Just looking over your SS quickly a few things come to mind......
Of course I would recommend Lantus for anyone, and I'm pretty sure Kazi would be OTJ very quickly. That's why I am hesitant to say oh yes you must switch, A package of Lantus is expensive and when you end up purchasing 15ml (1500 units) of insulin and only using 5 units of it it seems a little silly. Of course if money is not a big concern or you can get a smaller amount of insulin to start with (either by splitting and order with someone, or check the supply closet for anyone with left over Lantus) If you do purchase a package of pens/cartrideges and have leftover unopened ones you could sell them or donate them here in the board. So yes I would recommend the change if that's what you want to do, ifnot I think it might be possible to get there by tightening up the numbers a bit with your Vetsulin (assuming you have a bottle that is still useable and don't need to purchase any)
All things considered Lantus and Vetsulin are quite different and while we often do suggest that people reduce the dose for the first few days when making a switch in most cases that is because the person is giving what could be to high of a dose, or they made the increases to fast or to big at a time, or they have just begun hometesting and we don't have any information about what the dose of the other insulin was doing. many have also just joined the board and are making a food change at the same time (to lower carb) which can reduce insulin needs. In general the change can be made while keeping approximatly the same dose and while Lantus lasts much longer (longer duration=has a BG lowering effect for 12-16 hours, Vetsulin usually last only 6-8 hours) Lantus is also less potent in it's ability to lower BG suddenly (it works slower and milder) it also has less risk of causing a hypoglycemic episode and allows us to obtain lower BG levels ( in the range of a non-diabetic cat) for many hours with much less risk than attempting this with Vetsulin.
Here is the reason: The manufacturer of Vetsulin writes: Achieving effective glycemic control
The goals of managing diabetes mellitus include:
* Controlling the clinical signs of hyperglycemia (polyuria, polydipsia, and ketonuria)
* Avoiding hypoglycemia (blood glucose <50 mg/dL)
* Obtaining blood glucose curve values in the desired range:*
o Cats: 120−350 mg/dL over the course of the day, with a nadir between
120−180 mg/dL
Keep in mind that the normal non-diabetic BG range for cats is between 50-120 mg/dl (typically less 100 mg/dl) when using a human calibrated glucose meter and organ damage from high blood glucose could be occuring at numbers above 150 mg/dl. For that reason cats treated with Vetsulin should never be below 120 mg/dl accoding the manufactuer (for safety reasons because of the risk of hypoglycemia) which means that almost no healing can occur and organ damage will continue. Although these recommendations are somewhat erring on the side of overly cautious (and assume owners are not regularly home testing and dosages are based on curves done by the vet which may be elevated due to stress) it is possible to obtain tighter BG control with careful monitoring but in general there is often not enough contol possible to allow for adequate healing of the pancreas.
Lantus works longer and genteler and allows tighter control of BG without a serious risk of hypoglycemia when BG is carefully monitored by the caretaker. A cat on Lantus will able to maintain a BG almost consistantly under 200 mg/dl and with a nadir between 50-120 mg/dl for several hours each cycle will have BG values near that of a non diabetic cat thus promoting healing of the pancreas and preventing possible organ damage from higher BG levels.
The trick to using Lantus is being able to give the correct dose consistantly every 12 hours to maintain this lower BG level. The action of Lantus produces a "curve" unlike that of Vetsulin in that it is almost peakless, so the "curve" is more of a flat line in lower ranges. If you open some spreadsheets of Lantus/Levemir kitties here on the forum you will see what this looks like. Your SS shows what is typical of Vetsulin (especially with a cat on lower doses who is close to remission) as the overall numbers become lower you are often in a situation where a preshot (which is to high to be considered normal) is to low to be able to safely adminster insulin so you have to skip a dose or give a much reduced dose which in turn means the cat goes 12 hours with no (or to little) insulin and the BG just continues to rise for 12 hours essentially undoing all the progress that was made in the previous days. It is litterally like riding a rollercoaster.
Based on the preshots you have had over the last few weeks and the nadir (which on Lantus would be allowed to be lower) I would actually consider a starting dose of 0.25U. As far as the difference between the U-100 insulin and the U-40 (Vetsulin) there is no need to convert anything. You will need to use the correct syringes with Lantus (syringes for U-100 insulin) we use a .3ml (3/10 cc) syringe with half unit markings. You will see that they are different from the U-40 syringes used with Vetsulin (they are thinner and smaller) dosing a U-100 insulin in small amounts is somewhat more difficult than a U-40 but with these syringes and perhaps a magnifying glass it can be done pretty consistantly.
At the top of the forum in the "stickys" there is lot's of information about using Lantus (storage, handeling, testing, pictures of syringes and dosing guidelines) read all of this and ask any questions you come up with here. This is the most important stuff about Lantus. Once you have decided to give it a try then we will be happy to help you along the way.
If you are not convinced Lantus is the way to go after reading and getting advice here, then there are some people who can help you to "tweak" the Vetsulin a little and give it a little more time to try and get into remission (it is possible on Vetsulin) but it is going to be frustrating (more so than lantus) and require serious monitoring and a bit of your time.
The last point...Your spreadsheet mentions refusing some foods and eating some dry food....
this is going to be a big factor in going OTJ and a crucial one in terms of maintaining a remission. What foods are you feeding? Are you familiar with the appropriate diabetic diet (Janet & Binky's food lists)? Are you working to eliminate the dry food completely from the house? If you need help or suggestions on how to convert "ktty crack addicts"
I have lot's of experience, and we can give you some links to information on how best to accomplish this.
