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HaleyM

HaleyM

Member Since 2022
Hello, my name is Haley. My cat's name is Tulip (we found her in a tulip tree). She is currently 14 years old. She was diagnosed 2/22/22. She had been losing weight, drinking a lot, then quit using her box) Vet prescribed 5 units of Novalin N every 12 hours after her 2 meals. We started that on Wednesday last week. We are now feeding high protein/low carb fancy feast wet food twice a day. After doing a lot of reading I am questioning this insulin and dosage. I got home testing (relion) equipment today (on 2/27/22) and after a few failed attempts her BG showed 58 (7 hours after her morning meal/shot). Am I right that this is too low?? I can absolutely test her again before tonight's meal/dose but what number should I be looking for to know what to do. (The vet wants us to come back on Tuesday as well)
 
That is way too large a starting dose as mentioned by Kelly. I be.I eve most cats start at 1.0. I have never used Novolin and it’s not a good insulin for cats. The best ones for cats are lantus, Levemir, or Prozinc. Novolin is fine for dogs.

I hope someone with Novolin experience will respond soon. When are you supposed to give the next shot?
 
I'm supposed to be feeding her now - 8pm cst. Trying to get more blood, but even though I am pricking I must be hitting the wrong spot because I am not getting blood. (I've tried looking through a flashlight and have watched lots of videos!)
I'm going to keep trying and will text the vet in the morning.

Or vet is still only doing curbside drop off appointments and communicating via text messages.
 
Oh my word. I just had a heart attack. So glad you decided to read and question.

Can you please put whatever data you can into our spreadsheet? https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
We are used to reading that and it will help us a lot

Also when you get a chance, please have a read through the Help Us Help You post

What is current diet? Are you testing ketones?

Do you have a hypo kit?

I don't think there are many members around with Novolin experience, @Larry and Kitties ?

Need those answers before I can advise on dose, but a 58, 7 hours after a 5U Novolin N shot is very concerning. Severely overdosed in my opinion without having any other data/info, personally I think you're lucky she's still alive. The absolute max I would give is 1U, but if low carb I'd go 0.5U. However, that is a very steep dose reduction so you have to monitor ketones.

Copying and pasting this pertinent info from the sticky:
With an insulin with an early onset, it is important that your cat has eaten before you give a shot. Generally, you want to feed your cat and give a shot an hour after your cat has eaten. The order for this process is:
(1) test, (2) feed, (3) wait 60 min, (4) shoot

Remember: Insulin is given twice a day at 12-hour intervals.

Starting Dose:
For a cat that is eating dry food or other higher (over 10%) carbohydrate food, the starting dose is 1.0u.
If the cat is eating a low carbohydrate (preferably) canned or raw food diet, the starting dose is 0.5u.
If and when to shoot: Generally speaking, if you are new to managing your cat’s diabetes, it’s recommended that no N/NPH is given if the BG is below 250 mg/dL [13.8 mmol/L] on a human glucose.

 
HaleyM said:
I'm supposed to be feeding her now - 8pm cst. Trying to get more blood, but even though I am pricking I must be hitting the wrong spot because I am not getting blood. (I've tried looking through a flashlight and have watched lots of videos!)
I'm going to keep trying and will text the vet in the morning.

Or vet is still only doing curbside drop off appointments and communicating via text messages.
Click to expand...
See my reply just now - test, feed, then wait 1 hour before giving insulin. And please do not give anything above 1U (I prefer 0.5U without having data, but reiterating checking for ketones with such a steep reduction)

The ears need time to form more capillaries, trouble getting blood is normal. In fact, if you get a lot of blood when first starting, you probably accidentally hit the vein
 
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
c2b8079a-b471-4fa6-ac36-9ac1c8d6dcca-jpeg.57072
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6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up

Here is a video one of our members did
VIDEO: How to test your cat's blood sugar
 
I agree, 5 units is far too much. I can’t believe the vet would order that. I would start with 0.5u to 1unit. Maximum.
I would also ask to swap to a suitable cat insulin as mentioned above by Elise in post 3.
Warm the ear first before trying to get the blood.
If you need help with the spreadsheet just ask.
 
