Toujeo anyone experienced?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Ken and Sneakers, Jan 4, 2020.

  1. Ken and Sneakers

    Ken and Sneakers Member

    Joined:
    Jan 27, 2010
    Hello everyone. I use to be on the board a long long time ago and now look for and help people that find me from different areas of the internet. In any event

    Someone wrote me and their vet prescribed Toujeo Lantus which I have had no experience with.
    When I searched it I have learned it is concentrated Lantus 300cc meaning for every 1 unit you give you are really giving 3 true units. This seems like it may be almost impossible to work with as many cats need small doses even half and quarter units and smaller doses which would be impossible to measure using this insulin.
    The vet prescribed 2 unit 1x daily which is really 6 true units which is a massive starting dose. Told her to lower the dose to half unit (1 1/2 true units) 2x daily. I guess I want to know if anyone is using this insulin and what do they do about dosing and how it is working? We can micro-dose but would rather that be when we are close to remission rather then at the beginning. Thank You for your time
     
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I have never heard of this insulin being used on this forum and I have been here for several years.. I just looked it up online. It does appear to be stronger.
    In the literature it says it should not be used for children. So I would think the same would apply to cats as they are smaller than children.

    I would advise your contact to not use this insulin at all, and to use another vet who knows more about feline diabetes. Lantus should be given twice a day to cats and a dose equivalent to 6 units is far too much. The starting dose should be around 1 unit twice a day.

    I am going to tag the moderators to see if they have heard of it.
    @Marje and Gracie
    @Wendy&Neko
    @Sienne and Gabby (GA)
     
    Last edited: Jan 4, 2020
  3. Sam & Esse

    Sam & Esse Member

    Joined:
    Oct 18, 2017
    Hello :)

    I used Tresiba for my Sammi cat, but there was a bit of discussion on Toujeo on the Tresiba (degludec) ISG.
    It was in this post, starting on May 26, 2019.
    We discussed possible ways of micro-dosing, although none of them seemed feasible enough that I'd try on my own cat :nailbiting:
    On a slightly --very slightly-- positive note, from my understanding, if you use the pen needles with the TOUJEO SoloStar which contains 450 units (not the TOUJEO Max SoloStar which contains 900 units) you can give a 'true' 1 unit dose. Any half unit or quarter unit doses, however, would require dilution. Jill describes how it might be done in the June 5, 2019 post on the same thread.

    :bookworm: So, depending on which pen is being used, the smallest dose possible with pen needles is either 1 unit or 2 units, and if a u100 syringe is being used to draw out the insulin (and the syringe has half unit marks) the smallest (hopefully) accurate dose would be, like you wrote, 1.5u.

    I truly thought the first cat I'd learn of to use Toujeo would have a high-dose condition :facepalm: That, at least, would make dosing somewhat simpler. Wishing the very best of luck to the Toujeo user and their sugar kitty! But also hoping they might consider switching to an insulin that's a bit easier to measure, and has more experienced users to offer advice :bighug:
     
  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I would ask the vet to rewrite the prescription. At this point, there is no current research that I'm aware of indicating that Toujeo should be used with cats. If I had to hazard a guess, the vet thought s/he was prescribing a generic form of glargine (Lantus). The generic is Basaglar, not Toujeo. I agree with you --there is a HUGE probability of overdosing with a U300 insulin.

    There are Lantus discount cards still floating around. I hate the fact that the vet screwed this up and someone would have to spend a lot of $$ for a different concentration of the same insulin.
     
    Diane Tyler's Mom likes this.
  5. Ken and Sneakers

    Ken and Sneakers Member

    Joined:
    Jan 27, 2010
    Thank You for the replies and especially for the link to the old post. I am going to have her use this giving a dose equivalent to 1 1/2 units bid until she gets a regular vial of lantus. FWIW don't need lantus discount cards. The best place I have found to get Lantus is at craigslist where vials and even a box of pens can cost $100 or less
    depending on what part of the country you buy it from.
    I wish everybody the best
    Ken
     
  6. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    I would agree with Sienne that I would ask for a prescription for Lantus or Levemir. Toujeo might be a good option for very high dose cats but not in this instance. With Toujeo, you would need to use the pen needles. That means you couldn’t microdose.

    We have had a couple cats here that the caregiver has used Toujeo. One of the challenges is that the methods of regulation here (TR and SLGS) were written for U100, not U300, syringes. We would not be able to offer you much, if any, dosing advice.

    Other concerns are the potential for overdose if a U100 syringe is accidentally used and also the fact that Toujeo likely has a longer duration than Lantus so if you don’t know what you are doing with it and on top of the cycles, you could have a greater chance that any really low numbers could last a very long time.
     
  7. Ken and Sneakers

    Ken and Sneakers Member

    Joined:
    Jan 27, 2010
    Yes a u-100 syringe was used and the person was giving 2 units sid. The equivalent of 6 units, We have gotten her syringes and lowered the dose to 1/2 bid which is 1 1/2
    true units until she gets some regular Lantus,
    FYI
    I understand dosing and tight regulation which I practice. I don't do things necessarily the way the board says it has to be done. Don't need close to all those spot checks that people here do, (I certainly understand them) and also sometimes use some scale dosing as I value giving the shot on time and using the overlap. This is what works for me and the cats that I work with
     
  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I have seen a couple examples of Toujeo used by accident, and one on purpose. The on purpose one was for a cat on acromegaly with relatively high doses where changing dose by 1 unit in a U-300 insulin made sense. That was over 3 years ago. Of the mistake examples, one was (thankfully as it turns out) an acrocat. Caregiver was fostering and gotten insulin for "free" from shelter where cat came from. Turns out it was Toujeo, not Lantus. Cat suddenly went from high ugly numbers to lots of green when the new pen was used. Caregiver changed back to Lantus, cat wasn't on that high a dose.
     
    Ken and Sneakers likes this.
  9. Ken and Sneakers

    Ken and Sneakers Member

    Joined:
    Jan 27, 2010
    Yes. this was by accident (I hope) as the vet supplied it to the caregiver.
     

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