? Switching to Lantus on Monday! Dose help?

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StephG

StephG

Member Since 2016
Hey! It's me again! We are going to switch to Lanuts on Monday Am cycle. We currently are shooting at 1:15am and 1:15pm. He's getting 8.2 units of Prozinc and up until his first dose of 8.2 the prozinc wasn't lasting long enough and he increases after his meal and stays higher for around 4 hours (which is typical for Prozinc).
I don't want to start too low on lantus but I don't want to overload him right from the start either.
I was thinking 7 units would be a good start but I have no experience with Lantus so I'm kinda terrified!
He has never had ketones that I know of. He was diabetic for a month or two before I realized there was a serious problem and got him to the vet. He's not a picky eater. He gets 4.5oz 9Lives pate at meal time and the rest of the can, around 0.8 oz at +4-- which on prozinc was tending to stop him in his tracks and he would surf for a bit then go back up. He's very reactive to food, especially after nadir.
I am thinking about breaking his meals up into one main meal of 3.5oz then 3 or 4 snacks of .5oz each. I don't want to shoot myself in the foot by changing too much at once but I don't want him to drop too fast at any time and cause a bounce. I could try continuing what we are doing now and see where he starts to drop and go from there.
If you need any more info from me to help me determine what dose would work best-- just ask.
I want to do TR. I have been told he needs to not have the 1 teaspoon Young Again Zero dry food at +7 even though he gets 2 tablespoons of extra water with his meal and 1 tablespoon with his +4 snack. I'm going to find something to switch that to. For now I'll use his regular pate.
He gets Pet Alive Pancreas Booster, half a cap with each meal. Zobaline with his pm snack. He gets 1/2 teaspoon pumpkin puree with his AM meal or snack. And for now he is getting his 17mg Baytril antibiotic with pm meal. His last dose is Friday April 7th.
I have gotten use to calling him Chuck on the forum. I might switch the name on his Spreadsheet to avoid confusion.
 
I think I'd probably suggest starting at 8u. However, it's good to have more than one opinion, so I'll ask some other experienced folks to weigh in with their thoughts on it. Good idea to give plenty of time for people to make suggestions.

Most people break up the meals. It helps to even out blood sugar - what exact schedule works best for a cat is trial and error. I fed punkin 3 oz at preshot and 1.5 oz at +3 every day. Other than that I gave him a small bite of cooked chicken breast for pokey treats.

Is the amount of food you're giving him the right amount for his weight, ie, is he holding steady at an appropriate weight, not gaining or losing? If I'm understanding what you're saying correctly, is he getting 10 oz or so of food every day now? I think you're saying 4.5oz + 0,8 oz per cycle, but maybe you mean per day. That just seems like quite a bit of food to me, but with an unregulated cat they aren't absorbing the nutrients for it, so they might eat more than otherwise.

Have you looked at the ingredients of the Pancreas Booster, just to make sure there aren't any sugar-derived ingredients? Anything with "-ose" in the ingredients list? Dextrose, sucrose, glucose, galactose, mannose, etc.? I just always like to double check on supplements to make sure they aren't raising blood sugar.
 
I think I'd start at 7.5 or 8U....we don't want to drop back too far and have any glucose toxicity set in

As for feeding, I'd continue with the feeding schedule you have...4.5oz at meals and .8 at +4 if that's keeping him at a good weight.

As with ProZinc, usually it's best to get most of their carbs in before nadir (now we just have to figure out when he's going to nadir on Lantus!) or it can do the same thing...slam the brakes on any remaining action of the insulin.

Some cats can eat all the way up to +10 without problems, but generally, it's best to get most of the food in before nadir. You can experiment later with different feeding styles but I'd stick with the one you know for now.

Good luck on the Lantus! Hope it works better for Chuck...AKA Satan!
 
