Switching to lantus need help

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raysofhope

raysofhope

Member Since 2012
Hi
I am wanting to switch my cat to lantus,she has been on prozinc for 2yrs but she is now completely messed up as far as regulation, she is loosing weight as we speak and her numbers are a mess.
I s lantus dosed the same as prozinc? And how to I keep it fresh? I've had to buy 5 pens as our pharmacies don't sell the cartridges or one pen at a time. 335.00 is a lot of money for me so I need some help to keep this stuff as long as possible. Also do I roll the cartridge or shake it what's the best method? If there is a page on fdmb all about this please post the link for me..thanks
Diana
 
Hi Diana and welcome to Lantus Land. There are a number of sticky notes at the top of this forum to read. To answer the questions on handling Lantus, read the Info, handling and storage sticky. Your Lantus should be good until the expiry date if handled properly and kept in the fridge.

Someone today mentioned Target pharmacy being a good source for buying a single pen. You can get a Lantus coupon that makes a single pen much cheaper, but make sure you list your kitties age as at least 18.

As for dose, we start kitties based on their actual and/or desired weight, with some consideration to the dose on a previous insulin. What is your cat's weight?
 
You'll need to call around to see if you can purchase single pens. n some areas, Target will sell a single pen and in some places they won't. Also, try hospital outpatient pharmacies. They may be in a better position to sell a single pen.
 
Hi Diana,
Welcome to Lantus Land. I hope that Lantus will work for your kitty. Lantus doesn't like to be shook up, so handle it gently and keep it in the 'fridge (the opened pen as well as the rest of the pens in the 5-pack). The manufacturer's instructions say that you should discard an opened pen after about a month, but that is intended for humans who carry it around with them and don't refrigerate it (and have much larger doses than cats). Here we normally try to use a pen until it is empty.

That's a big weight loss for a single year. Does your kitty have other health issues (besides diabetes)?

There's a lot of info. in the "stickies" at the top of the Lantus forum. Try to read a little each day. I think that the biggest difference in dosing with Lantus as compared with ProZinc is that Lantus needs to be consistently dosed every 12 hours. You don't have the hour or two leeway that you have with ProZinc and other PZI insulins. Good luck with your Lantus adventure.

Ella & Rusty
 
Hi Diana,

Welcome to Lantus Land!

I looked through Angel's spreadsheet and a few things jumped out at me. Looks like she's had a couple of UTI's in the past 6 months, plus an infected tooth, plus a lot of vomiting. When she vomits is it clear, foamy, or is there food in it?

Has she been tested for pancreatitis?

Do you have confidence that the previous infections have been cleared up? Any follow-up testing done, any symptoms still remaining? I'm just wondering if there are any other factors that might be making her blood sugar high.

If you have recent labs for bloodwork, there are people here who can look at it and help interpret if you want.

Do you have her previous spreadsheet? I'm just wondering what her numbers looked like before, since you said she's lost regulation now.

The biggest change you're going to need to wrap your head around is that Lantus dosing isn't done on a sliding scale and we don't adjust the dose based upon the preshot. So lean on us for the first little while as you learn how to change her doses.

Another big change is that you'll need to get a mid-cycle test in every cycle, in addition to the preshot tests. Lantus dosing is primarily based upon the nadir (low point) that the dose gets her to - which usually happens somewhere mid-cycle.

According to the weight formula, her dose would be 1.25u (11lbs = 5kg; 5x0.25 = 1.25).

Using a weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
the formula is 0.25 unit per kg of the cat's ideal weight
if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
Online Calculator for Converting Pounds to Kilograms
Click to expand...

However, that's more than she's been getting recently. When are you switching? i'd like to talk about a starting dose with a couple of other people and get back to you.

Make sure that when you change, you get the u-100 syringes to go with Lantus. Prozinc uses u-40 syringes, so you'll want new ones. you'll also want syringes with 0.5u markings. Once you switch to Lantus, you'll hold the starting dose for about 5-7 days unless she goes under 50.

Read through the yellow-starred stickies at the top of this page (right above people's posts) - you won't be able to remember all of it, but it will give you some good information. Ask if you have any questions! We encourage people to post regularly while they are learning so we can help as things come up. We'll watch her spreadsheet and help you figure out when to change her dose, too.

Hope I haven't overloaded you with too much information - fortunately, you've got the basic feline diabetes stuff down and don't have to learn all the testing/shooting stuff too!

I'll get back to you about an idea for a starting dose by tomorrow.

