Switching to Lantus-need help

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Deena and Malby

Deena and Malby

Member Since 2016
hello,
My cat was diagnosed on 12/6/16 and has been on Vetsulin since. I haven't had much luck getting his numbers below the 300's. I switched vets recently and he is suggesting to put him on Lantus.
Do most people prefer to use the pen or the bottle?
ALSO, it is more much more expensive than Vetsulin but my vet said it can last up to 6mo if handed properly. I really don't trust that...maybe 3mo but I don't want the vial to become contaminated or loose its effectiveness so I can see me throwing it out after 3 mo and still having a lot of left over product. So I can't see the vial being very cost effective?
Just wondering what everyone's experience is with Lantus and what seems to work best! Im going to start shoooing around for the best prices soon so any suggestions would help.
 
Hi and Welcome Lantus and Levemir Land - the nicest place you never wanted to be.

Deena Traina said:
Do most people prefer to use the pen or the bottle?
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Most of us use the pen (without the attached needle - you draw the insulin with a syringe). It can actually last up to six months, if stored in the fridge. Depending on the dose Malachai ends up on, you very likely will use it up before it loses effectiveness if you go with the pens. With the vial, unless he is a high dose kitty, you do thrown some out. Many here purchase their insulin pens from Mark's in Canada (@Chris & China can give you the info on how to do that). You just need a prescription from your vet. It's much cheaper than anywhere in the US.

Here is a post full of tips that can help you get the most out of the Board: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/

We love to help here in L&L Land, so don't be shy and ask lots of questions. We're happy you and your beautiful Bengal boy are here.
 
Hi Tricia (and Harvey),
Thanks for the warm welcome and response! Yes I've heard the pens are the better way to go. I'm in the US so can Mark's ship the Lantus to the US and it stay cold? Are you ever concerned about that? Look like your in CA, I am as well.
Thanks for the help!

Deena
 
Technically, it is against the law for them to ship here, but they do it, and as I said, many people here use them. I haven't bought from them myself, but I assume they put cold packs in with it. Chris would know for sure. I would be careful about it during the summer, but even in Southern CA it isn't too stinkin' hot yet (is it?), so it should be safe now. If you get a 5 pack, you probably won't have to order again until the weather is cooler.

Yup, I'm in Northern CA, so I'm on the same time as you are. It would help if you could add your location to your signature block, since we have members all over the world. It helps to know what time zone they are in. You can just say "Southern California" or "California"- whatever you're comfortable with. I was going to say CA, but since we have a lot of members in Canada, that might be confusing.
 
Tricia Cinco(GA) & Harvey said:
Technically, it is against the law for them to ship here, but they do it, and as I said, many people here use them. I haven't bought from them myself, but I assume they put cold packs in with it. Chris would know for sure. I would be careful about it during the summer, but even in Southern CA it isn't too stinkin' hot yet (is it?), so it should be safe now. If you get a 5 pack, you probably won't have to order again until the weather is cooler.

Yup, I'm in Northern CA, so I'm on the same time as you are. It would help if you could add your location to your signature block, since we have members all over the world. It helps to know what time zone they are in. You can just say "Southern California" or "California"- whatever you're comfortable with. I was going to say CA, but since we have a lot of members in Canada, that might be confusing.
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Smart! Okay thanks :)
 
yes it can last a long time....
I only used my vial for 100 days... and it never had a problem, then I gave it to someone else....

you can also call around local pharmacies and see if anyone is willing to sell you one pen for less....
there still are some stores that will negotiate.
I bought a pen for $50 once... the second time he charged me 92.

but you have to try ...
usually it's the smaller mom/pop type pharmacies that are willing to haggle.
 
Ok thanks. Another member had also suggested Mark's in Canada. I just reached out to @Chris & China who is supposed to have some information on that. Hopefully they will sell cheaper. The cheapest I've found it so far is $92. I bit higher than I can afford.
 
I've used a pen for 90 - 100 days. Your vet is correct, it's all in how you handle the insulin. It looks like Malachai is on a smaller dose of insulin so a pen should last a few months. There are people here who have used a vial for 6 mos. My only concern with a vial was that if you drop it, your insulin is now all over the floor. The pens are encased in plastic and while you don't want to be treating the pen like a soccer ball, it will likely survive being accidentally dropped. Just keep the insulin in a safe spot in the refrigerator.

As Rhiannon said, some pharmacies will sell an individual pen. Look at places like Sam's Club, Costco and Target as well as check with hospital outpatient pharmacies. It may be a way to tide you over until you can order from Marks.

Also, were you giving Malachi a shot twice a day? There isn't a dose in your PMPS column. You'll also need to get used to getting at least one test during the PM cycle. Lantus dosing is based on the nadir, not on your pre-shot value. I'd encourage you to look over the sticky notes at the top of the board, The strategy for dosing with Lantus is very different than with Vetsulin and it can take a while to adjust your thinking to a long-acting insulin.

I believe the cost for a box of 5 pens from Marks is under $200.

