Caninsulin VS Lantus

My 6 year old has recently been diagnosed within the past 2 months. I’ve only recently started randomly home testing and his numbers are messed up. He’s currently on 4u of Caninsulin 2x a day but only have a few days left of insulin before making the switch to Lantus. My “NO GOOD” vet said start with 1u 2x a day. I’m afraid this is too low and will potentially be harmful to my cat.
He originally was 756 when diagnosed, 277 2 hours after injection and feeding. 3 days ago he was 477 2 hours prior to his evening injection and tonight was 477 1 hour before his evening injection. 1 hour later, for curiosity purposes, he measured 417.
Please help, as he’s still young, and my vet is USELESS!!!

 

Hi and welcome Mayellah. I am so glad you researched and found FDMB. Yes, we can help!

First, the 4 units of insulin is a very high dose and actually we do recommend starting dose of any insulin of one unit. Then with consistent testing (always before an injection and then at least once during the 12 hour cycle between shots) you can see how the insulin is working and if it is not effective over a period of time, then it can be adjusted by 0.25 Unit, so you don't pass by the best dose.

Have you increased the dose yourself or has the vet made this recommendation?

Too much insulin can look like not enough because the cat's blood sugar will "bounce".
Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high: (possibly contributing to your kitty's high BG at the high dose he's on)
BG goes low OR lower than usual OR drops too quickly.
Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing at all or home testing consistently.

Lantus is a good insulin for cats, it's longer lasting and more gentle. However it works differently than Caninsulin and you can read about how it works in the yellow tagged sticky notes at the top of the Lantus forum HERE. Read about Lantus being a "depot" insulin, because you will not see an immediate response using this insulin. It takes time to build the depot and patience is required.

And please, do not inject 4 Units of Lantus 2X a day. That's a huge dose and might do harm to your cat by causing the BG to drop too low. We don't want the "bounce fuel" to be depleted and the cat have a hypoglycemic event.
I am tagging some very experienced members to look in on this thread and provide more input.
@Bron and Sheba (GA)
@MrWorfMen's Mom

Here's the basic testing routine we recommend: (do what you can on work days - before bed is useful along with the essential pre shots)
test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
test at least once near mid cycle or at bedtime daily to see how low the BG goes
do extra tests on days off to fill in the response picture
if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose

Please create a signature and set up the spreadsheet so that we can see your cat's information right away each time you post:
Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the country/time zone matters) Be sure to SAVE when you are finished.
Spreadsheet: You will see how the trends and patterns emerge, and members can review his/her progress before offering suggestions or advice:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

There is a treasure trove of information here on the board, and a very supportive community. There are members at every stage of this diabetic treatment experience and we will help all we can.

Going forward, please start a new thread in the Main Health forum HERE so that more members can read and respond. This is a peer reviewed message board and I would not want to be the only one providing information, or worse yet, providing incomplete information. This Introduction forum is only the welcome mat and you deserve the full benefit of the experience and knowledge available here.

 

He was initially told to have 3u after diagnosis. After another fructosimine test he was upped to 3.5 and I was told to adjust according to behaviour. He was still sluggish, lazy and just not himself after the 2 weeks on 3.5.

 

Thanks for your lengthy informative response. I’ll read it again in the am. It’s a lot of info tontake in, especially at this hour.

 

Hang in there Mayellah!! I'm glad you made it over here from the Facebook group!

Yes, there's an overwhelming amount of information here but there's also an overwhelming amount of people who really care so take it one step at a time and you'll get there too!!

 

Hi Mayellah and welcome to the forum.
@Idjit's mom has given you good advice..
It can all seem overwhelming in the beginning but it does get much better.

I agree that 4 units is a lot of insulin in a newly diagnosed cat.
When you start on the Lantus, which is a great cat insulin, I would start on 1 unit twice a day. It sounds as if you are testing the blood glucose levels which is great.
Test before every shot to see it is safe to give the insulin and again during the cycle to see how low the insulin takes your kitty. Testing between +4 hours after the insulin and +7 hours after the insulin and testing at different times each cycle will give you lots of data for the spreadsheet.

One other thing I would do is buy a bottle of Ketostix from Walmart or a pharmacy and test the urine for ketones which can form in unregulated diabetic cats. It is a simple test. Just collect a urine sample, dip the test strip in the urine and compare it against the colours on the side of the bottle. Anything above a trace needs vet attention.

There are lots of experienced people here who will help you. Ask lots of questions.

 

You've got great advice so far. I agree the 4u dose of Caninsulin is too high. Seems you started at far too high a dose than is recommended. I too think starting at 1u with Lantus would be the way to go unless your cat has a history of ketones or DKA.