Stressing over Insulin Choices

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DEF

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Hi Everyone, I am sorry to join this club made up of diabetic kitties but happy to find such a helpful place. I have spent probably 6 or 7 hours a day on the internet since Pinkie was diagnosed a week ago.

I can handle everything I have read so far --food switch to wet (doing that now) and home testing (started 2 days ago) but the simple decision of what insulin to use is stressing me out. I tell myself that there is no 'BEST" kind for every cat but I read one thing and then another so feel overwhelmed with indecision or in my case making too many multiple decisions.

Pinkie was prescribed Humulin N and has been taking it for a week --found out pretty quick that this kind was not recommended . I read a study about Lantus and thought this is the one to try. Went back to the vet and he said Humulin N was what they always use (as it is the cheapest and what people want) and there was no reason to change unless it wasn't working. He was very nice about it and willing to switch once he realized I just didn't want the Humulin. I got a prescription for Lantus but haven't filled it yet.

Later that night I read 2 convincing recommendations to use PZI written by vets --that was the 'best' insulin to use. Closest to a cats insulin. (But you have to make sure to get the right type-- ie bovine from a place like BCP) I felt sick--my vet would think I was a big pain in the neck as I had just convinced him to give me the Lantus.

I had already got a meter 2 days ago but I wasn't dosing according to what it said as I was still just following vets instructions (.2 twice a day) . I just took her back and told him about the self testing and asked about the PZI --he said If I didn't mind
the cost he would probably go with PZI ---given a choice of Lantus or PZI . I brought him info on BCP in Texas and he called in a prescription.

They are supposed to call me at home to complete transaction.

I still can't make my mind feel at ease--no matter which I get I feel I should get the other one. I am worried about the ice melting in this heat and damaging insulin. I tell myself that maybe the Lantus would have been better for complete remission which is my goal if at all possible. And I just read a thread on PZI forum asking about remission stories and most are on PRO ZINC not the one I am ordering.

Is PZI from BCP a good choice or should I go with the Lantus as she is newly diagnosed? I am leaning towards the PZI as the vet seemed OK with that one but change my mind every 5 minutes. Thanks so much for your insights as I can't dilly dally any longer--we need to get off the Humulin.
 
Hi and welcome.

First of all take a deep breathe, you're not going to make a wrong decision, moving away from the N is the best choice. So you already made the right decision.

I've used BCP PZI and I've used Lantus and Levemir. The reason you're seeing ProZinc cats going off insulin now is because that's the newest insulin that vets prescribe, it's relatively new to the market, just a few years now, and it replaced another popular vet only insulin called PZI Idexx. But PZI BCP is great. If you hometest and change your cat's diet to low carb canned only you'll do well with it. They ship it very well and it comes with an ice pack, at least it did a few years ago when I ordered it.

The studies you read, probably one by Dr. Hodgkins, they were good in their day. BCP PZI is one amino acid away from a cat's naturally produced insulin, all of that is true.

What I prefer about Lantus is that it's curve is gentler and it lasts longer. The BCP lasted about 8-9 hours with my three cats that were on it. Where for my one cat now that is on Lantus and sometimes Levemir (I switch depending on what I have on hand) she does very well and her numbers stay low consistently.

If you have not paid for the PZI yet, I'd go with the Lantus, but if you have already purchased the PZI, you can get some really great advice here and I'm sure things will be fine. My Tucker was on PZI BCP when he went into remission the first time. He did go back on insulin later in life but he had a lot of health issues that caused that.
 
Welcome! Boy you've already headed in the right direction. I can't help with your decision but wanted to say 'WAY TO GO' already!

My vet knew nothing but Humulin N.... He had to look up Lantus in his human medical book before he would write a prescription. We're new to it as of end of August, KT's spreadsheet is in my signature if you want to see both. He's NOT low yet on the Lantus but he's not riding a roller coaster any more either...
 
Before you run out and buy the Lantus, be sure your prescription is
written for the 3ml 'pens', not the 10ml vial.

Lantus has a relatively short shelf life once opened, and you will toss
out a LOT of the 10ml vial, when it goes bad in 1-3 months.

The 3ml pens are more expensive up-front, but they are way economical
in the long run. You open one pen at a time and many here use it to
the last drop with proper handling. You still need insulin syringes for U-100 insulin.

SOME hospital pharmacies will sell you one pen at a time...call around; get prices
and availability.