 
Hello,
Yes I shoot Malachai 2X a day. I just don't have a lot of evening numbers as I go to bed a few hours after I inject him. Yes, I've read that it is very different from Vetsulin. Have you ever ordered from Marks? Any idea how much a pen costs there or a pack of 5? Do they sip with ice packs?
 
Deena Traina said:
Have you ever ordered from Marks? Any idea how much a pen costs there or a pack of 5? Do they sip with ice packs?
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See Shelly's post above your last.

Deena Traina said:
. I just don't have a lot of evening numbers as I go to bed a few hours after I inject him.
Click to expand...
With Lantus (and really with all insulins), it is very important that you always test before you give a shot, to be sure it is safe to shoot. It is also highly recommended that you get at least one mid-cycle test per cycle, because Lantus dosing is based on how low the dose takes the cat. A test two or three hours after the shot is always a good idea, so if you shoot at, for example, 7 pm, and go to bed at 10, you can test at +2 and+3 and have a good idea if it is safe to go to sleep or if you need to set an alarm to test again. It will also give you an idea of what kind of food you should leave out - low carb or medium, etc.
 
Deena Traina said:
Hello,
Yes I shoot Malachai 2X a day. I just don't have a lot of evening numbers as I go to bed a few hours after I inject him. Yes, I've read that it is very different from Vetsulin. Have you ever ordered from Marks? Any idea how much a pen costs there or a pack of 5? Do they sip with ice packs?
Click to expand...
I think a 5 pack of pens from Marks is $149.99. They do ship with ice packs and for $10 more they ship in styrofoam. Their website has quite a bit of information. I took a picture of my prescription and forwarded it to them. They're keeping it on file for me. I held off ordering because of the cold weather. They suggest shipping in spring and fall due to temperature extremes. I haven't ordered from them yet, but was going to this week. Holding off a bit because my vial of Lantus ($288 at Walmart) is still fairly full, and I don't want to waste it. I have their phone number, and it's on their site. When I called them, they were very helpful.
 
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Deena Traina said:
Any idea how much a pen costs there or a pack of 5? Do they sip with ice packs?
Click to expand...

A single pen is $49.99 but you can get a box of 5 for $149.99 plus $25 shipping

There are probably hundreds (if not more) of people using Marks for their cats insulin since I originally found them a couple years ago and I've never heard one complaint!

I do try to keep this post updated with the latest prices http://www.felinediabetes.com/FDMB/...canadian-pharmacies.49608/page-2#post-1344374
 
Hello and welcome from me too. My kitty Neko also started on Caninsulin (Vetsulin) then made the switch. I think you'll be happy with the change.

No need to worry about warm temperatures at Marks - it's snowing again! :arghh: They are about 20 minutes drive from me.
 
Chris & China said:
A single pen is $49.99 but you can get a box of 5 for $149.99 plus $25 shipping

There are probably hundreds (if not more) of people using Marks for their cats insulin since I originally found them a couple years ago and I've never heard one complaint!

I do try to keep this post updated with the latest prices http://www.felinediabetes.com/FDMB/...canadian-pharmacies.49608/page-2#post-1344374
Click to expand...
Thanks for finding them and sharing the info. :D Knowing they sold Lantus at a more reasonable price helped me decide to make the switch. I forgot to add about the $25 shipping.:facepalm: :)
 
Glennie said:
Thanks for finding them and sharing the info
Click to expand...

I was screaming it to the rafters, I assure you!! I'd been doing Google searches for about 6 weeks trying to find someplace to get cheaper Lantus and all I was getting was those "website pharmacies" in Canada that had horrible reviews and noplace within 150 miles of me would sell me just one pen. There was just no way I could afford another $300 for a vial so I was within weeks of having to take China off Lantus

One day I did another search for Canadian pharmacies and Marks popped up! I knew someone living in Vancouver and they told me they were a real brick and mortar pharmacy connected to a doctors office. I called and talked for probably 2 hours with the pharmacy manager asking all kinds of questions to check them out.....and when I was finally satisfied, I had the vet fax in a script....I think one of the things that impressed me the most was they didn't even want my credit card info until they had the script!

The one thing that saddens me is all the people out there that may be choosing to euthanize because they can't afford the insulin because they don't know there are options like Marks!

I was like "I found the gold at the end of the Rainbow and it's in Canada!!" :):):):):)
 
I ordered the 5 pack of pens within the past month $187 included the $25 shipping + $10 for styrofoam packaging. I used my last vile almost 5 months (I didn't finish it, switch because I thought maybe it was loosing potency).

You can upload the prescription using their on line order form or email it to them and call to place the order and pay. If you call, speak with Rita. She has been more than helpful. If you have any other questions let me know.
 
Chris & China said:
I was screaming it to the rafters, I assure you!! I'd been doing Google searches for about 6 weeks trying to find someplace to get cheaper Lantus and all I was getting was those "website pharmacies" in Canada that had horrible reviews and noplace within 150 miles of me would sell me just one pen. There was just no way I could afford another $300 for a vial so I was within weeks of having to take China off Lantus

One day I did another search for Canadian pharmacies and Marks popped up! I knew someone living in Vancouver and they told me they were a real brick and mortar pharmacy connected to a doctors office. I called and talked for probably 2 hours with the pharmacy manager asking all kinds of questions to check them out.....and when I was finally satisfied, I had the vet fax in a script....I think one of the things that impressed me the most was they didn't even want my credit card info until they had the script!

The one thing that saddens me is all the people out there that may be choosing to euthanize because they can't afford the insulin because they don't know there are options like Marks!

I was like "I found the gold at the end of the Rainbow and it's in Canada!!" :):):):):)
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Well, thank you, thank you, thank you for all your hard work researching a cheaper option. My vet recommended Lantus, but I think it was $588 at Walgreens. Walmart was more doable at $288 a vial, but at that time, I thought it only lasted a month. And we can't do $288 a month, not with 3 kids on inhalers (about $300 per inhaler per month-thank you, Obama and crew). I decided I could do a one time $288 till I could order from Marks. And now I find it lasts longer, but I'm going to order soon. All your hard work is really helping a lot of us and our kitties. Bless your heart.
 
That's what I did too....my first vial was $168.....but then I learned about the pens and the fact that we could use them to the last drop instead of throwing half a vial away but when it was time to get new insulin, it had climbed to $240 for a vial and over $500 for the pens

The drug companies are making out like bandits in all this, that's for sure!!

No way could I afford even the $240 at that point, much less over $500!! I live on SSI of about $700/month so it wasn't going to happen!
 
Hello again everyone,
What syringes would everyone suggest I buy to use with the pens? I know I am supposed to get U-100 but is there any recommended brand, gauge, mm that works best?
Also, I'm a little confused on how I am supposed to use a syringe with the pen. Does anyone have any information on this? I've read a lot of different things like some people say to inject air into the pen (NOT the insulin) while others say don't put air into the pen at all. I just want to make sure I'm doing it correctly and don't even know where to start. I ordered Lantus on 3/13 so am just waiting for it to arrive. Malachai will most likely start Lantus next week so I'd like to order some syringes asap. Thanks to all!
 
Hi Deena:

From the sticky
LANTUS & LEVEMIR - SYRINGE & INSULIN INFO: HANDLING, DRAWING, & FINE DOSES

PROPER HANDLING OF LANTUS and LEVEMIR:
  • Lantus and Levemir should be visually inspected prior to administration. Use only if the insulin appears clear and colorless.
  • Never shake or roll your vial, cartridge, or pen.
  • In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
  • Do NOT use Lantus or Levemir if it has been frozen.
  • Do not inject air into cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.
  • If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It may contaminate the insulin vial with silicon.
The least expensive syringes, and often the easiest to get, are the Relion syringes from Walmart.
upload_2017-3-13_22-32-26.png
 
Thanks Tricia,
I saw a lot of people say 1/2 Unit markings are better. Since I'm just switching over we Lantus we are starting with a 1unit dose but I'm sure we will go up as he's a high dose kitty. Thank you for the info above.
 
Hello and Welcome,
Hope you get your lantus soon, since you would take the dose up in 0.25u steps getting hold of the syringes with the 0.5u markings is a good idea,

Deena Traina said:
as he's a high dose kitty.
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What makes you say this??
Looking at the data you have the largest dose you shot was 3u, that's not considered a high dose:)
Has he been tested for high dose conditions? is that what you mean?

I would reiterate what Sienne said above and recommend that you always get a test before you shoot insulin and as lantus dosing is based on how low the dose is getting the cat, if it's at all possible getting at least one test midcycle am and pm.

Here are the links for the stickies on dosing that Sienne mentioned, just in case you haven't found them, they should give you a good idea of how we typically dose and the reasoning behind it, there are other stickies at the top of the board full of very useful info too, they are all worth reading.
http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-start-low-go-slow-method-slgs.129446/
http://www.felinediabetes.com/FDMB/threads/lantus-levemir-tight-regulation-protocol-tr.1581/
 
Hello,
Over on the Vetsulin board, I was told it was super high for a cat and he should have been started at .5-1unit not 2 the vet had prescribed. He is definitely doing better on a larger dose though. He probably would have ended up at 4units had he stayed on Vetsulin. I will definitely be able to check mid-day doses when I start him on Lantus. We are starting him at 1unit and will make adjustments after 1 week on that dosage. I'm pretty sure he will need more but I'm also following my vets advice of start low and go slow :)
 
Deena Traina said:
Since I'm just switching over we Lantus we are starting with a 1unit dose but I'm sure we will go up as he's a high dose kitty.
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Why do you say he's a high dose kitty? The spreadsheet only shows him going up to 3 units, which isn't all that high. If you can monitor, I would have started at 3 units of Lantus. We take the dose of the existing insulin into consideration when switching. If you want to be conservative, you could go back to 2.5 units. My Neko was on 5 units of Caninsulin (same thing as Vetsulin) and we started back at 1 unit of Lantus (as per my vet's recommendation too) - that was a big mistake as I had to go all the way back up, and then some. I wasted a lot of time with her back in higher numbers again.

Since you are going backwards so much in dose, I strongly recommend that you get daily ketone tests in. His numbers will probably be a lot higher when you start Lantus.
 
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