honeymoon over :( Overwhelmed- Lantus or Caninsulin?

Hello everyone,
Im back after almost 15 months OTJ...sad and overwhelmed and a bit freaking out at thinking the next few months of my life are going to disappear into the staying awake all night doing blood curves and worrying all the time....
And we planned a 3 week holiday in the US in one month, so Im worried--can I get her regulated by then? No one can look after her here...

My vets and I were amazed we achieved regulation or normalisation in only 2 months before, and even on Caninsulin! But I know it was thanks to you guys and the advice here! so I've converted my vets and spread the FDMB word.

first, the background: although now Sara's BG is back to hovering between 250-290, and is on low carb wet food exclusively. some PU/PD, very hungry.
She has CRF also, on fortekor, and I think we'll have to put her back on a mixture with Royal Canin Renal LP, fairly low carb for a CRF diet, and give insulin accordingly.

the Question: we had thought about putting her on Lantus, but then she went into remission. Now I'm wondering what to do: Lantus, Caninsulin, PZI? I've read the sheets in each forum.
She had sharp drops with Caninsulin before, but I work from home and test BG at home so managed, no hypos. Different insulins work in such different ways, I'm not sure if I have the mental energy/ ability/ space to learn a new system, very complicated with overlap etc...
but then there was that study about getting better remission with Lantus...

but this is her second time around, she's getting oler, the CRF is advancing a bit.... she's still plenty of energy and happy...

just a bit overwhelmed wondering what to do, wondering if anyone has advice...

thanks,
love

 

Re: honeymoon over --which insulin to start?

i think there's an advisory out that caninsulin should be avoided. there were some problematic batches, i believe.

honestly, nobody really knows which insulin will be best but til you try you won't know. my experience was with PZI and lantus, and i've advised some on prozinc. as far as i'm concerned, lantus, levemir, and prozinc are all good insulins for kitties. you'll probably get the most hands-on help with lantus or lev because the ISG is very active, and there's a written protocol for it (tilly). but i wouldn't worry too much about the choice. the point is to get in there and start the insulin again. plenty of cats have gone back into remission so maybe yours will too.

i get my lantus from canadadrugsonline.com for $129 for 5 cartridges (including shipping) and have been very happy with the supplier. cleo gets about 1.5u BID and they last about 2.5 months per cartridge.

 

Re: honeymoon over --which insulin to start?

I suggest either using Lantus, Levemir or PZI. They are longer acting insulins than the caninsulin and usually cats don't experience the sharp BG drop as the caninsulin. Many cats use these other insulins with great results. If you get the Lantus or Levemir, buy it in either the cartridge or pen form. The price is a little more than the vial, but you will get five times as much use from it since you will end up using almost every drop. With the vial of Lantus or Levemir, you usually end up throwing a lot away since it generally loses its effectiveness within a month or two.

As for your trip, do you have someone you can show how to hometest adn give insulin to take care of your cat when you are gone? If not, I recommend boarding her with your vet if that is possible. One suggesting if boarding with the vet is that you write out clear and precise instructions how to care for your cat while you are gone including testing before every shot with your meter. That is what I do with mine when I have to board them and even though my vet does not always support my decision to test before every shot, they will follow my instructions when I board them.

 

Re: honeymoon over should try lantus?

thanks for the support!
I know no one can choose her insulin...but I was hoping someone could say whether to "go with what you know" if it's for a short period to get numbers down a bit, or try something new.

If I knew she was going back on insulin for life, I'd do lantus. the caninsulin was just the idea of it being short term to get her numbers down a bit..
I was only thinking Caninsulin because I know how it works on her, and just need to get her numbers down a little bit...plus Im heading into a month with tons of work to do at the office and Lantus seems like a challenge!

and frankly, the idea of Lantus/ Levemir where you dont know when the nadir is--and it can change from one day to the next--that scares me. then I'd have to be testing all the time to see when the nadir is!!! so she doesnt hypo on me.

and the idea of managing the duration/ overlap with next PS.... if previous shot still working, and you shoot again, then double risk of hypo, no?

still a bit scared...

 

Goodie came off honeymoon after about 1 1/2 year same as your kitty. I was so sad, nervous and stressed out - it was not a good time for me. I kind of felt like it was all new again!
We had used Lantus before and achieved OTJ status after about 3 months and switch to canned food. I was definitely hoping she could pull it off again, which she did after 2 months. But let me tell you, the road seemed looooong and very frustrating. After 1 month I was not seeing any change happening and was beginning to feel frustrated that we were in this road again.
And then all of the sudden it just happened.