We feed our cats more than just twice a day, bigger meals at AMPS and PMPS and at least 2 or 3 smaller meals during each 12 hour cycle.
 
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I am still struggling to get blood, but won't give up. I went ahead and tried to feed her (fancy feast classic pate) because she seemed starving and annoyed. But she won't eat anything, not even lick it. This is super unusual for her.
 
HaleyM said:
I am still struggling to get blood, but won't give up. I went ahead and tried to feed her (fancy feast classic pate) because she seemed starving and annoyed. But she won't eat anything, not even lick it. This is super unusual for her.
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I don't know if someone already mentioned it but if her ears are cold, they won't bleed easily. Especially in the beginning. Make sure they're warm before trying to get blood.
 
Was able to finally get her to eat a little bit, was scared to give her any insulin? Now (about 1.5 hours after eating) was finally able to get a drop of blood. BG was 288. Should I give .5 units? Or 1?

My poor girl must feel like a pincushion after all I have put her through today.
 
HaleyM said:
Was able to finally get her to eat a little bit, was scared to give her any insulin? Now (about 1.5 hours after eating) was finally able to get a drop of blood. BG was 288. Should I give .5 units? Or 1?

My poor girl must feel like a pincushion after all I have put her through today.
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I'm sorry I truly cannot soundly advise either way - I've never used Novolin, and there's not enough history for me to go from.

0.5U is safer bet...if it's even safe. I'd want you to test again the next few hours, but with the testing struggles you have I don't want to rely on that (not a criticism! We all struggle when New)

58 to 288 really isn't a terrible rise for 6 hours. Which leads me to believe her pancreas may still be a bit functional, and/or she needs a lower dose (the possibility that 5U was close to ok is out there, but very very slim). You could try to estimate 0.25U if you feel more comfortable with that.

Edit: I am heading to bed, if you decide to shoot try to get a test in at +2/+3
 
How was she diagnosed? Fructosamine? Any other symptoms?

After diagnosis, did the vet do any curves? Before or after food change?
 
As I have been reading more and more tonight, I have found yet another confusing thing. This novalin n insulin is injected with a u-100 orange capped syringe. So 5 units is 0.05ml, correct? I think (???) other insulins uses a u-40 syringe? So 1 unit would be 0.025ml?

Do I have all of this wrong? 5 units from a u-100 is equal to 2 units from a u-40?

She was diagnosed with blood work but I think the vet only did a partial curve before I picked her up , we had an ice storm coming in last week and I thought it was best to get her home rather than having her get stuck in the vets office for a few days. We didn't change her food til after getting her back.

I will call the vet bright and early tomorrow and continue trying to home test as often as I can. Thanks everyone for your help and time!
 
I am so glad you are questioning your vet. I don't think your vet has much, if any experience in treating feline diabetes. As others have already told you 5 units is too high of a dose. Also Novalin is not a good insulin for most cats.

To help get blood flowing in the ear it needs to be warm. You can use a warm rice sock to help warm it up Massaging the ear towards the tip also helps. Often the ears need to learn to bleed. Also always give Tulip a low carb treat every time you test, even if you are not successful. This will help her associate testing with something good. Food low carb treats include freeze dried chicken or bonito flakes.

Better insulins for cats are Levemir, ProZinc and insulin glargine (Lantus, Semglee & Basaglar). All of these are longer acting insulins that do not have the steep drops like Novalin and Vetsulin. If you decide on Levemir or one of the insulin glargine brands, get the prescription for the pens instead of the vials. Then you will be able to use almost every dose before it becomes ineffective. Also don't worry about the 28 day expiration info for these insulins. That is for human users per FDA rules. The insulin is usually effective for several weeks after that date. One pack of pens will give enough insulin to last 9 - 12 months or more.

If you decide to look for a new vet, create a separate post and include your location. We may have members near you who can recommend someone.

This is a new journey for you and Tulip. We are here to help you. As you may have discovered there is a lot of info here. Ask any questions you have. We have all been where you are now and are here to help.
 
Hi @HaleyM – I hope everything is okay this morning. Do tell us know what the vet advises – in all honesty, I have very little confidence in this vet.

