Switching to Lantus

Good Morning,
So, my kitty has been on Prozinc for 9 months. I have not been able to regulate him. His +6 test is usually between 250 & just under 300. At the beginning he was off the charts at over 500. I asked my vet if I could try to switch him to Lantus because I have read good things about it and I have a supply left over from a family member who passed away. She said we could try and recommended that I start him on 2 units a day twice a day. She told me the correct syringes to use and gave me a little supply of them to get started. Why am I terrified to switch him? I guess I'm afraid because I can't test him all the time the way some people are able to and I'm scared that he might get hypo or have a weird reaction from this new insulin and if I can't test him constantly I might not know until it is too late. I also have an 11 year old that I am constantly shuttling around and so I am not home all the time to test him. It is also getting increasingly hard to test him. The first several months he just let me do it. Now he puts his ears back and lies on his back and begins to swat at me. Sometimes he even tries to bite me. He is such a sweet kitty and very docile. I am so stressed out about this! The vet ran bloodwork the other day. She told me it wasn't bad. Her only worry was his creatinine. If was 2.4. She said she wanted to get it down to under 2. She also suggested to get him on eating WD. When I told someone on another group that, they said she was an awful vet and that food is crap. She is such a caring vet who really seems to care and love kitties. This is the second vet I brought him to as the first vet just scratched his head when we played with his insulin amounts and could not really regulate him. New vet was so upset when she first saw him as his teeth were in pretty bad shape. She suggested me pulling 4 of his teeth and told me he was really in a lot of pain. It was breaking her heart. She did also say he was in early stage kidney failure. She claimed the feeding is a balancing act as diabetics need high protein but the kidney failure is the opposite. Is this correct? Other group members say this is BS and she only wants to sell her food. I'm sorry, I could be wrong but the impression I get from this vet is that she just wants to help my boy. This is making me stressed out!!!! Please offer me some advice. I'm not sure what to do. I test him on a human meter and he eats all wet, Fancy Feast pate. Should I start the Lantus today. I know with Prozinc if I am not home at exactly his shot time it is ok to go under an hour later. Should I switch him to strictly WD. He also eats about 6 cans of Fancy Feast a day. He's always hungry. Vet says his thyroid is fine. Thoughts anyone??? Thank you in advance!
Sincerely,
One Stressed Out Kitty Mama

 

Hiya Cindy! Welcome to lantus land! Please read the stickies at the top of the forum. There are lots of wonderful people here to help guide you and Butter. I'll tag some now and bump this so you can get some guidance on when to start and your other questions.
@Wendy&Neko @Chris & China @Stacy & Asia @Bobbie And Bubba

 

Thank you so much! I'm so confused and stressed!

 

One- no, it is not true about not giving high protein food if the kidney values are high. It sounds like your cat (name??) is in stage 2, which my civvie has been in for years and he's doing just fine. It is only in Stage 4 or 5 that you need to watch how much protein you give the cat.
Two- Don't give WD. You can give any wet food, even Friskies or Fancy Feast like many people do on here.
Three- I know you need to give less Lantus compared to ProZinc, but I don't know how much less. I'll let someone else answer that for you.
Four- When you do switch, do it on a day you can stay home and monitor.
Five- You should think about doing a dental. That could cause the BGs to be high.
Six- Are you giving treats every time you get a test? It helps the test not be so traumatic for the cat.

Good luck!! (I thought this posted a couple hours ago. )

 

Welcome! Butter (I assume that's his name) is absolutely adorable!

Lots to consider in your post. I'll leave the food questions to those with experience with the FD-kidney disease combo. It's tough, but I think it can be done, you may just have to prioritize one over the other (likely the kidney disease-- insulin can always be dosed around other issues) to get the right balance and have your kitty feeling better. I wouldn't leap to the conclusion that the vet is just trying to sell you food. First, while "prescription" diabetic diets are indeed often terrible, that's not necessarily the case across the board for all prescription diets, and second, many vets make these recommendations out of a lack of knowledge (other than what is "taught" by pet food representatives!), not direct avarice. If your vet is otherwise excellent, don't let this turn you away from her.

That sounds awful on the teeth. Cats hide pain really well, so I can believe that things got out of hand there without any indications from him. Just fixing that may go a long way in bringing down some of the high BG numbers you have been seeing since diagnosis. If problems are that extensive, it's especially important to use X-rays to guide the dental treatment, as lots of (painful) problems can lurk under the gumline. Poor little guy.

I hope Lantus is a better fit for your kitty. I would wait to start on the new insulin on a day when you can (if necessary) monitor all day, have plenty of strips and supplies, etc. It does happen once in a while that you get a stronger-than-usual response to a new insulin on the first day, best to be ready just in case. You don't have to be testing all day, every day with Lantus, but we do suggest that you always get pre-shot tests and at least one test during every cycle, so maybe that is less intimidating?

Hang in there!