Please read, read, read on the Insulin Support Group for Lantus, especially the
'sticky's" on handling Lantus. Your vet may not know much about Lantus.
The first thing is: do not shake or roll it.

Lantus ISG:
viewforum.php?f=9
 
I thought I was reading my initial battle with choosing the right insulin. I sat on the fence just like you are between the BCP PZI and Lantus. Depending on whose study I read or whose literature I saw...I went back and forth. Ultimately, my Vet convinced me to go with Lantus. Her reasoning was the longevity of the duration, the consistency in the product (evidently in the past, there's been some issues with raw materials?), the reduced wonkiness of dosing, and the quality of the support literature. And she said....if I wasn't happy, we could always switch later.

So we started on Lantus just about a month ago and all in all, have been pleased (although sometimes impatient ;-) ) with the gentle nature of Lantus. I feel safe using it and know that I am not here 24/7. We do buy the pens and just use a regular syringe to pull up.



You are already WAYYY ahead of the game in your knowledge and you're thinking about all of the right stuff. Know either are very good choices. Think about your lifestyle and your ability/frequency to test because this does play a role between the two!
 
Thanks to everyone who replied.

I did go and get the Lantus filled and called BCP and asked them to hold off sending PZI for right now. They hold the prescription for a year so I can always switch. Still feeling uneasy despite kind reassurances from Tucker's Mom.
I still feel obssessed with researching this to death.

Also now I will have to figure out doses based on tests (much more scary as I am afraid of making a mistake) instead of the vet's easy instructions of 2 shots a day.

(PS Karen I did read about this issue and had asked the vet to make the prescription out for cartridges not the vial. The first place wouldn't fill it as the cartridges are replaced by the pen now. I just couldn't imagine going back to the vet for ANOTHER prescription (especially since he did one for PZI today) but luckily the second place filled it as written as I was just going to use the cartidges out of the pen anyway.)
 
DEF

Many people here successfully use lantus, so you have no reason to stress, it isn't like you've chosen a bad insulin.

For some cats, it doesn't seem to matter which insulin you choose, they do well.

Some cats are more sensitive and do better on one insulin over the other.

Lots of people here have successfully used BCP and prior to lantus I would have used it as well if I'd had the choice.

Now I'd likely choose either lantus or levemir but that's just me.

You can't know whether either insulin is 'perfect' for your cat until you try it. I highly doubt whether it will be WRONG.

You have a lot to deal with, overloading yourself on this is not going to help you get through it.

I prescribe your favorite beverage and treat...

Jen
 
I'll chime in with Lantus. We were given Lantus 3yrs ago and Raja went into remission about 6 weeks later. Now we are back and I asked the vet specifically for lantus because it's what we know and are used to.

It is a personal decision but I believe that it's best not to switch insulins often so if you've already filled lantus and are using it then I would stick with it for some time. I know some of the oldies will be able to chime in about how long to stay on an insulin before switching
 
I've used Humulin N, PZI from BCP and currently Levemir which is quite similar to Lantus but with some advantages.

I liked the PZI from BCP and had no problem with the shipment arriving cold. I used it in 2008-2009.

Then I switched to Levemir and love it.

Levemir and Lantus act pretty similar with two significant exceptions that made me choose Lev.

Lantus is guaranteed for 28 days with no refrigeration
Levemir is guaranteed for 42 days with no refrigeration --- lasts longer = less waste

Lantus has an acidic base liquid which stings when injected. (a human diabetic has confirmed this)
Levemir has a neutral base liquid -- no sting.
 
We can really relate to your story!! The agonizing between Lantus and ProZinc, the research, the vet's attitude and approach, the many phone calls, and the multiple prescriptions to get it right. ;-)
Relax and know that all your time and energy are well spent, you have made a wise choice. We wish you success.

Start low with the dose since it takes a couple cycles to reach full effect.

For those who like the technical details, here's some of my research findings for your "enjoyment" (reposted from the Lantus group) ...

...
Yes, precipitates are solids. Lantus forms micro-precipitates so the solids would be microscopic, technically they are crystals.
This deposit of precipitates is the "depot" or "shed".

upon further research ~O) ...
When Lantus is first injected it forms into micro-precipitates (hexamers) that are too large to be absorbed and are put into "storage". They immediately start to break down and after 1-2 hours (ECID) the smaller (dimers) and smaller molecules (monomers) start to be absorbed (the shed doesn't have to be totally filled before any is available). This gradual process ensures that Lantus is slowly and steadily released. In a human study some Lantus is still at the injection site 24 hours (low dose) to 36 hours (high dose) after the injection! With a 12/12 hour injection schedule the next injection occurs well before the previous injection is gone resulting in 2 (or more) overlapping cycles. This carryover helps with Lantus’ already relatively flat curve.

