QUestions about Lovey Switching to Lantus?

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lovey11

Member Since 2013
my new vet suggested switching to Lantus. I have read good things on this site about it.

she wanted an initial starting dose of 2.5 based on my cat's BG levels, Prozinc dose (1.75 needed to be increased probably) and response, etc.

I posted this to the board and experienced members recommended dose of 1 or 1.5 based on ideal weight calculation and experience. I spoke to my vet about this and she said that I should start lower and then go up in a few days if BG are High. I was thinking of 1. 5?

In the dosing information, I read it said to increase by .25 units for under 3 units, but it seems hard to measure that with a u-100 needle. Do you measure by .25 units? Can I jump by .5 units if he BG nadirs are pretty high if I start at 1.5? My cat has been on Pro Zinc for a little over 3 months. My vet- gave me some U100 without half dose marking, but I have some monoject u 100 with half dose markings. Des anyone use the monject. It seems like the plunger needs to be pushed down harder than the u-40 needle.

Also, I work weekdays so I will not be able to spot check BG's midcycle until the evenings. what do you think?
If the nadirs are on the high side, would that be OK or should I only try a new dose on a weekend Friday night to Sunday night?

I read that Lantus was less potent in most cats than PZI.
 
Lantus isn't less potent, it just works differently. You won't generally see major swings up and down.

It has a gentle onset and wear off.

Plus, it has a cummulative effect. You need to wait 5 days on the 1st dose and 3 days on any subsequent dose to see how the dose is doing and if it needs increasing. Any test number under 50 mg/dL gets a reduction of 0.25 units.

Doses adjustments are made based on the nadir, with some consideration of the pre-shot test. You get mid-cycle tests when you can. A before bed test is helpful in alerting you if you might need to intervene to raise the numbers.
 
It's safer to start low and work up. I would start on 1 unit and increase from there.

The protocol we use says you hold the initial dose for 1 week unless the cat drops below 50. This is because lantus is a depot insulin which means it needs time to build up in the cats system and before you see the impact of the dose. After that first week dose increases of 0.25 are made every 3-5 days based on the cats nadir.

Protocol : http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

Do your syringes have half unit markings?

What time do you leave for work and return home roughly?

Wendy
 
Even thought, my cat has been on pro zince with 1.75. you think I should start at 1? Another member also said 1 or maybe 1.5. and the ideal weight calculation would make it about 1.25 or so I think. Her Bg's have been on the high side for the last weeks. thanks for your input. You need at least 5 days to see the dose's full effect.
I do have monoject with half unit markings.


I leave by 7;30 and return at 4:00.

thanks for such a quick response.

Do I have to stop the other insulin for a cycle before starting Lantus?
 
Wouldn't do any harm to miss one cycle before changing over.

Better to be safe than sorry and start on a lower dose.

Can you test/shoot at 6am and 6pm and also do a before bed test at 10pm most weekdays? With occasional tests at 4pm? That should give enough data to know what's going on, and at weekends we can test to find the nadir.

The protocol says you hold the initial dose for a week, then after that you can change dose every 3-5days depending on the nadir.

Wendy
 
yes, I could probably do those times.

I could check the nadir during the night time cycle. Would that be safer for Lovey? I could check her at 11:00 or 12 thanks for your help.

I appreciate your suggestions and input.
 
What about food? I usually feed Lovey three-fourths of a small 3 ounce can of cat food before shot time. I was giving her two other small snacks. (maybe one fourth or less of a can) My vet doesn't like the snacks. what is the best for Lantus?
 
That would be great.. If you could test at 11 or 12 then that's a +5 or +6 which is around nadir time for this insulin. you could vary it depending on her PMPS or how tired you are ;)

With lantus you don't want to feed two hours before the shot because you don't want her preshot number influenced by food, otherwise you can free feed or mini meals or whatever works for you. I prefer multiple small meals through the day as big meals can stress the pancreas.

For treats many people here feed freeze dried chicken as it's lows carb and they love it.

Also for now , don't shoot under 200.

Wendy
 
Last question, I promise .......
Lovey loves freeze dried chicken. Its funny you said about stressing the pancreas. I used to feed lovey half a can at shot time but now I feed her three quarters of a can. do you think that could have contributed to higher readings in the last weeks?

Or does the insulin have to deal with the bringing down the food spike if you have too many meals and not work as well?
 
She was eating Fancy feast chunky chicken 5 percent carbs and 44 fat.

and she used to eat weruva paw licken chicken as well since I wanted less fat because she had pancreatits at one point.

My vet asked me to switch to fancy feast classic. It is about 4 percent carb, but more fat, a tad less protein. I add some boiled chicken too. Latest blood work pancreas levels were within range.
 
lovey11 said:
What about food? I usually feed Lovey three-fourths of a small 3 ounce can of cat food before shot time. I was giving her two other small snacks. (maybe one fourth or less of a can) My vet doesn't like the snacks. what is the best for Lantus?
Click to expand...

Do you test feed and shoot within about 15 minutes? If you feed enough time bfore the test, the glucose may be elevated. You want about 2 hours food free before the shot pre-tests.

Snacks or grazing are fine; the Lantus action is continuous, not a spike. Your vet is thinking of how to manage shorter, non-depot insulins which have a more sudden onset and quicker wear off.
 
I learned from this board not to feed 2 hours before preshots. Yes, I test and shot and feed probably within 30 minutes or less.
 
When you get a chance, I would take her for a cleaning. There might be cavities of infection hiding there - you know from your own dental visits that sometimes they cant see the issue until they xray. And even gingivitis can spike blood sugar.
 
I will take her for a cleaning. the vet said she needed one. Thanks for your help That does make sense
 
Do you think I should get the cleaning before changing insulin or just as soon as I can? In case it is spiking blood sugar.
 
Clean them as soon as you can. Either way, you'll need to monitor the glucose levels, so that won't change. And you have a better chance at control if poor dental status is elevating it.
 
Thanks for you input. I was reading your notes on Jo, a cat you were helping. He started Lantus at 2 units. was he on another insulin before?
 
No, Dusty was returned to his rescue for being 'sick', rather than taken to the vet. He was down to 5 lbs (from 9 lbs originally) with awful diarrhea. He was put on a high fiber food to help with the diarrhea and of course it was high carb, too, so it set the diabetes on fire. The rescue can't afford low carb dry or canned, so initially, he was started at a higher insulin dose because of that. He also was diagnosed with a heart murmur, possibly due to muscle wasting from the excessive weight loss brought on by the diabetes - it'll cause the body to cannibalise its own muscle for calories.

When the adopter took him back, I offered to come help her test, to make sure he was safe. She has severe arthritis in her hands and poor vision, so home testing wasn't likely. I coached her on food as best I could. Dusty will eat Fancy Feast Classic pates and they're in her budget. She insists on leaving dry food down too, so I picked out the Wellness Core original which he didn't like. She went and got the Evo Cat & Kitten which he will nibble. It turns out the Wellness isn't as low as we originally thought, its closer to 17% calories from carbohydrates, so that worked out OK.
 
I didn't realize Dusty was a rescue. Oh poor cat, 5 pounds. Some cats aren't as lucky as others. It is amazing the time and care I see on this board for cats. That's nice that you helped as much as you could. I am glad Dusty would eat the fancy feast and Evo.
 
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