12/29 CRYSTAL - advice please on Lantus V Levemir for acrocats?

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suki & crystal (GA)

suki & crystal (GA)

Member Since 2014
Hi everyone
Not much to report, Crystal still "in the pink" as usual. Has been on 10u Lantus for 5 cycles will increase to 10.5u for tonight's shot. New needles with half units have arrived from ebay so that should make life easier.

Just a question please. I've been reading as much as possible about acromegaly and looking at quite a few SS. I've noticed a few acrocats (Punkin, Neko and Cobb) switched from Lantus to Levimer - so any advice about this would be helpful for me, I intend visiting my vet next week for an IAA test and perhaps it might be an option? I have it in the back of my mind that when Crystal had the acro test the vet college recommended the change from Caninsulin to Levimer, but I'm not sure how I ended up with Lantus instead, perhaps it was due to cost or availability but at that time I didn't really know there was much difference between the two.

Also I picked up from someone else who was feeding raw food that a lot of the nutional value is lost if you freeze it. I prepare 2kg of minced chicken at a time and freeze daily portions for Crystal and would hate to think that after all that effort she isn't getting the full benefit.

Bitterely cold here in France today, Crystal roasting by the fire quite comfy.

Suki & Crystal
 
Levemir has a slightly longer depot/duration than Lantus; this can be very helpful in high dose conditions as it may reduce the peaks at the end of 12 hours. Because you're high dose, getting the vial, rather than the pens, may be most cost effective for you. And Canadian pharmacies sell it for less than US ones.
 
I don't know if there prices between Lantus and Lev are markedly different. It used to be that Lev was a little less expensive. The one factor that many caregivers of high dose cats have mentioned is that especially with big doses, there's an increased chance that Lantus will sting. (Lantus is mildly acidic and the acid is neutralized when you inject it. This causes Lantus to form microcrystals which gradually dissolve and give it it's long duration.) Lev is neutral and as a result, there is no sting.
 
I don't believe that Lev has a longer duration. Early on, people would make that observation. As it turns out, the duration, for most cats, is the same. The onset and nadir are later which gives it the appearance of having a longer duration.
 
For me, Lev is not less expensive. It's roughly the same price as Lantus.

The later onset can be helpful if you are out of the house all day, and it may give you a lower preshot - so you'll have to get used to shooting at the nadir and could be faced with lower than normal preshot numbers.

Cobb never really reacted to a sting of Lantus, but I know a number of cats do.

The one thing we've noticed with Lev is Cobb does not bounce nearly as much. He has a much flatter curve, which I think makes him feel better because there are very few wild swings in BGs.

You may also find that you're on a lower dose of Lev. Most people's Lev starting dose is 70% of Lantus.

If Crystal also has IAA, switching may help to break the IAA because the antibodies could bind to the Lantus, not the Lev (if that makes sense).
 
I stayed on Lantus with Punkin, mostly because I wanted his nadirs to be predictable by the time i went to bed (at +4.5). If he were still alive now, I'd probably have tried out the Lev because I have seen a lot of high dose cats do very well with it.

He never reacted to the Lantus shots so for him, I don't think the acidity was an issue. I've heard mixed comments from people's experience with that. Some cats are bothered by it, some aren't.

I think it's up to you. If I were wanting to make the switch, I would definitely finish up whatever Lantus I already had bought and then make the change.

When/if you do switch, we suggest people drop to 70% of their Lantus dose to begin with and then quickly increase. Occasionally a cat has a big reaction to the Lev and that's the reason for starting at 70%. Often they'll get back to the same dose as the Lantus, but just in case you do want to drop back with the dose at first.

The process is to just give your Lantus shot and 12 hours later give your first Lev shot. You probably want to give the Lev shot when you will be home that full day so you can monitor.
 
Neko also didn't flinch at high doses of Lantus, we got to 8.75U. I switched to Levemir when she was down around 1U mainly cause I wanted to try to break her habit of diving at night and bouncing during the day and I'd tried everything else. She too is flatter on Levemir and showing a bit more green during the day, so I sleep more. I also think she prefers being flatter. A large number of high dose cats are on Levemir. The only possible down side is that the onset and nadirs are later. But ECID and if the cat nadirs often near PS, it's actually easier on the caregiver.

I'm surprised about what you've heard on raw food. All the manufacturers freeze cause that's what you have to do to sell and distribute the product. You do have to try to get all the air out of the packaging so you don't get freezer burn which can have some impact on quality. The raw I serve Neko is in a day's worth of food in vacuum sealed pouches. Raw should be used within three days of thawing. I've had a number of conversations with the owner of a local manufacturer of raw pet food, specifically about freezing, packaging, and nutritional quality. She said there hadn't been any studies done of the nutritional quality of raw pet food frozen in various types of packaging. Most people who make their own make it in larger amounts and freeze for later use.
 
Hi all
Thanks for all your comments, I think my best course of action would be to wait for the result of the IAA test (which I hope to have done next week) and then make a decision based on the result. I'll check out the prices of Levemir at the pharmacy as a comparison - just a point the Lantus I bought (the 5 pens in a box) was charged at 68 euros (about $82) which makes it much cheaper than the Caninsulin, I wonder if it should have been 68 per pen? I have one and a half pens to use up anyway.

I can't remember where I read about the possibility of losing nutrional value by freezing raw food, I think it was in someone's post recently (perhaps a lady from Ecudor?) but I've read so much lately my head is whirling, but I'm just going to carry on freezing, too many other things to worry about. As you say Wendy, it's just not viable not to freeze. I just take out a daily portion the night before to thaw ready for Crystal's breakfast, she loves it.

Well, whatever you are doing tonight I hope you are with your loved ones and wish you a very happy New Year and good health to beans and kitties alike.

Suki & Crystal
 
In my part of Canada, a pack of 5 cartridges of Lantus is the equivalent of 71 euros and Levemir is 85 euros. I don't know if it makes a difference there, but I saved a bit checking around different pharmacies.

Have a great New Year's Eve Suki!
 
Thanks Wendy, and a very happy New Year's Eve to you - we are just off to a party locally, hope you have something nice planned. Crystal had a yellow this afternoon (!), fingers crossed we see a few more.
Hugs to you both
Suki & Crystal
 
All the raw food sites , whether commercial or homemade, recommend freezing the food. Cooking food does cause nutrient loss and all canned foods are cooked.

Have a good time, I'm glad that Crystal gave you a permission slip.
 
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