newbie changing from pzi to glargine-what dose?

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gary&vinnie

gary&vinnie

Member Since 2010
Vinnie is a 13-year old indoor/outdoor orange cat who was obese at 20# and developed DM this year with typical hyperphagia, polydipsia, polyuria and weight loss. Down to 14# now, no longer overweight. Started on PZI 3 months ago with poor control; AMPS in the 300's while bid PZI dose being increased weekly from 1u dose to 8u now. Never saw a nadir below 150 until this week (125). Changed from dry food to 2-3%carb wet food two weeks ago (12 oz/day). He still is a succesful hunter so he supplements his own diet. Finally now with AMPS and PMPS in the low 200's on 8u bid.
Bottle of PZI just about empty so got a prescription for Lantus today after reading about it a bit online. Got the U100 syringes. Vet wants to start at 3u bid, which is the usual starting dose, I know. Seems like we'll be repeating the long process all over again. She thinks Lantus dosing is supposed to be less than half of PZI. Hard to find references on doing the switch online. I did see an article by Julia Bates DVM, Glendale WI, recommending 50-75% for starters, which would be 4-6u for Vinnie.
Appreciate your thoughts...
 
Hi sorry can`t help you with dose but if you put DOSE ADVICE in your subject line you will get more eyes on it ok Hope this helps Kath
 
Libby and Lucy said:
welcome to Lantus Land! Do you have you numbers from the last few weeks anywhere we can see them?
Click to expand...
...and does your vet consider 14 pounds to be vinnie's "ideal" weight?
welcome to the group! :-D
 
thank you all!
14# is his ideal weight (big cat). don't want to see him lose more.
We'll work on a SS but it'll be awhile.
 
Welcome to lantus land--Lantus(glargine) is different than the other insulins, because it needs consistancy in the dose and times, and you will need patience..Do not shake or roll lantus(glargine) it is quite fragile & must be refrigerated--Refrig life is about 28-36 days, depending whether you use the vial, the cartridges or the solo star pens(my preference)--Lantus is fragile so never shoot insulin back into the vial or it will be contaminated by what's in the syringe'
Read the Stickys on the top of the page and so much info you need to know is there--Also come here every day, ask questions, someone is here 24/7 to help you! You will be glad for the change--
 
the usual starting dose is 0.25u per kg of the cat's ideal weight which in this case would be 1.6 units dosed BID. however, vinnie's previous dose and numbers on pzi should be taken into consideration when coming up with an initial starting dose of lantus. the change in diet made two weeks ago is another consideration. posting the last couple weeks of numbers will give us a better idea of a starting dose... if you're looking for opinions/input.
 
8/7 AMPS 351 7u.............PMPS 265 7u
8/8 AMPS 360 7u....+9 158..PMPS 290 7u
8/9 ............7u............. PMPS 202 7u
8/10 ............7u.............PMPS 265 7u
8/11 AMPS 317 7u, +3 162,+5 209......7u
8/12 AMPS 327 8u, +3 164, +7 175.....8u
8/13 ............8u...........+10 148.... 8u
8/14 AMPS 259 8u.........................8u
8/15 AMPS 256 8u......+5 199...........8u
8/16 AMPS 204 6u.............PMPS 221 6u
8/17 AMPS 205 6u.............PMPS 362 8u
8/18 AMPS 327 9u....+5 105
 
Welcome to the best place for a DC ..Trey was DX in May and today because of the help I got here he is off insulin for 23 days Hoo Hoo...Sending Angels and Green healing light to get you off to a good start... Kath ;-) :mrgreen:
 
I had my cat, Blackie, on ProZinc before July 25th, and she was getting 8u BID from mid June until about a week or 2 later, when she went hypo. Mind you, she was eating high carb food at the time of the hypo episode. She's been on wet since then.

I've changed her insulin to Lantus on July 25th, and she was started at 1.0u BID. I'm still trying to get her regulated, and it's a slow going process.

I'm NOT a vet. I would think that starting him at 1.0u BID of Lantus would be good. Just a thought.

I wish you and your kitty all the best on this. :) It's really a good insulin.
 
