New to (Lantus) group

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Breanna H, May 22, 2020.

  1. Breanna H

    Breanna H Member

    Joined:
    Dec 23, 2019
    Hello all!

    Tigger and I will be joining the Lantus group after spending lots of time in the Prozinc group since December 2019. @Deb & Wink has been my hero.

    As you can all see, Tigger is on a high dose of Prozinc (7u, currently) and after interviewing a slew of vets, I finally found one willing to switch me to Lantus and consider Acro/Cushings testing, if the switch to lantus doesn't help our situation. He is a large cat, 19 pounds at diagnosis and now holding around 16lbs. To keep him here, he is eating about 3-4 cans of Fancy Feast a day and a can of Friskies. He would eat more if I let him but since he is maintaining, we seem to be good. Still is producing large amounts of urine. But overall seems happy and still plays here and there.

    My prescription (hopefully) will be arriving in the mail today from my new vet. I plan on sending it to Mark's Pharmacy. I got a lot of good information from the Facebook group/forum on how to do this. We did a telemed appointment to start since the office is about an hour away from us. The new vet seems willing to research and learn about new protocols and insulins. He said he would look into Levemir, since he does not know much about this insulin in cats, as an option if Lantus doesn't work for us. Other vets simply dismissed this when I asked them about using it.

    The new vet said his initial thought was to start Tigger on 2u/2x a day to see how he starts off on the Lantus. He wants me to do a complete curve this weekend on the Prozinc, just to get a better idea. Does this seem like the right dose when switching to a new insulin?

    I have read all the stickies in this group, several times and I think I know about the new posting guidelines (posting a new thread every day, with the date, name and AMPS/PMPS number and linking the old thread).

    Any advice anyone has would be great, especially those on high doses or those who have switched from Prozinc. I am nervous about learning about a new insulin and how Tigger will do. I felt pretty comfortable with Prozinc and knowing, usually, how he would react. I do work full time Monday through Friday but my husband works from home so is able to get one midday check for me, after +4.

    Sorry for the long post and thank you in advance for all the knowledge and advice you all will provide me!
    I don't know what I would do without this forum! (Be even more stressed and have a very unhealthy, unhappy cat, I am sure.) :bighug::cat:
     
  2. Susan & Claudio

    Susan & Claudio Member

    Joined:
    Sep 20, 2019
    Welcome. :bighug::bighug::bighug:
    Here's hoping Lantus will be the one that works for Tigger.
     
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  3. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Welcome. No need to apologize about long posts. The more info the better. Since so many post daily we have the one post a day rule but that’s just so nothing gets missed. You can change your subject if you have a question or add the question mark to get attention to your condo. I’ve never used Prozinc but it seems to me that you might be starting on too low a dose of Lantus so I will tag for help on that.
    @Wendy&Neko @Sienne and Gabby (GA) @Marje&Gracie
     
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  4. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
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  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello and welcome from someone who also had a super sweet cat. On your list of tests to get should be IGF-1 (for acromegaly) and IAA or insulin auto antibodies bodies. Both tests get done at the same place, Michigan State University. Hold off on the Cushings test until the other tests come back first, they are more likely. One in four diabetic cats has acromegaly. My girl had both.

    As for dose, typically we consider the dose of the existing insulin when switching. That means going to 7 units of Lantus . You could back it off a little bit, but not much. Some cats have a strong reaction to the switch. And yes, Levemir would have been a better choice. For dosing methods, I would strongly encourage Tight Regulation with a higher dose cat. It allows you to increase faster if needed, and it sounds like you are feeding all low carb wet food.

    Don’t worry about the vial vs pen thing. I preferred cartridges, which are pen refills available in Canada, but at larger doses you will still go through a vial. I think Marks will give you what you want and not be fussed about what the prescription says,
     
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  6. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Gave Breanna the info about using Levemir instead of Lantus, since her cat Tigger is a high dose kitty. Linked her to all the Acro info I could find from the Acro ISG forum, before her visit with this new vet.

    But even this new vet she had the telemed appointment with, was not willing to prescribe Levemir.
    Sure hope that Tigger does better on the lantus insulin Breanna. We're rooting for you and Tigger.

    No, it does not. No, the lantus dose should NOT be reduced to 2U. It took time for Tigger to get to the 7U of Prozinc. Dose of Lantus should be the same amount.

    Full curve this weekend won't hurt, even if it is still on the Prozinc insulin.
     
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  7. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Breanna and Tigger and welcome. I’m sure you will like Lantus. I’ve used both Lantus and Levemir and liked Levemir better and you can always swap over to Lev later. My vet hadn’t heard about Levemir when I mentioned it either (this was a few years ago now) but he researched it and was happy to prescribe it.
     
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  8. Breanna H

    Breanna H Member

    Joined:
    Dec 23, 2019
    I definitely will suggest the IAA as well. Im pretty sure Tigger at least has acro ☹ he fits a lot of the symptoms.

    That's really what I wanted but I'm trying to work with who will at least work with me o_O I decided in my desperation a switch to lantus was better than staying on the prozinc, getting no where. Although, now I'm really having doubts about this vet. The fact that he wouldn't go straight to levemir and only wants to start at 2u makes me think he really isn't as knowledgeable as I was hoping.

    I really did push for the levemir. After reading everything, it clearly makes sense. I am having doubts now about even bothering continuing with this vet or switching to lantus since he is only suggesting to start at 2u.

    I could always go to 7u myself but I hate having to be dishonest with another vet about the dose I am actually giving.

    Does Marks give you as many refills as you need? Or would I have to get a new script for refills if I do the dosing myself?
     
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  9. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Marks Marine Pharmacy only requires the initial prescription from their customers in the US.
    So you would not need a new script for refills if you do the dosing yourself.
    By that I think you mean that you would be starting Tigger off at a higher dose than the 2U 2 times a day this new vet suggested?

    You would need a new prescription if the lantus does not work, and the levemir is needed.
    Plus you need a vet that is willing to draw blood for the IAA and IGF1 tests.
     
  10. Breanna H

    Breanna H Member

    Joined:
    Dec 23, 2019
    Yes, sorry that is what I meant. I don't want him to have a DKA episode by dropping the dose too low.

    I suppose that is true. At least he is willing to test for these.
     
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  11. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Just saw another new member over in Feline Health with a kitty (Lily) that was on 7 units of Prozinc and switched to 1 unit of Lantus. Take a look at the spreadsheet, the reduction was not the way to go.
     
    Last edited: May 23, 2020
    Reason for edit: fixed link
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  12. Breanna H

    Breanna H Member

    Joined:
    Dec 23, 2019
    I completely agree. That much of a drop does not seem right. I'll try to convince him to start at a higher dose when I send him the curve he wants. If not, I trust you all with dosing. All of your years of experience clearly wins.
     
  13. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    @Wendy&Neko thst spreadsheet link doesn’t seem to be working.
     
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  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Oops, fixed it.
     
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