? Switch from caninsulin to lantus

[Marina & Chico]

Chico has been diagnosed in the beginning of january 2021, we we prescribed 2UI caninsulin 2 a day. We were already very close in switching to lantus when a sudden change in Chico’s BG happened yesterday. It is still not clear what does that change mean for Chico’s insulin needs hence our question: when should we consider safe to transit from caninsulin to lantus? Should we have a few days of stabilized caninsulin dose before the change? From the information on starting on lantus we have to wait for at least 3 days on the same dose before making a dose change decision therefore we are affraid to chose a dose that would be too high for him.

thank you all for all your help

 

[Panic]

Very nice cycle! I would keep Chico on that 1u dose until his nadir (lowest BG point of the cycle) creeps over 150 consistently.

I would post on the Lantus forum and specifically ask what dose they recommend for Chico, but I imagine they're going to say to stick to the 1u. Also you can ALWAYS lower the dose if needed, you do not need to wait three days to decrease, only when considering a dose increase.

 

[FrostD]

I agree, the 1U looks good! It looks like you're seeing a bounce, so don't be alarmed at the high numbers. Unless Chico managed to get into some high carb food?

You can switch to Lantus whenever you like, but I agree with posting on the Lantus board for opinions on starting dose. I believe you are referring to Tight Regulation with Lantus - and you are correct that you must hold a dose for a few days before changing (the number of days depends on a few factors... typically when you switch to Lantus, you'll hold the starting dose for 5 days).

But until you switch I just wanted to remind you of the guidelines for Caninsulin dosing:
Hold the starting dose for at least a week UNLESS

• your cat won’t eat or you suspect hypoglycemia
• your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

After 1 week at a given dose perform a 12-hour curve (i.e., testing every 2 hours) OR perform an 18 hour curve (i.e., testing every 3 hours)

So for now I'd hold the 1U dose for a week unless he goes below 90.

 

[Gill & George]

Hi Marina,
You don't need to wait to stabilise him on canninsulin to make the switch, with the speed at which the caninsulin is dropping him he may continue to bounce and swing from high to low. The advantage of Lantus is that it has a longer action and typically for a lot of cats it makes it easier to control these bounces.

The caninsulin is still dropping him quite hard and fast, and you are not getting the duration, so he jumps up at the end of the cycle, this is sometimes also accompanied by a bounce (likely triggered by the fast drop), which is when the counter regulatory dumps glucose into his system for anything up to 6 cycles. When this stops happening what you see is them 'clearing the bounce' which is when they just drop sharply and often quite fast.
On feburary 3, pm cycle he dropped into the blues and yellows that was the bounce clearing, so when you shot 1u, you saw it have an effect on Chico, if he had continued to bounce chico would have continued to stay in the higher numbers, looking pretty flat, you wouldn't have seen the curve you saw.

Start a thread in the Lantus forum.
I'll get some experienced folk (including some who have done the switch themselves) to take a look at your ss and we can help you with a starting dose, based on the results you have been getting on caninsulin.

How is Chicos Tummy? Any improvement on the runny poops? If that has settled down it might be influencing his numbers, infection, inflamation, and stress influence their blood glucose levels.

 

[Marina & Chico]

Hi Marina,
You don't need to wait to stabilise him on canninsulin to make the switch, with the speed at which the caninsulin is dropping him he may continue to bounce and swing from high to low. The advantage of Lantus is that it has a longer action and typically for a lot of cats it makes it easier to control these bounces.

The caninsulin is still dropping him quite hard and fast, and you are not getting the duration, so he jumps up at the end of the cycle, this is sometimes also accompanied by a bounce (likely triggered by the fast drop), which is when the counter regulatory dumps glucose into his system for anything up to 6 cycles. When this stops happening what you see is them 'clearing the bounce' which is when they just drop sharply and often quite fast.
On feburary 3, pm cycle he dropped into the blues and yellows that was the bounce clearing, so when you shot 1u, you saw it have an effect on Chico, if he had continued to bounce chico would have continued to stay in the higher numbers, looking pretty flat, you wouldn't have seen the curve you saw.

What about the PM cycle on february 4? do you think it might be a new bounce as well?

Start a thread in the Lantus forum.
I'll get some experienced folk (including some who have done the switch themselves) to take a look at your ss and we can help you with a starting dose, based on the results you have been getting on caninsulin.

thank you, i will

How is Chicos Tummy? Any improvement on the runny poops? If that has settled down it might be influencing his numbers, infection, inflamation, and stress influence their blood glucose levels.

it is better but still not firm, at least it is not as liquid as it used to be on Purina, we will start giving him probiotics, hoping this will help as well

 

[Gill & George]

What about the PM cycle on february 4? do you think it might be a new bounce as well?

Yes it certainly looks like it. In the am cycle he dropped almost 200pts in 3 hours. Thats a big drop and when I see it, I expect to see a bounce. The fact that he stayed flattins in the pm cycle, almost like you didn't give insulin suggests the bounce. He has been clearing his bounces quickly one or two cycles, so this morning or tonight I would, if he holds true to form expect to see him clear.

(be attentive of low yellow or blue PS)

it is better but still not firm, at least it is not as liquid as it used to be on Purina, we will start giving him probiotics, hoping this will help as well

I'm glad there is some improvement, is he just on the cosma for now? or did some of the other food arrive?

 

[Marina & Chico]

Yes it certainly looks like it. In the am cycle he dropped almost 200pts in 3 hours. Thats a big drop and when I see it, I expect to see a bounce. The fact that he stayed flattins in the pm cycle, almost like you didn't give insulin suggests the bounce. He has been clearing his bounces quickly one or two cycles, so this morning or tonight I would, if he holds true to form expect to see him clear.

(be attentive of low yellow or blue PS)

I'm glad there is some improvement, is he just on the cosma for now? or did some of the other food arrive?

we have pretty low BG at +3 248, so your observations seem to be correct.

We had him one day on cosma and then switched to animonda which is LC and doesn't have weird chemicals, the meat is a combination of organs. We chose animonda for now because it was the only better option that we could buy in pet shops in the city. The order from zoohit didn't arrive yet, and it looks like it will arrive the earliest on Monday only.

 

[Gill & George]

We chose animonda for now because it was the only better option that we could buy in pet shops in the city.

I use Animonda Carny with my cats (non diabetic) as well. I like it no funny ingredients. George can't have it now because he needs reduced phosphorus. They're pure chicken is single ingredient and their pure beef is as well.
I also use feringa, and wildfreedom range. I use a variety of flavours and brands with them. Being cats they seem to get bored of flavours if I feed them too regularly so I rotate.
George has a rotation of flavours as well, but to be honest, he's not one to get bored of food. .

It's good if you can source something suitable locally makes life easier especially if delivery is delayed.

The order from zoohit didn't arrive yet, and it looks like it will arrive the earliest on Monday only.

With covid restrictions their deliveries have been taking longer. Hopefully it will arrive soon.