The website for the pancreas booster says the ingredients are:
Pancreas Booster is a 100% herbal formula and contains the following ingredients in therapeutic dosage:
Bromelain
Papain
Gymnema (Gymnema Sylvestre)
Goat's Rue (Galega officinalis)
Sweet fennel (Foeniculum vulgare)
I still haven't seen any benefits from it on the spreadsheet but I figured it isn't hurting him so we will use it up.
Chuck still needs to gain a bit of weight. Probably another pound. He's 11 pounds right now but still on the thin side. I don't want him fat but his normal was 13.5-14.5 pounds. So I would settle with 12. That's why he's getting so much food. Once he's up to weight I plan on cutting back the amount slowly while monitoring his weight so he doesn't start losing again.
I agree we don't want any toxicity issues. I'm just worried he might not need as much if the lantus lasts longer. If I start 8 how quick will I know that it's too much, if it is?
The 8.2 units of ProZinc only got him down to 158 on the first time so he had room to drop.
I swear his pancreas isn't putting out any insulin at all. But I haven't had him tested for acro or IAA yet so who knows.
BTW, his FD was steroid induced. His labs are entered on the ss.
 
StephG said:
If I start 8 how quick will I know that it's too much, if it is?
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As much as you're testing, you'll be able to keep him safe.

It can take 5-7 days before you see the full effects of the dose, but some cats react a lot quicker. Generally though, you have to "fill the depot" before you see the full effects of any particular dose.

When you start the Lantus, you'll want to put a line on your spreadsheet (make it a totally different color) so that it's clear that you've switched insulins.
 
I can tell from some of the test results (the last several blood tests) that the reference ranges from your lab are likely measuring differently than the reference ranges that were used on the template. You might want to change them so that the test results become meaningful. I also changed the font of any of Punkin's labs that were abnormal to red so that they stood out. You can look at his lab tab on his spreadsheet to see what I mean. It's helpful to quickly spot which labs might be a problem.

Thanks for explaining about the food - definitely if he's underweight you want to help him get back up to a healthy weight. That all makes sense.

Typically the switch from ProZinc to Lantus is 1:1, and he's not getting much action on the ProZinc at his current dose. That's why I wouldn't decrease it by much. It *shouldn't* send him much lower than he is getting on the ProZinc. The difference would most likely be that it will hold out longer - which isn't the same as dropping him lower.

Are you open to testing him for the high dose conditions? It can be helpful to know what you're dealing with.
 
I definitely want him in better numbers so I'm willing to start at 8 units. I was just looking at his labs and didn't realize when I entered them that they didn't match the ranges or units listed. I'll look over them tomorrow and add the listed ranges on the paperwork I have. I'm not sure if I'll be able to convert them to the list. I'll mark the abnormal levels red.
I do want to test for both conditions. The vet thought we should see how he does on lantus and go from there. We thought the UTI would be the cause but halfway through treatment and no changes so I think we were wrong. It was the reason for his slower eating though. He's back to eating all of his food right away.
I think by the end of the month I should have enough saved to cover the blood tests for acro and IAA. I'll get a basic panel done too. Have to recover from buying two vials of ProZinc in one month. Long story short: I thought the first was damaged/compromised because of his need for higher dose.
 
Just change the reference ranges on the spreadsheet. You don't want to try to convert your test results. It's easy to change the reference ranges.
 
Hi Steph, just confirming that Monday when you start the Lantus you'll be able to monitor closely the first 24 hours or so? It looks like yes from your spreadsheet to date. :) Some cats have a strong reaction to the change of insulin, some don't. If you look at Jack's SS, he switched from Prozinc to Levemir at 6.5 units, had a strong reaction, but eventually had to keep increasing.

Which syringes are you using now - the U-100 one?

And one last set of questions (for now ;)), why was Chuck on steriods? Was that for the IBD? Is he still on it? Some of the IBD kitties here go on budesonide instead of prednisolone as it's friendlier on the BG's. My Neko was on budesonide and I didn't notice any difference in her blood sugar. The IBD can also be a reason for weight loss. Probiotics are good to add to mix if you aren't already.
 
Wendy's comments reminded me - I saved a link she posted a while back in the "Where Can I Find?" thread. Look in the second half of the first post for the section called "My Cat May be Ill/Not Feeling Great/Have a Special Condition" - you want the section on Digestive Problems - look for the link to the use of probiotics in IBD kitties. It's a great link with solid information - research references at the bottom.
 
