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Switching Prozinc to Lantus
- Thread starter Airway
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Hello and welcome. I hope Lantus can help get Orion better regulate. Love his little face.
There is lots of information (initially overwhelming perhaps
) at the top of this forum. Start reading there. There are two methods people use for dosing, Tight Regulation Protocol and the Start Low Go Slow method. Give a read over the two of them and decide which ones suits your situation.
When we convert from Prozinc to Lantus, we usually take the dose of the current consideration into mind. The 3.5 units of Prozinc looks like it was too much, so maybe starting at 3.0 units would be better. Pick a day (weekend?) or two when you can monitor more closely when you start Lantus, just in case he has a stronger reaction. We recommend people monitor fairly closely the first couple of cycles.
I am glad you know you need to switch syringes. We've had one or two people switch without the change. We make dose changes in 0.25 unit increments, so you might want to invest in a good light system and magnification if you don't have one already.
There is lots of information (initially overwhelming perhaps
) at the top of this forum. Start reading there. There are two methods people use for dosing, Tight Regulation Protocol and the Start Low Go Slow method. Give a read over the two of them and decide which ones suits your situation.When we convert from Prozinc to Lantus, we usually take the dose of the current consideration into mind. The 3.5 units of Prozinc looks like it was too much, so maybe starting at 3.0 units would be better. Pick a day (weekend?) or two when you can monitor more closely when you start Lantus, just in case he has a stronger reaction. We recommend people monitor fairly closely the first couple of cycles.
I am glad you know you need to switch syringes. We've had one or two people switch without the change. We make dose changes in 0.25 unit increments, so you might want to invest in a good light system and magnification if you don't have one already.
You never know what will work for what cat, but I do hope Lantus works better for Orion. Sorry this is your second time at this dance.
Just so we have the bigger picture, would it be possible for you to start getting at least a "before bed" test every PM cycle? Given that Lantus is dosed based on the nadir, it's hard to know whether you're seeing those high AM pre-shot numbers due to Orion dropping into lower ranges during the PM cycle. If you recall from your other kitty, getting some spot checks during both AM and PM cycles is really important.
Airway
Member Since 2013
I get a preshot every evening before Orion gets his shot. It's very difficult for me to get numbers in the middle of the night. I typically go to bed within a half hour of giving his PM shot.
Kris & Teasel
Member Since 2016
I know you have this restriction from your posts on the ProZinc forum. I'm learning with Teasel now on Lantus that a +2 test can be an important "heads up" that an active cycle might be ahead. The BG activity and necessary monitoring can last quite a while because of the slower action of Lantus and the effect of the depot. Things you might want to think about before making a change.
Airway
Member Since 2013
Is a +2 all I would need to get during the PM cycle? He needs to switch to something other than Prozinc. His numbers just vary too much on that and I can't get it under control. The vet feels Lantus would be a good switch.
Kris & Teasel
Member Since 2016
A +2 is the baseline to assess what might happen. If your +2 is lower than PMPS then you might have an active night cycle ahead that would require more monitoring, steering with food, etc. Have a look at Teasel's PM data on 02/25. It wasn't a case of a lower +2 after the PM shot but I had to track his BG until midnight my time to make sure he wasn't dropping. Everything happens in slow motion with Lantus and I compared it to driving a tank versus driving a sports car.
ETA: I think Lantus might help Orion but you have to decide whether you can fit in the monitoring with your own personal schedule. He might take to it well and have an uneventful changeover but surprises are still possible. It has to work for the human as well as the kitty.
Kris & Teasel
Member Since 2016
I'm not trying to dissuade you from trying Lantus, Angela. It might be just the ticket for Orion. I just wanted you to think about how it might fit into your schedule. The depot insulins can (ideally) stabilize a bouncy cat but Levemir would have some of the same dosing/monitoring requirements as Lantus.
Bobbie And Bubba
Member Since 2015
Hey Angela, and I hope you get a good result with Lantus when you switch. I did. From reading through I see that you go to bed shortly after the PM shot. As Kris was explaining the reasoning for a +2 and that it could be possible for it to be an active cycle which would require you to be up and monitor. Would it be possible for you to change your shot time that would give you a bit more time in the evening to monitor if necessary? Just an idea.
Airway
Member Since 2013
Here is the problem. I sleep 10-12 hours per night. I take medication at bedtime that causes me to pretty much be out of it for at least 10 hours. Once I take my medication, I'm usually asleep within a half hour, and I have to allow at least 10 hours for it to wear off for me to be awake and conscious enough for work the next morning. I'm trying to do the best I can. 
I read the stickies, and I'm confused about the dosing. If 3u is what I give of Prozinc, will I start with 3u of Lantus?
I read the stickies, and I'm confused about the dosing. If 3u is what I give of Prozinc, will I start with 3u of Lantus?
