Switching from Caninsulin to Lantus

Hi Guys

Im a little bit worried about the switch to lantus - in that Javas numbers are higher, and still relatively all over the show. We switched on Saturday morning.

Previous dose was 4U BID Caninsulin. We changed from Caninsulin to Lantus after 4 weeks as the Vet wasn't happy with his progress.
Vet started him on 2U BID Lantus, with instructions to move down only during the first 3 days if his we got a pre shot reading of less than 10, and a post shot reading of less than 5. I believe she is following the tight regulation protocol I have seen on here We home test, and reward with Greenies (i know its carby, but we figure 1 treat a day after test isn't the end of the world..............wrong?) He gets up to the testing spot randomly throughout the day

Our lovey vet (referred to as LV going forward) researched the best food available to him in NZ, and we decided on Ziwipeak (it smells vile!!!, and he won't eat it all at once like he does friskies pate, but does eat it) as while it has no advantage over Friskies Pate in carbs, the phos is more reliable than the min level declared with friskies. Java's senior panel showed elevated Urea - she did say that while he was not on insulin and went DKA 3 days later, it would be a good idea to try and get him on kidney friendly food now as we regulate him if he will eat it!

So, long story short, im worried that Lantus isn't doing much for him at the moment. He isn't drinking a lot of water which is normal (now he is on insulin) for him, and he is eating, putting on weight (300grms in 2 weeks) and is now 5.05kgs (from 4.88 2 weeks ago). He is happy, and still hungry, waking me up at night for food.

Is day 3 too early? And if he goes up (which I know will happen seeing his numbers at this point) will he come back down at some point?

Thanks = and sorry for all the possibly useless info

Charlene

Hello Charlene and Welcome to you and Java to Lantus Land. There are several starred Sticky Notes on top of the forum, which I encourage you to read. There's a lot to take in and I still reread them every once in a while.

First things first, yes, it's too early to be concerned. From our Protocol Sticky:

"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

Click to expand...

Lantus is a depot insulin so it takes several cycles to build up to see what the dose can do. Lantus also teaches you patience, not my strong suit. :lol: And we dose Lantus based on the nadir or low point in the cycle, not the preshot.

What is Java's weight? Is that his idea weight. Our protocol also decides the starting dose based on ideal weight.

A couple of housekeeping things. First, could you put a line in your spreadsheet separating when you switched from Caninsulin to Lantus. That'll help us visually when we look at your spreadsheet. BTW, Neko started at Caninsulin and we switched to Lantus too, although she's now on Levemir. And secondly, the majority of the advisors on this board speak American or mg/dl instead of the World values or mmol/L. Your spreadsheet will do the conversions, but when you report data, it's best to speak in mg/dl. Either look at the US tab on your SS or multiply by 18. Being in Canada I also have to do the conversion.

Regarding food, we had a member a while ago in New Zealand. Let me see if I can find out what food she fed and I'll get back to you.

Right there with you on the patience thing Wendy!! - 7 days? Sheesh! lol

Javas normal weight is about 5.5kgs so hes not too far off it now! I've updated the spreadsheet as suggested Will try to remember to refer to the US values

I was thinking exactly along the same lines as Wendy. It can take 5 - 7 days to see how Lantus is doing. It takes that long for the insulin depot to form. That said, I don't think Java's numbers on 4.0u of Caninsulin are all that different than what you're seeing on 2.0u of Lantus. A

The depot is one of the big differences between Lantus and Caninsulin. Caninsulin is considered a "harsh" insulin because you can get a rapid drop in numbers. Lantus is gentle. What it doesn't have in terms of that immediate punch is made up for in duration. Lantus is a long-acting insulin; Caninsulin is short to medium in duration. The other big difference is that dose adjustments are based on the nadir and not on the pre-shot numbers.

Just to double check -- are you using U100 syringes? Caninsulin requires a U40 syringe -- it's concentration is different than Lantus and you need syringes that are calibrated for the concentration of the insulin.

Hey Sienne

Def using U100 - we used the last U40 on his last Canninuslin shot which was pretty timely

Ill keep updating his sheet and wait it out

C

Hello again, I found the low carb food that the other NZ member had used. It's the canned Whiskers jellymeat loaf style, but I have no idea if it's kidney friendly. I seem to remember someone in Australia using the Whiskers, as well as the occasional Ziwipeak. You should try to find some treats other than Greenies as they are rather higher carb. One treat a lot of the cats like here is pure meat protein, such as freeze dried chicken pieces, or other protein (turkey, duck, shrimp etc). You can get larger packages for a better deal in the dog section of pet stores. Another alternative is to buy some chicken breasts and just boil them in water. You can cut them up into small cubes, save a few aside and freeze the rest.

More on the U-100 syringes - do they have half unit markings on them? The protocol here calls for changes of .25U which are pretty hard to eyeball if you don't have the 1/2 unit markings.

If 5.5kg is Java's ideal weight, the formula used for starting dose is to multiply that weight by .25 which is 1.375 which we'd probably round down to 1.25U - although we do consider the dose on the previous insulin.

No half unit markings which is going to be hard! LV is looking into sourcing though

One other option to 1/2 unit marks is to use digital calipers. Here's an example of what some people here use. Marje did a post on Dosing with Calipers. I use the BD syringes, as that's all that's available here, and I find the markings quite inconsistent. It doesn't matter so much with humans but the tiniest difference does with a cat. So I use calipers my hubby bought at his favorite metalworking store. The bonus of calipers is I set them to the dose I want and if I'm away at shot time, DH knows to just measure the insulin with the calipers and we get consistency.