Welcome! I too switched from PZI to Lantus recently. I have a long-time unregulated diabetic that was on 6 unit a day. Because he wasn't a new diabetic, it was recommended that we start Lantus at 2.5 units twice daily. I was a little paranoid about starting too high, so I actually started at 2 units twice a day and have stepped him up slowly. I established a feeding routine with consistent times and quantities and food type (brand/flavors). We have now stepped up to 8 units a day and are starting to get some movement in the right direction. It has been a slow and sometimes frustrating process, but I know that we did it the right way to avoid complications. While stepping up the insulin, you will want to be testing for ketones as well.

I am hopeful that I will be able to regulate Fin on Lantus because he had been on PZI for more than three years before I adopted him and it never worked well for him. I wish you luck and I am happy you found this board! Great advice and plenty of information for you to make the best decisions for you and your pet.

Barbi and Fin
 
thanks everybody!
from what I'm reading today (from Queensland) I learned that Lantus is LESS potent than PZI in most cats, so I'll start with 7u bid which probably won't be enough, but ought to be safe.
 
hmmm, starting lantus at 7u bid sounds pretty scary. i forgot to ask, is vinnie prone to developing ketones? has he ever been in diabetic ketoacidosis (DKA)? has vinnie ever been tested to rule out any high dose conditions which may be effecting the treatment of his diabetes?
 
I'm with Jill, 7u sounds like a pretty high dose to start. If Vinnie had been diabetic and on a high dose for a long time, then it would be reasonable to assume that dose is safe for him. Since Vinnie is a newer diabetic, though, it would pay to start at a lower dose and work up until we find his ideal dose.

If you were brand new, then calculating the starting dose at 0.25 units per kg of ideal weight would be 1.6 units. I don't think you need to go all the way down to that, since Vinnie HAS been on higher doses and done pretty well. I actually think your vet's suggestion of 3u BID sounds very reasonable and safe. Then you can adjust from there based on the protocol. It doesn't have to take long to adjust upward, and then you'll know for sure his dose isn't too high. What do you think?
 
He has been diabetic since April.

Well, the deed is done! Started lantus at 7u last night, 7u again this AM. So far so good. I'll do a +14 and a +16 and +18 today (relative to last night's dose) since I have the day off.

8/7 AMPS 351 7u.............PMPS 265 7u
8/8 AMPS 360 7u....+9 158..PMPS 290 7u
8/9 ............7u............. PMPS 202 7u
8/10 ............7u.............PMPS 265 7u
8/11 AMPS 317 7u, +3 162,+5 209......7u
8/12 AMPS 327 8u, +3 164, +7 175.....8u
8/13 ............8u...........+10 148.... 8u
8/14 AMPS 259 8u.........................8u
8/15 AMPS 256 8u......+5 199...........8u
8/16 AMPS 204 6u.............PMPS 221 6u
8/17 AMPS 205 6u.............PMPS 362 8u
8/18 AMPS 327 9u...+5 105..PMPS 169 7u LANTUS ..+4 261
8/19 AMPS 240 7u
 
hi there

you may want to read this sticky: New to the Group
and use the curve chart as a guideline for spot checks.

7u is a very high dose to start with, on Lantus, please do keep an eye on kitty.

Read the shed stickie too, this is something you need to understand as well and take into consideration
Insulin Depot AKA Storage Shed

Post if you need assistance, lots of members here to guide you along.
 
8/7 AMPS 351 7u.............PMPS 265 7u
8/8 AMPS 360 7u....+9 158..PMPS 290 7u
8/9 ............7u............. PMPS 202 7u
8/10 ............7u.............PMPS 265 7u
8/11 AMPS 317 7u, +3 162,+5 209......7u
8/12 AMPS 327 8u, +3 164, +7 175.....8u
8/13 ............8u...........+10 148.... 8u
8/14 AMPS 259 8u.........................8u
8/15 AMPS 256 8u......+5 199...........8u
8/16 AMPS 204 6u.............PMPS 221 6u
8/17 AMPS 205 6u.............PMPS 362 8u
8/18 AMPS 327 9u...+5 105..PMPS 169 7u LANTUS ..+4 261
8/19 AMPS 240 7u..+2 219..+4 211..PMPS 190 7u


P.S.: we did read the stickies before deciding to change to Lantus
 
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