My question has to do with feline diabetes. My 7 year old male probably got diabetes from being overweight. At one point he was 22 pounds and now is down to 17 pounds. Getting him regulated continues to be a problem. He was diagnosed in December of 2015 and is on his third type of insulin now, Lantus (glargine), which has the most flat curves. I have kept a detailed glucose log for him, indicating dates, times, glucometer readings, insulin units given, and what food he was given, and type it into a Word table weekly from the written notebook which I email to my vets. I do a 12 hour curves on him every weekend.
He goes to 3 different vets, a holistic one, a traditional one, and a university veterinary hospital for an internal medicine specialist. I’ve had to do a lot of research myself on feline diabetes and found the German protocol was the only one that actually lists a dosing protocol for Lantus. A dosing protocol for glargine is what I need, but none of my vets will agree to the German one or give me a US one. Lantus drug sheets from the pharmacy do not go into dosing at all, and only talk about humans taking it. I didn’t agree with the internal medicine intern or resident who suggested prescription dry food. All the articles I read say feed only canned food, no dry, which is what I’ve been doing.

The traditional vet is the one prescribing and dosing the glargine, and one day his glucose went very low and I had to feed him extra food and not give him any insulin and then he seems to go into smogoyi effect. After reading the German protocol, I believe the traditional vet had him going up too fast, about a unit per week, which might be OK for Prozinc, but not for Lantus. The German protocol would only recommend going up by 1/4 or 1/2 a unit, but they say you can do it in 5 days time. The internal medicine vet wanted 10 days or more per dose before raising the dose.

This time I waited nearly 3 weeks to raise his dose by a half unit since the numbers of his last curve were mainly in the upper 300’s. His glucose dropped to 45. I didn’t give him any insulin that evening and called the vet first thing in the morning (by then his glucose was over 535) and we went back to his old dose. There are 2 other possible reasons for the drop besides raising his dose. I was at the bottom of the vial of Lantus. I read that Lantus shouldn’t be rolled or disturbed much and is a clear liquid that doesn’t seem to settle like the Prozinc and Novolin N did. Perhaps the Lantus in that vial did settle and was more concentrated at the bottom. I did look on website to find instructions for humans with the vial, not the Solostar pen, and it doesn’t say to roll it.
The other thing that might have affected him is that my holistic vet started him on Standard Process Feline Whole Body Support supplement. She had me wean him up from 1/4 pill once a day for a week, 1/4 pill twice a day for a week, 1/2 pill twice a day for a week, and just this past weekend I started giving him a whole pill twice a day, which is the standard dose for a cat. Could the Standard Process Whole Body Support be causing him to get better and not need as much insulin? They need to notify you on the bottle somewhere if that is the case. So I’m going back to the 1/2 pill twice a day on that one and have tried calling them for information but haven’t received a call back yet. I am thinking about calling the FDA to inquire what they know about dosing Lantus in a cat and about Standard Process Feline Whole Body Support in a diabetic cat.

I can email you the entire glucose log for my cat if you let me know how to get it to you since I can’t attach a file in Delta’s Ask the Vet. It is 51 pages long so far.

Marked as spam
Asked on June 23, 2016 5:39 pm
Private answer

Quite a detailed question. The reason you cannot find a standard dosing protocol for glargine insulin in cats is that there really isn’t one! With my extensive use of this product in cats I can assure you that literally each cat needs to be treated as an individual. Developing a smogoyi effect is a common problem. What’s more what was working last week may not work this week. At the sanctuary we develop a table for each individual as to what dose to give based on the blood glucose level at the time of dosing. Some are complex while some cats are quite simple. Having looked at the ingredients in the Standard Process Feline formula it is possible that it may affect the dose of insulin needed. It is beyond the scope of this forum for me to prescribe specific doses for a cat that is not under my care. It seems like you may have too many cooks in the kitchen already. It may behoove you to choose one to administer to the needs of your cat. Consultations among veterinarians is common, but one should assess all the information and make the final decision.

Marked as spam
Posted by Dr. Gaylord Brown
Answered on June 24, 2016 4:06 am