Lantus vs. Levemir

Breanna H

Breanna H

Member Since 2019
Hello!
I'm sure I'm missing this somewhere but I figured I would ask.
I am composing an email to my vet to ask to make the switch for Tigger from Prozinc to a depot insulin. I had thought I should ask for lantus but the more I am reading the sticky notes, I am a little confused on how lantus and levemir are different. Do they really work much differently? I saw one small section under one sticky that explained some how they both worked but thought I could get more clarification here.
Which one might be better for Tigger?
I know a lot of people use Mark's Pharmacy in Canada, is pricing any different between the two insulins? Is there anywhere in the US that is cheapest to get it? Not that this really matters to me but if one would work and it's cheaper, then bonus points!
If you look at Tigger's numbers, you can see Prozinc isn't cutting it. I know I should rule out Acromegaly/insulin resistance but I wanted to try switching insulin first. With everything going on (and who knows how long this may last), switching insulin seems easier right now than hauling my sugar kitty into the vet for blood work, since my vet allows me to email her numbers and questions.
Thank you all again for your time!
 
Hi Breanna,
As Tigger is on a higher dose, levemir would probably be better as Lantus can sting at higher dose.
The difference between prozinc and Lantus and levemir is that prozinc is an ‘in and out’ insulin. One dose does not effect another.
Lantus and levemir are depot insulins, meaning that each dose leaves a little insulin under the skin which over time forms a depot. This depot releases insulin as well as the normal shots and this helps with the duration of the doses. One dose can effect another dose.
Not sure I’ve explained it well but here is a sticky about it
http://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/

I have used both Lantus and levemir and liked levemir better. It has a later onset then Lantus 2 hours V 3 to 4 hours and the duration was longer with levemir with Sheba. I have not used prozinc but from what I’ve observed, you can shot lower numbers with Lantus and levemir which is a real advantage.

Some cats that have not done well on one insulin can do a lot better on another, and sometimes it doesn’t make a lot of difference. But I think it is worth swapping.
I don’t live in the US so can’t comment on the pricing except to say that Marks pharmacy in Canada is a lot cheaper than in the US.
 
Breanna H said:
is pricing any different between the two insulins?
Click to expand...

Marks is currently having a shortage of Lantus, but they have Basaglar which is also Glargine insulin. It's $125 for 5 pens or cartridges plus $25 shipping. That's 1500 units of insulin which is enough to last most cats at least a year...some up to 2 years

Levemir is $170 plus $25 shipping for 5 pens

I try to keep this thread on Buying insulin from Canada updated with the latest prices
 
Higher dose cat, go for Levemir. I had a higher dose cat (and sometimes she was lower dose), i much preferred Levemir. So did my cat. As Bron said, the onset and nadir are later with Levemir. With Neko the onset was +5, nadir anywhere from +9 to +12, most of the time. You do have to get used to shooting lower numbers, but you also have hours before the next shot takes effect.

The insulin may make some difference, but no matter which insulin, we suggest testing for acromegaly and IAA (insulin auto antibodies) when you get to 6 units.
 
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Bron and Sheba (GA) said:
As Tigger is on a higher dose, levemir would probably be better as Lantus can sting at higher dose.
Click to expand...

Wendy&Neko said:
Higher dose cat, go for Levemir. I had a higher dose cat (and sometimes she was lower dose), i much preferred Levemir.
Click to expand...

Levemir it is. Hopefully she is willing to give me the prescription. If not, that involves switching vets, which is a process in itself. I had no idea the difference between the two it sounds like Tigger would benefit from a longer onset nadir.

Chris & China (GA) said:
Levemir is $170 plus $25 shipping for 5 pens
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Sounds fine to me. At this point, it is still cheaper than all the Prozinc I will be going through at a higher dose. Can my vet write me a paper prescription or should she submit the prescription directly to Marks?

Wendy&Neko said:
The insulin may make some difference, but no matter which insulin, we suggest testing for acromegaly and IAS (insulin auto antibodies) when you get to 6 units.
Click to expand...

I do plan on asking about this but my vet currently has no idea Tigger is at 6u, and as of this morning, 6.5u. She insists I should hold doses for at least 3 weeks and does not believe in regular home testing, other than for curves, so right now she thinks he is only on 1.5u. If I only kept him at this dose for this long, I was worried about DKA, so I have been following the advice of the forum and using the modified Prozinc method. I asked her about insulin resistance and holding doses too long but she told me it doesn't work that way in cats? Which through all my research, I know to be false. I know I need a new vet, ultimately but with everything going on right now, it's inconvenient to try to find one and actually sit down with one to discuss Tigger's current condition. I at least have gotten my current vet to be on emailing terms with me, rather than bringing him in, which is nice. So I'm hoping she will switch me to Levemir with not many questions or much issue. I don't want to wait around to get him regulated so I thought this was a good step for my current situation.

Wish me luck and thank you all so much for the information and advice, it was truly helpful!
 
Breanna H said:
Can my vet write me a paper prescription or should she submit the prescription directly to Marks?
Click to expand...

She can write you one and you can take a picture of it to send to Marks, or she can call it in to Marks or fax it. They are great and will work with just about anything they get!
 
Well the vet answered. No go for the levemir. She said she has never had a cat on it, it is not common to use in feline diabetes and they don't use it due to how expensive it is. :banghead::facepalm: She wants me to continue on the Prozinc. Hopefully I will be able to get Tigger into a new vet here soon before I have to buy a whole new bottle of Prozinc.
Tigger is eating me out of house and home and the amount of litter I go through is crazy. But I finally have him maintaining his weight despite his numbers at the moment. He's lucky I love him so much.
 
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