Re: getting a drop of blood. You might try putting the lancet device on a deep setting. Some people don't use the lancet device at all but freehand the poke. A cat's ears are much tougher than you think – generation upon generation of cat fights have toughened the ears.
 
we were never successful until we ditched the lancing device and went freehand with vaseline and warming the ears up. Freehand is the way to go imo
 
Thank you all SO MUCH!! I think I am getting the hang of getting the blood. I think I was going too low on the ear, and too close to the edge. But the biggest difference was adding a warm sock. I have been using the lancet freehand from the start. This morning I was able to test and got blood on my first try BG was 368. She was still slow to eat - but I wonder if she is just starting to get picky about her wet food. I did go ahead and give her a shot - but at reduced units. I called the vet and they are going to bring her in for a full day observation and testing every 2 hours - something I can't do during the week, cause I am a school teacher. Then I will have the opportunity to talk about a different type of insulin and we can get the dosing correct. I will get the data from the vet to put on our spreadsheet - and I can test multiple times throughout tonight, so hopefully we will get a better picture of her curve.

For the Novalin N I have been using the u-100 orange tipped syringe this entire time. Pulled back to the 5 mark. I know that this dose is far too high, but maybe based on the different syringe it isn't 10 times too high - only 2 times too much? I will get to the bottom of it with the vet.

Again I can't thank this group enough - I have been pouring through all of the FAQ and stickies for the last 2-3 days and the amount of information is so helpful and the support is super reassuring! --Haley
 
So the lines on the syringe are the number of units - the "5" line is 5 units. But if you're trying to figure out volume, U100 is 100 units per mL, so 5 units is 0.05mL...but much easier to stick to units ;)

You did shoot 4 units this morning? So the "4" line? Still far too high in my opinion.

We don't know what the right dose is, but experience tells us it is not 5U. Combined with it's a very harsh/unsafe insulin, still getting the hang of testing, not much data - that's why we recommended a full reset. 0.5U likely isn't the right dose either, but it's better to start small and safe. Hold the dose for 5-7 days, then work on increasing. Better too high for awhile than too low for even a minute.

As for the curve at the vet, I'll be interested to see. Keep in mind numbers are often elevated at vet due to stress
 
My concern with the vet is it sounds like they may not have any experience treating diabetic cats. Treating feline diabetes is not the same as treating diabetes in a dog. Cat's bodies respond differently to insulin than a dog does. Given this vet has started you on an insulin that is bad for most cats and at too high of a dose, if it were me, I would not trust this vet to do a curve on any of my cats. Now that you are home testing you can do your own curves at home.

I also recommend getting a prescription for one of the longer acting insulins that I listed above.
 
Hi Haley, I was looking at your spreadsheet and wondered why you upped Tulip from 3 to 5 units this morning, did you do any more tests after that

that was quite a drop at +3 with Novolin and those 3 neon greens after that ,is Tulip OK?
I really think you should consider changing to either Lantus or Prozinc
I see in your remarks you gave her a snack @+5 you really should have given her something to eat starting at +3

Can you set up your signature click on the blue link
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help

@HaleyM

@tiffmaxee

@Bron and Sheba (GA)

@FrostD

@Lisa and Witn (GA)

@Red & Rover (GA)

@Bandit's Mom

Ladies I happened to look at Haley's SS and almost had a heart attack when I saw her day cycle , I have no idea why she raised Tulips dose again to 5 units
I see she went back to 3 units tonight, I was hoping she would see the tag
I was just worried for Tulip or maybe I should mind my business since she didn't ask for help
 
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Hendrick's mom and dad said:
@Diane Tyler's Mom my theory is, the AMPS of 600 maybe caused a reaction of "oh wow I better give more insulin"

all the way down to 31, wow. And I damn near feinted when Hendrick threw a 66!
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Hi, yes that's what she probably did when she saw the 600, but we advised her that 5 units of Novolin as way to much and drop it down to 3 units which she did ,then back up to 5 units. We suggested to switch insulin.
Those lime greens were scary. I hope Tulip is ok
 
