Squeak going from Vetsulin to Lantus Friday

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CathyLonghurst

CathyLonghurst

Member Since 2014
I ask for guidance in starting Squeak on Lantus. I hope to do this on Friday, since I will be home all weekend and can monitor him closely.

Squeak is 6, a Maine Coon mix, and weighs 13-14 pounds. He was between 16-17 pounds, then lost 5 pounds when he first got sick.

He is doing very well on Vetsulin, but now that I have the opportunity, I am going to try Lantus. His vetsulin dose has been 4 units morning and 4 units night.


He currently eats 9Lives Super Supper, and has sliced ham for his test and shot reward.( The reward is two thin small slices two times a day. It was the lowest carb and sugar in the lunch meat which is all he wants. He is perfect on getting the shot because he knows he is getting the ham)
He eats some 9lives (maybe 1/2 a can) canned food in the morning before his shot, and quite a bit at night (1-2 cans) before and after his shot. He varies on whether he wants to eat or not. I have tried other cat foods, baked chicken, chicken liver, raw chicken, scrambled eggs, putting parm on food, etc.
Whiskas Purrfectly Fish Tuna Entree is available all the time for all the cats, but Squeak is not interested.

I am gone for 10 hours 5 days a week and cannot space his food out better than that and he usually will not eat unless I am home. He seems to be back to his normal self. Talking all the time and having an appetite again- on and off on appetite.

What dose do I start him at and what needles do I use? Not sure if I need to be here or Lantus relaxed.

I appreciate this board and everything the members here do for cats and their people.
 
Hi Cathy, and welcome to you and Squeak to the TR forum. You can chose where you want to post. There is a lot more traffic on this forum so you'll tend to get more answers and traffic throughout the day. Your first stop here should be to read all the Starred Sticky notes at top. I'm going to ask you to make some changes to your spreadsheet (SS). In the AMPS and PMPS columns you currently have time of day. What should be there is the PS (preshot) value, some of which you have listed in the Remarks column. Could you change the SS to reflect any BG test data that you have? Take a look at some of the SS from others around here and you'll get the idea what it looks like. We are very data driven here so the SS is important to those when we are looking at suggestions for dosing.

Neko first started on Caninsulin (aka Vetsulin) and it wasn't lasting long for her so we switched to Lantus. We have a formula for the starting dose that is based on the kitties ideal dose (.25U per kg). If Squeak is 13-14 lbs now, do you think that is his ideal weight, too heavy or should he add more weight? If 13-14 lbs is about right, then his starting dose would be around 1.5U. We usually take into consideration the old dose, but we'd need more data on how Squeak is doing on his current dose to factor that in. With a AM preshot (AMPS) of 92 today, I expect he's on too high a dose of Vetsulin. Based on what you think his weight should be, it might be best to start at 1.5U of Lantus and we can fast track you up if we need to.

You'll need U-100 insulin syringes (needles) with 1/2 unit markings on them. Since I'm in Canada, I only have access to the BD-Ultrafine II, cause they have a monopoly. If you are in the US, there are lots of options. You can either ask your local pharmacy what they have or even go shopping online at American Diabetes Wholesale. A lot of people here like the Terumo Thinpro, but others use Relion, Monoject, etc. There are options for short or long needles, you might want the longer ones because of Squeak's longer hair. You'll find the U-100 syringes have much thinner needles. I was so pleased how much easier injections were when we switched.

For testing, we ask that people get two tests per cycle. That includes one each before the morning and evening shot plus one other per cycle. In the morning it can be an in the door/out the door test and the evening can be a test before you go to bed. You can do testing at different times during your days off work, to help fill in the spreadsheet so we can see how Squeak is doing on a particular dose.

With Lantus, you can spread out the meals more than you did with Vetsulin which has a harsher onset. Many smaller meals are easier on a healing pancreas. People here use either auto-feeders or freeze some wetfood to thaw out later if they are going to be gone during the day.

And please keep on asking questions - we love to help. :-D
 
Thank you so much! I changed the info on the ss and put in all of the details I have, sorry it isn't more.
I have a problem with being able to feed Squeak more often during the day. I am gone for 10 hours. There is wet food out, but it isn't the one Squeak prefers. I have a cat that has a severe intolerance to Chicken. I have found only one food he can eat without having constant diarrhea, so it is out all the time for all the cats.
Squeak seems to not want to eat unless I am home. I tried keeping him in a different location with his food and it didn't help. I cannot keep the intolerant cat in the otherl location because he also has asthma and that room is not good for him.
I appreciate any and all suggestions, advice, help, and pointers.
 
thanks for fixing the spreadsheet - so you've really just started Squeak, right? He was diagnosed in March?

your schedule is workable - everyone here has lives and we just figure out how to work with things. what you'll be depending on is evening cycle tests to help figure out how low a dose is taking Squeak.