Be aware that as you increase the dose, or are already using a large dose, the depot fills with more of the large precipitates and higher insulin concentrations causing the whole breakdown/diffusion/absorption process to slow down, you end up with a higher and longer duration insulin peak. A delayed shot is like a dose reduction because as the depot dissolves away its carry-over effect is continuing to be reduced for the next shot and cycle. After a longer shot delay the process is often refered to as refilling the shed, which is simply getting the 2 (or more) overlapping cyles back up to their full initial and carry-over strengths. It takes a couple cycles for the process to reach equilibrium again whenever you make a dose change.

You'll need to base the dose more on the nadirs (low point in the cycle) than the pre-shot (see “Shooting &Handeling Low Numbers”!). The peak of these insulins is so late and the effect of the dose so long-lasting, well past the next shot, that the dose size is more likely to affect your next pre-shot than to have any effect on the immediate situation.

Did I mention ECID (every cat is different)?
Be patient and go slow.

From "petdiabetes.wikia.com/wiki/Lantus":
White3.gif
 
Thanks again for the many replies.

I don't like the thought of the insulin 'stinging' poor Pinkie. If she reacts with pain I will have to rethink the Lantus.

I have read and reread so much of the instructional information. Thanks for posting info Lug --I read it and I am still struggling with what it all means I didn't get what a nadir was until I saw this:

http://www.bd.com/us/diabetes/page.aspx ... 01&id=7381

I wish I could just dose based on the current BG reading --that seems so much easier. Look at the number and then a chart of dosages.

But it seems with Lantus you can't do that --- you have to figure out the nadir number (low number?) and apply this to a dose you give several hours later???? Don't really understand it but I will just have to study more.

I have another question concerning syringes.

The doctor gave me a prescription for 100 u syringes , 1/2 cc , 1/2 inch long, 30 gauge.

But I know the recommendation here is to use 1/3 cc syringes. Is there a chart to convert from one syringe to another so that I can use the 1/2 cc ones that I have? A one unit mark on one would not be the same as a one unit mark on the other, correct? I see a chart for using 40 u syringes but how do you use 1/2 cc syringes instead of the 1/3 cc syringes? The does would seem to be microscopic. Thanks so much.
 
I don't like the thought of the insulin 'stinging' poor Pinkie. If she reacts with pain I will have to rethink the Lantus.
Click to expand...

Most people don't have any issues with stinging....if you do draw the insulin up 30-60 mins before you're going to shoot - something about bringing up to room temp, takes out the sting.

The doctor gave me a prescription for 100 u syringes , 1/2 cc , 1/2 inch long, 30 gauge. Is there a chart to convert from one syringe to another so that I can use the 1/2 cc ones that I have?
Click to expand...

Here's syringe 101 ;-)
The strength of an insulin is measured in International Units (IUs). The two common strengths are U40 and U100, meaning 40 units and 100 units per milliliter, respectively. Lantus is a U100 insulin, which I'll explain after the next sentence....
Cubic centimeters (cc's) and milliliters (mL's) are interchangeable, so syringes marked 1ml equals 1cc; 0.5 ml equals 1/2cc. 3/10cc equals 0.3m. So back in Lantus world (100U insulin), each 1mL or each 1cc (because they're interchangeable) equals 100 units of Lantus insulin.

So...the syringe your doctor order and that you have is just fine. I'll explain what the numbers mean here:
Your prescription = 100 u syringes , 1/2 cc , 1/2 inch long, 30 gauge
100U = Lantus insulin syringe because each ml or cc equals one hundred units of insulin - perfect!
1/2 cc = this means that the little marks on the syringe can be pulled up in .05 cc or ml - this is the smallest perfectly accurate dose you can get, so if your dose is 1.5 - perfect, 2.0, perfect, 2.5, perfect. Where the 1/3 cc comes in handy, is the finer doses, but you should do fine with what you have.
1/2 long= this is the length of the needle. Personally, I use the 5/16" need, but the 1/2 is fine too - just make sure when you're tenting the skin, that the needle doesn't come through the other side - no big deal.
30 gauge = this equals the size or diameter of the needle. The higher the number, the smaller it is. 30 is perfect. The other time you will run into "gauge" numbers is in buying your lancets. Same thing here and it will really be trial and error with Pinkie; with some 30 gauge is perfect, some need 28.

