switching to lantus this weekend

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cbrown1

Member Since 2013
Hi everyone!
We are finally able to switch over to lantus from Novalin N. Now.... any advise on the best way to switch? Our vet wants to first try once a day dose for a few weeks to see if it works, if not will switch back to BID.
Should I skip his am dose of novalin and start the Lantus dose tonight (as we plan to give it in evening) or still give the novalin this morning?
I will be doing normal preshot testing as well as random spot checks for first few days of lantus until I see how Mr. Pink reacts.

Thanks!!
 
It is really up to you whether to skip or give the insulin - maybe the BG number will decide for you. I see nothing wrong with making the switch and giving the lantus at normal shot time.



Our vet wants to first try once a day dose for a few weeks to see if it works, if not will switch back to BID.
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I don't understand this. In order for lantus to be most effective it needs to be given twice a day (BID) not once a day. By giving only once a day, you are going to find that the numbers will be all over the place and you are going to get very frustrated with the results. Lantus is a depot (shed) insulin and needs time to build up the depot - think of it like putting gas in your car - if you fill the car up, you can drive for many miles, if you don't fill it and let it get to Empty - you can't drive anywhere.....Lantus is the same, the tank likes to be filled and dosing BID will ensure that the tank stays filled.

Have you had the chance to read the stickies on the lantus forum yet? If not, may I suggest you spend some time reading through it and asking questions.

viewforum.php?f=9
 
It would be safe to start off at 0.5 units per shot, twice a day.

It may be more optimal to use this formula to calculate a starting dose:
1) the lower of ideal weight or current weight
2) in kilograms (pounds divided by 2.2
3) multiplied by 0.25
 
yay!!!!! Can you mark the "switched to lantus" bigger and in bold?

BTW those numbers are really good. I wonder if a switch to say Fancy feast classic pates (around 4%)that are lower carb than friskies (around 8%) might be enough to tip him into remission? A normal cats BG is 50-130. If he doesnt go above 150 I might not be even shooting him right now to see how he does for a few days.


Wendy
 
If/when you do start the Lantus, I definatelty would start on a low dose like 0.5IU.

A few key things about Lantus:

- Lantus is depot insulin - it takes a few days for a dose to build up in the cats system ( or to drain if you reduce ) so it takes a few days to see an impact of a dose change. And when starting out it takes a week to reach optimal levels. So if you see greens within the first day your dose might be too high as its only going to get more of an effect as the days go on. You want to hold the starting dose for a week to see how it goes. Unless he drops under 50 in which case you want to decrease by 1/4 unit immediately.

- Lantus has a slow curve - it starts to kick in around 2 hours after the shot and has maximum effect around 5-7 hours after injection (the low point of the day or "nadir") . Dose changes are based on the nadir so its important to get tests mid cycle so you can be sure he isnt dropping too low (under 50). Lantus only lasts 12 hours in the cats system so its given every 12 hours.

Lantus protocol: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
Handling lantus : http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151


Wendy
PS what meter are you using?
 
Lantus can and does last more than 12 hours in a cat. It does not last for 24 hours though. If you only dose once a day, then the insulin will be used up, the depot will drain and your cat's BG numbers will go high. The typical duration of Lantus may be anywhere from 14-20 hours, depending on the cat. The reason for the 2 doses a day, is so you take advantage of the overlap between doses. You want sort of a steady stream effect, not fits and starts from a single dose every 24 hours.

You also want the insulin depot to be full, not constantly draining and refilling from a single shot per day.

ECID. Maybe your cat will be the rarity that does well on only one dose a day. Typically though, that is not the case.
 
Just checking in to see how Mr Pink is doing. Maybe you want to try sneaking the dose up a little to somewhere between 2 and 2.25 to see if you can get some more greens and help his pancreas heal more? We are trying to get him in the 50-130 range

Or maybe try and pick the lower carb friskies to see if you can get his numbers down naturally - what flavours/types are you giving?

Wendy
 
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