? L&L protocol questions

Panic

Panic

Member Since 2019
Hi everyone, ProZinc user here! I'm doing some on-the-side research into different types of insulin and the L&L insulin are the only ones I don't have personal experience with. If anyone has time, could you answer some of these questions I have?
  • In-and-out insulin typically recommend food shortly (1-3 hr) after shot time to steer the drop. Is this needed for L&L? Any particular feed times otherwise recommended?
  • What is (generally speaking) typical duration, peak, and onset for most cats?
  • If L&L are handled virtually the same, why is Lantus more commonly used than Levemir?
  • Is protocol for L&L to test, feed, shoot all within about 15 minutes?
I think everything else I need is already available on a sticky, I just haven't been able to find these. If there is a sticky somewhere with that information by all means point me in that direction! Thank you c:
 
I'll do my best to answer.
  • With some of the in and out insulins such as Novolin and probably Caninsulin/Vetsulin, it's probably wise to have food on board about 30 min. prior to a shot. With L & L insulin onset isn't. until approximately 2 hours after injection. Thus, you can test, feed, and shoot in rapid succession all usually within 10 - 15 min (or depending on how fast your are). Further feeding is often helpful but not so much to steer the drop but more as a means of giving the pancreas a break with several small meals vs one large meal. With a cat that has an early nadir, the early part of the cycle may have several meals across the first 3 - 4 hours to act as a buffer for dropping numbers. In general, we suggest to try to feed a cat prior to nadir so there's more insulin to offset the effect of food. However, depending on the carb sensitivity of the cat and whether the cat is used to grazing, this may not be an issue.
  • Again, in general, the depot insulin onset is at around +2, nadir is around +6 and duration is 12 hrs or sometimes longer. And all of this can vary widely. (My cat's onset was at around +1 or +2, nadir was at +3 or +4, except when it wasn't.)
  • Lantus came on the market first and was more widely available. Frankly, it was probably marketing.
  • Yes.
 
Thank you SO much Sienne for taking the time to answer my questions! It's really interesting comparing the depot to the in and out insulin. :)
 
Regarding Levemir........when I switched my girl from Lantus to Levemir in 2015 (only due to the acidity of Lantus and high dose my girl was on), my vet hadn't even heard of Levemir. It seems there hasn't been a lot of veterinary research papers published with Levemir until recently to get that info out to the veterinary community and I'm sure it's still a mystery to a lot of vets.
 
Levemir's onset is on average around +4 and nadir around +8. My girl wasn't average. :p Onset around +5 and nadir generally +9-+12, except when it wasn't. Fewer vets have experience with Lev due to when it became available. For some people, the +8 ish nadir is harder to deal with schedulewise. For me it was better. The later onset and nadir changes timing on feeding smaller meals too. Higher dose cats tend to be on Levemir instead of Lantus, because Lantus's acid base can sting at higher doses, and lower doses for some cats.

I think some vets have used Lev for dogs, and I've heard it's stronger with them. So there is this myth floating around that Lev is a stronger insulin, when in fact most cats have similar doses from one to the other.
 
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