Advice about switching to Lantus from vetsulin

[JaniceC]

My cat Felix has been on Vetsulin since Nov 1 and now he’s on 1U. He’s on wet FF and Friskies pate. I recently changed vets snd she suggested Lantus but she suggested starting on 2U saying she starts all cats on 2U when I questioned the dose. I know from the group that starting on 2U of Lantus is too high. How do I handle this without friction? How do I balance the directions of my vet with advice from the group? Thanks for your advice. This is his spreadsheet but I stopped testing temporarily because his lungs are inflamed and I have to use the Aerokat inhaler and the vet said it’s more critical to take care of the breathing and not stress him further with ear sticks.
Felix (Janice Ho Lung Chin) 's Sugar Sheet

 

[CORKY]

Welcome to FDMB!
You do not have to be afraid to confront your vet, most vets also are aware f our Forum let him know that you have done your research, that you feel uncomfortable starting on such a high dose, and afraid of hypoglycemia, that you rather start slowly on the Lantus, this is your cat, therefore you are in control, he’s the vet, but you have the right to question him for the best interest of you cat, I will tag another member that can share a better light on Lantus and dosing, she is extremely knowledgeable on the subject. Keep post on you’re in the place, we are here for you
@Sienne and Gabby (GA)

 

[tiffmaxee]

Welcome. First of all good that you are switching to lantus! At first I had two spreadsheets, a special one for my very experienced wonderful vet as I was worried about not following his advice. Soon that ended and he didn’t give me dosing advice. He showed my ss to his veterinary students. I’d start on 1 unit. If your vet questions that you have a perfect excuse as you aren’t testing much due to her wise advice. Dies your cat mind testing? Max didn’t. He got a special treat after each ear prick which helped and he wasn’t even a foodie!

 

[Sienne and Gabby (GA)]

The original research on using Lantus with cats that established the Tight Regulation Protocol as both safe and effective uses a weight based formula to deterimine the starting dose. Initial dose = 0.25 x cat's ideal weight in kilograms. For an average sized cat with a normal weight (approx. 10 lbs), the starting dose would be approximately 1.0u. The guidelines that were published by the American Animal Hospital Assn recommends a starting dose between 1 - 2u. It's possible that your vet is making a recommendation based on a cat that's not eating an exclusively low carbohydrate diet.

Lantus is a very different insulin than Vetsulin. It is gentler, has a longer duration, and the biggest difference is that it is a depot-type of medication. The depot is what makes it such a good insulin for cats. One other difference is that with Lantus, your dose is based on how low the insulin brings your cat's numbers. If it were me, I would let the vet know you are nervous about starting out at 2u given that when you dosed 2.0u of Vetsulin, Felix's numbers dropped as low as 137. Even with 1.0u, you saw a 144. Given that Lantus is new to you, starting at a lower dose will make you more comfortable.

Also, it will take 5 - 7 days for the insulin depot to form and stabilize. While some cats can have an initial marked response to a change in insulin, it's typical that the response may be a bit less over time as Felix's system adjusts. So, give Felix some time to get used to Lantus. It will also help to remember that any time you make a change in dose, it will take several cycles for the depot to catch up with a change in dose. You may want to read over the sticky notes at the top of the Lantus board, especially the notes on dosing methods. There's also a post on the depot. Just so you're aware, Tight Regulation was published in one of the leading veterinary journals several years ago. The Start Low Go Slow method was developed here so your vet may not recognize the name. It's a fairly typical approach to dosing.

 

[Wendy&Neko]

Hello and welcome. My Neko started on Caninsulin (Vetsulin in the US) and switched to Lantus. Both of us were much happier with the switch. Do you have the U-100 syringes you'll need for Lantus? Ideally ones with half unit markings.

I agree with the others on dose if you can't test as much. My girl very quickly learned to follow me with the test kit, once she figured out it meant treats! She was a foodie. Some people use test time as a time to brush or do other cuddles, whatever works for your cat. I hope his lungs get better soon.

