Help with switching from Lev to Lantus. Dosing?

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LabTroll

Member Since 2014
Jordan has been on Levemir for several months. She takes 5.5U BID and has nadir at 7hrs-ish of ~150 on the Relion. A few months ago my vet wrote a Lantus script, I bought a pen from a USA pharmacy and in the 3 weeks I used it we saw weight gain, nicer hair, better attitude...until it went flat and her BG rose and went all out of whack. Decided to give the Lantus another try.
Why?
She is starting to get good numbers on the Lev and I'm fine that it has taken months to bet there but the Lev we've been using was a gift from a medical friend and I can't get more without breaking the bank.
She can't keep on weight with Lev and her hair is a bit knotty and greasy.
More but...Oh and when I shoot her left side she hisses and tonight she bit at me. :(

Question is really: How much Lantus to give?
With her sugar finally approaching a good range I just can't start at the bottom again. Not again.
Vet recommends going from the 5.5U Lev to 3U Lantus and she is uneasy about even that.
Ideas? Advice? Please?
 
We don't have many people go from Lev to Lantus, but the general recommendation when switching from one L to the other is 70% of the current dose, which would be more like 3.75U. Some cats see a quick response. Just be ready to increase if Jordan does not.

If your spreadsheet was more up to date, we might be able to give more detailed advice. Hint. Good luck with the switch. Since Lantus is an acid base, kitties on higher doses sometimes feel a sting.
 
Usually people go the other way, from Lantus to Levemir and we suggest starting a little lower...about 70%. I've seen one or two who switched from Levemir to Lantus though due to better results or problems with Levemir, so I hope it works out for you!

Just FYI .....A lot of us are buying our Lantus from Marks Marine Pharmacy in Canada because we can get a 5 pack of pens for $133.99 plus $25 shipping instead of over $450 that they run in the states.

They're very dependable and great to work with and of the over 50 people I've heard from who've bought from them, not one has had any complaints, so if you have a script, you can save a lot of money going through them!

The last post in the thread "Insulin from Canadian Pharmacies" has the information on them!
 
I haven't updated her spreadsheet in a long while...I could but it's still very very patchy since I test infrequently.
Why?
After a year and a half of trial and error I know that she starts high. Like 300 or more high.
It's only in the past couple weeks - at doses above 5U that we've been seeing anything under 200 so I'm not worried about overshooting.
My mother glares and my father undermines me about not leaving dry out for other pets...

I want to start at 4U and monitor her all weekend over the first few cycles. She's already acting like the higher doses of Lev sting so we'll just acknowledge that and figure out a way to minimize it maybe.
 
Good Luck!

Have you considered testing for high dose conditions?
And in some cases, folks with cats that swing greatly from pre-shot to nadir may do well with a bolus+basal insulin approach, when it isn't due to bouncing.
 
We typically don't suggest testing for high dose conditions until a cat reaches 6.0u. It's certainly a possibility.

If you're finding that your cat is starting a cycle high and you're not getting any spot checks, there's a good chance that numbers are dropping lower by mid-cycle and then bouncing back up. I would not recommend using a basal/bolus approach until there is sufficient information on your SS to warrant that approach.
 
I'd encourage you to record things on your spreadsheet especially right now with the insulin change. If you need help with dosing, we really need to be able to look at least at the past 3-7 days of tests. It'll also help you figure out when to increase. Decreasing the dose is a safety measure when switching from one L insulin to the other, but you may very well need to increase to the Lev dose, and seeing the BG tests in context will help you do that safely.

Good luck with the switch! Punkin got up to 15.5u on Lantus and didn't ever seem bothered by it. It does have an acidic base, though, and Lev is neutral, so there is a valid reason that some cats experience stinging with it. Have you read about the difference between Lantus & Levemir? It's a great link that will help you understand more.
 
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