So no charts needed, you have exactly what you need in regards to syringes to get going!
 
Many cats stabilize (become regulated) on Lantus so you can pretty much shoot the same dose every time. The dose is changed slowly over time in order to raise or lower the curve. Lantus is not a harsh short-acting insulin, it is much more relaxing to use. Try Humulin if you want stress! :YMSIGH:

The nadir (low point) is THE key point with all insulins, a low but safe nadir is the target and goal. With the shorter acting insulins you pick a dose based on the pre-shot and hope that the cat ate the right amout of food, is not under stress, etc. to offset that dose and reach a safe, low nadir (good luck). Cats don't always eat the same amount and the day-to-day changes in body metabolism/chemistry mean you are always, futiley, in reaction mode. Lantus is nothing like that. With a little luck you can get into a relatively comfortable routine. Plus, without the roller-coaster BG levels Pinkey is much likelier to improve and go into remission. :smile:
 
I wish I could just dose based on the current BG reading --that seems so much easier. Look at the number and then a chart of dosages.

But it seems with Lantus you can't do that --- you have to figure out the nadir number (low number?) and apply this to a dose you give several hours later???? Don't really understand it but I will just have to study more.

But you can't do what you want with ANY of the insulins. Any insulin will cause Blood glucose levels to change throughout the period between shots. You need to know how that particular insulin affects your cat from the time it gets its injection throughout...how quickly it kicks in, how low the bgs go, how quickly the insulin wears off and the 'shape' of the curve. The only real difference that I've seen with lantus is that preshot tests (ie what your cat's bgs are at shot time) matter less than the nadir or low point of the curve.

Honestly, you can get lost in the details of the molecules and the pH and all the rest, but it doesn't have to be that complicated.
 
Jessica & Boo Radley said:
Cubic centimeters (cc's) and milliliters (mL's) are interchangeable, so syringes marked 1ml equals 1cc; 0.5 ml equals 1/2cc. 3/10cc equals 0.3m. So back in Lantus world (100U insulin), each 1mL or each 1cc (because they're interchangeable) equals 1 unit of Lantus insulin.
Click to expand...


NOPE !
each 1mL or each 1cc = ** 100 ** units of insulin because there are 100 units of insulin per mL (milliliter).
1 unit of insulin is .01mL (one one-hundredth of a milliliter)

Jessica & Boo Radley said:
100U = Lantus insulin syringe because each ml or cc equals one unit of insulin - perfect!
Click to expand...

NO...each ml or cc equals ** 100 ** units of U-100 insulin

Jessica & Boo Radley said:
1/2 cc = this means that the little marks on the syringe can be pulled up in .05 cc or ml
Click to expand...

Sorry, NOT CORRECT. 1/2cc capacity syringe only means that the total liquid capacity of
the syringe is 1/2 cc (=1/2ml) That would be 50 units of U-100 insulin if filled completely up.

3/10cc capacity syringes can hold up to 30 units of U-100 insulin if filled completely up.

Both 1/2cc and 3/10cc syringes are typically marked for units of U-100 insulin as follows:

First little line near the tip = "zero",
Then 1,2,3,4,5 (first numbered mark). Then 6,7,8,9, 10 (next numbered mark).

The capacity (1/2cc or 3/10cc) has nothing to do with the 'size' of the dose between markings.

Jessica & Boo Radley said:
1/2 long= this is the length of the needle. Personally, I use the 5/16" need, but the 1/2 is fine too - just make sure when you're tenting the skin, that the needle doesn't come through the other side - no big deal.
30 gauge = this equals the size or diameter of the needle. The higher the number, the smaller it is. 30 is perfect. The other time you will run into "gauge" numbers is in buying your lancets. Same thing here and it will really be trial and error with Pinkie; with some 30 gauge is perfect, some need 28.
Click to expand...

Most of us here prefer the 3/10cc capacity, 5/16" length (short) needles, 31 gauge (smallest) syringes
with 1/2-unit marks (if you can get them). The unit markings on 3/10 cc syringes are slightly farther
apart than on 1/2cc capacity syringe, so loading doses is a tiny bit easier. But 1unit in a 1/2cc syringe
is the same as 1unit in a 3/10cc syringe. Just measure to the "1" unit mark (or whatever your dose is).

