Old Member, "New" Cat, Questions on starting insulin

Good morning,
We were Lantus members a long time ago and our situation then was different than now, so I have questions. My cat Josie seems to have diabetes, but we have not started treating yet. My vet is hoping that once we get her infection under control that her glucose will go down. I've been testing her for the last 4 days and her highest number was 242 before eating in the morning and it dropped to 190 7 hours later. Today her am number was 231 and 4.5 hours later it was 189. She was getting Fancy Feast pate plus some higher carb FF foods, but I've taken away all high carb foods as of last Thursday. Josie has multiple health issues, but this eye infection has really taken it's toll. She's not eating well even with the meds, so I am now supplementing her food by syringe feeding twice a day.

Questions: What dose would I start at? Also, where do you get Lantus and what syringes would I use? We see the vet on Wednesday and I want to be ready if she okays starting insulin. I was shocked when I saw the price of Lantus. I didn't know it had gone up so much.

History: Josie is 15 years old and has CKD, IBD, degenerative disc disease, and now a serious eye infection that started as herpes, but is now swollen around her eye. She is on 5mg prednesolone, (for more than 4 years), Cyproheptadine (appetite), Cerenia, Pepcid, Ondasetron, 3 different eye meds, and now Clavamox. Thank you for your suggestions and support.

 

Hi Ele,

Sorry to hear about Josie. Can you tell us how much Josie weighs? Starting dose of Lantus is based upon that. U-100 syringes with half-unit markings are the ones you should use.

You can get Lantus pens from Mark's Marine if you can get a prescription from your vet: https://canshipmeds.com/search-3/?drugName=lantus solostar pen for pets (insulin glargine). Much cheaper than getting from the local pharmacy in the US. I ordered recently and it took about ten days from order placement to receipt of the insulin in the mail.

 

Hi Katherine,
Thanks for the quick reply. Josie weighs about 7.2 pounds. I'm trying to get her weight up, but it's a struggle.
Ele

 

If you wish to follow TR, the formula for a starting dose is .25 units for every kilo. Since Josie weighs about 3.25 kilos, I would start her on .75 units. If you're going to follow SLGS, I would start her on .5 units. This is the sticky you need to read to refresh:
Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Do you have calipers to measure increments of .25 on a syringe?

 

Thank you. I have some U100 syringes and no calipers. I don't even know what you mean by a caliper. LOL I thought there were syringes that had the .25, etc. markings. At least I think that's what we used to use.

 

From what I know there has never been a syringe that had .25 unit markings. If they had been invented they would be making a lot of money from people on the FDMB! In my post above, I linked a condo about using calipers. You can try eyeballing the doses but because printing on syringes can be off by a lot, calipers ensure consistent shots every time.

 

Welcome back but sorry you have to be here. I hope once the infection is gone you will quickly see remission. How long has it been since you eliminated the hc food? That will also make a difference in your starting dose. Like Katherine I think calipers make a huge difference as the syringe markings can vary by so much. Fine for a human but not so much for a cat. Not everybody uses them but I would have been lost without them.

 

Welcome back.

Some people have been using Semglee, a biosimilar to Lantus that is apparently much cheaper in the US. Basaglar is another biosimilar insulin used by some.

Part way down this Sticky Note is a list of commonly used syringes and links where to get them:
Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing