Lantus dosing versus Vetsulin

[Chester’s Dad]

For folks more well-versed in this area than I (and with apologies if this question has been answered before):

When comparing Vetsulin to Lantus, it seems at first blush that a vial of Lantus is about 600% more expensive ($300 as opposed to $50 for Vetsulin). Does this bear out in practice, though?

I see that a vial/pen of Lantus is U-100, while Vetsulin is U-40. Acknowledging for a moment that they are different drugs with different responses—am I to understand that a Lantus pen would hold 300 units, while a Vetsulin vial would hold 400 units, thus making the price difference much more manageable than initial sticker shock?

Sorry for the confusing question, but I appreciate any help as I try to educate myself!

 

[Bellasmom]

@Judy and Boomer @Bobbie And Bubba @Sienne and Gabby (GA)

 

[Bellasmom]

@LizzieInTexas

 

[tiffmaxee]

Many of us purchase Lantus from Canada, Mark’s Marine Pharmacy, a brick and mortar store. It’s much cheaper. I had one vial but it lasted for six months and I threw away half of it. The pens can be used to the last drop and can be purchased individually but I always bought a box of five. You still need to buy the needles as you will use the pen like a vial.

 

[Olive & Paula]

I can't answer in Units. I don't know if this helps or not.

Lantus pen is 3 ml per pen. You can get box of 5 pens which total 15 ml. The vial whether it's 40u or 100u is 10 ml.

Buying from Marks Marine in Canada, the box of 5 pens for Lantus is under $200. I don't know about Vetsulin.

 

[MrWorfMen's Mom]

I put this spreadsheet together to see how the costs would compare albeit I used $56 for Vetsulin. It doesn't take into consideration the point tiffmaxee made that she ended up throwing out unused insulin from vials which could happen with the Vetsulin too. In the long run, I'd suggest the costs are at least comparable and in some cases, Lantus could be cheaper despite the initial spend being higher. Hope this helps.
https://docs.google.com/spreadsheets/d/1-DU77Pfy5RMxN61hD3iRuQ32nAlgWUy1EAXlPso36aM/edit?usp=sharing

 

[Sienne and Gabby (GA)]

I'd urge you to think in terms broader then cost. Vetsulin/Caninsulin (they are the same and Vetsulin = Caninsulin outside of the US) was not formulated for cats. It was developed for dogs. A cat's metabolism is very different in that a cat's metabolism is faster. As a result, you do not get the kind of duration with Vetsulin as you do with Lantus. As a result, by the time you get to your next dose, numbers may have skyrocketed. The effect of Vetsulin wears off at around +8 at the very latest. That said, Lantus was developed for humans and a cat's metabolism is faster than ours which means you dose Lantus twice a day in cats.

Vetsulin is also harsh and potent. By that I mean you have to feed a meal at least 30 min in advance of giving a shot and a shot can cause a fast drop in numbers early in the cycle. Lantus is less potent -- you typically don't get a sharp drop in numbers -- and gentle. There is also research that speaks to the potential for cats going into remission with Lantus. I'm less familiar with similar research with Vetsulin.

The American Animal Hospital Association has guidelines for the treatment of diabetes. The insulin they recommend for cats is either Prozinc or Lantus.

Also, a 10 mL vial of Lantus contains 1000 units. Comparing vial-to-vial may be a better means of comparing cost. Usually, people purchase a box of pens -- this includes 5 pens. The US price is around $400 for a box of pens. The box would give you 1500 units. The box of pens is more economical than a vial. I'm hesitant to say how long a vial will last. A great deal depends on how large or small your cat's dose is. The advantage of a pen if your cat is getting a smaller dose is that you will finish the pen far sooner than a vial. While the manufacturer will say a pen is good for only a month, it would take me close to 3 months to finish a pen and the insulin was still good.

 

[Tomlin]

I'd urge you to think in terms broader then cost. Vetsulin/Caninsulin (they are the same and Vetsulin = Caninsulin outside of the US) was not formulated for cats. It was developed for dogs. A cat's metabolism is very different in that a cat's metabolism is faster. As a result, you do not get the kind of duration with Vetsulin as you do with Lantus. As a result, by the time you get to your next dose, numbers may have skyrocketed. The effect of Vetsulin wears off at around +8 at the very latest. That said, Lantus was developed for humans and a cat's metabolism is faster than ours which means you dose Lantus twice a day in cats.

Vetsulin is also harsh and potent. By that I mean you have to feed a meal at least 30 min in advance of giving a shot and a shot can cause a fast drop in numbers early in the cycle. Lantus is less potent -- you typically don't get a sharp drop in numbers -- and gentle. There is also research that speaks to the potential for cats going into remission with Lantus. I'm less familiar with similar research with Vetsulin.

The American Animal Hospital Association has guidelines for the treatment of diabetes. The insulin they recommend for cats is either Prozinc or Lantus.

Also, a 10 mL vial of Lantus contains 1000 units. Comparing vial-to-vial may be a better means of comparing cost. Usually, people purchase a box of pens -- this includes 5 pens. The US price is around $400 for a box of pens. The box would give you 1500 units. The box of pens is more economical than a vial. I'm hesitant to say how long a vial will last. A great deal depends on how large or small your cat's dose is. The advantage of a pen if your cat is getting a smaller dose is that you will finish the pen far sooner than a vial. While the manufacturer will say a pen is good for only a month, it would take me close to 3 months to finish a pen and the insulin was still good.

I've now personally experienced EXACTLY what you are saying. After 1 month of Vetsulin, we are officially changing to Lantus. My boys #s drop off as quickly as 2 hours post insulin & then he gets a few good hours & by 6 hours his numbers are back into the mid-high 200s.

The published research, now that I've had a chance to check it out, does say Lantus is what has been shown to give cats the best chance at remission because of how it works. You can use this link to download a pdf of this very informative journal article: Managing Feline Diabetes: current perspectives, published in 2018. It actually discusses each insulin, treatment & monitoring, new & emerging therapies. VERY helpful!!

https://www.dovepress.com/managing-feline-diabetes-current-perspectives-peer-reviewed-article-VMRR

I also became a little concerned about Vetsulin after reading about how it was pulled from the shelves & then put back on & why, including label changes & the need to "shake" it because there are 2 suspensions (one

 

[Sienne and Gabby (GA)]

@Amy47 - thanks for the article!! Jacqui Rand is one of the authors of the Tight Regulation Protocol and has done impressive research on the use of Lantus in cats.

 

[Tomlin]

How many pens should I get at once??? Starting dose is going to be 1 unit

 

[Tomlin]

@Amy47 - thanks for the article!! Jacqui Rand is one of the authors of the Tight Regulation Protocol and has done impressive research on the use of Lantus in cats.

For some reason it wouldn't print off PubMed but I was able to get it from Dove Press! If you put the title in PubMed though, you are able to find/review similar articles which is nice & helpful.