Converting from Caninsulin to Lantus!

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asoolty

asoolty

Very Active Member
Hello everyone!

I need help to convert my baby cat to lantus ?

I need some tips...


currently she's under Caninsulin 3 units x 2 times a day every 12 hrs

what i've been doing "under vet's instructions" I take 10 units, and mix with 90 unit of solution to lighten?


do i have to do this with lantus aswell? and for startup how many unites i need to start with ? 1 or 1/2 ??

waiting for an answer..


tc
 
Hi tc! I don't have the answers you need, but wish you lots of luck in the transition. Someone who can help should be along shortly.

I would recommend that you change your icon from the candle to a question mark. That will help ensure it's noticed and the candle typically is used for posts in memory of a kitty.
 
Cross post from health forum
viewtopic.php?f=28&t=21742&p=215966#p215966

hi there,

do you know the weight of your cat? could you give us her name?

Are you home testing?

The health forum will give you the basic with diet and home testing, but if you'd like to start Lantus, you can post here too, and we'll try to help you along.
 
Ronnie & Luna


My cat is 3.8 KG


Her name is Nonitta and she is 12


diabetic since April 2009

and under Caninsulin


and yes i do home testing
 
when are you starting Lantus?

Are you still located in the Kuwait area?
Just wanna double check cuz of time zone differences.

Please read thru the information stickies above in this forum to familiarize yourself with Lantus.

Especially the dosing protocol we follow here: Tilly's Protocol: Modified Version

You'll also want to read the New To The Group stickie
and the Proper Handling & Storage of Lantus/Levemir stickie.

Others will be along to help with your starting dose.


Is there any history of ketones in the urine?
Are you checking for ketones at home?
And she is only eating low carb wet food right? (fancy feast?)


.
 
welcome to Lantus Land!

Lantus cannot be diluted, so no, don't mix it with anything, just use it straight out of the vial or cartridge. Also, Lantus uses different syringes than Caninsulin. Make sure you have U-100 syringes, this is very important! When you draw up your insulin, it will look like a teeny tiny amount, especially since you are used to using a diluted insulin.

When you say her dose is 3 units, are you drawing the diluted insulin to the 3 unit line?

If you can give us a couple of weeks worth of her numbers on Caninsulin, we can help you with a starting dose for Lantus. Without numbers, we really can't.
 
.

If you have a chance, it will really help to have a spreadsheet with your data while on Caninsulin.

As well as with Lantus, it's a good way for others to follow your progress on Lantus and offer dosing feedback when you need it.
We like to read a lot of spreadsheets!

Follow this link to the Tech forum on how to set that up: Spreadsheet Set Up
You can post in the Tech forum as well if you need further assistance with a spreadsheet.

If that's not possible, you will need to type up a lot of data/numbers when you update a reply here with kitty's numbers.
Having a spreadsheet keeps everything together and is easier to follow.
A spreadsheet can be attached to your signature line (have a look at others signatures here and you'll see how it looks)


.
 
Ronnie & Luna said:
when are you starting Lantus?

Are you still located in the Kuwait area?
Just wanna double check cuz of time zone differences.

Please read thru the information stickies above in this forum to familiarize yourself with Lantus.

Especially the dosing protocol we follow here: Tilly's Protocol: Modified Version

You'll also want to read the New To The Group stickie
and the Proper Handling & Storage of Lantus/Levemir stickie.

Others will be along to help with your starting dose.


Is there any history of ketones in the urine?
Are you checking for ketones at home?
And she is only eating low carb wet food right? (fancy feast?)


.
Click to expand...


Yes I am from Kuwait

I did all my reading .. got very good information for a start , specially from here http://www.tillydiabetes.net/en_6_protocol2.htm
Ketones i'm not quite familiar with the term ? is is the sugar in the urine or stones,,


If sugar then yes .. not at home but the test was done by my vet.. and her diagnoses was confirmed twice

she is under low carb fancy feast yes
 
Hi Just want to welcome you to LL and may your kitty make a save and speedy recovery Kath :mrgreen:
 
yes sugar in the urine.

