07.01. Simba PMPS 374 New to Lantus, switched from Protaphane - help please!

Hi,

After struggling with Protaphane since the beginning of Simba's diagnosis (27.11.2020) we finally switched to Lantus. Tonight was the first shot (3 units) so I am eager to see how his body responds. Protaphane didn't achieve the results I had hoped for. A couple of days ago I stopped giving dry food entirely and Simba's on a low-carb wet food diet. Simba's a big boy currently weighing 6,5kg, he should be around 6kg.

Looking back I know exactly what triggered his diabetes... 16.9.2020 I took Simba to the vet and he got a cortisone injection for his occasional mild coughing. It had been on and off for a while and at first I couldn't understand why he'd try to cough up hairballs once a week - obviously that was the asthma. His weight at the time was 8kg and he was on Hill's z/d wet food... I'm pretty sure that played a big role as well.

I'd appreciate any tips and advice on what to expect when switching to Lantus! Also a question about meal times - is it better to have strictly two meals a day or two main meals pre-shot and some little portions in the day. Simba's a very hungry boy and loves his food, so I've found it easier to distribute some smaller portions throughout the day as well, including a "night snack" at +2 post-shot.

 

PMPS +2 340, not as a significant drop as I experienced with Protaphane the last three nights at PMPS +3 and +4. Should I skip on the night snack and check back in PMPS +6?

 

Hi Lina,

Hope Lantus works better for Simba. I am still a newby, but have notcied that people do very different feeding schedules because every cat is different, and every care giver has different constraints. The important thing to know is that it is not necessary to give only two meals.

Many of us find spreading the food around helps keep the curve shallower and smoother, but how to accomplish this will require you learning how Simba reacts to Lantus first. When is his onset (many cats is only at +2 but it varries) and where is the nadir usually.

Keep posting asking questions and most importantly, collecting data! People will help you adjust as needed.

Good luck!

 

If you can free feed i highly recommend it. I weigh the food dished on my kitchen scale to make sure my picky eater is eating enough. While kitty isn't regulated they might be extra hungry bc they are essentially starving from the inside out. You just have to pick up food 2 hours before shot time. This is so kitty is hungry when you shoot and you get a number uninfluenced by food. I also like to do a +11 test so when I do my oreshot test I know of numbers are heading up or down. That helps when deciding to shoot a low number or not.

3 units is quite high for lantus so definitely get in as much testing as you can and always have a hypo kit on hand

 

Simba sure is cute! I'll tag a couple people where your switching to Lantus! @carfurby @Sue and Luci @Butters & Lyla @Gill & George

 

Thank you for the advice! I'll want to do a curve on him, do you have any idea when would be a good time? Should I try do one immediately after starting Lantus or wait for a week or so?

 

Okay, that actually makes it easier as we struggled having a strict two meals a day schedule anyway. He doesn't get food for a minimum of 2 hours before shot time, usually 3-4. In the morning he gets food at 8am and the previous meal/snack has been either his 8pm dinner or 10/11pm snack. Also the +11 test is a really good idea, especially in the evening! I hope to get a full nights sleep this month.

I'll keep a close eye on him tonight to avoid a hypo scare on the first shot of Lantus. Thanks for the tips, I really appreciate it!

 

I'm not certain but I think where your starting Latus tonight. You don't use the same dose as what you were using with the Protaphane. I'm hoping someone will help you with that. I just want to be sure. @Sienne and Gabby (GA) @Wendy&Neko

 

This is what the vet advised to do... but I'm taking all the advice from here that I can get!

 

Hi Lina,

I know nothing about protaphane, but we switched from prozinc to Lantus in hopes of being a gentler insulin. It has been the case most days, so I think your perception might be correct... however, every cat is different, so perhaps is better to err on the side of too much food until you have more data under your belt?

 

Simba was asking for his night snack, I've just given it to him. I'll see what the BG is in half an hour.

 

I swear I can keep the time by hercules begging for food! He seems to know exactly when 2 hours has passed!

The more you test the better, but unless Hercs is low, or I am about to go to sleep and want to be sure he is OK, I don't test more often than every two hours. My understanding (someone correct me if I am wrong please), that 30 minutes later you would mostly be determining the effect of the food on his BG. That might be what you want to know anyway, but I just though I comment...

 

Yeah I get that! I wouldn't usually test so soon after giving a bit of food but I'd like to see if I'm alright to go to sleep. Simba looks pretty comfortable after 1/4 tin of Sheba perfect portions luxury pate. That's what he's had mixed in with the last few packets of Royal Canin Diabetic wet food before our zooplus order arrives.

 

Simba is sleeping peacefully and measured at 383 +4. The food has definitely entered his system. I'll be back with an update at +8 Goodnight from us for now

 

Welcome to the subforum. For inquiring minds, Protaphane is also known as NPH (brand names Novolin N and Humulin N).

A couple of things you need to consider in the switch to Lantus:

With the NPH, you would have rolled/mixed the insulin before using. Don't do that with Lantus.
With the NPH, my understanding is that it is recommended to test, feed, wait 60 minutes, then shoot. That is because NPH can start to have an effect soon after it is injected, so you want the carbs from the meal in the system. With Lantus, you test, feed, shoot all within about 10-15 minutes. Lantus is a gentler insulin, so you'll often find that it takes a couple of hours before onset (the point when the insulin starts to have an effect).

I'd suggest putting an extra row in your SS, to show the break and add comments switched to Lantus.

As for the dose, we do usually look at how the previous insulin was working, and take that into consideration. You did manage to get some extra tests in prior to your switch to Lantus, and I see one cycle with 187. I think 3u looks fine as a starting dose of Lantus. I'm glad you got some extra tests in tonight, good job! Some kitties show a quick reaction to an insulin change, while others need some time to adjust. With Lantus, it may take 5-7 days when first starting out to let the depot build, and to see what the dose can do. Have you had a chance to look at the sticky on dosing methods?

When exactly was the last time you fed dry? Since you also recently changed from feeding dry to just canned food, that can have a noticeable affect on BG with some kitties.


It is important to get a sense of how your own cat responds to insulin, and the carbohydrates from their food; no two cats respond exactly the same way. How my cat reacts to insulin and carbs may be completely different than how your cat responds. That is why we often say "know thy cat".

From the basics sticky:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose
• How to do a Curve - a simple explanation

With Lantus, we often like the +2 because it can sometimes be a good indication of how the cycle will go. If the +2 is higher than preshot, it usually indicates that not much downward movement will occur in the blood glucose levels. If the +2 is the same and certainly significantly lower, then that could signal more testing is required as the numbers may drop a little more quickly. By taking additional tests, that will allow you to monitor and feed to help slow down the drop.

If you have any questions, just ask, we're happy to help. Good luck with Lantus

 

+8 hasn’t gone down much at all - 355. Happy to sleep through to AMPS.

 

8.1. AMPS 322. I'll start a new thread for today, thanks for all of the help and tips!

Thanks so much, very helpful!

With Protaphane I used to inject it directly after food as well, didn't know any better. I've added the row in my SS to clarify things. I'll have a look through the dosing method sticky and the basics sticky. I stopped giving dry food on Monday, pretty much as soon as I joined the forum and saw that it's actually not recommended at all. Simba loves wet food way more anyway so it wasn't a tough switch. Today I'll be testing at +6 only, unless it will begin to look like he's feeling unwell at some point throughout the day. I think +2 or +3 will be good to measure in the evening to determine should I wake up for a check-up at some point. It's all a learning curve right now!

 

8.1. AMPS 322. I'll start a new thread for today, thanks for all of the help and tips!