Choosing a new insulin here need advice...

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Theresa and Simba (GA)

Theresa and Simba (GA)

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Hello everyone. I have been absent, just lurking because all has been fairly well with Simba. This week we are changing insulins due to the Vetsulin recall . Our Vet steers us toward Humilin N for the economic value but for better control he recommends Lantus or Levemir. I have been looking forward to the day when I could switch Simba to a better product. He has done ok on Vetsulin ... well you know the deal there. My vet has left it open for me to choose. Simba is a non-ketonic diabetic. Never has had ketones. He was up to 5 units BD a day of Vetsulin after a year of treatment. (We did start low last year) He has had a pretty hefty appetite through this and plenty of highs, the lows and hypo situations are rare for him. Sorry for the short notice but, I should make this desicion today. The doc gave us some sample doses of Humilin to try first and Simba says its the same old same old. He has had only 3 doses of Humilin at 3units BD. Results= slow drop from the 400's to 110 nadir and a steady climb back up to the 400's. Blech. ( granted the dose has been lowered)I have read about Lantus and Levemir here in the past and have seen members have great success. We do take him for regular checkups every few months, test his urine at home and have gotten better with our hard to do BG home test. He has bad ears. We have to use the paw pad method. I realize the expense is bigger but it seems that it would level out due to the benefits of the product. We are thinking that we would prefer the Levemir starting at 1 unit BD. For the gentleness of the curves and ability to overlap dosage lessening chances for hypos. Do you guys think that we are on the right path? Definitely need some help from the pro's here. Thank you in advance for you advice.

Theresa and Simba
Diagnosed March 09
Vetsulin
 
Hi, Theresa,

I wish I knew more about insulin differences -- someone more knowledgeable will be able to comment, I'm sure. I can that Lantus has been a wonderful medication for my kitty! It requires a very regular schedule, and a commitment to testing and reacting to tests. But I think many kitties have moved to Lantus from other meds and done well.

Just wanted to send hugs. Good luck with your decision!
 
There will probably be more people around this evening if you have the time to wait for responses.

Gabby was originally on Humulin N (NPH or N) when she was first diagnosed. I wasn't home testing then so I can't say for sure how well it was working. She was put on N by the vet at the emergency hospital. Based on fructosamine test results, my vet opted to switch Gabby to Lantus. The fructosamine levels were very unimpressive. When my vet and I discussed the switch, her comment was that. "N is a good insulin for dogs. It's not a good insulin for cats." (She's a feline specialty vet.) It's also my understanding that there is a much greater risk of hypo on N given its quick onset and the steepness of the curve. Given the remission rates with Lantus (and by extension, Levemir), I lean in that direction. But, you are also asking the question on the Lantus forum we all use either Lantus or Levemir here so we're a bit biased!
 
hello theresa. i think you'd be happy with either lantus or levemir. they're both wonderful insulins. however, since simba was diagnosed over a year ago and was up to a relatively high dose of vetsulin, i think you're probably better off going with levemir.

as to a reasonable starting dose... i don't feel comfortable commenting without more information. we like to see a couple weeks worth of numbers (we're very number driven here :-D ), as well as learning how increases were made (in increments of 0.25u, 0.5u, 1u, or more) before suggesting a starting dose. generally speaking, we usually recommend starting out with a slightly lower dose of lantus/levemir when switching from another insulin.

good luck with the switch!
 
Thanks so much for the replies, I will watch for more. I am definitely leaning towards the Levemir, only because based on what I have read here at FDMB and other pages I think it will be the best for Simba. I meet with the vet tomorrow for a new script and will see what he says. When we start on the new insulin I will start a new spreadsheet. I did not keep the old one up to date. I am looking forward to seeing how this product will work on him. I will double check here when I see what his recommended dosage is before our first shot. I am glad now that Vetsulin is out of the picture my vet has opened all the doors for diabetes control. You guys are the best.
 
If you do decide to go with the Levemir and continue to post here (and please feel welcomed and join us!), even if your Vetsulin spreadsheet isn't up to date, if you can attach it it will be helpful information to have at least at the beginning.
 
Re: Got our prescription...

My vet was a little reluctant at first, as he is not as knowledgeable with Levemir as he is Lantus. He tended to lean towards Lantus but I still insisted on Levemir. He went for it. I chose Levemir only because, after researching, I felt is was best for Simba. I will head for the Levemir board with our first dose info later. Shot time is 8pm. BTW, you senior members would be proud of me as I convinced him to sway my way. He did warn me about doing strict home testing with a longer acting insulin and he wants to do a fructosamene in a month. He also wants an update of BG numbers from first 10 days. He has been caring for Simba 12 years. Off to wally world... Thanks for your interest.
 
Theresa:

There are many, many Levemir users here. I think you may find that the Lev board isn't as active as this Board. You are more than welcome to stay since Lantus and Lev work essentially the same and the same rules apply. If you look at our dosing protocol, it is for both Lantus and Lev users.
 
I may be too late w/ this, but check out Costco for the Levemir. There was a notice in w/ receipt that it was on their "preferred formulary" and would be considerably cheaper than the regular price there.
 
Hi There! Sorry I didn't get around to posting earlier, but I'm here now! Just wanted to let you know that I switched Spot from N to Lev after 7 months of torture! N did not work at all for Spot. I truely believe that you will like Lev. I had my reasons for going with Lev instead of Lantus, but both insulins work almost the same and both are very good insulins.

I am not trying to sway you one way or the other about which forum you should visit...but I found that the Lantus board has more action....there is always someone around to help answer questions and give support. The folks on the Lev board are very very knowledgeable on the insulin and are very nice folks, as are the folks on the Lantus forum. So, it's your choice, and if you decide to continue in Lantus Land, we'll see you later!!
 
Re: update...

Just wanted to let those who posted here know that we went with the Levemir and are working now to find the correct dose. Have been on Lev board but will check in here too. I ended up at Wal-mart, where we paid $110.00 for it. The cheaper syringes helped to balance the additional cost. I must admit, I did like the U40 syringes better. Much easier to see. The vet also sent us home with a bunch of needles that are better to poke him with instead of the lancet for home testing. So far his numbers are too high for my liking, but, I have been encouraged to be patient. Simba will get a fructosemene test after we finish this vial. Thanks for your interest.
 
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