7/18/2018, Nana, 331

Hi all,

We just switched Nana to Lantus on Monday. She was on ProZinc before. She is a high dose cat. She has no other conditions, Vet thinks she's just a high dose kitty.

So she was on 7 units BID of Prozinc. We started Lantus on 3 units BID. So far, her she has not dropped below 250 on 3 units.

I have lot's of data for ProZinc. But if she was on 7 units of ProZinc before, what that mean she would need roughly the same amount of Lantus?

So far, I am not liking these numbers. I hate having her in the 300's for most of the day.

Should I increase the dose to match Prozinc?

Thanks!

 

Just a suggestion but you might want to indicate if you're following TR method or SLGS. You can read about that in the Yellow Sticky notes at the top of the page.
If you put a ? mark first , in the title someone will notice it & you should get an answer about increasing the dose.
We usually wait 3 days before increasing But some one that knows better than me will help you with that.
Welcome to the Lantus Forum

 

Hello and welcome here. My girl had two high dose conditions. Has Nana ever been formally tested for acromegaly or IAA (insulin auto antibodies)? One in four diabetic cats has acromegaly.

It looks like she is still eating some dry food? That can also make a big difference in dose needed. Have you ever tried feeding just low carb wet food or raw?

When you switch insulin's, we consider the dose of the previous insulin. Since Nana was in 7 units of Prozinc,which initially got her green, but she seems to now be just seeing blue, we would have suggested starting much closer to 7 units of Lantus. Maybe you could jump up to 5-6 units, but only if you can monitor closely. Some cats respond well to the change.

Actually, we might have suggested using Levemir instead, as higher doses of Lantus can sting due to it's acid base, though not all cats. We've had some higher dose cats on Lantus too. Neko got up almost on9 units of Lantus, but she definitely was happier with Levemir when she was on higher doses.

 

Thanks for the reply! The dry food is starch free and is 5% carbs. I did try taking it away and just feed her LC wet food. That didn't change anything.

The Vet doesn't think Nana has acromegaly because she has no signs of it. The other thing is that when started Vetsulin back in March, she responded really good to 2 units. Then one day, it just stopped being effective. The vet does suspect IAA, I'm not sure how that can be treated.

I just checked for ketones and other stuff on the dipstick and everything is negative. The glucose measured +100. I will boost the dose up to 6 units tomorrow and monitor her closely.

She has no clinical signs, she's eating and drinking normally. I switched to Lantus on a hope I can get her into remission. I follow the TR method once I see some blue and green's.

 

A relatively recent study showed that only about a third of cats showed signs of acromegaly when they were diagnosed it. Other than a higher dose and being really food focussed, my Neko had no symptoms. Having a good dose at a lower dose, then needing to increase as the dose is no longer good, can be a sign of the acro tumour growing. Her spreadsheet doesn't look like the classic IAA spreadsheet, especially for a cat relatively recently diagnosed. But you can only know for sure by getting the blood tests done. IAA is supposed to be self limiting over time, about a year. But having a IAA diagnosis may change your dosing strategy.

 

What does a spreadsheet with classic IAA look like? I would be very curious to see just in case I see those patterns for Nana.

I am taking her to the vet in two weeks. I will ask to test her for acromegaly.

Thanks again for the help!

 

My buddy Lou was recently diagnosed with IAA, but he hasn't really shown any obvious signs of a high dose condition (his dose has never gone above 4u). Wendy can provide you links to obvious spreadsheets you can review. She's amazing like that (and I don't say that lightly ). The tests for Acromegaly and IAA go to the same place (MSU), so if you're going to send them a sample, you might as well test for both. I would ask your vet to check for acro and IAA (insulin autoantibodies - my vet wasn't familiar with the acronym IAA so I had to send her the link to the test on the MSU website).

My buddy Lou reacted beautifully to Vetsulin at first. He almost went into remission within a month of diagnosis, but failed on the last day of the trial. In the last year, it's like something was keeping him at high numbers, and I had to dose him higher and higher to see results. Unfortunately with an unexpected surgery last year and healing this year, I didn't get him switched over to a depot insulin as soon as I would have liked. He's seeing some beautiful numbers on Basaglar (glargine) though, which is so fantastic and comforting. I wish you luck with Nana!

 

I just thought about this: Wendy posted some information on my July 2nd post after I found out Lou had IAA only. She provided links to other IAA only spreadsheets and a post with basic information about IAA if you'd like to review it. The link to my July 2nd post is HERE for your reference.

 

Thanks for the info. What is R listed on some of the spreadsheets? Is that rapid insulin like Vetsulin?

If so, should I explore dosing Prozinc with Lantus?

 

Just took her BG at +5 hours and it was 93!! I gave her 4 units! I would have to dose 7 units of Prozinc just to get low 100's.

I am so happy!! Hope it stays!

 

R is short for Humulin or Novalin R insulin. It's a shorter acting insulin, more like 4 hours in the average cat. So even more rapid than Vetsulin or Prozinc. I would not combine either of those with Lantus, and would only use R under the eye of someone experienced in it's use. And I don't think it's something you need at this point.
I'm glad Amanda stepped in with some reading for you. Having a kitty with just IAA is less common.

Me too on hoping it stays. An IAA kitty will often see initial signs of progress, then it fades away. If you look at Neko's 2012 SS, ignoring the first month with a bad meter, you'll see that she showed good numbers on a dose, then it went away. I called it "the dose going stale". It's like the antibodies kept ramping up. Then in August, her antibodies started breaking when she had radiation therapy to treat her acromegaly tumour.

I would test again in an hour. Paws crossed the insulin switch is making the difference.