08/25 Kirby Switching to Lantus from Humulin - dosing?

Hello, my vet is switching my cat Kirby to Lantus. He's been on Humulin for close to a year but it is no longer working for some reason, and he had a recent episode of DKA. I recently started home-testing, and his stats are in my signature. His numbers have been "bouncing" around.

My vet has prescribed that he begin with 2 units of Lantus starting tomorrow morning. I posted the below post in a different group, and it was suggested that I post here as well, to see if anyone has suggestions re: starting dose or anything I need to be on the lookout for during the switch. (I did read the tabbed articles in this group!) I don't want to second-guess my vet and am hoping that 2 units is a conservative reasonable dose based upon his recent levels. Any feedback is appreciated. Thank you!

https://www.felinediabetes.com/FDMB...vice-regulating-diabetes.234137/#post-2619579

 

got

I forgot to mention that Kirby eats a low-carb canned cat food (Instinct Lamb original formula pate). And the anticipated 2 unit dose will be twice a day.

 

Welcome. I see Sienne sent you over. I’m hoping the other mods will weigh in on your starting dose. I only used Lantus so have no advice. How long ago was the DKA? It would be helpful to add a signature. That way you won’t get asked the same questions over and over again.

 

Hi Staci and Kirby!!!

I don't have experience with switching to Lantus, but wanted to say welcome!

 

almost 3 weeks ago. Thank you, I will add a signature!

 

Good to know. On the linked thread someone thought it was in the past. It will be a factor with dosing now and going forward.

 

Hi

Hi Elise , she will be using Lantus

 

I know the switch is to Lantus. I just don’t know anything about switching from Humulin as to what the Lantus starting dose would be.

 

Sorry I didn't realize it, my bad

 

@Diane Tyler's Mom I wish I did have advice.

 

Me too, her kitty dropped pretty low on the Alpha Trak

 

@Staci I don't know what syringes you use with Humulin , just want to be sure that you know to use U-100 syringes with Lantus. Its good to buy the ones with half unit markings.
It makes it easier when increasing and decreasing . We increase and decrease by 0.25 units

 

Wow....you were giving up to 4U of N and up to 4U of R??? That's absolutely nuts...I'm not sure I'd trust your vet in the first place.

We take the dose of another insulin into consideration when suggesting a starting dose of Lantus.

Since he's been fairly routinely given 3U of N, that's probably where you should start with the Lantus but if at all possible, I'd try to get at least 2-3 tests after the AM shot and at least 1-2 on the PM cycle after the shot in case he reacts quickly to the Lantus.

I'm going to tag @Wendy&Neko too add another experienced opinion but I'm not sure she'll be on before your AM shot

 

@Sienne and Gabby (GA)

@Wendy&Neko

Hope you don't mind the tag, do you have any advice on a starting dose for @Staci she is switching from Humulin to Lantus
Thank you

 

Thanks Chris

 

Thank you! I appreciate your advice. After a lot of anxiety I gave him 2 units per the vet's advice. I am quite nervous because of his recent DKA. And he is so underweight I don't want him to be over dosed anymore. I will be purchasing some ketostix today as well as a human monitor, as he is almost out of the alpha Trax strips.

I should note that the 4 units of R on his spreadsheet was user error by me, as the clinic had given me a larger syringe and I misread the numbers. The vet did not tell me to give 4 units of R. But hopefully the days of using R at all are behind me.

This is all overwhelming but I hope as I move forward with testing that we can get this under control soon.

 

Hi Staci,

You were commenting in your opening thread on Feline Health that Kirby has been harder to regulate of late.

By way of general information, it can sometimes be tricky to administer insulin to cats who are underweight. Some of them can end up going very low, even on small doses of insulin. If the cat is recovering from DKA this can make for an even trickier situation. In such circumstances it may help to feed a higher carbohydrate diet temporarily to enable sufficient insulin to be administered safely and consistently, and to help the kitty to regain weight. Also feeding a more calorie-dense food can help with weight gain. Once the kitty is clear of DKA and has regained enough weight the diet choice can be revisited.

I'm not implying for one minute that this is the case with Kirby, I just wanted to pass on a snippet of information that might be handy for you to know about.

Sending best wishes for Kirby's regulation to improve very soon.


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