Possibly switching Grandpa to Lantus

[Beck and Philly]

Hi all. Grandpa was diagnosed in early May as diabetic. We started with Vetsulin. We experienced some green and blue numbers for awhile. He then started vomiting at +6 every cycle. We hospitalized him and did 2 ultrasounds at 2 different vets.

On June 20, they diagnosed pancreatic cancer that had metastasized to several other areas. The vet at the 24 hour hospital recommended stopping insulin and letting him just live out the days left. We did that for a week or so, and since he had no appetite we believed he was truly at the end.

However, as time went on we realized he was no longer vomiting and his jaundice seemed to start to fade. He started crying for food again and eating everything in sight. We talked with his regular vet who disagreed with the hospital. She said we should definitely continue with the insulin regimen.

Now we are running low on his first vial of Vetsulin. We have been seeing high numbers the last couple of weeks. We've seen a couple of 600s, several 500s, and high 400s. Yesterday we did see a 250, which was great. We found that feeding several small meals really helps with the vomiting - only one episode since June 20 and that was a day he missed a snack. He begins crying for food about an hour before his 2 main meal times.

Note: His spreadsheet has a couple tabs. Sheet 1 was the first weeks with a human glucose meter. There's a newer sheet for the current AlphaTrak meter.

So, all of that brings me to my questions. My vet is great and is always willing to help us try new stuff. She was more than willing to write a script for Lantus, but they don't carry it in the office. She said if we fill it, she recommends a 1u dose. We currently dose 2u of Vetsulin.

Would you guys think we have a better chance of consistent lower readings with Lantus? Any concerns in switching? Are pens the best way to go? Are there economical ways to order or buy?

All advice welcome.

 

[Gill & George]

Hi Beck, welcome to Lantus Land, so sorry Grandpa has been having such aahard time. We would usually take into account the dose of insulin they are already on, so 1u would seem a little bit of a low starting point? Though with the data available on vetsulin I'm not sure of how low that might have been getting Grandpa.
How much does grandpa weigh?
Is he on an all wet diet?
Have you had a chance to read the info on TR or SLGS for Lantus?
If you decide to give Lantus a try bear in mind that when you switch insulin they can something have an initial strong reaction, so you want to plan the switch for a time when you can monitor the first few cuccyc closely if needed.
Vetsulin has a reputation for being a harsher insulin than Lantus, with Lantus it is possible to achieve smoother flatter curves, but it can take a little while to stabilizer onto a good dose.
The pancreatic cancer can also affect BG, and may impact the curves.
Does your vet disagree with the hospital RE the pancreatic cancer? Or just on how to proceed with Grandpa's care?

 

[Chris & China (GA)]

Would you guys think we have a better chance of consistent lower readings with Lantus? Any concerns in switching? Are pens the best way to go? Are there economical ways to order or buy?

Yes, I think you'd see better numbers with Lantus because it's a longer lasting, gentler insulin...of course there's never any guarantee but if you went through the message board and found all the people that had switched, I think you'd find pretty much 100% were happy about it.

Most of us are buying our Lantus from Canada because it's 1/3rd to 1/2 the price. It takes about a week, but the savings are worth the wait.

Here's the Information on buying insulin from Canada

The pens are the better buy because each one only holds 300 units, where a vial holds 1000. Most cats can't use 1000 units before it loses efficacy so you end up throwing half of it away. The pens last until the expiration date on the box, usually at least 2 years away.

You still use regular U100 insulin syringes to pull the insulin out of the pen instead of using the special pen needles.

 

[Beck and Philly]

Hi. Thanks for responding. Grandpa currently weighs about 9.5 lbs, down from 12 pre-diagnosis. He is underweight, and I would like to add some back on. He is on a wet diet plus some home-cooked chicken as snacks.

I don't know what TR or SLGS is. I read the intro posts to this board, but those acronyms aren't familiar.

I work from home, so I can monitor him.

 

[Beck and Philly]

To answer the vet question, he has seen two docs at my regular vet and two docs at the hospital. The doc who diagnosed diabetes also performed the initial ultrasound. She said she saw "something". She said if he were hers, she would euthanize because he didn't look happy. He'd been vomiting, so I wouldn't look happy either.

Not willing to accept that, I took him from regular vet to vet hospital. He spent a night on fluids and had a new ultrasound the next day The radiologist and two vets called with a hopeless diagnosis. We believed that one since three vets agreed.

Now that he is still here, not vomiting, and eating/ playing, I have contacted my favorite vet (not one of the three above). She's on board with exploring ways to improve his life. She seems to believe that he does have cancer, but is always open minded. She has been with me through three animals with kidney disease and two with cancer plus other series ailments. Her philosophy is that if the animal is still "present'" meaning alert and acting like they are wanting to engage, we continue to help them live rather than help them die.

I am now in touch with an internal specialist with a board certified radiologist. This week he will collect the previous ultrasounds and we'll see what he thinks. We aren't going to drag Grandpa from place to place, but we will take steps to confirm or disprove the diagnosis.

 

[Bobbie And Bubba]

Hey and welcome and sorry that Grandpa has a pancreatic cancer DX. Sounds like he is just an amazing cat and is doing really well all things considered.

I switch from ProZinc to Lantus and was really glad I did since there is a protocol for using it.

If you don't want to wait for Lantus to arrive from Canada, I have gotten my Lantus from Alan in the supply closet many times. He will sell you a set of 5 pens or just one pen. He is very nice to deal with and I have the insulin in 2 days.

 

[Amanda and a Loudogg]

Hiya Beck!
I just switched my buddy Lou from Vetsulin to glargine (we're using Basaglar) Memorial Day weekend. I have been seeing some pretty pronounced results, considering. I could barely get Lou into high blues, let alone into greens on the Vetsulin. Our only "problem" is Lou was so used to being in higher numbers that he's become a bounceaholic. He's getting better with that though. One day at a time. These depot insulins are completely different from Vetsulin, so reading the stickies on the top of this forum will be essential. Information regarding the SLGS protocol are located there, also HERE. The TR protocol is also HERE for your reference.

Best of luck switching!

 

[Beck and Philly]

Thanks all! I had glanced through the stickies this morning before posting, but will read them all now. I am familiar with some of the concepts from posts on the main forum, but I want to truly understand. Thanks again!

 

[Sienne and Gabby (GA)]

I didn't see if anyone answered your question re. the dosing methods:

• TR = Tight Regulation Protocol
• SLGS = Start Low Go Slow

There are sticky notes describing each.