PZI questions - Lantus not working (repost from main forum)

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SHK

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Thank you in advance for any advice, stories, anything you can give me. I'm pretty desperate right now. I am failing my EQ and it is a terrible feeling. I'm grasping at straws; he is not improving. :sad: I know all cats are different, but I'm learning mine is very different (I like to call him special).

Question for PZI users - were you ever on Lantus but switched to PZI? What were the reasons, and did your cat do better?

Question for non-Lantus users (Humulin, etc.) - were you ever on Lantus but switched to something else because Lantus wasn't working for your cat?

Background: We've gradually upped the Lantus dose (via regular conversations w/Vet; I fax him my spreadsheet each week) and were at 6u yesterday, and I dropped EQ back down to 5 this morning. He is in the 300s, steady as a rock, with a few dips into the high 200s. His symptoms (increased drinking, massive pee clumps) have not subsided since his diagnosis 6/7/12. We're doing everything else right - zero carb wet food, lots of extra water, as much BG testing as my schedule allows, regular ketone testing (negative). I have next week off, so we'll be going to the vet (UGH, it stresses him out so much, but I need to test him to see if he has an infection or anything that could be making it hard for him to respond to the insulin). I even bought strips that test for leukocytes and specific gravity, before realizing that they're not good indicators of a real infection unless the urine sample is completely sterile. Live & learn.

I had a brief conversation with a vet in another city yesterday. She has never seen or treated EQ, but based on my spreadsheet, she suggested asking my vet if he thinks a different type of insulin - PZI - might work. I need to educate myself on different types of insulin, but want to hear from those who have switched. This is the reason for my post. I posted this in the main forum as well. Hopefully that's ok.
 
Re: PZI questions - Lantus not working (repost from main for

I wish I had words of wisdom for you. :cry: I hope the vet finds something that will help EQ. cat_pet_icon
 
Re: PZI questions - Lantus not working (repost from main for

Lantus users will give you more ideas on Health. I am guessing they will ask how fast you upped the dose. Sometimes if you increase in larger increments than .25 or .50 and don't give the dose time to settle, you go over the ideal dose and the cat reacts to too much insulin in similar numbers as too little.

And I noticed hmJohnson mentioned high dose conditions like Acro. That is also a possibility that the vet can explore.

A few people change from Lantus to PZI. It is usually because their cats don't "feel well" on Lantus. They seem lethargic. It is not often that people switch because the Lantus is not working. While not every cat on Lantus goes into remission (which is true for every insulin) most people are able to get their cats regulated on Lantus and in comfortable numbers at doses under 2 units.

Rob & Harley (GA) switched from Lantus to PZI. You might send her a pm and ask why and how she thought it worked.

I would never consider Humulin as an alternative. Some people do switch to Levemir from Lantus. Again it seems to be a difference in how the cat reacts behaviourly, but not necessarily numbers wise.
 
Re: PZI questions - Lantus not working (repost from main for

Jeez, seven days later and I just realized I didn't thank you for your responses. I apologize.
 
Re: PZI questions - Lantus not working (repost from main for

I'm sorry you are having such a difficult time. As a person with a cat who has triads disease, I can sympathize with the struggle.

Is it possible you have gotten into the Syomogyi effect? Sometimes high flat numbers are a sign of that. I got into that with Gus even though I do home testing. My vet started doing fructosamine tests to help figure out what was going on plus he didn't look like he felt good. Secondly, since Gus has pancreatitis, it often makes him more difficult to regulate. My vet prefers we run in the mid to low 200s at preshot and for him to not drop too much below 150 at any point. She explained in detail why. We no longer aim for tight regulation because it is dangerous for him due to the pancreatitis.

Is it possible your kitty has pancreatitis or any other underlying issues effecting the blood glucose levels? The clumping urine seems unusual.

I too went through the whole - should I switch to another insulin thing. It's really hard to know. One vet did a small study of 8 cats showing levemir worked better than Lantus, but that is a tiny study and I've spoken with him about Gus and he said he didn't know that levemir would necessarily be a magic bullet because of the pancreatitis. What has helped is pain meds because pancreatitis is painful when it flairs up. The pain meds often bring his BG down.

I have spoken to other people on this board who changed insulins and most did so for two reasons: their cat didn't feel good on Lantus or because their cat's numbers were swinging drastically between highs and lows (which is rare for Lantus).

Anyway - I personally don't believe in a one size fits all for any meds. Each kitty is different and ultimately the only way to really know is to change insulins and see what happens. Just keep in mind you have to drop the dose with a new insulin and start from scratch. You will have to relearn how the insulin works in your kitty.
 
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