You only need a 'conversion' chart if you are using U-100 syringes for U-40 insulin.
No conversion is needed for 1/2cc U-100 syringes vs. 1/3cc (3/10cc) U-100 syringes.
 
Thank you for detailing all that, Karen. I was about to reply with corrections, but you got it all.

This is why the board is peer reviewed, folks. It is not to make anyone feel bad if they get something wrong, it's for protection of everyone. So many people are reading who don't post, it's important to make sure they are getting correct information.
 
PZI is fine. Just start low and go slow allowing a few days for each dose to settle in. Maisey was only on for a month and has been fine ever since. I still test occassionally, like this week - she was 51.
 
lantus really does not sting or burn with smaller doses. humans usually are taking much larger doses and that is when it stings. I have 2 out of 3 cats on lantus. originally starting at 2 units and they never knew they were getting anything. so no worries with burning/sting on your small dose.
hang in there and do not overload yourself with all the details. you WILL drive yourself crazy if you try and over analyze everything
 
Phoebe_Tiggy_NortonGA said:
Levemir and Lantus act pretty similar with two significant exceptions that made me choose Lev.

Lantus is guaranteed for 28 days with no refrigeration
Levemir is guaranteed for 42 days with no refrigeration --- lasts longer = less waste

Lantus has an acidic base liquid which stings when injected. (a human diabetic has confirmed this)
Levemir has a neutral base liquid -- no sting.
Click to expand...

I'll admit I'm a little biased because I've only used Lantus and had very good results with it, but I did want to comment on these thoughts.

While Levemir is guaranteed for a little longer, it really doesn't matter if you keep the Lantus refrigerated and handle it properly. In both cases, if you have the pens you'll use up or come very close to using up the 3ml of insulin before it goes bad, so there'll be practically no waste with either insulin.

As for the stinging, you're shooting an incredibly small amount of insulin subcutaneously, far less than what a person will shoot. Cats have very high pain thresholds, especially when it comes to their skin (can you imagine what it would feel like if you picked a person up by the skin on their neck? Definitely not as sensitive as people). I always gave Bandit his Lantus shot while he was eating, and not once did he ever even notice I gave him a shot.

In my opinion, the differences between these two insulins are negligible, and I would consider them interchangeable.
 
Karen - I went to work this morning wondering if I said 1unit equaled 1ml......but didn't have access to a computer to double check....in CCU, we mix 100 units per 100ml for IV drips making the ratio 1:1., so I'm glad you caught that - In reference to syringe, my mind set was on markings vs. cc and of course 1/2cc is .5ml or 50 units. My pharmacy recently stopped carrying 0.5 unit increment syringes, so it's fresh on the brain.

In any event, I can't say I'm impressed with the way you handled it...but hopefully you feel better and since the correct info got out, it is what it is.
 
Jen & Squeak said:
would the main difference between lantus and levemir be the flexibility in scheduling for levemir?
Click to expand...

I don't know how well anyone has tested the use of Lantus on a changing schedule basis, but from my experience with Levemir, it has few problems with schedule changes if a couple of standards are maintained.

There are basically 2 types of schedule changes needed by users, either moving shots later or earlier. To move a shot later by as much as 3 hours, split the dose in half, give the first half at normal shot time and the other far enough ahead so that it is 12 hours before you need the next shot to be. For example, if you need to move your PM shot from 8PM to 10PM, you shoot 1/2 dose at 8AM and the second 1/2 dose at 10AM. So your next PM shot is a full dose at 10PM. It extends the duration of Lev with little disruption to BGs, although there probably will be that dose change reaction we sometimes see with a higher number probably the following day.

The more challenging type of schedule change is getting an earlier shot. I can safely move shots 2 hours earlier by reducing the dose by 15%. That's kind of my ballpark figure, and would depend on the dose.

Gandalf's recent charts aren't anything to go by because he has a lot of concurrent disease problems now, but if you click the "entire spreadsheet" link in signature and select Page 3, the summer of '09 was probably some of his best numbers and that was the year I began my split dosing regimen for him and he was in his best health. Then he got pancreatitis in Sept that year. Compare how crappy his numbers were on Page 2 to page 3 and you can see the split dosing definitely made a difference.
 