Where did you get your spreadsheet template? It looks like one from a different FB group. I'm just saying that because that FB group's spreadsheet has a bug that means it doesn't always display on tablets and phones. The links to our spreadsheet format are here: How to Create a Spreadsheet: BTW, our spreadsheet was the first one that other groups have copied.

 

[JaniceC]

Welcome to FDMB!
You do not have to be afraid to confront your vet, most vets also are aware f our Forum let him know that you have done your research, that you feel uncomfortable starting on such a high dose, and afraid of hypoglycemia, that you rather start slowly on the Lantus, this is your cat, therefore you are in control, he’s the vet, but you have the right to question him for the best interest of you cat, I will tag another member that can share a better light on Lantus and dosing, she is extremely knowledgeable on the subject. Keep post on you’re in the place, we are here for you
@Sienne and Gabby (GA)

Welcome to FDMB!
You do not have to be afraid to confront your vet, most vets also are aware f our Forum let him know that you have done your research, that you feel uncomfortable starting on such a high dose, and afraid of hypoglycemia, that you rather start slowly on the Lantus, this is your cat, therefore you are in control, he’s the vet, but you have the right to question him for the best interest of you cat, I will tag another member that can share a better light on Lantus and dosing, she is extremely knowledgeable on the subject. Keep post on you’re in the place, we are here for you
@Sienne and Gabby (GA)

Thank you for that. Sorry for not checking but it’s been stressful.

Welcome. First of all good that you are switching to lantus! At first I had two spreadsheets, a special one for my very experienced wonderful vet as I was worried about not following his advice. Soon that ended and he didn’t give me dosing advice. He showed my ss to his veterinary students. I’d start on 1 unit. If your vet questions that you have a perfect excuse as you aren’t testing much due to her wise advice. Dies your cat mind testing? Max didn’t. He got a special treat after each ear prick which helped and he wasn’t even a foodie!

Thanks for your advice. . Felix doesn’t like testing and neither do I but we’re slowly adjusting with a lot of praying before

The original research on using Lantus with cats that established the Tight Regulation Protocol as both safe and effective uses a weight based formula to deterimine the starting dose. Initial dose = 0.25 x cat's ideal weight in kilograms. For an average sized cat with a normal weight (approx. 10 lbs), the starting dose would be approximately 1.0u. The guidelines that were published by the American Animal Hospital Assn recommends a starting dose between 1 - 2u. It's possible that your vet is making a recommendation based on a cat that's not eating an exclusively low carbohydrate diet.

Lantus is a very different insulin than Vetsulin. It is gentler, has a longer duration, and the biggest difference is that it is a depot-type of medication. The depot is what makes it such a good insulin for cats. One other difference is that with Lantus, your dose is based on how low the insulin brings your cat's numbers. If it were me, I would let the vet know you are nervous about starting out at 2u given that when you dosed 2.0u of Vetsulin, Felix's numbers dropped as low as 137. Even with 1.0u, you saw a 144. Given that Lantus is new to you, starting at a lower dose will make you more comfortable.

Also, it will take 5 - 7 days for the insulin depot to form and stabilize. While some cats can have an initial marked response to a change in insulin, it's typical that the response may be a bit less over time as Felix's system adjusts. So, give Felix some time to get used to Lantus. It will also help to remember that any time you make a change in dose, it will take several cycles for the depot to catch up with a change in dose. You may want to read over the sticky notes at the top of the Lantus board, especially the notes on dosing methods. There's also a post on the depot. Just so you're aware, Tight Regulation was published in one of the leading veterinary journals several years ago. The Start Low Go Slow method was developed here so your vet may not recognize the name. It's a fairly typical approach to dosing.

