually started at 1 unit twice a day. increases are done based on data collected thru hometesting. numbers obtained only before a shot don't and can't tell you enough about whether the dose is working so spot checks need to be done here and there. most people get those spot checks or do curves on the weekends or when they have a day off.

with enough data, you can see if the dose is working or not, and if it's working too well (aka: taking kitty too low).

if increases in dose are needed, they are done in small increments. roughly 1/2 a unit at a time and in some cases even less than that. cats really are tiny little creatures and it doesn't take much in their little bodies to make big differences. i know i haven't been using lantus very long but take a look at my spreadsheet. adding a drop to Mousie's dose (going from 1.5 units to a drop more than 1.5) makes a huge difference in what numbers i get from her.

starting at 2 units twice a day or going up in dose by whole units at a time often results in the correct dose being overlooked completely.

now, for some more of my bluntness, and to be honest, some people aren't gonna be happy with what i say, but, you want to know this stuff right, and you deserve to hear as much of it as you can take.....i've been here now roughly 3 and a half years.....i've seen more cats hypo, get ketones, or even die on N or Vetsulin than any of the other insulins. we used to hold hands and walk people thru hypo nights around here a few times a week.. seriously...nowadays i'd say we're lucky (actually that doesn't sound right does it) to see a couple a month if that. it doesn't happen very easily on the gentler insulins and definitely not when doses are based on data and knowing one's cat.

feline diabetes is becoming very prevalent and more and more, people and vets are learning more about it and it's treatment. thus, prescriptions of lantus and the pzi insulins is becoming more and more the norm and not the N and Vetsulin that used to be.

personally, when i used to read things like "my vet said i could expect less than a year" after someone's cat was diagnosed, i couldn't help but think to myself "yeah, because your vet is gonna make dang sure to kill your cat by then" when i'd read "my vet started us on 5 units twice a day of Humulin N" or even more. ugh!

i know in some cases it's all that can be used, because of it's tempting price tag. but if one of the other insulins can be purchased, why wouldn't you want to use them?

so go with your lantus. all you have to do is start lower, collect data, and ask for help figuring out if things are going right or not. believe me, no one here is gonna steer you wrong. i have yet to see someone here purposefully tell someone to do something that was gonna hurt a cat. we're crazy kitty people here. :-D
 
"Specialists"

The best published guide to managing Lantus is this: http://www.tillydiabetes.net/en_6_protocol2.htm

The specialists are on FDMB. And most of us don't have certificates on the wall. We learned how to manage FD via seasoned members who paid-it-forward and being willing to listen to those people sometimes over the instructions from those with initials after their names. If I had continued on the path set for Gandalf's FD treatment by vets, he would have been gone several years ago.

Please take in to consideration what Cindy detailed. She is right on every point.
 
I am probably one of the few caretakers whose kitty did not do well on Lantus but id doing excellent with N. I first tried lantus on Twigie after I adopted her since I was already using Lantus for four of my other kitties. I tried it for about a week and noted very little decrease in BG, both PS' and in between shots. I then switched to N since it not expensive. Twigie is doing excellent on N, I can keep her BGs below about 125 throughout the day with just a little N. I typically shoot 0.0 to 0.4 units bod depending up PS BG. My only reservation is that Lantus might have worked if I would have given it more than a week.
 
Larry and Kitties said:
I am probably one of the few caretakers whose kitty did not do well on Lantus but id doing excellent with N. I first tried lantus on Twigie after I adopted her since I was already using Lantus for four of my other kitties. I tried it for about a week and noted very little decrease in BG, both PS' and in between shots. I then switched to N since it not expensive. Twigie is doing excellent on N, I can keep her BGs below about 125 throughout the day with just a little N. I typically shoot 0.0 to 0.4 units bod depending up PS BG. My only reservation is that Lantus might have worked if I would have given it more than a week.
Click to expand...

That's wonderful that N is working so well for you! I do think that 1 week is not enough time for Lantus to start showing good numbers. It takes a week alone to fill up the shed before the body can use any of it.
 
Status
Not open for further replies.
Back
Top