? Switching from Prozinc to Lantus

[Lisa and Smoky]

I am thinking about switching Smoky from Prozinc to Lantus. I need an insulin that can be flexible with dosing as my schedule can be challenging.
Can someone explain how to change over from one to the other? Smoky is doing very well on prozinc as far as his BG numbers are concerned.
The problem seems to be that he is feeling miserable and looks sick while in the first half of the cycle. I noticed that he feels better when on lower doses of prozinc but then his blood sugar is higher again. Any help would be much appreciated.

 

[Sienne and Gabby (GA)]

Welcome to the Lantus and Lev board.

To be honest, Prozinc is far more flexible and forgiving than Lantus or Lev. You have a window of about 30 min with shot time before you need to begin to be concerned with being off schedule when using Lantus or Lev.. Lantus and Lev are depot-types of medication. If you shoot early, the early shot acts like a dose increase and a late shot acts like a dose reduction. If your schedule is unpredictable, your timing could have an impact on the depot. Unlike with Prozinc, dosing is based on the nadir and you don't adjust the dose based on the pre-shot numbers. You might want to read over a few of the sticky notes at the top of the board.There are two notes that discuss the two options regarding dosing -- the Tight Regulation Protocol and the Start Low Go Slow method. There is also a note about using Lantus when you work full time and want to use Tight Regulation. There's also a note that describes the depot.

Some cats become adjusted to being in high numbers. As a result, once you find out your cat's diabetic (and none of us know how long our kitty's has been diabetic at the time they're diagnosed) and you start giving insulin, their body isn't used to being in closer to normal numbers and they feel lousy. Also, if numbers are dropping like they did today, there's a good chance that Smokey will experience a "bounce" -- because his body isn't used to being in green numbers, his pancreas and liver overreact and dump a stored form of glucose and counterregulatory hormones which cause the numbers to spike. This makes some cats feel pretty rotten.

 

[Lisa and Smoky]

I'm concerned about the high costs of Lantus and dose flexibility. I know many members order from Marks Marine Pharmacy in Canada. I did email them and it's difficult to send insulin here now with it being in the teens in PA. I don't know if it is legal to transport insulin from Canada to US in a car. Scratch that thought, I am closer to Niagara Falls than Vancouver. That part of Canada is closer to the west coast of US, and I am on the east coast. I'm still reading the sticky notes for Lantus. There are a lot of them and I'm learning so much.

 

[tiffmaxee]

Check the supply closet to see if you can buy a pen from someone. Then when the weather clears you can buy from Mark's. With Smoky's dose a pen will last at least two months and probably three.

 

[saltycat]

I had to call around, but did find that the local wal-mart would split the box and sell a single pen. Others have had luck with CVS. If you call around you hopefully can find one. I did this when we switched to get him started on the insulin and then used Mark's for the cost saving.

He looks like he is doing pretty good on the prozinc, I would consider sticking with it since you need some flexibility in scheduling and lantus / lev like more consistent shot times.

 

[Lisa and Smoky]

Thanks for your reply. My vet wrote me a prescription for Lantus but it was for the vial. The cost was $280 in my area of the US. I don't know if my current vet would give me a script for a single pen. I like the flexibility of dosing with prozinc and it's pricey, $125 for a vial but not as much as the Lantus.
My concern for the prozinc with Smoky is that he seems to feel crappy on it when on higher doses. I don't know if it is just the current vial he is on or if getting a newer one would help. The one I have is about 80% gone.

 

[Chris & China (GA)]

and it's pricey, $125 for a vial but not as much as the Lantus.

Just FYI.....ProZinc and Lantus really are comparable in price (paying US prices).....Lantus is considerably cheaper if you buy it from Marks

ProZinc is a U40 insulin, so a 10ml vial holds 400 units....at $125, that's .3125 cents per unit

Lantus is a U100 insulin, so a 10ml vial holds 1000 units....at $300, that's .30 cents per unit

At Marks, Lantus is $99 for a 10ml vial, so that's .099 cents per unit....so 1/3rd the price

 

[julie & punkin (ga)]

Is it possible that him feeling yuckier with larger doses of insulin could be that it really is that he feels yucky when his blood sugar gets in green numbers?

That's reported fairly often. If a cat's blood sugar is mostly in the 200's, as an example, then the cat's body will perceive that as normal. When the insulin gets the blood sugar down into normal range, the cat feels yucky. This is called Glucose Toxicity (sounds worse than it is) - the cure for this is to keep getting the cat's blood sugar down into green numbers. The more time they spend there, the more the body "remembers" that this is normal.

Think of it like a coffee-drinker and their caffeine. Non-caffeinated is our natural state, but if one drinks coffee every day, that feels pretty great. Take away the caffeine and people get headaches and feel wiped out. But 3 days after no-caffeine, the body remembers that this is normal and the headaches go away.
It's the same situation with high blood sugar and cats. The way to get him used to it is to continue to give enough insulin to get him back under 100 - provided you can test enough to keep him safe, of course.

 

[Ella & Rusty & Stu(GA)]

I am closer to Niagara Falls than Vancouver. That part of Canada is closer to the west coast of US, and I am on the east coast

The next time you go to Niagara Falls, be sure to shop in a Shoppers Drug Mart (big Canadian chain). You don't need a prescription to buy insulin in Canada and prices are reasonable (compared to the US). Bring a small cooler or lunch box with you. Put the insulin underneath your lunch supplies. Don't volunteer that you bought insulin when you cross the border. In Niagara Falls Canada you are a legitimate tourist, not just an American buying drugs! I live in northern NY state. This fall I went to Cornwall, Ontario to buy Levemir (and "to visit a friend and have lunch with her"). I didn't declare anything and my car wasn't searched.

Good luck if you decide to switch to Lantus. I tend to agree with @Sienne and Gabby (GA) 's post above: Prozinc might be a better fit considering your irregular schedule.

Ella & Rusty

 

[Wendy&Neko]

I've taken insulin in a car and on a plane from Canada to the US. Both times it was with the diabetic cat. They didn't blink or even care about the meds in my cooler. What got the security staff excited for the flight was the kitty litter. Going the other way, I bought my test strips in the US and drove them into Canada. I could almost guarantee an eye roll from the border guards when I said the most expensive thing I had was diabetic supplies for my cat. I never got stopped for it.