The original research on using Lantus with cats that established the Tight Regulation Protocol as both safe and effective uses a weight based formula to deterimine the starting dose. Initial dose = 0.25 x cat's ideal weight in kilograms. For an average sized cat with a normal weight (approx. 10 lbs), the starting dose would be approximately 1.0u. The guidelines that were published by the American Animal Hospital Assn recommends a starting dose between 1 - 2u. It's possible that your vet is making a recommendation based on a cat that's not eating an exclusively low carbohydrate diet.

Lantus is a very different insulin than Vetsulin. It is gentler, has a longer duration, and the biggest difference is that it is a depot-type of medication. The depot is what makes it such a good insulin for cats. One other difference is that with Lantus, your dose is based on how low the insulin brings your cat's numbers. If it were me, I would let the vet know you are nervous about starting out at 2u given that when you dosed 2.0u of Vetsulin, Felix's numbers dropped as low as 137. Even with 1.0u, you saw a 144. Given that Lantus is new to you, starting at a lower dose will make you more comfortable.

Also, it will take 5 - 7 days for the insulin depot to form and stabilize. While some cats can have an initial marked response to a change in insulin, it's typical that the response may be a bit less over time as Felix's system adjusts. So, give Felix some time to get used to Lantus. It will also help to remember that any time you make a change in dose, it will take several cycles for the depot to catch up with a change in dose. You may want to read over the sticky notes at the top of the Lantus board, especially the notes on dosing methods. There's also a post on the depot. Just so you're aware, Tight Regulation was published in one of the leading veterinary journals several years ago. The Start Low Go Slow method was developed here so your vet may not recognize the name. It's a fairly typical approach to dosing.

Thank you for this information. I will look at those boards. It seems 1U would be a better starting point. We gave Vetsulin a try and I will post the recent spreadsheet if I can navigate this site. His pm numbers are mostly in the 200’s but am are in the 300’s which they think might be the Dawn effect. Do you think Prozinc might be another option and easier to manage? I don’t have much info about it but the Lantus seems to take longer to regulate and very complicated. And it seems like a lot of vets are not really well informed about how the depot works. I would welcome your thoughts.
Felix (Janice Ho Lung Chin) 's Sugar Sheet

 

[JaniceC]

Hello and welcome. My Neko started on Caninsulin (Vetsulin in the US) and switched to Lantus. Both of us were much happier with the switch. Do you have the U-100 syringes you'll need for Lantus? Ideally ones with half unit markings.

I agree with the others on dose if you can't test as much. My girl very quickly learned to follow me with the test kit, once she figured out it meant treats! She was a foodie. Some people use test time as a time to brush or do other cuddles, whatever works for your cat. I hope his lungs get better soon.

Where did you get your spreadsheet template? It looks like one from a different FB group. I'm just saying that because that FB group's spreadsheet has a bug that means it doesn't always display on tablets and phones. The links to our spreadsheet format are here: How to Create a Spreadsheet: BTW, our spreadsheet was the first one that other groups have copied.

Thanks. We were giving Vetsulin a chance but although the pm numbers were ok the am numbers stayed in the 300’s so my vet thinks it’s time. I would like to know how you managed the switch from Vetsulin and how long it took because I’m nervous about it since I can’t do much midcycles. What do you think of Prozinc as an alternative?
In the beginning I didn’t realize there were 2 different Feline diabetes groups and I started the spreadsheet with the Facebook group and someone in your group helped to add a signature to it. I don’t know if I can still create one on this site. I’m not great with tech. I will try to post his recent spreadsheet here. I hope it works
Felix (Janice Ho Lung Chin) 's Sugar Sheet

 

[CORKY]

When I started testing and going craaazy! one of our members, Suzanne, told me this: Take a step back, Breath in, breath out, cats are very sensitive to stress, you stress they stress, I said those words in my mind every time testing time came up, and it really worked, I was calmer more secure, and so was Corky

 

[CORKY]

Thanks. We were giving Vetsulin a chance but although the pm numbers were ok the am numbers stayed in the 300’s so my vet thinks it’s time. I would like to know how you managed the switch from Vetsulin and how long it took because I’m nervous about it since I can’t do much midcycles. What do you think of Prozinc as an alternative?
In the beginning I didn’t realize there were 2 different Feline diabetes groups and I started the spreadsheet with the Facebook group and someone in your group helped to add a signature to it. I don’t know if I can still create one on this site. I’m not great with tech. I will try to post his recent spreadsheet here. I hope it works
Felix (Janice Ho Lung Chin) 's Sugar Sheet

Thank you for that. Sorry for not checking but it’s been stressful.

