? Starting Ziggy on Lantus after a year on Vetsulin. Advice for starting out?

Natalie and Ziggy

Natalie and Ziggy

Member Since 2018
Hi, everyone. So as of tonight (or tomorrow morning?) I am switching Ziggy to Lantus, after he spent a year on vetsulin. I plan on sitting down and reading all of the documentation on Lantus on this site, but I guess I just want to see if there is some general advice I should consider when giving Ziggy his shots and adjusting dosage?

I am planning on starting him at 1 unit (with U100 syringes, don’t worry), and will be testing and giving shots at his usual times, twelve hours apart. Normally I wait about fifteen to twenty minutes after feeding to give a shot. Is this the best practice with Lantus?

Also, I received two Lantus pens from DCIN, and the expiration date is 28 days after opening. I assume that they will actually last longer than that? Do I have to keep Lantus refrigerated after the first puncture?

Sorry if this comes across as a bit vague, but I think I’m just looking for some starter tips to consider when starting out.:)
 
Natalie and Ziggy said:
Hi, everyone. So as of tonight (or tomorrow morning?) I am switching Ziggy to Lantus, after he spent a year on vetsulin. I plan on sitting down and reading all of the documentation on Lantus on this site, but I guess I just want to see if there is some general advice I should consider when giving Ziggy his shots and adjusting dosage?

I am planning on starting him at 1 unit (with U100 syringes, don’t worry), and will be testing and giving shots at his usual times, twelve hours apart. Normally I wait about fifteen to twenty minutes after feeding to give a shot. Is this the best practice with Lantus?

Also, I received two Lantus pens from DCIN, and the expiration date is 28 days after opening. I assume that they will actually last longer than that? Do I have to keep Lantus refrigerated after the first puncture?

Sorry if this comes across as a bit vague, but I think I’m just looking for some starter tips to consider when starting out.:)
Click to expand...
Keep both pens in fridge
 
Hi Natalie, welcome to Lev and Lantus Land!
Since lantus is a slow release insulin, I don't think there's any reason why you can't wait for 15 or 20 minutes after feeding to give him the shot. But I don't think there's any benefit to it. I test, feed, and shoot all one right after the other; if I waited to shoot I would be likely to forget to do it!
 
Hiya Natalie! Welcome to L&L land! I switched my buddy Lou from Vetsulin to Basaglar (glargine similar to Lantus) after almost a year as well. Let me say, it will be a crazy change for you! Basically, you'll have to forget almost all you know about Vetsulin and just dive in to being a newbie again. So frustrating, but ultimately very worth it! One of the best things about the L&L forum is you can choose between two protocols: Tight Regulation (TR) and Start Low Go Slow (SLGS). You choose whichever works better for you, but remember you can switch at any time if you need to. I love having the written guidelines available, it makes things so much easier.

Now as far as dosing, since Ziggy isn't new to insulin, you'll take his previous dose into consideration when switching. I'm not super comfortable giving dosing advice, but it looks like you'll want to start around 2.5 - 3.0 units so you don't lose any momentum. We'll let the experts chime in on that. Unlike Vetsulin, Lantus requires a much stricter dosing schedule, and you would make adjustments to the dosing time in 15 minute increments (I used to vary my time by 2-3 hours on occasion on Vetsulin). Since Lantus is a long-acting insulin, you don't need to wait for Ziggy to eat (just so that you know he will eat) before dosing. Old habits die hard here, I feed Lou and then dose him after he's done eating, about 10-15 minutes after testing. It's all good.

Just keep your insulin pens in the fridge and they're good til the expiration date. I wish you both the best of luck with the switch!!!!
 
I would start him at no less than 3u Lantus every 12 hours. We usually test, feed, shoot within about 15 mins and most find that shooting while the kitty is eating is a good way to distract them. Just remember to test before you shoot every time.

If you keep your pens refrigerated and keep them in a cheese drawer (not the door which is constantly being opened and closed), you can use them to the last drop, usually. The 28 days is for humans carrying them around in their purses or pockets.

We dose on the nadir here with minor consideration of the preshot. In other words, we are dosing for where we think kitty will be midcycle. It’s good if you are able the first several cycles to get random tests. You’ll also want to hold the initial dose 10-14 consecutive cycles unless he drops below 40 since he is not a newly diagnosed cat. If he drops below 40, he gets a dose reduction of 0.25u.

Glad you are with us and ask any questions you have!
 
Thanks for the replies and advice, everyone! I started Ziggy on Lantus last Thursday and followed what you all said. So far, I'm really liking this new insulin, and I think Ziggy is, too. At his present 3.0 U dose, he's hanging around the upper 200s to mid-300s. A little higher than I would like, but I love how the curve is almost flat! No nasty bounces like with Vetsulin. Ziggy is responding well to it, at least on the surface, anyway. He spent all evening zooming around the house and leaping all over the place in a way he rarely does. I think the dental procedure he underwent last month is going to help with his insulin therapy, too. My first impression of Lantus is extremely positive.

So is the general rule of thumb to wait a week before increasing/decreasing the dose? By .25 increments, if I'm not mistaken? I'd like to get his numbers a little lower but I don't want to rush anything!

I think the hardest part so far is the U-100 syringes. The needles are so short that it's tough to get the shot in!
 
You can usually buy syringes with different needle lengths. Which ones are you using? I tried shorter ones, 6 mm, and didn’t like them so went back to 8 mm length. Course, I had a long coat to deal with.

The length of time you wait to start depends on which dosing methodology you would like to follow. Have you read the Stixky Notes on Tight Regulation and Start Low Go Slow? People usually pick one to follow. With TR you could increase after five days, with SLGS it’s seven days.

Is there anyway to move that 1/4 can of food he gets later in the cycle to earlier? It’s best to give most of the carbs in the first half of the cycle when the insulin is strongest. Carbs later in the cycle can shorten duration and give you higher preshot values,
 
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