I'd agree with Wendy's suggestion of 1.5u for a starting dose. You'll hold that dose for a few days (5ish) and get tests in to see how low it takes him, then we can adjust the dose.

do you just have the 2 cats?

was he on dry food before diagnosis?
 
Ugh on the chicken allergy. I fostered a cat that wouldn't eat chicken and was surprised how many cat foods without chicken in the name still have chicken in them. :roll: There are some alternative products like Ziwipeak (venison, lamb, venison&fish, lamb&rabbit), Weruva Steak Frites, Wellness Beef & Salmon, or Natures Variety (Beef, lamb, duck, venison, rabbit) that don't contain chicken and are all low carb. Those are the brands I know of - I'm sure there are others. If your cats are like my boy cat, he prefers red meat foods.

If you water down wet food and make it soupy, it'll not dry out as fast and be available for grazing later if your cats like to graze.
 
Yes, Squeak was diagnosed in March.
I have 10 cats total and a German Shepherd.
5 of the cats have problems- deaf, asthma, diabetes, seizures, chicken intolerance, mangled paw.
 
Heck of a night you had with a 25 reading at +4! Glad you were able to catch that. You had fabulous numbers for the 2nd so I hope your transition to lantus goes well it's some amazing stuff.
Sounds like you've got your hands full but at least there's some good advice here. As to diet, I'm no expert but I'll say what I've heard is supposedly ham is the worst to give to cats something about being the hardest for them to digest. I was also warned against doing seafood too often due to mercury or other poisonings and they get spoiled on it/addicted to it so go figure Squeak has to be ironic. :lol:
Jerry is into Friskie's pates and I'm not sure that any of the large cans of pate have chicken. Some need checked into like I'm not sure what the "mix" in mixed grill is or what makes the supreme supper "supreme" or what exactly is in the country style dinner. Those would need to look into ingredients due to the other's chicken allergy but around here they also have turkey and giblets, ocean whitefish, salmon, some sort of liver, etc. Jerry LOVES wet food but even he gets bored with flavor so variation is good if you can fit it into the diet and make it work for everyone. Another option is the smaller cans if he is partial to chicken but can't have it due to the other you can pop one open for him and just spoil him real quick before you leave and save the rest for later. Depends on how picky/spoiled he is. :lol: Hope that helps some, best of wishes!
 
Yikes on that 25! Good thing you caught that Cathy. I'd definitely lower Squeaks dose at the next shot time, maybe to 3 units? You might want to call your vet first thing in the morning for a suggestion. There isn't a lot of expertise on Vetsulin here, but there is a user guide.
 
Tommy----- I have found two wet foods and one dry that does not have chicken. Only the Whiska's Purrfectly Fish Tuna Entree does not cause Tommy to have diarrhea. We went loads of foods, commercial and homemade, thru three vets, oodles of special tests, and one overnight stay before my husband figured out that chicken was the culprit. I steer clear of any poultry where Tommy is concerned. If anyone knows of another wet food other than Iams Tuna/Mackerel, please let me know. I have spent hours at stores reading every label and have only found three chicken free foods. Tommy is the asthmatic, not the diabetic.

Squeak- the diabetic- will not eat anything other than the 9Lives Super Supper or lunch meat since being diagnosed with diabetes. I have went thru all kinds of people and pet food with him and this is all he wants right now (and he doesn't really want it other than the ham.) :)
He has ate an odd meal of scrambled egg, or baked liver or baked chicken here and there. I have tried his old dry food and loads of canned food. He smells it and walks away. This cat would have ate your shoes before he got sick, so this is very unsettling.

You guys are so sweet and helpful and I appreciate all of you so much.
 
Since I feel like I will probably be here a lot- I am backing up to introduce my clan.



I will start with the cat that brought me here and then go by age.

Squeak Albert McLane- 6 yrs old.- a male ginger Maine coon mix- diagnosed with diabetes 3-8-14- (born in our house- his mother arrived pregnant with a mangled paw).

Princess Valentine Grace- 13 yrs. old- a female blond-peach color mix- has brain damage and seizures, cannot clean herself, but she is a joy. (Adopted from our former vet.)

Trixie Belle Mullinsky- 11 yrs. old- a female mackerel tabby- no health problems now- but had crossed eyes when we found her. She mothers everyone. (Found in a Waffle House parking lot).