For about a year I dose my Lantus kitties on a 16/8 hour schedule on the weekends because of my work schedule. It worked but was not optimum. Since I went to a normal 12/12 control has been a lot better.
 
I am a type 1 diabetic and have been since 1964. I chose Lantus for Morgaine because it is my back up insulin for my pump and I used it myself before pumping. Having said that, I have found it to be very reliable for Morgaine. Lantus, in humans, is considered a basal insulin, long acting. It was designed to create a flatter curve. Unlike Humilin N, Lantus doesn't have extremes. I can attest to this from a human perspective as I used to have incredible hypos at all different times. It was very unpredictable. I can't tell you how thrilled I was when Lantus came out. I used it and was completely happy with it except that I didn't use it up every month. I went on the pump for several reasons but Lantus wasn't one of them. I still use it occasionally if I need to take a break from the pump or if I take steroids for any reason. It gently brings me back into a safe and normal range. I think insulins have evolved a great deal and Lantus and Lev are the newer generation. Again, these are all developed for humans.

The studies done with Lantus by the Queensland group have excellent results for remission of newly diagnosed kitties. That is another reason I chose Lantus.

Cats are different of course but I love the gentle action of Lantus. Morgaine has lovely flat curves on this and always has. Other cats are not as lucky but the gentle action makes Lantus a safer choice, IMO. I think it is a very reliable insulin for cats and humans.

I use the 10ml bottles and am almost finished with the first bottle. I just keep it in the fridge and have had no problem with it. I also get it as my back up so the pen isn't an option for me since I never did use a pen. Old timer here but always willing to try new insulins.

I think PZI would also be a good option but I am not sure it is the best option for a first try. JMO but I would go with the gentle action of Lantus or Lev. It took us a while to get to the correct dose but right now Morgaine is regulated and doing very well.
 
Sienne, who's one of the most experienced people on the Lantus forum, just posted this article for someone else (maya & neo) regarding a trial between Lantus and 2 other insulins. Scroll down this page about 1/2 way to her post.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=51767&start=50

i'm trying to attach the document, but just in case i haven't got the right one, you've got the link.

my punkin has acromegaly and is getting 14+ units - i still use Lantus because he is doing so well on it and he doesn't even flinch when he gets his shot. i think it's possible that larger doses may sting, and he gets a large dose, but it must be individual because he really isn't bothered one bit by it.

all the studies i have seen recently seem to say that using Lantus (glargine) on cats with diabetes brings the greatest possibilities of remission for the cat. Just today I counted that there have been 29 cats go off of insulin since we came to FDMB the end of February. Not a bad track record.
 

Attachments

Elaine, I wanted to give you this link: Lantus/Levemir: New to Group?

There is a formula to start with a dose on Lantus - but if you have an average size cat likely you would start on 1unit twice a day. Lantus uses u-100 syringes. Lantus does like to be used with consistency, with shots 12 hours apart as much as possible. somehow we're all able to do that most of the time, and when we can't, we adjust shots to fit real life. believe me - we have ordinary people with the same real life you have that use lantus. most people work, some don't. some have little kids, some go to school and some are retired.

good for you for switching to the low-carb food (there are links to recommended food in that link above, stay under 10%, preferably under 7%) get rid of all dry food entirely, sounds like you've gotten the hometesting going (folks here can help you if you have any troubles) and start a spreadsheet. some cats can get their blood sugar under control just by diet changes. wouldn't that be super?

what are you feeding your kitter?

this can be so overwhelming when you think you have to decide all of it. the study i linked above is from 2009 and clearly says the highest rate of remission is Lantus. many people have had a lot of success with it - and here's the really great thing: if you don't like the insulin you start with, you can switch. some people do if their cat doesn't respond well to whatever they are on.

What people usually do is get started with the shots and the hometesting here, get that spreadsheet going and then begin posting daily on the Lantus Support Forum. All of us there help each other every day - it's pretty straightforward but it can be hard to learn to read your cat's responses and know when to adjust the dose a bit.

yes, we test - at least 3 times a day: preshot to see if it's safe to shoot and at least one mid-cycle so we know what the insulin is doing in kitty's body. if you work during the day it's still possible to get the testing in. there are no insulins that are safe to inject without testing to see how the cat's doing.

We'll help you the whole way. it's a nice community and people really go the extra mile for each other. :YMHUG:
 
Thanks again everybody --the advice and tips have been wonderful. It was those studies that made me decide to try Lantus--I want my non-diabetic kitty back if at all possible.

