Switching from Prozinc to Lantus tonight

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sylvan

Member Since 2011
Hello everyone,

Sylvan finally got a prescription for Lantus and tonight we are making the big switch from Prozinc. The vet has him starting at 2 units.

I'm a little nervous, but he's been on Prozinc for 4 months and it really hasn't been working for him. I hope Lantus will help him. I'm most afraid of how high he will go because he is ketone prone.

I look forward to your help and guidance.

Thanks,
Liz
 
Hello,
Welcome to Lantus Land!
If you havent already, read the stickies, print them out cuz you'll be referring to them often.
Let us know how we can help-lots of beans here to guide you along!
 
W E L C O M E !

We've only been here in Lantus Land a week, but Simon & I can tell you that you've come to the right place! :-D
 
Thanks everyone!!! I have the Lantus, new syringes, and have printed all the stickies. Now I just have to wait for shot time.
 
Welcome Liz!

I don't know if you've had a chance to read the starred sticky notes at the top of the Board. They will help to give you a foundation with regard to Lantus dosing. The biggest difference between Lantus and PZI is that dosing is based on the nadir, not on pre-shot values. Doses are also held constant until a reduction (drop below 50) is earned or the numbers indicate that more insulin is needed. Below is an overview of the sticky notes.
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Becoming Data Ready: What data you need in order to be able to work toward remission or tight regulation.

I'm presuming that since Sylvan is ketone-prone that you're testing for ketones at home. Does he have any other health issues?

Some cats will have a big response when switching insulin (and some don't). Chances are, though, that you will need to bring the dose back up to where it was with PZI. Just out of curiosity, it doesn't look like the 3.0u was bringing Sylvan's numbers down. Was there a reason that you weren't increasing his dose?

You also noted that he's not jumping. Is he having problems with neuropathy?
 
Welcome to Lantus Land, Liz and Sylvan.

We hope that Lantus will work well for you. It works much differently from Prozinc and the other PZI-type insulins, so do read the "stickies" with care. Everyone here will help you out, some with great advice, others with great support.

Ella & Rusty
 
Thanks again for the warm welcome, everyone!

Hi Gabby (or rather, Sienne, sorry):

As far as we know, Sylvan doesn't have any other health issues. We are checking for ketones, and so far he has had none since he's been on insulin. I believe he has problems jumping when he is dehydrated. We started adding water to his food (suggested by someone on this site) and he's been moving much, much better. I don't think it's neuropathy because he isn't walking with a "low gait"?

When he did have ketones, it was after he was first diagnosed. At first, our vet did not want to put him on insulin and we also were using a bad meter that read his sugar much lower than it actually was. He got sick pretty quickly and ended up in the hospital for 4 days. He then went on Prozinc. Our old vet was no help finding a good dose for Sylvan. He wouldn't even look at his chart, he just said keep it at 3 units.

We then switched vets, who seems to have a better handle on diabetes. But she had a hard time finding a Prozinc dose as well. She said not to go above 3.5 units. When we did raise the dose, Sylvan had really wonky numbers. He would go high, have a reverse curve, or he would have his nadir at shot time. So our vet thought he was getting too much insulin. No dose seemed to work when he was in the 200's, but when he was in the 300's, 2.5 units would bring him down. Maybe he has a panicky liver? He also had bad numbers at the beginning and end of every vial.

Anyhow, our new vet admitted she did not have much experience with Prozinc, and all her other patients were on Lantus. So I figured we would switch him over before he hit the 6 month mark. There seems to be a known protocol with Lantus, whereas with Prozinc it's all guess work.

Poor Sylvan has gone through so much and I hope this will work for him. He hasn't been himself for 5 months and still hasn't gained the weight he lost when he first got sick.
 
Welcome to Lantus Land! We have been here for about 4 months and Tarragon has made huge improvements over that time. I hope Sylvan has as good of results. I am not familiar with Prozinc, but do know that Lantus can work if you follow the protocol.

Vets are talking in generalities when they prescribe insulin and dose. They are not used to dealing with people who test religiously at home, so they sometimes go easy on the dosing with good reason. Less insulin is better than more insulin. Only by following the protocol have we really been able to make some progress. Tarragon is still not regulated, but he has gained weight, his fur is like cotton again, he plays like he did when he was a kitten and he no longer hovers around water. You have to learn to trust yourself and rely on the experts on this boards.

Good luck and welcome!
 
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