Thanks for your advice. . Felix doesn’t like testing and neither do I but we’re slowly adjusting with a lot of praying before



Thank you for this information. I will look at those boards. It seems 1U would be a better starting point. We gave Vetsulin a try and I will post the recent spreadsheet if I can navigate this site. His pm numbers are mostly in the 200’s but am are in the 300’s which they think might be the Dawn effect. Do you think Prozinc might be another option and easier to manage? I don’t have much info about it but the Lantus seems to take longer to regulate and very complicated. And it seems like a lot of vets are not really well informed about how the depot works. I would welcome your thoughts.
Felix (Janice Ho Lung Chin) 's Sugar Sheet

When I started testing and going craaazy! one of our members, Suzanne, told me this: Take a step back, Breath in, breath out, cats are very sensitive to stress, you stress they stress, I said those words in my mind every time testing time came up, and it really worked, I was calmer more secure, and so was Corky, also Corky has been on ProZinc since the beginning and it's been awesome it is like Lantus a 12-hour insulin 2 of the best insulins for cats

 

[Wendy&Neko]

I would like to know how you managed the switch from Vetsulin and how long it took because I’m nervous about it since I can’t do much midcycles. What do you think of Prozinc as an alternative?

I shot Caninsulin one night, and Lantus the next morning. Make sure you pick a weekend or other time when you can monitor more closely for a few days. Prozinc is also a good choice. If your vet has a preference between Prozinc or Lantus, you might go with what you vet is more familiar with. Lantus is generally more easily available, as it is also an insulin used by humans. Prozinc gives you a little bit more flexibility in shot times. So pros and cons for both types of insulin. But both are long lasting and gentle insulins. And both way better than Vetsulin. Both can take the same length of time to regulate.

Regarding mid cycles, if you aren't home much during the day, if you can test when you leave the house or when you get back home, that can help us figure out what is happening. Some people move their shot time earlier so they can get a +2 as they head out the door, and use that data to decide if they should leave out some higher carb food. Similarly at night, if you can get a before bed test that is at least a couple hours after shot time, it can also help figure out what the cycle will look like.

His pm numbers are mostly in the 200’s but am are in the 300’s which they think might be the Dawn effect.

Without more data it's hard to say. He could also be going lower at night and then bouncing. Many cats go lower at night. Getting those PM tests before you get to bed helps fill in the picture.

 

[JaniceC]

I shot Caninsulin one night, and Lantus the next morning. Make sure you pick a weekend or other time when you can monitor more closely for a few days. Prozinc is also a good choice. If your vet has a preference between Prozinc or Lantus, you might go with what you vet is more familiar with. Lantus is generally more easily available, as it is also an insulin used by humans. Prozinc gives you a little bit more flexibility in shot times. So pros and cons for both types of insulin. But both are long lasting and gentle insulins. And both way better than Vetsulin. Both can take the same length of time to regulate.

Regarding mid cycles, if you aren't home much during the day, if you can test when you leave the house or when you get back home, that can help us figure out what is happening. Some people move their shot time earlier so they can get a +2 as they head out the door, and use that data to decide if they should leave out some higher carb food. Similarly at night, if you can get a before bed test that is at least a couple hours after shot time, it can also help figure out what the cycle will look like.

Without more data it's hard to say. He could also be going lower at night and then bouncing. Many cats go lower at night. Getting those PM tests before you get to bed helps fill in the picture.