Tulip was at the vet on Thursday. I just copied the information that they provided to me. That is why she got 5 units. I was actually able to talk to the vet in person this time in the parking lot. She confirmed what I read, that 3 units of u-100 Novalin is equivalent to 1.5 units of a u-40 insulin, based on dilution. She recommended that I move down to 3 units in the future. She didn't realize that Tulip's diet had changed and said that when she did a curve for Tulip, when she was diagnosed, that 5 units from a u-100 dilution of Novalin seemed appropriate. She said that it was far too much based on what we saw on Thursday. We also talked about going even lower, to two units, but I want to be able to be home on the weekend to do a curve on that dosage for two days in a row. Tulip also has some trouble with her thyroid (it is underperforming), we are trying to get to the diabetes under control and will run more tests for her thyroid in 2 weeks.

I have used this vet for over 20 years and was able to speak to other diabetic cat owners from our town who use her. I trust her and think our problems have stem from the covid protocols that are still in place, it makes communication less than ideal. This is frustrating, but I was able to get a lot more from our conversation when I picked up Tulip last night. I still intend to switch to a slower acting insulin, but don't want to stop giving the Novalin until I have the new medication in hand obviously. My vet said that some insulins have had trouble with being back ordered or hard to come by. Was that a covid supply chain issue or something that is likely to continue in the future? I would like to make the switch only once, rather than bouncing between insulins.

Can you give me information about why you recommend Lantus or Prozinc over Levemir? I was thinking that Levemir was the direction I wanted to go. But obviously need to keep reading.

Thanks so much for your care and concern and all the information. I thought there was a link to our spreadsheet in my signature, but I guess I attached it incorrectly. I will go back and check the sticky.
 
HaleyM said:
I thought there was a link to our spreadsheet in my signature, but I guess I attached it incorrectly. I will go back and check the sticky.
Click to expand...

it's there, but what was asked is that you also put other info in your signature just so members don't have to keep pestering you with question about things like what kind of insulin is in use, age of kitty, etc. See mine below as an example -- lots of info and then also the link to the spreadsheet
 
HaleyM said:
Tulip was at the vet on Thursday. I just copied the information that they provided to me. That is why she got 5 units. I was actually able to talk to the vet in person this time in the parking lot. She confirmed what I read, that 3 units of u-100 Novalin is equivalent to 1.5 units of a u-40 insulin, based on dilution. She recommended that I move down to 3 units in the future. She didn't realize that Tulip's diet had changed and said that when she did a curve for Tulip, when she was diagnosed, that 5 units from a u-100 dilution of Novalin seemed appropriate. She said that it was far too much based on what we saw on Thursday. We also talked about going even lower, to two units, but I want to be able to be home on the weekend to do a curve on that dosage for two days in a row. Tulip also has some trouble with her thyroid (it is underperforming), we are trying to get to the diabetes under control and will run more tests for her thyroid in 2 weeks.

I have used this vet for over 20 years and was able to speak to other diabetic cat owners from our town who use her. I trust her and think our problems have stem from the covid protocols that are still in place, it makes communication less than ideal. This is frustrating, but I was able to get a lot more from our conversation when I picked up Tulip last night. I still intend to switch to a slower acting insulin, but don't want to stop giving the Novalin until I have the new medication in hand obviously. My vet said that some insulins have had trouble with being back ordered or hard to come by. Was that a covid supply chain issue or something that is likely to continue in the future? I would like to make the switch only once, rather than bouncing between insulins.

Can you give me information about why you recommend Lantus or Prozinc over Levemir? I was thinking that Levemir was the direction I wanted to go. But obviously need to keep reading.

Thanks so much for your care and concern and all the information. I thought there was a link to our spreadsheet in my signature, but I guess I attached it incorrectly. I will go back and check the sticky.
Click to expand...

