Question: Micro Dosing Lantus? Switching from micro dose ProZinc

[Wendy 17 and Merlin]

Merlin is getting between 0.1 and 0.2 units of PZI. If I switch to Lantus, which is much more concentrated, what dose might Merlin need? Would the Lantus dose be too small to measure?

What/where is the best price for Lantus? Are US customers not able to buy from Canada?

Am I correct in thinking that Merlin would spend more time in normal range with Lantus? Would that help his energy level?

I am so worried about Merlin. He is eating huge amounts of food and is so hungry. Cannot get any energy from it. It passes through him unchanged. He is losing weight rapidly and cannot digest his food. How much of this can be due to diabetes? Per his SS, he can hit between 50-100 mg/dL on his current dose (0.15 Units PZI) some of the time. But he bounces often and spends most of the hours in a higher range. He is very hungry and thirsty even when he is near his nadir and in normal range. Is that unusual?

Looking at his SS, should I be doing anything differently?

See also thread: Totally confused-Please help-Increase or decrease? | Feline Diabetes Message Board - FDMB

I will get the results of the EPI test in about a week. Due to the 12 hr fasting for the EPI test, I skipped insulin in the morning. It caused a big bounce 2 days later.

IBD of the digestive tract was ruled out as less likely (albumin was normal). His WBC is up (23.1 vs. 17.5 K/microL in Aug 2020 [ref 3.9-19]) due to infection or inflammation. Started on Zeniquin. Hx of pancreatic abscess/cyst. Spec PLI 17.0 (ref 0-3.5).
Creatinine 2.6 (prev. 1.7 [ref 0.9-2.3]), SDMA 9 (ref 0-14). BUN 45 (ref 16-37).

I ordered S Boulardii. Might that help? Has anyone had success in a similar situation?

I am skeptical about probiotics, having used Proviable for a long time without noticeable benefit.

 

[Diane Tyler's Mom GA]

Bump

 

[Sienne and Gabby (GA)]

Albumin level is not a definitive test for IBD. In fact, my cat's albumin level was never off. The only way to know whether a cat has IBD is by biopsy.

If Merlin isn't getting sufficient duration with Prozinc, Lantus may be a better option. You would use the same dose. However, remember you need U100 syringes with Lantus.

 

[Diane Tyler's Mom GA]

https://www.felinediabetes.com/FDMB/threads/should-i-stall-merlins-ss.236517/

@Wendy 17 here is one of your previous posts where Panic told you where to
purchase lantus much cheaper

 

[Wendy 17 and Merlin]

My vet mentioned that biopsy is the only sure way to know. Of course, I do not want to do that. IBD was suggested as Dx per ultrasound in 2019 when pancreatitis was first Dx. Merlin was switched to Royal Canin Feline Hydrolyzed Protein kibbles for IBD. Of course, that is very high in carbs and unsuitable for diabetes. The unsolved question is whether he is allergic to the home-cooked chicken breast diet he used to get and is eating again in addition to FF and Dr. Elsey's.
I remembered the pharmacy suggestion. Until I called them, I thought that we could no longer buy from there. I am trying to get the Rx approval for Lantus. Just worried how I am going to measure 0.1 unit. Per another post, the calipers do not work for the tiny amount of 0.5 U or less because the blades overlap.

 

[Veronica & Babu-chiri]

Hi about him being very hungry and thirsty have his thyroid and aldosterone levels been checked ?

And regarding the microdosing, you can actually measure with the calipers 0.1 unit the caliper does work although what I did was measure with the calipers and with that measure stablish a patter against which I compared the dose every time, not actually measuring with the calipers every time

I was using BD syringes with 1/2 unit marks and this is how 0.1 units looked like

When actually measuring a drop what I had to do was load the syringe to the zero mark and then actually count how many drops it still holded until I could stablis where the plunger had to be to actually dose a drop and this is what it looked like

 

[Wendy 17 and Merlin]

Veronica, thank you so much for the pictures. I understand how you measure drops. I am confused about the picture for 0.1 unit. The picture shows the plunger pushed BEYOND the zero line. Shouldn't the top of the plunger stop just a 1/10 division BEFORE the zero line?

Thyroid levels are perfect. I do not know anything about aldosterone. It was never measured. His blood pressure is ok. There is no fluid retention. Serum potassium is in mid range. Na and Cl are usually at the low edge of normal. When I make cat food, I use Light Salt (Na+K mix). Per Creat 2.6 +SDMA 9, IDEXX suspects some damage to kidneys. The left kidney is smaller.

I am very interested: Would you share the recipe for your home-made low carb-CKD diet? That is what I need also.
Your kitty is beautiful. His SS looks impressive. How did you accomplish it? Merlin has these deep plunges in nadir after ~3 hrs and then shoots back up and spends almost the entire day in the high BG range. He went to low normal nadir this morning but acted as if hypoglycemic. I asked my vet to let me try Lantus, hoping that will flatten the nadirs. Do you have any suggestions?