Glad to meet you, Diana!
 
Hi Diana!

Good morning! Wendy, Sienne, Marje and I had a chance to talk about it and look at the spreadsheets of some of the other kitties that have switched from ProZinc to Lantus. We're suggesting you start at 1unit. Following the guidelines, you'll want to check Angel about every 3 hours (yes, you can sleep) the first 3 days she's on the Lantus.

Tight Regulation Protocol

REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
It will be necessary to test kitty's blood glucose levels multiple times per day.
Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
Feed a high quality low carb canned or raw food diet.
Feed small meals throughout the day. Some kitties adapt well to free feeding.
Click to expand...

The most recent publication is on this page, about 5 paragraphs down - the PDF entitled "Management of a Diabetic Cat Using Long-Lasting Insulin." You might want to print it off, or at least read through it. There is lots of good information there.

Please ask if you have any questions!
 
Hi everyone!
Thanks for the advice,, as you can see by her ss 1.0 u was a bit much for her. This afternoon ,I got a 46 and it scared me!! When she gets below 100 she seems to get sick and not eat. As far as we know she doesn't haVe any other health issues. I think her kidneys may be going unfortunately. I had 2 other older cats have this happen. I am just hoping it's not the case, and if we can get her numbers down she will gain some weight. We did have bloodwork done a couple times this year and the vet said she was ok, this was before the tooth pulling. All I can do is try my best and hope for a miracle.. Thank you all for being there!
Diana and Angel
 
Your new dose will be .75U. Good catch today!

Are you feeding low carb and low phosphorus food? That will help the kidneys.
 
Hi, Yes the best I can.. Friskies special diet . mostly and chicken meat. and a tiny bit of Wysond epigon 90 dry. Like a tbl. at night sometimes. Mostly she wont even eat it.
 
You might want to come back up to 0.75 u for the dose in the morning as her new "regular" dose, then keep that until she goes below 50 again. The protocol calls for adjusting by 0.25u - you'll be amazed at what a tiny adjustment in her insulin dose will do. I'd encourage you to go to the 0.75u. Since she still has some high numbers, it can help deal with them if you don't reduce too much.

40's aren't something to be afraid of - just think of them as your "take action" zone. Non-diabetic cats often run in the 40's - we just don't want our kitties hanging out there because we like a safety margin since they are getting insulin. But if you can keep her in normal numbers (50-120) she has a good chance of having her pancreas heal and becoming diet-controlled, and even if that doesn't happen, it's great for protecting her body from the damage caused by diabetes.

Would you mind inserting a row above the date that you switched to Lantus and filling it with some color so it stands out? It would be helpful to remind us that you just started the Lantus.

I'd encourage you to get tests every 3 hours for another couple of days. From the TR Protocol page:
REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.
Click to expand...

She may feel yucky in normal numbers because her body has gotten so accustomed to high numbers. As she gets more used to normal numbers she'll feel better. I think it's like me and my morning caffeine - i feel gross without it, but being caffeinated isn't my natural state. if i could go through detox i'd probably feel better. not that it's likely to happen! ;-) :lol: but we do know that as cats get used to the normal numbers they readjust and do feel better with them.

Great job catching the 43!!
 
Thanks , yes I have adjusted her to.75 will see where that takes her. I do believe she is getting sick from the low numbers like you suggested, I am hoping to keep her in the 100 to 200 range, This would be way better than what's been happening on the prozinc.
 
oddly enough, it's pretty difficult to keep a cat in the 100-200 range. i think most people think that's ideal, too, because you want to stay under renal threshold (the point where kidneys can't cope with the sugar in the urine), but in my experience, it's hard to get a cat there.

it's actually easier to get them flat into the normal numbers. For whatever reason, people can get them to flatten out at 50-100, but when you have some higher numbers, say 150 or 200, then you've got a curve and the numbers in a cycle go from higher to lower. Perhaps Angel will do it, but i haven't seen very many cats stay flat in that range.

she would get used to the normal numbers if she stayed there for a few days.
 
Hello again. Julie is right about being more bouncy at higher numbers. With Neko, if she's seeing more green she's more flat than if she's not. I'd love her to be in the 100-200 range - as an acrocat I'm not so worried about pancreatic healing, but alas it's hard to achieve.

A quick comment, would it be possible for you to get some tests at night? Even a quick test before you put out the lights and go to sleep can add a lot to the picture on how Angel is doing on Lantus. She's probably bouncing today from yesterday's low.
 
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