Switching from Prozinc to Lantus Tomm-Questions!

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Lyndsey & Mittens

Lyndsey & Mittens

Member Since 2013
Hello everyone, my name is Lyndsey and my sugarkitty, Mittens was diagnosed with diabetes this past August. Since his diagnosis, he's been on Prozinc which has not been working very well for him at all (link to ss in signature)-he was very bouncy & had unpredictable responses while on this insulin. So, after trying everything ie. increasing the dose, decreasing the dose, sliding scale, I took him back to the vet (today actually) to see about getting him switched to Lantus/Levemir.
After showing the vet Mittens' spreadsheet, she agreed that it was time for a switch, so she prescribed Lantus (the pens) starting out at 2u every 12 hours.
Since Lantus is very different from Prozinc, I have a few questions.

*When does nadir typically occur with Lantus? How about onset?
*Is 2u too much to start out on? With the Prozinc, he was currently on 1.5u. He's 16 lbs.
*I know that with the L's, its best to hold a dose for a couple of days and that the dose is based on the mid-cycle number, so I'd only decrease/increase based on the mid-cycle number, not the preshot-correct? (I think that this is going to be the hardest concept for me to adjust to after using Prozinc)!
*How soon after starting should I expect to see a response in him with the Lantus? Will it take a few cycles in order to let the deposit build up?

Thanks for your help. I'm sure i'll have more questions as I start using this insulin.
:-D
Lyndsey & Mittens =^..^=
 
Hi Lyndsey.

You're right Lantus does work very different to Prozinc, so you're basically going to have to forget everything you learned. lol

Typically nadir is around +6 on Lantus and onset around +3 ish. A typically curve should look like a smiley face. Initially it takes 3-5 days for the shed to fill so dose changes are normally held for at least a week to "settle" although some cats react immediately others take a few days. That old ECID thingy.

2u is a little steep of a starting dose I think if he was mine and considering his last dose I would start him at 1u and work up from there. I find it is easier to start slightly below the ideal and work up rather than starting too high and work down.

Mel and The Fur Gang
 
Thanks Mel.

Argh...at +6 I'm at work, so it will be hard for me to check on him at +6 consistently during the week-unless I run home from work on my lunch break. Do you know how others deal with that issue? I will be home around +10, but that will be too late to catch nadir but it will allow me to make sure that he's rising before giving the next shot.

I guess I'm just a little confused as to how I'm supposed to know if I should increase/decrease if I cant be home to get a mid-cycle number during the day...to me, it feels like I'd be shooting w/o taking a preshot number, since the dose is based on nadir...but since doses should be held a week before changing anyway and I can get mid-cycles on weekends, that should work-right??

Sorry, I'm just having to relearn everything I've learned, feels like I'm having to think backwards from what I learned to do with Prozinc...lol.

2u did sound a bit high to me as well, so I will start out at 1u and work up from there.
 
Hi Lindsey. My cat Max just started on Lantus last Friday. Before that he was OTJ and before that he was on ProZinc, so I know just how you feel about re-learning everything you just learned. I've had a lot of similar questions too. I'm such a newbie on Lantus that I don't have much advice... still learning and re-adjusting my thinking. I work pretty far from where I live, so I'm not able to catch the nadir number during the day on the week days. After Max's PM shot, I try to catch a +3 and a +5 or +6 to check-in and see how the dose is working, and, like you mentioned, last weekend was a test fest while I was home to gather as much data on how Lantus was working on Max as I could.
 
Thanks Holly-that makes me feel better...I guess I just have to get over the fact that I wont be able to test during the day on most days. I looked at your SS and it looks like Max is doing good on the Lantus-hopefully he will be OTJ in no time! Is your avatar a picture of Max? What a beautiful cat!
 
Actually it's easier than you'd think...During the work week get you're preshots and whatever spot checks you can then on a day off run a curve. Then using that data we can help you to figure out dose adjustments until you get the hang of it.

Mel and The Fur Gang
 
Thanks Lyndsey! It is Max in the pic. I think he's pretty darn cute! ;-) Is Mittens your pic? Either way, cute kitty too in your pic! Thanks Mel! I will definitely need advice this weekend. Lyndsey the members of this group have been so helpful. It's been an adjustment in thinking for sure. Even knowing that the insulins are very different and on Lantus you hold a dose longer, I catch myself wanting to tweak the dose a little and members of this group remind me kindly to hold on.
 
Hi Holly,
Yes, that is Mittens as my avatar-I cannot for the life of me figure out how to get his picture to show up right side up...so eventually I just gave up so he will have to stay sideways...lol.

Yes, you are right, it is a big learning curve-I've been on the boards all day trying to learn as much as I can about his new insulin...it definitely requires me to use a different train of thought. Like you, I know that I will want to be adjusting his dose based on preshot-I think that it will take a while to let that one go...HA!

Thanks everyone for your help & advice-I know I will need it in the upcoming months! :-D

Mel, I did have one question. Considering his preshots are typically in the 400-500 range :YMSIGH: , would you still suggest starting out at 1u? Or something a little higher? (See, there I go wanting to base the dosage on his preshot number...sheesh).
 
All preshots tell you with the Ls is that it is safe to give insulin. So yes I would start at 1u and work my way up. One thing to keep in mind because of the shed a hypo can last 16-18 hours if the dose is too high.

Mel and The Fur Gang
 
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