I am still waiting for the EPI result. From the way others described enzyme-lacking stool (yellow, undigested, very stinky), he fits that picture.
@Veronica & Babu-chiri; @Sienne and Gabby (GA); @Diane Tyler's Mom; @Critter Mom; @Deb & Wink; @Marje and Gracie

 

[Wendy&Neko]

I am confused about the picture for 0.1 unit. The picture shows the plunger pushed BEYOND the zero line. Shouldn't the top of the plunger stop just a 1/10 division BEFORE the zero line?

Theoretically yes, but those were BD syringes. The zero lines are often poorly placed. At one point I was using a batch that I figured had about 1/3 of a unit below the zero line. Since Neko was on 0.25 units at the time, I ignored the zero line and just used the measurements as per the calipers.

Per another post, the calipers do not work for the tiny amount of 0.5 U or less because the blades overlap.

You use the tiny arms on the other side of the big ones. The ones used for measuring the insides of things. I had to make sure I had skinny arms too, to fit under the lip at the top of the syringes.

My vet mentioned that biopsy is the only sure way to know. Of course, I do not want to do that. IBD was suggested as Dx per ultrasound in 2019 when pancreatitis was first Dx.

Depending on where the inflammation is, you can get away with an endoscopy or colonoscopy instead. I'd rather know what I was dealing with instead of treating the wrong disease with the wrong medication.

 

[Veronica & Babu-chiri]

Veronica, thank you so much for the pictures. I understand how you measure drops. I am confused about the picture for 0.1 unit. The picture shows the plunger pushed BEYOND the zero line. Shouldn't the top of the plunger stop just a 1/10 division BEFORE the zero line?

As Wendy mentioned I used BD syringes ( those are the only ones available with 1/2 unit marks where I live) and the lines were no always that precise so I usually measured from the top of the syringe not from the zero line with the calipers

Your kitty is beautiful. His SS looks impressive. How did you accomplish it? Merlin has these deep plunges in nadir after ~3 hrs and then shoots back up and spends almost the entire day in the high BG range. He went to low normal nadir this morning but acted as if hypoglycemic. I asked my vet to let me try Lantus, hoping that will flatten the nadirs. Do you have any suggestions?

Thank you very much and his SS started to look like that once he went into remission, because while he was on insulin he was a diver and a bouncer till the last drop I gave him, and I do think that Lantus allowed for a better control with him and I also tried to "feed the curve" since I started learning more o less at what point he would start going down fast I tried to give him some food (his normal low carb food ) at that time to kind of slow down the drop so that he would not bounce so much later it did not always worked but sometimes it helped

 

[Wendy 17 and Merlin]

I am really interested to know whether your home-made low carb-CKD diet would help Merlin. How do you make it?
Do you have suggestions for Merlin's SS?
@Veronica & Babu-chiri

 

[Veronica & Babu-chiri]

I am really interested to know whether your home-made low carb-CKD diet would help Merlin. How do you make it?

In my experience the home made diet did helped my cats a lot although Babu-chiri went into remission from the diabetes on a comercial diet ( Nature's variety-instinct either chicken original recipe or turkey limited ingredient that are the ones available here ) and started on the home made diet later on when he started having CKD issues and the recipe I use was made specifically for Babu-Chiri and his sisters ( they all have CKD and a bunch of other issues )

In gereral terms if you want to cook the diete there are basically two options you make all from scratch or you buy the protein and buy a supplement or premix, there are a few premixes that the people here at the fourm use that I've heard are quite good, EZComplete, TC Complete Special , FoodFurLife but you could just post in the forum the specific question that you want to home cook and what premix do they recommend and I'm sure a lot of people here can give you suggestions

In my case I had to go for the option of making it from scratch because the manufacturers of the premixes won't ship to Mexico which means I buy the protein ( only chicken or turkey thights) at the butcher that I cook slightly in the oven, then grind it and I prepare the mix with the supplements and I add it to the grinded meat, it is not difficult but it is a bit time consuming, I prepare a big batch to last me about 3 weeks and is for 3 cats so it takes me about 3-4 hours when I do it

Here are some posts about home cooking that may help you
https://felinediabetes.com/FDMB/threads/home-prepared-diet-of-crd-cats.150441/

 

[Wendy 17 and Merlin]

Veronica, thank you. I was looking for a recipe to make my own premix. The convenience of premixes is great, but they are costly and often add additional phosphorus to them in the form of bone meal or calcium phosphate. For example, I bought a premix for CRF cats from BalanceIt.com. (BalanceIT.com) The problem was that my cats disliked the taste of it and then would not eat the food. Actually, what I have used for many years is the info on holisticat.com, where you calculate the phosphorus level of the home-cooked food from a database and calculate how much eggshell powder is needed to offset the phosphorus. Amounts of vitamins and supplements are also given for recipes. Here is a recipe:
Boneless/No Grind Recipes (holisticat.com)