Kris & Teasel
Member Since 2016
Teasel was at 3 u of ProZinc when I switched him to Lantus. I played it safe and dropped the Lantus dose to 2.5 u but upped it to 2.75 u after 6 cycles. I'm now at 3 u.Here is the problem. I sleep 10-12 hours per night. I take medication at bedtime that causes me to pretty much be out of it for at least 10 hours. Once I take my medication, I'm usually asleep within a half hour, and I have to allow at least 10 hours for it to wear off for me to be awake and conscious enough for work the next morning. I'm trying to do the best I can.
I read the stickies, and I'm confused about the dosing. If 3u is what I give of Prozinc, will I start with 3u of Lantus?
Airway
Member Since 2013
I hate to start over at 1u again if I don't have to. That's what the vet advised. Is Lantus dose adjusted in 0.25u increments usually? I've adjusted 0.5u at a time with Prozinc. I've never had syringes with half unit markings before. I always just eyeballed it. But if Lantus is adjusted in smaller doses I think maybe I will need them?
Kris & Teasel
Member Since 2016
The Lantus protocols generally recommend 0.25 u increments unless you have a very high dose kitty. You also need to use U100 syringes with Lantus whereas you have U40 syringes for ProZinc.
julie & punkin (ga)
Member Since 2011
I wouldn't drop back dramatically in dose when you make the switch. As Wendy explained, it's typically a similar dose as he had on ProZinc. I would start Orion at 3u on the beginning of your weekend, so that you can have time to monitor him.
For the nights - you aren't the only person who has been on here with a similar situation. We've had a surprising number of people in similar circumstances. You can still make Lantus work. If you are able to invest in a timed feeder, I'd go that route. If a kitty goes low, we use food to bring up their blood sugar. You can put food in the timed feeder and have it open during the night. I bought one for Punkin - the PetSafe 5 Compartment feeder - and it was the best thing I could've done. Later I found that one of the women here bought 2 of them - meaning that you could have the feeder dispense food 8 times that you had preset! I thought that was brilliant and if I had a diabetic cat now, that's what I would do.
One step at a time. Go ahead with the Lantus and we can help you work out the bumpy spots. No worries!
I'd encourage you to put something in your signature line that says you are unable to test past +2 in the pm cycle due to medical issues. That will stop everyone from asking you - because otherwise they will! It's something we routinely look at & suggest because so many cats have their lowest numbers in the pm cycle.
For the nights - you aren't the only person who has been on here with a similar situation. We've had a surprising number of people in similar circumstances. You can still make Lantus work. If you are able to invest in a timed feeder, I'd go that route. If a kitty goes low, we use food to bring up their blood sugar. You can put food in the timed feeder and have it open during the night. I bought one for Punkin - the PetSafe 5 Compartment feeder - and it was the best thing I could've done. Later I found that one of the women here bought 2 of them - meaning that you could have the feeder dispense food 8 times that you had preset! I thought that was brilliant and if I had a diabetic cat now, that's what I would do.
One step at a time. Go ahead with the Lantus and we can help you work out the bumpy spots. No worries!
I'd encourage you to put something in your signature line that says you are unable to test past +2 in the pm cycle due to medical issues. That will stop everyone from asking you - because otherwise they will!
It's something we routinely look at & suggest because so many cats have their lowest numbers in the pm cycle.
The formula for a starting dose that you noted is only used when you are starting your cat out on Lantus as the first insulin ever. It's not used when you're switching from another insulin to Lantus. When switching, you take the dose of the current insulin into account. You can make a direct switch, unit for unit, when switching from ProZinc to Lantus. Some members opt to reduce the Lantus dose slightly in case their cat has a marked response to Lantus.
Just out of curiosity, is there any way you can move your shot time so you don't have to disrupt your sleep to get additional tests at night. Part of the concern is that many cats experience lower numbers during the PM cycle. If you aren't able to test, there's no way to assess what is happening during the PM cycle.
With TR, you do not need 3 days of continuous monitoring. To use the protocol, you need to get your AM and PM pre-shots and at least one spot check, whenever possible, during both the AM and PM cycles. There is a sticky note at the top of the board that discusses using TR and working a full time job. That may help you to get a better feel for how Lantus works with your schedule.
We generally do recommend you use syringes with half unit markings. It will help you to dose more consistently since dose changes are, in fact, typically made in 0.25u increments.
Just out of curiosity, is there any way you can move your shot time so you don't have to disrupt your sleep to get additional tests at night. Part of the concern is that many cats experience lower numbers during the PM cycle. If you aren't able to test, there's no way to assess what is happening during the PM cycle.
With TR, you do not need 3 days of continuous monitoring. To use the protocol, you need to get your AM and PM pre-shots and at least one spot check, whenever possible, during both the AM and PM cycles. There is a sticky note at the top of the board that discusses using TR and working a full time job. That may help you to get a better feel for how Lantus works with your schedule.
We generally do recommend you use syringes with half unit markings. It will help you to dose more consistently since dose changes are, in fact, typically made in 0.25u increments.
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