If you go to your local pharmacy, they should sell a kit, in the diabetic section or ask a pharmacist behind the counter.
I believe the big brand used the most is Bayer Ketostix, not sure if this brand is available in your area, but ask anyway.

200.jpg


You'll want to be checking this on a regular basis if numbers are high. It's not something you want to have checked one-time-only at the vets.
Unregulated kitties can easily start throwing ketones, especially if there is a history of it. Check it out ok?

Please read thru the revised protocol that we've been following (up top - the "starred" stickie) here is the link again:
Revised Version of the Tilly Protocol
 
Libby and Lucy said:
welcome to Lantus Land!

Lantus cannot be diluted, so no, don't mix it with anything, just use it straight out of the vial or cartridge. Also, Lantus uses different syringes than Caninsulin. Make sure you have U-100 syringes, this is very important! When you draw up your insulin, it will look like a teeny tiny amount, especially since you are used to using a diluted insulin.

When you say her dose is 3 units, are you drawing the diluted insulin to the 3 unit line?

If you can give us a couple of weeks worth of her numbers on Caninsulin, we can help you with a starting dose for Lantus. Without numbers, we really can't.
Click to expand...


yes 3 diluted unites

tomorrow I will start working on the spreadsheet I do have some numbers
 
Ronnie & Luna said:
yes sugar in the urine.

If you go to your local pharmacy, they should sell a kit, in the diabetic section or ask a pharmacist behind the counter.
I believe the big brand used the most is Bayer Ketostix, not sure if this brand is available in your area, but ask anyway.

200.jpg


You'll want to be checking this on a regular basis if numbers are high. It's not something you want to have checked one-time-only at the vets.
Unregulated kitties can easily start throwing ketones, especially if there is a history of it. Check it out ok?

Please read thru the revised protocol that we've been following (up top - the "starred" stickie) here is the link again:
Revised Version of the Tilly Protocol
Click to expand...


hmmm i will check for it tomorrow
 
I just moved my cat from Vetsulin (Caninsulin) to Lantus about a month ago. I've had to use about 1/2 the dosage. So, I would start at 1U or 1.5U and go from there. You can take a look at Podo's spreadsheet and see how she reacted to the change over.
 
I'm not good at math or logic in the middle of the night, but if you're drawing diluted insulin to the 3 unit line, I think that is the equivalent of a dose of 0.3 units. If that is the case, then 1 unit of Lantus is probably too high a starting dose. If I'm not understanding correctly, please say so...
 
Libby I think that's correct.

U40 insulin has 1ml=40 units
so .25ml=10 units

fill a syringe to the 90 unit mark with water and you have 2.25ml, add the 10 unit insulin (.25ml) to that and you have 2.5ml of liquid which contains 10 units of insulin which means you have 4 units per ml or a U4 mixture (that's 1unit per quarter ml)

If you fill a U40 syringe to the 3 unit mark that is .075ml

When you take .075ml of your diluted U4 insulin (which has 1 unit per .25ml) you get .075 / .25 =.3 units

in other words to make things simple you have a an insulin that is 1/10th the strength so when using a U40 syringe you divide the measured amount of units by 10.

Lantus should not be diluted (I sure wish it could!!!) and being that it is U100 insulin makes measuring small amounts even more difficult.

Very important is that with Lantus you only use a syringe meant for U100 insulin. Without knowing what kind of results you getting while on .3 units of Caninsulin its hard to determine what a good dose of Lantus would be. However I expect that the results on Caninsulin were not showing good regulation and were most of the time in much higher ranges than we would be expecting from a cat on Lantus. When switching insulins we consider the dose of the previous insulin as a starting point and the results that one was seeing from that dose. However, Lantus has a longer duration of action but it is in general less potent than Caninsulin (so the same dose will have a longer effect but may not lower the overall BG level as much) so even a somewhat increased dose of Lantus is probably safe. Depending on what results the 0.3 units of Caninsulin was achieving I think a starting dose of 0.5U Lantus would be reasonable (and manageable)

The big question is are U100 syringes (with 1/2 unit marks) available in Kuwait? i know in some parts of the world they are not availble (Austrailia, Thailand, Singapore...) without them this fine dosing will be very difficult.
 
