Toujeo

[Pumpkin's Mom]

I just got this brochure from the people who make Lantus for Toujeo - a long lasting insulin. Anyone heard of it or know anything about using it for cats?

 

[Wendy&Neko]

It's a new super concentrated version of Lantus. Given the small doses that cats take, it would only be of use for cats with high dose conditions on really high doses of insulin. There haven't been any research yet on it being used for cats. I wouldn't want my girl to be a test subject. We had one member with a high dose cat accidentally give it for a couple of doses. Fortunately, the cat survived.

 

[manxcat419]

Toujeo is meant to last a bit longer than Lantus in humans. But as it doesn't last 48 hours, more like 36, it could give problems with shot times for cats as you'd need to give shots every 18 hours instead of every 12...IF it lasts about half as long in cats as in humans like Lantus does. The other big issue with it is that it's super-concentrated at 300U/ml which would make dosing small amounts incredibly difficult - we already have trouble enough with 0.25U and smaller doses without trying to measure doses just 1/3 the size. As Wendy says, it could have its uses for very high dose cats, but is likely to be restricted to those cats for practical reasons.

 

[Pumpkin's Mom]

My cat is on 5 units of Lantus every 12 hours right now. It would be nice to be able to go to a movie or out to dinner without worrying about getting back by 7:30.

 

[Wendy&Neko]

My shot time is also 7:30 and I do dinners and movies. With planning in advance. You can move shot times up by 15 minutes per cycle or 1/2 hour once a day. So, if you start a couple days in advance, you have a shot time of 6:30. Last month I needed a 6:15 shot time to make an event. I also see a lot of matinee movies. Or you can go to an early dinner, shoot late, then gradually work your shot time back to 7:30. Worst case, skip a shot for an important event, then resume the next day.

 

[manxcat419]

The problem for me with moving 7:30 shot times to 18-hour shots is that you would have to give every 6th shot at 1:30 am. Which sounds fine until you remember that you really need to get at least a +2 test and possibly more than that depending on the numbers. For me, moving a shot time or skipping completely once in a while is preferable to staying up all night every 3 days.

 

[Sienne and Gabby (GA)]

First, both Lantus and Toujeo are glargine -- their composition is identical. Since they are the same, they are both long-acting insulin.

The information above regarding duration is incorrect. Just like Lantus, Toujeo lasts 24 hours in humans. Onset, however, is later with Toujeo. (See this link comparing Lantus with Toujeo.)

It's the concentration of the two forms of glargine that differ. Lantus is a U100 insulin. Toujeo is a U300 insulin. It's 3 times more concentrated than Lantus. This may be an advantage for a high dose cat. However, for most of the cats on the board, this could pose a much greater risk for an accidental overdose. Consider if your cat is sensitive to insulin. Even being the least bit inconsistent with the dose could potentially result in symptomatic hypoglycemia. Further, I do not believe there are U300 syringes which would be calibrated for a U300 insulin. If there were, think about how hard it would be to accurately draw up a dose since the lines would be even closer together than on a U100 syringe. Of course, you could use the pen to measure a dose but, as we all know, the pens are not set up to measure small amounts.

 

[manxcat419]

The information above regarding duration is incorrect. Just like Lantus, Toujeo lasts 24 hours in humans. Onset, however, is later with Toujeo. (See this link comparing Lantus with Toujeo.)

Thank you @Sienne and Gabby (GA) - I'd looked at the Toujeo page and they had a graph actually showing activity up to 36 hours in humans...apparently their graph was a little misleading as it still showed some activity at the 36 hour mark! So thank you for the correction - I hadn't looked at the same page on their site that you found!

 

[Sienne and Gabby (GA)]

@manxcat419 - I'd have to search through the info you found. Were they referring to duration or half-life? Some of the pharmacokinetic/pharmacodynamic information can be confusing. What complicates it even more is that no one knows how a kitty will respond. All of the information on Toujeo is based on a human's response.

 

[manxcat419]

@Sienne and Gabby (GA) - I'd go with the information you have. This is the graph that's on their site https://www.toujeo.com/about-toujeo, but it's not all that accurate - it just shows 'some' insulin activity hanging around well after the 24 hours. I did wonder how they could get Glargine to last longer just by making it more concentrated. But I do think cats would still need to be dosed twice a day with Toujeo just as they are with Lantus. And measuring small doses with an insulin with 3x the concentration would worry me. It looks as though it's really only designed for use in pens, with the pen needle at the moment - and we already know that doesn't work well for cats.

 

[Sienne and Gabby (GA)]

@manxcat419 - Without the actual data, what the graph suggests to me, at least, is the action past the 24 hour point may be where the overlap between doses occurs.

 

[manxcat419]

That makes sense. And with a later onset, you'd expect the overlap to run longer as well. They don't provide the actual data - possibly that's deliberate, or maybe they think people just won't understand it anyway.

 

[julie & punkin (ga)]

@manxcat419 - Without the actual data, what the graph suggests to me, at least, is the action past the 24 hour point may be where the overlap between doses occurs.

It could also be a remaining depot action. That could explain why there is some action showing so much later after the shot. Consider that we know that a cat's blood sugar can still be influenced by a previously larger dose for as many as 4-6 cycles after a dose has been decreased because of the depot. That would suggest that "some" blood sugar control is still being exerted as many as 3 days after a shot.

If I had a high dose kitty I might be interested in trying this once I got above 10u, but I wouldn't try it with a "regular" diabetic cat. If I were going to try it, I'd wait til I was past 10u on the regular Lantus and then start at something significantly lower of a dose so there weren't any surprises. I'd also only do that because I am experienced - I wouldn't suggest it to anyone new.

 

[julie & punkin (ga)]

Hi @Pumpkin's Mom , I just went back and looked at your first post yesterday to see what Pumpkin's story is. Here is your earlier post.

Welcome to the group! We encourage everyone to start a spreadsheet and begin recording their kitty's blood sugar tests on it. There are directions here on the "New to the Group: Start Here" sticky.

If I understand correctly you are using the pen needles and increasing the dose by full units. Cats are very sensitive to small changes in insulin and we increase their doses by either 0.25u or 0.5u. Your dose increases of 1.0u may result in missing a good dose for him, and the counter-intuitive thing with diabetic cats is that too much insulin can cause high numbers. I'd encourage you to start the spreadsheet so that we can see what's going on with Pumpkin, and we can teach you how to "read" your test results. Not all high numbers mean that a cat needs more insulin and it can be a little tricky to learn to manage the dose.

Glad you and Pumpkin are here - I'm going to have to work hard to write his full name instead of my punkin's name. The "ga" you see after some of our names means that our kitties have passed away - "gone ahead" or are "guardian angels." I'm glad to meet you and will look forward to meeting your Pumpkin.

Here is a link that can help you find your way to information that we often use in this group: "Where Can I Find?" Keep asking questions and we'll help you learn how to help Pumpkin.

 

[jayla-n-Drevon]

Thank you @Sienne and Gabby (GA) - I'd looked at the Toujeo page and they had a graph actually showing activity up to 36 hours in humans...apparently their graph was a little misleading as it still showed some activity at the 36 hour mark! So thank you for the correction - I hadn't looked at the same page on their site that you found!

I was wondering about this.....and now ....I'm NOT!
Dre would go hypo for sure

 

[Squeaky and KT (GA)]

There is a group in Germany that's working with Toujeo for higher dose kitties but I don't know it's latest progress. I wouldn't dare use it - that concentration difference is just too much for kitty's little bodies. Fine with adult humans that take many units but it's not even suggested for children altho' I'm sure it's used for some of them too.