Hi Haley
You signature is good, if you can just add the meter you are using to it, I see you are using the Relion Premier on your SS

Please keep testing Tulip as much as possible especially at night, cats seem to drop lower at night, plus you may be missing if a decrease is warranted

About your question about why Lantus and Prozinc was recommend instead of Levemir I will tag a few members to answer that question.
Most of us use Lantus.
We order it from Canada 5 pens ,they would probably last you a year depending on the dose

There is also
semglee
Just call any pharmacy to see if they have the 5 pens, they will last you a year or more
Type in where you live and you will see where you can buy it
The 5 pens should last you about a year
Lantus is expensive if you live in the US
https://www.goodrx.com/semglee?dosa...rride=Semglee&quantity=1&sort_type=popularity
Semglee, it is a generic Lantus, and was approved by the FDA last June
About the same price for 5 pens from Canada or cheaper

Or from Marks Marine ,Canada
https://canshipmeds.com
Lantus Solostar For Pets from Canada
Insulin Glargine
Manufactured by Sanofi Aventis
Select product strength & quant 100U/mL - 3 mL - $49.99 100U/mL - 15 mL - $164.99


Some have their vet write the prescription as insulin glargine
We can discuss switching when you are ready
 
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HaleyM said:
She confirmed what I read, that 3 units of u-100 Novalin is equivalent to 1.5 units of a u-40 insulin, based on dilution.
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I don't know why you are saying this lol
You are using U-100 syringes , do you have the ones with half unit markings?
3 units is 3 units on a U-100 syringe
Below is a pictorial showing insulin syringe scales. The left shows half-unit scale which would be found with a U-100
49823063143_3437e9e997_o.jpg
 
HaleyM said:
Tulip was at the vet on Thursday. I just copied the information that they provided to me. That is why she got 5 units. I was actually able to talk to the vet in person this time in the parking lot. She confirmed what I read, that 3 units of u-100 Novalin is equivalent to 1.5 units of a u-40 insulin, based on dilution. She recommended that I move down to 3 units in the future. She didn't realize that Tulip's diet had changed and said that when she did a curve for Tulip, when she was diagnosed, that 5 units from a u-100 dilution of Novalin seemed appropriate. She said that it was far too much based on what we saw on Thursday. We also talked about going even lower, to two units, but I want to be able to be home on the weekend to do a curve on that dosage for two days in a row. Tulip also has some trouble with her thyroid (it is underperforming), we are trying to get to the diabetes under control and will run more tests for her thyroid in 2 weeks.

I have used this vet for over 20 years and was able to speak to other diabetic cat owners from our town who use her. I trust her and think our problems have stem from the covid protocols that are still in place, it makes communication less than ideal. This is frustrating, but I was able to get a lot more from our conversation when I picked up Tulip last night. I still intend to switch to a slower acting insulin, but don't want to stop giving the Novalin until I have the new medication in hand obviously. My vet said that some insulins have had trouble with being back ordered or hard to come by. Was that a covid supply chain issue or something that is likely to continue in the future? I would like to make the switch only once, rather than bouncing between insulins.

Can you give me information about why you recommend Lantus or Prozinc over Levemir? I was thinking that Levemir was the direction I wanted to go. But obviously need to keep reading.

Thanks so much for your care and concern and all the information. I thought there was a link to our spreadsheet in my signature, but I guess I attached it incorrectly. I will go back and check the sticky.
Click to expand...



@HaleyM

@tiffmaxee

@Bron and Sheba (GA)

@FrostD

@Lisa and Witn (GA)

@Red & Rover (GA)

@Bandit's Mom

I don't know if anyone is getting the tags
Can you also answer her question which is

Can you give me information about why you recommend Lantus or Prozinc over Levemir? I was thinking that Levemir was the direction I wanted to go. But obviously need to keep reading.
 
Diane Tyler's Mom said:
I don't know why you are saying this lol
You are using U-100 syringes , do you have the ones with half unit markings?
3 units is 3 units on a U-100 syringe
Click to expand...

Perhaps I am understanding this incorrectly, but from what I have read the amount of insulin in 5 units of a u-100 solution is different than the amount of insulin in 5 units of a u-40 solution. I was trying to compare the mount of insulin that I am giving to what I am reading other people are giving (but who are using different medication than we are currently using).

At least what I have gathered so far, is that my three units of novalin has 0.03ml of insulin solution. While someone else using a u-40 syringe/medication would be giving 0.075ml of insulin solution if they gave 3 units.

So my 3 units of Novalin has the equivalent amount of insulin that is found in 1.2 units of Vetsulin.

But I am new to all of this - have I misunderstood?