Seattlebrian said:
I just moved my cat from Vetsulin (Caninsulin) to Lantus about a month ago. I've had to use about 1/2 the dosage. So, I would start at 1U or 1.5U and go from there. You can take a look at Podo's spreadsheet and see how she reacted to the change over.
Click to expand...

This is very helpful ,, thank you :D

Podo .. such a nice name
 
confused_cat

kitty is confuse !!!!


let me say it again .. I use U-100 syringe with Caninsulin / what i do is the following: -

1- I take 10 unites of Caninsulin
2- dilute with 90 unites of Solution water
3- I inject her with 30 unites


hope this helps

about the 0.5 syringes we do not have them in Kuwait that is correct :(
 
asoolty said:
confused_cat

kitty is confuse !!!!


let me say it again .. I use U-100 syringe with Caninsulin / what i do is the following: -

1- I take 10 unites of Caninsulin
2- dilute with 90 unites of Solution water
3- I inject her with 30 unites


hope this helps

about the 0.5 syringes we do not have them in Kuwait that is correct :(
Click to expand...

Helps but it doesn't change the calculation much, you are giving 1.2 units of insulin.

10 units of Caninsulin measured in a U100 syringe is still 4 units (10/2.5) and that is in .1 ml liquid
you add 90 units water in a U100 syringe which has a volume of .9ml
mix them together and you have 1ml liquid which contains 4 units of insulin

fill the U100 syringe with 30 units of that mixure (30 units has a volume of .3ml) each unit of solution measured has .04 units of actual insulin in it

.04 units x 30= 1.2

If you had given the Canisulin undiluted using the U100 syringe you could have measured 3 units (which would be easily possible even with the syringes with only whole units markings either the .3ml syringes or even the .5ml ones) that would have been equal to 1.2 units of Caninsulin and injecting a tiny amount of fluid under the skin is much easier and more comfortable for the cat. In addition I'm not sure how much the process of diluting and mixing insulin and (hopefully with diluting solution obtained from the vet or the manufacturer) affects its stability and effectiveness.

The manufacturer does not recommend diluting Caninsulin (Vetsulin)

Can Vetsulin be diluted?
No. Vetsulin is a mixture of amorphous (soluble) insulin and crystalline insulin. The crystalline part is relatively insoluble which is why the insulin activity lasts more than a few hours. Vetsulin has a balance between the amorphous and crystalline parts. If Vetsulin is diluted, the balance between amorphous and crystalline parts is no longer 30% and 70%, relatively speaking. The amount of soluble insulin is increased by the aqueous diluent used. This results in an alteration of the pharmacokinetics of Vetsulin. With a larger aqueous fraction and smaller crystalline fraction, there would be a decrease in the crystalline portion responsible for the second peak of insulin activity.

In addition, the stability of the suspension is unknown if Vetsulin is diluted. The Vetsulin suspension is optimized to maintain the crystalline portion as a salt. If the water content is increased as with dilution, the solution "looks for a new balance" ie, it is not stable and the dissolved fraction increases with time.
Click to expand...

Considering the confusion about how effective your diluted insulin is, the uncertainty of the actual current dose and not knowing what kind of BG readings you are getting recently I don't think a conclusion can be made about what dose of Lantus is a good start.

Seeing some BG readings would be helpful, then we could just start out from scratch.

It will be possible to use the .3ml syringes with whole unit only markings but it isn't easy (My first package of syringes I got to hold me over till my ordered ones arrived) were .5ml and measuring just 1.5 units was tough but we managed.
 
truly helpful ..

thanks to everyone .. I will soon post her spreadsheet

and will hold it little .. a month or so ,, because i've just opend the new vial of Vetsulin .. hehe it is so expensive

but now i have a good idea on how to start and how to trait this insulin


Thank you once a gain to everyone :razz:
 
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