I truly believe that if your kitty went OTJ before he can hopefully go there again. But of course we have to face the possibility of that not happening; therefore I would suggest going into Lantus rather than the Caninsulin. However, I would wait until you are back from your holiday before embarking into the new Lantus territory, which as you already know can be very frustrating to figure out. Can you perhaps "go with what you know" as you said for a little while and then stop while you go away. Re-start the process with Lantus upon your return? Just a thought.
The numbers for your kitty doesn't seem to be incredibly high so probably a one month interruption will not be to detrimental. Goodie's numbers were originally in the 400's but this time around she was in the mid 200's as in your case. I was terrified to start her back on insulin while I was out of the house for about 14 hrs a day, so I waited about a month until my schedule got more normal and I could be back home within 12 hrs to re-test. I also started her in a very, very low dose (much lower that what I had given her before) just because I was just terrified that something would happen when I was away. I guess in the end it worked out ok, just took a little while for her numbers to go down.

 

Hi,
just a quickie from me as time short. Saw your post in caninsulin isg.

The nadir on Lantus doesn't really change day to day. It can move but it's not a sudden thing that I've ever seen.
Personally having used caninsulin then levemir (almost identical action to lantus and use the same protocol as lantus) I definitely vote for lantus or levemir.
Mind you, Luckys numbers were al over the place on caninsulin, got her beautifully regulated on lev in a short space of time (have a look at ss)

If you've got a few weeks till your trip you could still consider lantus-depends what you are going to do in terms of who will be looking after kitty.

You don;'t have the sudden drops on lantus that you do with caninsulin and tend to have lower preshots once you start seeing regfulation.
If your around 290ish then I'd be starting at no more than 1u BID.

Overlap if your monitoring you should have less chance of hypo on lantus than caninsulin.
It's when your working to get OTJ and shooting green numbers (under 100 preshot) that you need to be monitoring more closely.

Ultimately you have to go with what your more comfortable.
What I can't understand is how can the european caninsulin be ok if they are saying not to take vetsulin which supposedely is identicakl but the name for it in the states. Why wouldn't they just ship caninsulin to the states? That keeps dogging me. Also of the poeople coming here using it recently haven't seen any success (could be wrong, but don't think so)

As someone else has said the isg for lantus is very active. There is only me and a couple of others who check the caninsulin isg and I'm not really around at the moment.
Whatever you decide you can get help and support here.
Good luck :mrgreen:

 

Hi! and thanks everyone!

well, checked with the vets here about Caninsulin--they've never even heard of a problem and haven't seen any with their patients, soo...who knows?

Im following vet instructions, Caninsulin 0.6 BID (since she's kinda low in the 250s and reacts well to lower doses in the past). tried tonight--very nerve racking! completely forgotten in 18 months how to shoot. took us almost half an hour but she was a trooper and I think we got some in.

PMPS 269
+2 156

she felt great having lower BGs! Humans rewarded with pizza and beer.

Vet said to try one week, do a complete curve and see.
As Sara kitty is old and has some complications of CRF and occasional pancreatitis, didn't want to take a week or so to get her numbers down on Lantus/ levemir. Also as we are hoping this is just a bump of de-regulation after a teeth cleaning, and so we'll see after a week. then will go on lantus if needed.

During vacation: is a nightmare where I live in france. they are just starting to have pet sitters, and ones who can give shots are rare. I've found one, but kitty has to go to their house, with 3 dogs and 2 cats, be closed in a bedroom. for a weekend it'd be ok, but for 2 weeks! a bit much.
we have my 70 yr old mother in law coming to stay at the house, and she is not really an animal person although very kind. we can't aske her anything more than giving food....
so it's tough!

thanks for the support!

 

Here is the Feb 2010 USA Alert:
http://www.vetsulin.com/PDF/february-22-2010.pdf

 

A friend of mine has had her cat on Lantus for about 6 years successfully. Her cat neither has reversed and has stayed stable (of course needing insulin twice a day) but is eating a prescription diet (as we all know are not the lowest in carbs out there). I started my Apollo on Lantus, but don't have a good reading so far--it hasn't been too long.

Lisa and Apollo

 

Cynthia,

I just wanted to say I feel your pain. My cat Milo was OTJ for almost a year. We went on a 10 day vacation and came home to elevated numbers. I didn't start giving insulin until his number were over 200. I felt the same way you did. Had to reeducate myself on shooting, testing and such. Milo was on Lantus the first time we were able to get him regulated and I start him back on lantus at .5 units this time around. Yes, you can get dips in the numbers. If you look at my spreadsheet, you will see he had some very low numbers last night. But overall I would say I would concur with the others on this board and vote for lantus as a long term option. Hopefully Milo and Sara can find their way back to being OTJ!!!!

 

Good luck Cynthia and Kelly on getting your kitties back to OTJ!

I don't think that Caninsulin had the warnings that the US version of it (Vetsulin) did even though they are the same maker, just sold under a different name in other countries. I think you just want to be aware of the potential for instability and watch for it. If it seems like it is swinging BGs more than it should or not doing anything at all, then it might be time to look for something else.