Switching from Humulin-N- questions!!

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maggie&curly

maggie&curly

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Hi,
My cat Curly has been on Humulin-N 2 units twice daily and has not been responding well to it at all. I am switching him to Lantus. I just got two lantus pens mailed to me from another poster. One is not opened or used, one was used once. She said she was not sure if it was still useable as they were not sent refridgerated but hated to throw it out so she sent it anyway and said to check with lantus board people to see if it would still be useable. I put them in the fridge as soon as they came.

Also my vet was not too knowledgeable about lantus, she said to start low and go slow and test him frequently. I am just not sure where to start him- 0.5 units? 1 unit? Also I work today so am not going to start him on it until tomorrow when I will be home. When does it usually peak? Anything I should watch for? Any other tips or advice?

thanks for any input you can give-

Maggie and Curly
 
Maggie,

Welcome to Lantus Land!

Here is a link for new people to the board. You will find lots of useful information.

viewtopic.php?f=9&t=157.

And this one is on the handling of lantus.

viewtopic.php?f=9&t=151

I'm sure there will be others along to answer your questions. But until than take a look through these links. They'll be very helpful.

Hope to see you posting everyday.

And again welcome. :smile:

jan and sara
 
Welcome Maggie and Curly.

The initial dose of Lantus can be approximated based on the ideal weight of your cat in kilograms (dose = 0.25 x kilograms ideal weight). Most cats end up with a starting dose around 1.0u.

If you don't know how old the opened Lantus pen is, I wouldn't use it especially since it was probably bounced around in the mail.

Gabby was started on Humulin N and didn't do well either. N is very different than Lantus and whatever you know about N does not apply to Lantus. N is a shorter acting insulin. It's onset if much more rapid and is in and out of the system. Lantus is long-acting and there is overlap between doses making it much more gentle with far less risk of a hypoglycemic episode. Lantus is also a depot-type medication. (We refer to this as a "shed.") There is a pool of Lantus that forms under the skin which allows for the overlap between doses. There is a sticky note at the top of the Board about the shed. You will not get the full benefit of the first several days of a Lantus dose since a small portion of that dose goes to building the shed. As I said, this is one of the ways that Lantus and N differ. It will take up to 5 days for the shed to fill.

We also follow a dosing protocol here and we do work from a start low, go slow model. It sounds like you home test. That's wonderful! You will need to routinely test at pre-shot times as well as get spot checks throughout the cycle. Lantus dosing is based upon the nadir, or the low point of the cycle. This is why spot checks are crucial. If you can set up a spreadsheet, that will allow you to keep track of Curly's test data and allow us to help you with dosing decisions. The Tech Support center has instructions for creating a spreadsheet and attaching it to your signature. You don't happen to have a spreadsheet with Curly's BG test data from N, do you? There are also instructions for setting up a Profile. This will provide us with information on Curly's diabetes history, medical history, etc.

The general information about the dosing protocol that we use is in the sticky that I linked. You may want to open the links to the formal versions of the protocol and print them out for your vet.

What are you currently feeding Curly? We are very strong advocates of feeding a low carb, canned food diet.
 
welcome maggie and curly!
you've already received answers for most of your questions. regarding a starting dose for lantus... do you have the last few weeks of numbers for curly posted anywhere such as in a spreadsheet? we'd have a better idea of a starting dose for lantus if we had access to his numbers. we'd take his performance on humulin N into consideration...
 
Just want to welcome you and so happy you are getting away from N my cat was on it for 4 months and did very poorly on it I think you will see a big change in you kitty once you get settled with lantus try to take time to read the stickys at the top of this page they really helped me so much and this is the very best board full of so many knowledgeable people that can help you get started and again welcome and look forward so seeing you post here :mrgreen:
 
Just wanted to say I'm the one who sent her the Lantus. I gave Boomer 2 drops from one of them - I gave her the date I used it last, it has a couple weeks left before it expires. I FedEx'd it and it was wrapped pretty well, but yea, it probably did get baounced around. I couldn't throw it out. :sad:

Sienne and Gabby said:
Welcome Maggie and Curly.

The initial dose of Lantus can be approximated based on the ideal weight of your cat in kilograms (dose = 0.25 x kilograms ideal weight). Most cats end up with a starting dose around 1.0u.

If you don't know how old the opened Lantus pen is, I wouldn't use it especially since it was probably bounced around in the mail.
Click to expand...
 
Welcome Guys!!!
We're newbies too...we love it here and everyone is really kewl!
We also switched from N, but doodles was only on N for about a month...hoping for good things with Lantus.
heidi and doodles>"<
 
Hello and welcome - check us out (Condo Link or SS) as we were on Humulin & switched to Lantus. Our vet was familiar with Lantus & very supportive of our switch. It has been work, still is, and is very worth the possible rewards. Good luck to you!
May 23 Condo
 
Yes, Curly knows just how special this Lantus is and i think it will give it some extra magic power! Curly''s numbers have been very high- 400-500+ preshot. At the vet they had to give him some regular insulin on top of the Humulin just to get him down to 317. She is concerned that there might be other things happening now because of the long time of not being controlled, like pancreatitis or something. I hope not. He didn't have ketones or a uti, which surprised her, so hopefully he will surprise her on this insulin too.

so the other lantus pen should be fine if it got bounced around a bit? Like tracy said, they were both packed really well in bubblewrap.

thanks for your help-
maggie
 
Let's hope for the best! There's no way to know unless you try the Lantus. The opened pen may be fine as well especially since we know it came from a reliable source!
 
Re: +3, still reading HI

Should it be coming down pretty soon? I am using the Ascencia contour and every reading so far has been HI. I'm hoping in the next hour or so it comes down a bit.

Also, tomorrow I have to leave for work by 11 a.m. We started today at 2 pm. That would be 3 hours early. The alternative would be that he gets it 4 hours late. Being as I won't be home and this will be his second day on Lantus I am leaning toward the 4 hours late. Any thoughts?

Thanks for the support through this- its a bit scary as this is so unlike any insulin we have been on before!
 
Hi Maggie-

Wow, that's a challenging schedule. I have no idea what to tell you, but others here will. You should probably change the subject line of your very first post to something that says "dosing help needed"

Best of luck!!!
 
Thanks. He is still getting a reading of HI at 4 hours. He is acting better though, or maybe I just think so because of the new insulin. Do I just keep watching annd waiting? This is so hard!
 
Hi Maggie,

I just want to recap, to be sure I'm understanding the information here, and I have some questions. I apologize if you have answered some before.

Curly was previously on Humulin N, 2 units BID and not responding well. Do you have any numbers you can add to the spreadsheet from that time? What do you mean by not responding well? When was the vet visit you mentioned when they gave her Regular insulin?

Then you started Lantus at 2pm today with a test at HI. Subsequent tests today have also been HI. Question - did Curly have a shot of N this morning? Or just the Lantus?

And what time do you want your regular schedule to be?
 
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