Starting dose for Lantus? Any help appreciated! I could use help starting on this new insulin!

Sudio3

Sudio3

Member Since 2019
Hello,
My cat has been on Prozinc since November 2018 then went into remission July 2019 and off insulin until December 2019 when he started Prozinc again. He has been off insulin since 02/07/19 as it didn’t seem like the Prozinc was working anymore. We are starting Lantus tomorrow once the pharmacy fulfills the prescription. The vet said to start at .5 units. Does this seem like a good dose to start?

Also, we are going away from 02/24-03/03 and the cat sitter may not be able to come the same time every day. She may be an hour or two off from his normal time for insulin. Would this be ok or is it really important that he get the Lantus at the same time every day.
Thank you so much!

Marissa
 
Typically, if a cat is on a different insulin, you can use the same dose when you switch to Lantus. The starting dose actually depends on what dosing method you opt for. Could you look over the dosing methods sticky and get a general feel for either Tight Regulation or Start Low Go Slow?

With Lantus, you do not want your shot time to be more than 30 min off schedule. The cat sitter, if this person is familiar with giving insulin, should be aware that the scheduling is pretty rigid with most types of insulin.
 
I read the dosing methods sticky notes and will go with the Start Low Go Slow method. I will need to read it again. I picked up the insulin today but want to make sure I’m dosing right (it’s not clear on the U-100 syringe to me what half a unit is?) and I also want to make sure I’m supposed to ignore the numbers at the end of the insulin pen, so I’m waiting to hear back from the vet. He had me purchase a 3ML prefilled pen and I’m taking the insulin out of the pen with a syringe. I’m thinking of starting with a half a unit. I’m nervous about starting him on this as it will be hard for me to test his BG multiple times a day as I’m working (pet sitting so won’t be home much for the next week, I will be in and out but out for long stretches of time). And the week after that we are away for a full week so he won’t be tested that week at all while the pet sitter is watching him only getting the insulin. I’m also pregnant with a toddler and have another sick cat and it’s a challenge for me to get his blood sugar sometimes. It also seems a bit confusing to me about how to gauge his blood sugar on Lantus and I’ll have to read the sticky again and I’m pressed for time these days. But I do want what is best for him so will do my best to give him the care he needs. I appreciate any help I can get from this forum.
Thank you!
 
There are pictures in the Insulin Care and Syringe Info Sticky Note that show what half unit markings look like. What type/brand of syringes do you have?
 
Wendy&Neko said:
There are pictures in the Insulin Care and Syringe Info Sticky Note that show what half unit markings look like. What type/brand of syringes do you have?
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I checked out the pictures and wow half a unit is a super little dose! The brand syringes I have are BD Insulin Syringes 30 units U-100. Another quick question, is it possible to refrigerate the Lantus pen to make it last longer or should it really be kept at room temperature per the manufacturer?

Thank you!!
 
I used the BD syringes too. Do yours have the half unit markings on them? Mine did. It also helps to use a magnifier, good light and a light background above which you draw the insulin.

Definitely keep the pens in the fridge if using with syringes for a cat. People use pen needles and that mechanism doesn't work as well if kept cold, hence the note to keep outside of the fridge. You should be able to use your pen to the last drop.
 
Just to tack on a bit to Wendy's note. The manufacturer will say that your insulin should be discarded after 28 days. I used a pen for closer to 90 days.
 
Wendy&Neko said:
I used the BD syringes too. Do yours have the half unit markings on them? Mine did. It also helps to use a magnifier, good light and a light background above which you draw the insulin.

Definitely keep the pens in the fridge if using with syringes for a cat. People use pen needles and that mechanism doesn't work as well if kept cold, hence the note to keep outside of the fridge. You should be able to use your pen to the last drop.
Click to expand...
Oh thank you! I just put it in the fridge now! It doesn’t have the half measurement marks but I should be ok getting the half unit. Thank you for the tips!
 
You might want to source some syringes with half unit marks, we make changes by 0.25 units ata a time. So much easier with half unit marks there.
 
Wendy&Neko said:
You might want to source some syringes with half unit marks, we make changes by 0.25 units ata a time. So much easier with half unit marks there.
Click to expand...
Hmm ok thanks I will see if I can get these. I will ask my vet. Thank you. On another note, for the next week I will be very busy going back and forth between my home and the home I am pet sitting for. I will be staying over night at the persons home and then next Monday we are leaving on vacation for a week and a pet sitter will be here twice a day to take care of the cats and give Nudi insulin (if he’s on it) right now he’s not on anything. My question is would it be better to wait two weeks to start him on the insulin once we are back from vacation and I’m around more even though his numbers are steadily in the mid 300’s (alpha trak II meter) (AM & PM numbers) or start on the .5 units of Lantus even though this week I’ll be in and out and next week I’ll be gone completely. Thank you!!
 
Finding syringes online may be easier and cheaper. Try ADW for syringes. You'll likely need a prescription.

Whether or not to wait may depend on what Nudi's numbers look like. I'd be worried about the possibility of diabetic ketoaciosis in an untreated diabetic.
 
Nudi is seeing numbers all above 200, so looks like he needs insulin. In addition to the concern about DKA Sienne mentioned, his body is going to get used to higher numbers the longer without insulin. If you could try 0.5 units this week, you'll have an idea how low that dose is taking him and then decide if he should be on a smaller dose while you are gone. Typically if there is a petsitter and no or less testing, we suggest a reduced dose.
 
Wendy&Neko said:
Nudi is seeing numbers all above 200, so looks like he needs insulin. In addition to the concern about DKA Sienne mentioned, his body is going to get used to higher numbers the longer without insulin. If you could try 0.5 units this week, you'll have an idea how low that dose is taking him and then decide if he should be on a smaller dose while you are gone. Typically if there is a petsitter and no or less testing, we suggest a reduced dose.
Click to expand...
Ok thank you. I can start him on the .5 tomorrow but I will be gone most of the day tomorrow so there won’t be much testing. We can pretty much guarantee the am and pm BG numbers but the mid-day BG numbers will be hard to get this week before we leave for vacation on Monday. That being the case do you think it’s better to start on the .25? Thank you so much!!
 
No, I stick with 0.5 units. He hasn't been on insulin for quite some time, and was on 2 units when you stopped. Plus that way you can see what 0.5 units might do while you are gone. Remember, the depot still has to build. You can always start tonight (if not too late) or tomorrow night if that's better for monitoring.
 
Ok thank you. Just FYI he was actually on .5 units when I stopped.

So the pet sitter just let me know that she will need to fluctuate the time she gives him the Lantus most days. I’m wondering if I should try Prozinc again as it’s my understanding you can be up to an hour off giving Prozinc and still be ok. The Prozinc didn’t seem to be working which is why I was switching to Lantus. But I could try again? Thank you so much.
 
He needs insulin of some sort, Prozinc will be better than nothing. Then maybe Lantus when you are back in town.
 
Ok thank you. I stated him on .5 Prozinc this morning and will keep him on this until we get back on March 4th. When we get back we will see how he’s doing and most likely switch to Lantus. Thank you for all the help. Hopefully he gets some relief on the Prozinc.
 
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