When I first got the diagnosis the vet recommended DM DRY and DM canned which I bought immediately.

Once on the internet I knew 'dry' was 'bad' but I am trying to give it to my other 5 cats. It has alot less carbs than the Science Diet Mature they are all eating.

My cats (all 'tamed' ferals and strays ) always got the best food or so I thought. They have ate nothing but dry Science Diet all their lives , supplemented with a bit of canned food heavy on the gravy which they liked. Mainly, licking out the gravy.

I was stunned to learn Pinkie who is not fat at all had diabetes. Pinkie is not crazy about the DM canned and Fancy Feast Classic doesn't have gravy but she eats a bit of it. She likes people tuna when she gets her shot. I am going to try all the other recommended kinds of wet food as I am throwing out LOTS of uneaten food everyday.

I finally got up enough courage to start the Lantus last night. I gave a hair below 1 ml. My hands shake slightly when I am trying to measure the dose--can't control it -- don't know if it is coffee or what (but I am not giving up coffee!!!) I have already had to waste a dose as I was trying to fine tune it and squirted out too much. . I am using 1/2 cc instead of 3/10 cc but I ordered the smaller syringes , hopefully that will help.

I stll don't know how to chart but I will learn tomorrow. I just know that the BG numbers I am getting
don[t seem too extreme (ie around 200 to 250) not great but we have just begun. In the beginning she was around 350.

Thanks again.
 
You're doing great.

Regarding the Fancy Feast classic, you could try adding a tiny bit of water, mix that up and microwave. That would enhance the scent and give the impression of a gravy food. Might help her decide she likes it.

You're not the first person to feed Science Diet and end up here and you won't be the last. I fed dry food to all my cats before coming here too.
 
me too. when you don't know any better, why wouldn't you? now, of course, i wonder if any of my other cats would've lived longer if i'd fed them canned food. i loathe the canned food - it stinks, you have to wash their dishes, out here we are rabid recyclers, so you have to wash the cans and lids as well. dry food is so very easy - pour it in the bowl and walk away.

punkin used to get bladder infections every year or more - and now i'm thinking it was all that dry food. he even got them when he was on the vet's prescription "easy on your bladder" dry food. jeesh. anya had vet prescription dry food for chronic diarrhea from when she was little - and she's now fine on the canned food as well.

but, you can only do what you know how to do - now i would never give any dry again. i've sent my girlfriends who have cats the links to the catinfo.org site on feline nutrition that Dr. Lisa's done.

it's a great idea to add the water - it's especially good when the kitty's not regulated yet and still having some higher numbers. just keeps everything flushed through. and if it makes it yummier, all the better!
 
To all the seasoned members, I have just read not to shake or roll Lantus. My vet told me to gently roll the Lantus between my hands before giving the shot but not to shake it, is this correct.
They also told me I could use one vial for up maybe six months. I can not afford to buy a vial of this Lantus every month, it was 110.00 at Walmart.
My vet also told that I do not need to home test because the cat is so difficult they will test her once a week at the vet. I am not sure if can home test her anyway.
 
she's your cat, terri. you can do anything you want. your vet works for you. if your vet isn't working for you, you might be happier with a different vet. a lot of times, however, you just have to say what you want and the vet will go along.

don't shake or roll the lantus. earlier kinds of insulin needed to be mixed - this is a clear liquid and you want to treat it gently so it lasts that 6 months. users here have been able to use it for 6 months - yes. and it is expensive. next time you buy, ask to get a single pen and use that as a vial. the official word from Lantus.com is that they guarantee it will last for 28 after opening. if you take are of the lantus - don't shake it, keep it refrigerated but don't let it freeze, don't inject anything back into the liquid insulin (ie, don't adjust your dose by shooting excess back into the vial) your vial should last quite a while.

the syringes have a lubricant inside of them and you don't want to shoot that into the vial. pre-lubricant days this was ok, but not any more - so squirt out the excess into anything except back into the vial.

i don't know about your vet, but it cost me $24 every BG i had tested at the vet's office. it costs something to hometest for the strips and meter, BUT, you have kept your cat safe by doing so.
 
Julie

Thanks, I did not know the syringes has a lubricant in them and yes I have been shooting the liquid back into trying to get out the air bubbles and such. Had no idea, no one told me. What about these air bubbles? What about the pens and how does that work? Are they less expensive?