Yes, I'll be home all week to monitor. I have u100 needles 3/10cc with the short needles and half unit marks.
Chuck use to get depomedrol shots for his uncontrolled itchy ears. They never could figure out what caused his ears to itch so much. They have since he was a kitten. He gets frequent ear infections because he itches them raw with his dirty feet. We usually treat with otomax ear ointment. The depo shots helped a lot but I never knew they had risk of diabetes. He's had probably 3 in the last 2 years. Including one on the day of his first lab results I added then again in the beginning of May 2016 and was Dx with diabetes on August 18, 2016.
I have human grade probiotics, acidophilus. I'll check the Page you listed for ideas. Not sure if he can have what I already have here.
His ibd was treated with fortiflora but got better mostly because of wet food. Once I switched him to mostly wet food his potty issues improved then once he was off dry completely they improved a lot! He still has soft stool (main reason for dirty feet, which we refer to as "sh***y foot" at my house) the pumpkin helps him actually form turds instead of patties. (Sorry if TMI) and he's less gassy. Honestly never heard a cat fart til Chuck started with ibd issues. Now it's "normal" to us but visitors tend to be shocked. He's always sure to welcome strangers with a hello from the wrong end! The old vet said that's more ibS than his ibd. Call it what you will... We still love him! Because he was maintaining weight and normal the old vet said it wasn't necessary to treat.
His symptoms are much better on wet food so a probiotic might be a good addition.
Sorry, I tend to get chatty.
 
Hey Steph, your "welcome from the wrong end" had me in hysterics! They say cats don't belch either and that is why they scarf and barf but, guess what? Bubba burps!

Good to see you here and we will all be watching and cheering you on. Remember, ProZinc forum is just next door and lots of us that have come over to Lantus, go and visit there frequently.
 
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LOL Chuck burps too! He's such a gentleman!
About 10 hours til his first lantus shot. :nailbiting: it really does feel like I'm starting insulin all over again for the first time.
 
StephG said:
LOL Chuck burps too! He's such a gentleman!
About 10 hours til his first lantus shot. :nailbiting: it really does feel like I'm starting insulin all over again for the first time.
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That's how it felt to me too but I really think you catch on quickly and just keep asking questions. :bighug:
 
StephG said:
About 10 hours til his first lantus shot. :nailbiting: it really does feel like I'm starting insulin all over again for the first time.
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I felt the same way when I switched Neko from Lantus to Levemir. At least the second time round you know you are looking for onset and nadir to start, and how to recognize them. Typical Lantus onset is +2 to +3. You may not see much in the way of a nadir until the depot fills a bit more. But there's always the cat factor. :cat: Best of luck!
 
I'm not seeing a thread for today so will go ahead and comment on this one. We suggest everyone start a new thread with their first post each day so that they don't get too long. What did you decide for a starting dose? I meant to encourage you to get on the line with it, rather than the 8.2u that you've been giving.

He's at a large enough dose that the increases are probably going to be in larger amounts now until you get to the "right" dose and start seeing better numbers. When you're in the bigger doses, going up by tiny increments isn't enough to "get on top" of blood sugar that's rising rapidly. I did that with Punkin, and am the voice of what not to do - unless, of course, it works for your cat, lol. I kept increasing in 0.25u increments even when he was over 10u. Seemed like I was always one step behind in getting control of punkin's blood sugar. I've seen since then that it's more successful to use a larger increment once you've gotten into larger doses.

Increasing by 0.25u at 8u is like fattening a 1.0u dose - something that works really well when you're basically at a good dose and just tweaking it. Think of it in percentages: many typical diabetic cats are started at 1.0u (ish) and dose increases are made in 0.25u increments - that's a 25% increase. At 10u most people move to 1.0u increases if their cat is still uncontrolled - which is only 10%. When you look at it like that, larger increases make sense. You can consider a range of 10-25% increases, depending on what's going on with Chuck's blood sugar. It's good to have someone with experience take a look if you're considering a larger percentage increase.

Hope the first shot goes well with no surprises!
 
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