Lil Bit Philistine- 10 yrs. old- a female mackerel tabby- no health problems, loves to be pet, but panics if she feels cornered and is very afraid of any type of care- nail clipping, etc. (Found in a RV dealership parking lot, drinking from a pool of anti-freeze) Will go feral if you try to clip her nails, give meds, etc.

Boots McGee- 9 yrs. old- female black and white tuxedo cat- no health problems other than feeling like a victim. (Showed up in our yard late one night talking, talking, talking.)

Martha Tiberius Claredon- 9 yrs old.- female German Shepherd- her hips bother her a bit (showed up in our yard scared, hungry, and had been abused. She was terrified of men, but is a happy and adjusted dog now. Loves all animals.)

Alice McAlicestair Windsor- 8 years old- a female mackerel tabby- no health problems. Unafraid and too clever. (Ran up to meet the dog and stayed.) Martha and Alice are best friends and Alice has a language she only uses with Martha.

Penny Pi McLane- 8 yrs. old- a female calico ragdoll mix with a mangled paw. (Showed up on a cold December day, pregnant and needing a home. 4 days later she gifted us with Bubble and Squeak.)

Bubble Gandhi Yoda McLane- 6 yrs. old- a 16 pound male ginger Maine Coon mix- very healthy and very much a gentleman. (Born in our house)

Casper McParrot- 4 yrs. old- a female solid white cat, deaf and prone to being pig shaped. (Ran up to my husband in a busy parking lot, as a very small kitten, and he brought her home)

Tommy Edward- 1 year old- male tailless ginger tabby. Picked up at a boat dock on a very cold day. (After months (constant diarrhea) of tests, vet visits, and trial and error we found he has an intolerance to chicken. Digestion is fine with the right foods, but he also has asthma.)

So my husband and me are outnumbered, outwitted and covered in fur head to toe- but at least all are loved, neutered/spayed, indoors, (dog is half and half), safe and fed. :)
 
With no insulin since 5:45 pm yesterday, he tested at 186bg @ 12:30 pm today. Is it possible he does not need insulin? Going to vet after work today to pick up u100 syringes, and will consult him.
 
Would someone please take a look at Squeak's SS? Since his bg reading of 25, night before last, I have not given him any insulin. Vet was not in yesterday and I never heard from him last night.
I want advice from people that have experience with these issues to be sure I am not putting Squeak at risk.
Thank you.
 
I would be cautious. After going very low, some cats are more sensitive to insulin.

If he goes over 200 mg/dL, and you'll be awake for the next 8-12 hours, maybe give 0.5 units.

It can be increased later; you can'y get it out once it is in.
 
I would probably plan to start Squeak on insulin asap. Lantus takes a while to build up in the body, and while it's possible to see an immediate response, it's also possible that you're not going to see much action for the first few days on Lantus.

really glad you caught that 25. Reading your spreadsheet, it sounds like there were no symptoms, is that right?

180 this morning is already out of the range of normal blood sugar for cats, so he's still diabetic and still going to need insulin. I'd go ahead and restart. He's in a great range of numbers now, and it can be easier to get a cat's BGs flatter and under control when you're starting with a lower number as compared to waiting until he's 400 and then starting. Not sure why you're waiting, but i'd go ahead and jump in.

REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
Click to expand...

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Click to expand...
 
Hi, guys. :-D

You've got some very helpful people on here with tons of knowledge to share with you. Have you started him on the Lantus yet? If so, you may want to start as soon as you can. As someone mentioned on here, Lantus takes a while to build up in the body, and once it does, it's a very good insulin and it works nicely when used consistently.

I just took a look at Squeak's SS, and noticed that you gave him 2u of Vetsulin this morning. Please note that you do need to get at least 1 test in between the preshot tests so that people can take a look at how he's doing with the insulin during the day.

Also, if you want to give him Lantus, I don't know if there's a weaning period to take him off the Vetsulin, or not, and you may want to check with people who used Vetsulin. I remember when Blackie was on ProZinc, I immediately switched from ProZinc to Lantus with no ill effects.

Try and get a mid cycle test in today, please, ok? Those are extremely important to get, and by not doing so, nobody can really give you the proper advice/instruction on his care without first knowing how he's doing during the day.
 
hi cathy!

happy caturday!

last night something was tickling my brain that i'd seen and meant to mention. when Squeak was low the other day, i saw a note in the ss about spaghetti sauce. you probably want to just stick to karo syrup, honey, gravy from the high carb cat food or maple syrup when you're pulling up blood sugar. spaghetti sauce likely has onions and garlic in it and cats can't have those. the syrups and gravy will work fast and be effective for mr squeak.

you have quite the clan of furkids! there must be stories behind all of those names. :-D Bless you for taking in all those special needs babies.

hope you're having a great day!

julie
 
We were started on Vetsulin too and switched to Lantus as soon as we could, at the time there was an FDA warning against Vetsulin. The switchover was quick and not a problem.

