Switching from lantus to Prozinc- Thoughts please

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Andrea&Tennessee (GA)

Andrea&Tennessee (GA)

Member Since 2014
I took Tennie to the vet today to have a lump on his back looked at- luckily it turned out just to be a cyst.
Our conversation turned to his current dose of 4.75 U BID. she said that she felt that this was a really high dose and suggested that I make the change to prozinc or another insulin (I forget which one).

Before Tennie had his bout of pancreatitis we were doing well with 2 units BID. Since then, the dose has gone up and up just to try to keep him in the yellow.

I was under the impression that a longer acting insulin like Lantus would be better for him. Is that not true?

We are also going to have an ultrasound done to look for any issues that may be causing his need for such a high dose. The vet said that Acromegaly is in the back of her head.
 
The best insulin is the one which works best for your cat. I suspect Prozinc will wear off too soon. Levemir might be worth trying.
Pancreatitis can be chronic, and happening at a low enough level it doesn't read on the test for it. That will keep the numbers somewhat elevated.
Insulin auto-antibodies also can result in elevated glucose levels. Pop into our high dose forum and read up on the conditions to see what, if anything, rings a bell for you.
 
I myself would try ProZinc next since that is a very different type of insulin. Lantus and Levemir are similar in their actions. Also, ProZinc is less expensive and thus if it does not work less money is lost.
You could also try BCP PZI insulin. You vet can order yo a free 5 ml sample. Just note that it can take weeks to get the free sample.
Right now My Murfy is doing good on 13 units Levemir and 7 units BCP twice daily. I tried Lantus and N but they did not work.
My Badger is on abount 1.4 units N and 3.4 units Prozinc twice daily. I give the N early, before he eats since I othwewise I see a 1oo-200 BG spike after eating. I previous tried Lantus, Levemir and BCP and they did not work well.
 
Unfortunately I'm getting an error message trying to access your spreadsheet so I can't see whether increasing too slowly might be a problem and check for any other dosing issues. Although 4.75 units is higher than average it certainly doesn't qualify as a really high dose.
 
I reviewed Tennie's SS prior to my previous reply. It opened for me fine by just clicking n the link. I just triee agin now and it works/views fine. I am using Chrome on Win 8.1
 
@Vyktorsmum-I think part of the problem is that I was increasing too slowly. I am trying to step it up but am having a problem with consistent shot times due to work.
@Larryandkitties- do your cats have high dose conditions?

I think that I read there is more of a "window" with ProZinc?

We are definitely getting a drop with the Lantus, but not as much as I would like to see. I wasn't going to worry about things too much until we hit 6 units, but the vet is saying he is already getting a large amount. I don't think that she has had too many "high dose cats". She did tell me that if he turns out to be an acro- cat, he will be her first.
 
Yes, both Badger and MurrFee are your atypical diabetic cats with respect to dose.
My Patches II is doing great on about 1.3 units of Lantus twice daily. I can keeps her BG below 140 all day.
Do not forget ECID (each cat is different)
 
Yes Larry, I'm trying to keep the ECID idea in my head frequently.
I am hoping that our ultrasound will point us in the right direction, or at least rule some things out.
How long did you wait to try new insulin with Murfy?
 
Max hovers between 4-7 units or levemir. I believe the recommendation for "high dose" is 7 units twice a day of lantus. Your dose is higher than a lot, but not extremely high. It's interesting that you had better control a few months ago. The pancreatitis can increase the insulin need, you'll probably need a higher-than-average dose of whatever insulin he's on. Once you get into a normal range, the pancreas might start to heal, and then the need could go down.

If it were me, I'd stick with the depot insulin and raise it until I'm past an actual "high dose", or > 7U twice a day, as he seems to have some response. If you start a new insulin, you have to start from scratch, and it might take even longer to get him regulated especially if his insulin need is high.
 
@Meya14 the vet did comment that she didn't want me to have to start all over again. So it might make sense, like you said, to keep going with the lantus for the time being. Besides that I just got a new vial and I wouldn't want to throw that money away.
Has Max always been on levemir or did he start on a different insulin?
 
Andrea&Tennessee said:
How long did you wait to try new insulin with Murfy?
Click to expand...
MurrFee came to me as diabetic on 8 units of Levemir twice daily and was doing goo and I then switched to Lantus since My other cats were one Lantus. He did not do as well on Lantus since I switched back to Levemir. He did good except he got acute pancreatitis. After recovering from that his Levemir dose increased in order to keep his BG within bounds. It is not nice to see HI BG at like +3. He was doing OK on about 19 units of Levemir twice daily. Then I switched my Badger from BCP to ProZinc and just tried the BCP on MurrFee since I had some BCP left. This change started in January. Low and behold Murfee did better with the little BCP added. I gradually increased the BCP and reduced the Levemir an I am seeing a lot better BGs
 
So it seems like it is ok to switch around to see what works best?
It seems like it could just be the pancreatitis that is making him need such a high dose. I guess the ultrasound will give is a better picture.

Larry- did you speak with your vet before adding in the BCP? Or did you just have previous experience with your other sugar kitties?
 
Max was originally on Lantus when first diagnosed. We went up to 7U twice a day with no response, and my vet and I decided to try levemir. We then took the Levemir up to 7U a day (we probably didn't need that switch! - wasted a lot of time), and then it was noticed that Max had a tooth infection. He had a dental done, went down to 3U, and has been going up and down since then. He's at 4.5U now. I think his pancreas is kind of randomly working and we're trying different foods so that's all affecting it.

I do like the levemir better than the lantus though, cause Max doesn't flinch/hiss with the levemir. The lantus was stinging him.
 
No stinging so far. Tennie barely moves when he gets his shot. But I am aware that as we go up I may need to move to Levemir due to the sting issue.
The tooth thing is also in the back of my mind. If nothing else comes up that may be our next move.
 
I'd investigate infection if you continue to go up. I initially thought teeth might have been an issue, but when the vet looked the first time, she said they "looked ok". The problem was neither of us could get a good look, cause he hates his mouth touched. When his breath became bad and gums bleeding I knew that was probably an issue. Wish we found it sooner. He had multiple infections in his back teeth and extractions.
 
Pancreatitis often throws a screw in the works....I'd probably just continue increasing the Lantus every 6 cycles until you start to see some blue numbers

Once you get to 5 units, you can increase .5 at a time instead of .25 too

ProZinc really isn't cheaper....remember, it's a U40 insulin, so a vial may be cheaper than Lantus, but it only holds 400 units...a vial of Lantus holds 1000 units
 
OHHH never thought about the U40 difference!!
5 units is our next jump- is it ok to keep upping every 6 cycles if my shooting has been off by an hour or so every week?
 
I think as long as you're still getting nadirs that are yellow or pink, you can continue to go up every 6 cycles

Looks like you're testing enough to keep him safe
 
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