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HaleyM said:
Perhaps I am understanding this incorrectly, but from what I have read the amount of insulin in 5 units of a u-100 solution is different than the amount of insulin in 5 units of a u-40 solution. I was trying to compare the mount of insulin that I am giving to what I am reading other people are giving (but who are using different medication than we are currently using).

At least what I have gathered so far, is that my three units of novalin has 0.03ml of insulin solution. While someone else using a u-40 syringe/medication would be giving 0.075ml of insulin solution if they gave 3 units.

So my 3 units of Novalin has the equivalent amount of insulin that is found in 1.2 units of Vetsulin.

But I am new to all of this - have I misunderstood?


View attachment 63647
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Haley I'm sorry but I can't help you with this, I have no idea .
Why are you trying to compare this anyway
@HaleyM
 
HaleyM said:
Perhaps I am understanding this incorrectly, but from what I have read the amount of insulin in 5 units of a u-100 solution is different than the amount of insulin in 5 units of a u-40 solution. I was trying to compare the mount of insulin that I am giving to what I am reading other people are giving (but who are using different medication than we are currently using).

At least what I have gathered so far, is that my three units of novalin has 0.03ml of insulin solution. While someone else using a u-40 syringe/medication would be giving 0.075ml of insulin solution if they gave 3 units.

So my 3 units of Novalin has the equivalent amount of insulin that is found in 1.2 units of Vetsulin.

But I am new to all of this - have I misunderstood?


View attachment 63647
Click to expand...
So although from an amount of "insulin per volume" standpoint yes, but we only care about the units themselves. The syringes in the picture are marked in units, so if you're giving 3 units of Novalin you go to the 3 line. If you switch insulin, we usually start around the same units of insulin (but please ask for advice, that's not always the case) - so as long as you have the correct syringes, it would still be to the 3 line - regardless if it's U40 or U100.

The syringes themselves are different volumes per line if that makes sense - the internal volume of the U100 syringe would be 0.01mL for 1U, but the internal volume U40 syringe would be 0.025mL - I think that's what you're getting at. The markings are in units, the internal volume is what differs.

I like Levemir from a flatness standpoint, but Lantus/semglee also good (and often less expensive).
 
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FrostD said:
So although from an amount of "insulin per volume" standpoint yes, but we only care about the units themselves. The syringes in the picture are marked in units, so if you're giving 3 units of Novalin you go to the 3 line. If you switch insulin, we usually start around the same amount of insulin (but please ask for advice, that's not always the case) - so as long as you have the correct syringes, it would still be to the 3 line - regardless if it's U40 or U100.

The syringes themselves are different volumes per line if that makes sense - the internal volume of the U100 syringe would be 0.01mL for 1U, but the internal volume U40 syringe would be 0.025mL - I think that's what you're getting at. The markings are in units, the internal volume is what differs.

I like Levemir from a flatness standpoint, but Lantus/semglee also good (and often less expensive).
Click to expand...
Thank God you came along Melissa , I wouldn't even know where to begin to help her with this.
Did you happen to read #27 her vet lowered it to 3 units.
I was just worried when I saw all those neon greens on her SS
I hope you're telling better Melissa
@FrostD
 
Diane Tyler's Mom said:
Thank God you came along Melissa , I wouldn't even know where to begin to help her with this.
Did you happen to read #27 her vet lowered it to 3 units.
I was just worried when I saw all those neon greens on her SS
I hope you're telling better Melissa
@FrostD
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Yes 3U is still too high. I can't advise on what dose would be better unfortunately, because I don't see how low she's actually gone. The 63 the other night indicates dose is too high, not sure if she may have gone lower
 
Just found this posted by a member about Levemir
The biggest difference between Lantus and Lev is that its onset and nadir are later than with Lantus. If a cat's nadir is at +6 with Lantus, nadir with Lev could be a couple of hours later. This may be a consideration for your schedule. I stuck with Lantus because of the timing of the cycle and my cat's time of onset and nadir. Other than the timing, Lantus and Lev act in a very similar way

Part of that process is getting a feel for basic concepts:
  • Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
  • Peak/Nadir - the lowest point in the cycle
  • Duration - the length of time insulin continues to lower blood glucose
 
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