I’m leaning towards Prozinc but I believe my vet is more familiar with Lantus so it might be the better choice. Are you happy with Lantus and do you find it difficult to stick to such a rigid dosing timing?

When I started testing and going craaazy! one of our members, Suzanne, told me this: Take a step back, Breath in, breath out, cats are very sensitive to stress, you stress they stress, I said those words in my mind every time testing time came up, and it really worked, I was calmer more secure, and so was Corky, also Corky has been on ProZinc since the beginning and it's been awesome it is like Lantus a 12-hour insulin 2 of the best insulins for cats

 

[JaniceC]

I’m leaning towards Prozinc but I believe my vet is more familiar with Lantus so it might be the better choice. Are you happy with Lantus and do you find it difficult to stick to such a rigid dosing timing?

When I started testing and going craaazy! one of our members, Suzanne, told me this: Take a step back, Breath in, breath out, cats are very sensitive to stress, you stress they stress, I said those words in my mind every time testing time came up, and it really worked, I was calmer more secure, and so was Corky, also Corky has been on ProZinc since the beginning and it's been awesome it is like Lantus a 12-hour insulin 2 of the best insulins for cats

Your spreadsheet is awesome. How did you steel yourself to shoot with numbers in the blue? I chicken out at 170. I don’t think I’ve seen a spreadsheet so stable before.

 

[Wendy&Neko]

re you happy with Lantus and do you find it difficult to stick to such a rigid dosing timing?

Neko passed away 9 years ago. I was very happy with Lantus compared to Caninsulin when I made the switch. She was happier too. There is a little wiggle room with dosing. You can be out by 1/2 hour once a day, or 15 minutes each shot, without any impact. I had a monthly meeting that meant I had to leave the house 3/4 of an hour before regular preshot. I just moved the shots up each cycle for a few days before hand. So with a bit of planning, it was doable.

 

[CORKY]

Your spreadsheet is awesome. How did you steel yourself to shoot with numbers in the blue? I chicken out at 170. I don’t think I’ve seen a spreadsheet so stable before.

Thank you ! It has been a long journey of trial and error, tears and lots of sleepless nights and definitely lots of guts! I shoot in the 70’s , but I learned that with lots of coaching and learning how the insulin works on Corky and using nothing but low carb foods to spike up the BG if necessary, stay here, there’s sooo much to learn, even after going on 4 years I am still learning from each and every one of you

 

[JaniceC]

Thank you ! It has been a long journey of trial and error, tears and lots of sleepless nights and definitely lots of guts! I shoot in the 70’s , but I learned that with lots of coaching and learning how the insulin works on Corky and using nothing but low carb foods to spike up the BG if necessary, stay here, there’s sooo much to learn, even after going on 4 years I am still learning from each and every one of you

I’m having sleepless nights too. I really appreciate all the support Ii have been receiving here. I’m not very tech and am not used to navigating this site. Do I stay on this thread when I try the new insulin or if I need help understanding my numbers when I start or post on the main forum?

 

[JaniceC]

Neko passed away 9 years ago. I was very happy with Lantus compared to Caninsulin when I made the switch. She was happier too. There is a little wiggle room with dosing. You can be out by 1/2 hour once a day, or 15 minutes each shot, without any impact. I had a monthly meeting that meant I had to leave the house 3/4 of an hour before regular preshot. I just moved the shots up each cycle for a few days before hand. So with a bit of planning, it was doable.

I’m so sorry to hear about Neko.
Do you mean for the next dose you moved it 15 mins earlier each shot till you were back on schedule or each day?

 

[CORKY]

You are doing great! We will do anything for our precious fur babies. Stay here for now keep us informed, you’ll see the difference after a cycle or two how Lantus will make a difference, and we will be here with you in this journey

 

[CORKY]

I’m so sorry to hear about Neko.
Do you mean for the next dose you moved it 15 mins earlier each shot till you were back on schedule or each day?

yes, until you reach the time you want to AMPS/PMPS