Terri
 
Terri,

The pens work out cheaper because they only hold 3mL or 300units, I believe of insulin per pen, but you get 5 pens in a pack when you purchase them which you only open 1 at a time, Lantus has a fairly short shelf life once it is opened (about a month or 2 if refrigerated)...so with each pen you are only opening 300 units at a time. While a vial holds I think it is 10mL of insulin or 1000 units, with the tiny doses that a cat takes, you end up throwing a lot of the vial away when it stops being effective anymore, but with the pens, you can use just about all of it before needing to open the next pen. So 5 pens ends up lasting you over 6 months where a vial may make it just a little over a month, maybe 2 months if it is handled very gently.

Hope that helps & someone please correct me if I have the amounts wrong..Its been a long week.

Mel, Maxwell, Musette & The Fur Gang
 
Terri, your vet gave you instructions that were used for PZI Idexx before they stopped making it. That needed to be gently rolled, etc.

I have not gotten my Lantus that I ordered from Canada yet, should be here next week, but I was a lot cheaper than buying locally. I paid $108 for five pens. Maybe that would be an alternative for you. To help prevent air bubbles, I pull the plunger up and down a few times then push hard on the plunger before I insert that into the pen. I then twist the plunger up like a screw slowly, not pull it straight up, I avoid air bubbles 90% of the time doing it that way.
 
i do the same thing with the syringes. work the plunger so it's loosened & moving freely, then close it tight so all the air's out of the syringe before you withdraw the insulin back into it. if your dose is 1unit, draw a little more than 1 unit up into the syringe. remove the syringe from the vial.

hold the syringe with the needle pointing up and tap it with your finger - might have to give "sharp" taps to it to shake the bubbles loose, then squirt the excess insulin and hopefully the bubbles, out of the needle.

sometimes they stick and are hard to get out. you just do the best you can. some syringes are much worse than others for that.

you can put air into the air of the lantus vial, but you should not squirt anything, air or lantus, from back out of the syringe into the liquid insulin. don't sweat that you've already done it, just stop doing it now.

mel - there is a lot of experience that says the lantus is good for much longer than 28 days if you're taking care of it. enough that Jill revised our information sticky on Lantus to say it could last up to 6 months. Lantus & Levemir, Info, Proper Storage and Handlingi would absolutely not ditch it at a month without seeing evidence that it wasn't working.

if the numbers seem to be creeping up, or you see floatie or stringy things in the insulin, then it needs replacing. but otherwise i have seen many people use theirs for several months. it's too expensive to just toss it if you're not sure it's not ok.

i'm not sure about the measurements, but i compared the cost at one point and if the kitty is at less than a 7u dose, it's more cost effective to use the pens.
 
I paid $255 for 5 pens at Walgreens but Wal Mart wouldn't fill it all as it said cartridges instead of pens. They wanted to contact vet but he was already closed for the day. (thank goodness) He thinks I am using PZI which is the last prescription he called in for me :YMSIGH: I didn't want them to call him as I will just tell him the next visit.

I ordered a drug one time from Canada but it wasn't left at my house as it required a signature. Rode around in a hot truck all day and went back to the warehouse until they could try again but the next day was Sunday so they couldn't delivery it. Be sure and find out exactly when it will be delivered so you can be there--even if it doesn't require a signature you don't want it to sit outside in the heat. You could leave a cooler wih ice by your front door if you arent going to be home. And a sign to tell them to put it in there.

My vet also just wanted to test in the office once a week until regulated then less often I guess. I am sure he doesn't have a single client testing at home as he was surprised when I told him I was doing it. I don't think he really wants the $20 --I think he thinks it is alot of trouble and stress to test at home and not necessary. I met a lady today at the store whose cat has been on Humulin N for year and she just goes to the vet to test. She did know not to feed a high carb food. Obviously , most people don't test at home. They just give the shots 2x's a day. I believe the blood glucose numbers are kept pretty high to make it 'safer' to dose blind. And I am assuming from articles that I read that is why the remission rate is not as good.
 
while testing is mostly the norm here at the FDMB, most people in the 'real world' will not test. many will not even treat. Vets tread a delicate line when advocating treatment...and many are still not aware that testing at home is valid and usually quite easy. I was my vet's first client who tested. She had been taught by an 'expert' to skip serial curves and instead dose by fructosamines.... :o
 
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