1/22 - First Day on Lantus, Questions

[FrostD]

Hi,

Could just use a quick sanity check here!

- Mr Kitty was fairly flat through +4. From what I understand, this can be fairly normal when first switching? I plan to get +6 and later tomorrow. But the PM +2 387 surprised me a bit.

- I'd like to be more aggressive in trying to get him to a better dose, so thinking TR in the short term. But how long should I wait before increasing the dose the first time? I read the depot can take up to 5-7 days, but we're on a fairly small dose right now.

- The package insert said only inject room temperature insulin, let the syringe sit out. Is there a reason for this other than comfort?

- With Vetsulin, the advice was to shoot about 20-30 mins after feeding. I saw in another post here that's not necessary, can do it all within 10-15 mins. I did wait the 20-30 mins today because I didn't know, was there any harm in that?

- Where are the majority of users doing the injections? I was only taught scruff, wondering if others have found better luck elsewhere like the sticky shows. The vet double checked my technique after having all these issues, and supposedly I'm still doing it right.

Oddly enough, he tried to cuddle with the dog today. For the past 5 years they've had a mutual understanding that they each leave the other alone. Not sure what to make of that

Really appreciate all the help!

 

[tiffmaxee]

First of all keep it in the fridge and it will last minimum 5 months and maybe longer. You can’t rush it. You need to let the depot build before increasing. Lantus doesn’t start working, onset, for about two hours for most. So you need to test, feed,shoot all 5-10 minutes. No need to wait. I used to shoot on the flank and stomach. You can shoot in the scruff though. Just alternate where you inject and see if it makes any difference. TR gives the best chance at remission. For most cats tge nadir with Lantus is between +5-7 but it can be earlier or later. You will need to get some mid cycle tests both during the day and night cycles as cats often go lower at night. The +2 is often a good indicator of what to expect on a cycle. If it’s lower than the preshot then it might be an active cycle and getting a mid cycle test is a good idea.

 

[Wendy&Neko]

If you just started Lantus, it'll be helpful to write "Start Lantus" or something like that, in the blank yellow line before today so we can see when you did the change.

The initial dose should be held at least 5 days to build the depot, if following TR. Unless after 3 days we see nothing but pink, then we might re-evaluate.

 

[Hercule's mum]

I'm curious about the temperature thing.... I neve read that and shoot most of the time with lantus just off the fridge.... It is clearly reducing his BG, so I think is fine?

every cat is different, but with hercs we din't see any response to lantus until day 3.
I use the rotate between left, right of scruff and flanks. I was using prozing but noticed bigger drops when shooting in the scruff (which led to more bouncing, in bouncy hercs case...), so now I only alternate between left and right flank. I also find easier to go for the flanks because I usually shoot while he is eating, so disturbs him less. It might not have the same effect with Lantus, or with your cat... As Elise say right down where you shoot each day, and see if it makes a difference or not.

 

[Sienne and Gabby (GA)]

The package insert is based on human use. (Lantus use for pets is off label.) Humans use substantially more insulin than most of our kitties. When pens were developed, it made the the insulin far more portable for humans -- if you were traveling, not every hotel would have a refrigerator for storing your insulin. The pens were developed so you were safely carrying a small amount of insulin along and you didn't need to carry syringes if you used the needle tip. None of that is applicable to cats. It is more relevant to keep the insulin at the same temperature so the pen mechanism (i.e., there's a plunger that moves down the pen as you use up the insulin and keeps pressure on the insulin so it's always at the stopper end of the pen) works efficiently. in addition, since you will be using the pen appreciably longer than a person would, keeping it refrigerated (and it's refrigerated at a pharmacy) will help to prolong it's use.

Vetsulin is a shorter acting insulin and it has a rapid onset. Lantus onset doesn't begin (at least for most cats) until about +2 whereas with Vetsulin onset is earlier. With Lantus, you don't need to have food on board since it takes around 2 hours for the insulin to start working. The only issue with your having waited 20 min or so prior to giving a shot is to make sure you're shooting at PMPS 12 hours after you gave the morning shot.

I always shot in the scruff. Ostensibly, the absorption is better at other spots but I never had a problem with absorption. (I also tended to give more fur shots if I injected elsewhere.)

 

[FrostD]

Thanks all!

I had updated the sheet early yesterday for Lantus, must have just had trouble syncing the changes for a bit.

I think I'll continue the scruff just for consistency, then once I have some run time on this insulin try shooting elsewhere.