12/5 Luna - AMPS HI, +2 477, +5 357, +9 273, +11 174, PMPS 169

For_Luna

Member Since 2019
We had a really good two days on 12/1 & 12/2, and now we're back to HI again. I'm thinking (hoping) it's a bounce since she shot up and stayed there after the near 24 hours of blue, but this is the 3rd day. And last night it looked like we were getting somewhere at +6, but she was back into the 400s at +8.

We went with a heavy 1.5U this morning, so hopefully we see things start to come down.

I'm sure we had days like this is the past, but being able to get hourly readings with the Libre makes the spreadsheet look scary when she's high.
 
Both of our vets said they like Lantus. What's the difference?

One of the endocrinologists/diabetes researchers I have spoken described Levemir and Toujeo as being less erratic than Lantus. So, in cats that aren’t responding well or in cases where someone is trying to refine treatment, a switch will often be made from Lantus to Levemir or Toujeo.

You may want to have your vets tap into UPenn if they haven’t already & see what they think. They may be waiting to get more info before making a change.
 
Both of our vets said they like Lantus. What's the difference?

Well I think @Wendy&Neko @Marje and Gracie @Sienne and Gabby (GA) can explain it better than I could. But it has a later nadir for most cats so it can level them out and possibly help with making bounces smaller. It's dosed like lantus

Ollie's 1st vet was against it because he didn't know anything about it. I wanted to change because at the time the high dose Ollie was on bothered her. I just changed it myself. Her vet for the last year is okay because Ollie was on it before we started with her.
 
One big difference is that Lantus is a U100 insulin vs Toujeo being a U300 insulin -- it's 3 times more concentrated. I would be very reticent to suggest Toujeo unless someone's cat was getting a very large dose of insulin like 30u. If the dose was that high, you could give 10u of Toujeo vs 30u of Lantus. Since Toujeo is also glargine, I'm not clear on how it can be less "erratic" than Lantus.

One other difference is that Lantus is acidic an causes some cats to flinch or be uncomfortable. This is more of an issue if a cat is on a large dose of insulin. Many CG's of high dose cats switch from Lantus to Lev because of the acidic nature of Lantus.

Lev has a later onset and nadir. Where the nadir with Lantus is at +6, with Lev it can be at +8 or later. When I first joined FDMB, the conventional wisdom was that Lev gave longer duration. With more observation, it was clear that this wasn't the case -- it was a matter of the nadir being later I have seen cats switch from Lantus to Lev and do exceptionally well -- they bounce less, cycles are flatter, etc. I've also seen cats where the switch has made absolutely no difference.
 
Some low dose cat’s also do skin twitching with Lantus, due to it’s acid base. Neko seemed to get better duration on Lev. Her cycles were definitely flatter. She didn’t drop as fast and was slower to come back up at the end of the cycle. I really liked the nadirs near preshot time, as I was almost always home for that. The late onset was also a bonus, I had hours to get food into her after shot time. What Neko liked best is that she could eat later in the cycle, plus she no longer reacted to the Lantus sting.
 
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