Unlike Lantus, Vetsulin is a fast acting insulin w/ no carry over. Lantus builds up a reserve in the body (we call it the "shed" or "depot"), which is slowly release and replenished w/ each shot. It can take up to a week to establish the shed, patience is needed with using Lantus. Also every time the dose is increased the shed needs to rebalance and that can take up to 3 days and numbers can actually go up during the balancing out of an increase. Totally nailbite_smile nailbite_smile nailbite_smile !

Since Lantus is a human insulin you can probably get the syringes cheaper at your local pharmacy. Most vets don't carry them. You may need a prescription depending on your state. They will be a lot cheaper too, and even more so if you order them online. Many of us use Terumo Thinpro Insulin Syringe 31G 3/10cc 3/8", from American Diabetes Wholesale they are only $13 for a box of 100, our old vet charged us $45 for a box of the U40 syringes. ADW carries the other brands too and they are really fast on the delivery. The numbers on the syringes may be a little confusing. Just be sure you get U100 syringes (they have an orange cap, not red), 31G means 31 gauge needle (the thinnest), 3/10cc the amount the syringe will hold (this is the thinnest, so the lines are further apart and easier to read!), 3/8" is the length of the needle (as Wendy said you might want the longer 1/2" needles because of Squeak's long hair.) We usually adjust doses by .25U so the half unit marking are really helpful. More than you ever thought you needed (or wanted) to know about syringes, right? ;-)

You mentioned having food available all day. Is it canned or dry? It is amazing how much dry food can raise the BG levels for a diabetic cat. And on the ham treats, have you considered ham baby food? Just get the kind w/ no onions, ! It doesn't have added sugar and most cats love baby food as a treat.

Where are you located btw, knowing that can help w/ figuring times zones (we have members all over the world!) There may also be a member close by if you need some help.
 
By the time I got the needle and dosage info, the vet was out of town, and Squeak had the very low bg, so I am waiting until the vet is back so I can buy the needles and start Squeak on Lantus.

Thank all of you for your kindness and replies.
 
sounds like a good plan! for what it's worth, i loved the syringes that Ann/Tess mentioned, the Terumos. They're cheap but very good, the plunger moves very smoothly and the markings are more accurate than on many syringes. You might want to get just enough at the vet to tide you over until you can get an order from ADW.

If you decide to order from ADW, you can save some $ by registering first at http://www.mrrebates.com . Then you go through them to ADW and you'll accumulate a percentage of what you spend at ADW and can get a rebate every so often. I've gotten checks from them for as much as $36. Just helps offset the cost of the supplies.

Whenever you're ready, just holler. :-D
 
Vets often don't carry the U100 syringes, just the u40s because those are the type used for "pet" insulin. i don't know where you are but here I went to CVS and could get packets of 10 for about $3.50 until my order came in.
 
Thanks everyone. My vet is really good on prices. I checked online after getting the first syringes and insulin and he had charged less than any place I could find online.

I know this is a stupid question, but here goes- I see people post about starting at .25 or .5. How do you do that with a u100 syringe? The lowest mark was 1 unit.

Also, if you look at Squeak's SS (still on Vetsulin, right now) he is reading good without insulin most days. I am kinda worried about giving him anything new since he is doing so well. I welcome opinions please.
 
We use syringes with 1/2 unit marks. So, a .5 would be on the mark and a .25 would be right between two marks.

Squeak is doing really well.
 
Thank you Dyana.
If you wanted to start with .5 and the first mark was 1, how do you do it? The vet showed me the needles when he and I first spoke about changing Squeak to Lantus, and it started with 1.
 
I would get the syringes with 1/2 unit markings next time. If all you have is syringes with 1 unit marks, then you would have to eye ball what 1/2 unit would be. I would play around with some water or colored water and measure 1 unit and slowly count out the drops, trying to be consistant with the drop sizes. I would practice getting the same drop size, at first. When you're good with the drop sizes, then measure to 1 unit again, and push out half of those drops and see what it looks like. If you use colored water, you can save that syringe with the measured dose to compare other doses (of insulin) of the same size to. Just some thoughts.

Whether you give insulin depends upon his numbers at PS, though. Please post and don't feed, if he's below 150.
 
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