 

Do you have any blood glucose tests from 2018? All I see is to September 2017 on the spreadsheet. What is the current Prozinc dose and how is kitty (what is his name) doing on that dose? We take the existing Prozinc dose into consideration when switching to Lantus or Levemir. Two units Lantus may be too low. The reason I meantion Levemir (similar action but later onset/nadir), is that it's often a better insulin for cat with higher doses. Lantus has an acid base and can sting some cats. Might be why he's "cranky".

Your vet is what I would call uniformed, not necessarily just trying to sell you the food. WD is a horrid choice, for kidney disease or diabetes. Are you feeding any dry food at all? I would toss it out. Cats aren't great at getting enough water and need more water, not less which is what they get in dry food. Don't blame the vet, I've heard that in Canada they get 4 hours of nutrition training on cats and dogs in school, and the big pet food vendors do the teaching. Not much better from what I've heard in the US. Similarly, they don't get a lot of training on feline diabetes. For kidney disease, you want low phosphorus, but high quality protein. Fancy Feast is rather higher phosphorus, I would look for other wet food options with lower phosphorus as the first step.

 

Cindy, here is food list with carbs and protein and phosphorous amounts, http://catinfo.org/chart/index.php

Her kitty's name is Butter!

 

Hi Cindy. You have all ready been given a lot of good advice. I just want to say that I had Bubba on ProZinc first for 6 months before switching to Lantus and I was so glad I did. The big difference with the two insulin is that ProZinc doses on what the Pre Shot number is with some consideration to the nadir. And Lantus is the opposite, dosing on the nadir considering the pre shot. Here's what I love about Lantus: There is an actual protocol . With ProZinc, I was always grabbing at straws to try and figure out what dose today???? If you follow Tight Regulation you only have to be available to test before shots, get a mid-cycle test each cycle and one before you go to bed since most cats go lower at night. ( I admit, I test a lot...... )

If you could start getting some PM test that information would really be helpful to get a better picture of want is going on. He could be going lower in the PM and then bouncing. Look back to 9.18 on your spread sheet, he started the PM cycle at 274. The next morning he was in a red number, 409. Knowing some more trends in the PM will also help to know what dose he should start off with Lantus.

About the bad teeth, they could very well be what is causing higher numbers and until you get them removed he will stay high. A bad tooth took Bubba out of remission the first time.

And I agree about your vet just not being informed about Feline Diabetes. Like Wendy said about them getting 4 hours of nutrition and it is by the pet food companies ( that gets the vets in their back pocket ) they also receive very little training for feline diabetes, about one day or so. My first vet when Bubba first got DX said he would be happy if I could keep Bubba no higher than 200 and 2 units.

The TR protocol and the Start Low, Go Slow method were both written for the use of a human meter and I see that you use a Contour meter. Keep asking questions, we will help you all we can.

I do understand the stress of starting with a new insulin; I cried the whole day before I switched, but I will tell you again, I am so happy I did.

 

Hi Cindy! Just checking in to see if you and Butter are starting this weekend and if you're (hopefully) more excited than nervous now you know you've got support and resources here. Please update us.

 

I switched today to Lantus. I started him at 2 units. His preshot number was 407. I will try to test again every 2 hours to see where he is at. I did the dental in the fall. I think it did help him. He seemed happier but the numbers still didn't go down very much. I took your advice on the treats. He has been letting me test. Thank you so much!

 

Thank you so much. We started this morning and his preshot was 407. I gave him 2 units of Lantus and I plan on testing as much as I can today to see where this takes us. I will keep you posted!

 

I just started posting his numbers again. It has been very frustrating because his numbers are always the same. We were currently at 4.5 units of ProZinc twice a day. Today we started on Lantus. 2 units this morning and his preshot number was 407. I have been researching other food. I will keep you posted! Thank you!

 

Do start a new condo (thread) with today's date, name, and AMPS like the others you see. Link to this condo.

 

THANK YOU!!!

 

How do I do that??

 

Go to the top of the Lantus forum again and on the top right, look for "Post new Thread"



In the subject put the date, name, AMPS ###

In the body of the post, put the link to the prior one (copy the link from the address bar of this post and paste it into the new one) so people can quickly go back and read what's been going on.

Then just ask any questions you have, report on how he's doing...say whatever you want to say!

 

Hi Cindy, I just wanted to wish you good luck with the switch.

Let us know how we can help you.

 

Thank you so much! I have been testing as much as I can. Numbers do not seem to be dropping. I am going to get bloodwork from the vet's office tomorrow. Does Lantus take a while to kick in from the switch?

 

Yes, read the Sticky Note about the Lantus depot. It takes up to 6 cycles to build the depot so you can see what a dose is doing. That's why we hold the starting dose for several days. If 4.5 units was his dose on Prozinc, 2 units may have been too low a starting dose of Lantus.

 

Just to throw two more cents in... the amps and pmps are +12, often the highest and frequently the last numbers to come down. Without any in between spot tests, it'll be hard to say if this is an ok dose fur Butter.

 

If you can get a mid-cycle test for the AM cycle and the PM cycle that would be great. If it is impossible to get one in the middle of the night, at least get one before you go to bed so you will know how the cycle is heading and if you need to give a little food to steer the numbers up some to keep Butter safe.