? Lantus or Levemir? How do you choose?

[Kate and Geoff]

After 6 months of Prozinc and a spell on Caninsulin, Jack’s numbers are anything but stable. Prozinc has been a happier experience for Jack (and ourselves) but a recent Fructosamine test result shows that we have some way to go. There is a lot of volatility in his readings and dose tweaking doesnt appear to work. Trying to predict his numbers is nigh on impossible as he is far from a text book case.

His food is always wet, very low,or zero, carb and his glucose is monitored regularly. Injections are timed precisely and all food and water is measured and weighed. We are also in constant contact with his excellent vet who works tirelessly to help him.

From our readings we can see that both Levemir and Lantus are highly regarded and seemingly give flatter and smoother curves. We are hoping to learn from your knowledge and experience so as to help us make a decision on which way to go.

Many thanks

 

[Wendy&Neko]

Hi and welcome. First thing, could you change the subject line prefix please? GA means guardian angel or gone ahead.

Looks like Jack likes to bounce! My Neko was on Caninsulin, then Lantus, then Levemir. Lev was my favourite. It gave flatter cycles. Which meant more sleep at night. Another consideration for me was that Neko got to a higher dose (as high as 8.75 units), and higher doses of Lantus can sting due to it’s acid base. She preferred Levemir too. The one consideration is that the onset and nadir are later. While Lantus typically onset’s around +2 and nadir around +6, Lev is a couple hours later for each. That doesn’t always work for everyone’s schedule. It was actually better for me. I could shoot and go out for dinner in the evening. And the early morning nadir checks, if I needed them, corresponded with the time I was getting up for my workout anyway. One thing to consider is that ECID, not all cats are flatter on Levemir, though the majority are, and the times for onset/nadir may vary. My girl liked to be fashionably later with both.

From our experiences here, most people are happy switching to either of the L insulins from Prozinc. Does your vet have experience in either? Mine didn’t so I learned everything.

Any other known health conditions going on with Jack?

 

[Carol & Murphy (GA)]

I switched Murphy from Prozinc to Levemir and wish I had done it sooner. Wendy's right - the cycles are flatter, and I like the idea of a depot.

 

[Ti-Mousse (GA) Pepe (GA)]

I started Ti-Mousse on Caninsulin them switched to Lantus. He was always growling when shooting as if it was hurting and the numbers were not doing better. Switched to Levemir, injections are OK no more growling, cycles are flatter so numbers are going down slowly but without too much bouncing. ECID but I feel Ti-Mousse is going a lot better since I switched!

 

[Kate and Geoff]

Hi and welcome. First thing, could you change the subject line prefix please? GA means guardian angel or gone ahead.

Looks like Jack likes to bounce! My Neko was on Caninsulin, then Lantus, then Levemir. Lev was my favourite. It gave flatter cycles. Which meant more sleep at night. Another consideration for me was that Neko got to a higher dose (as high as 8.75 units), and higher doses of Lantus can sting due to it’s acid base. She preferred Levemir too. The one consideration is that the onset and nadir are later. While Lantus typically onset’s around +2 and nadir around +6, Lev is a couple hours later for each. That doesn’t always work for everyone’s schedule. It was actually better for me. I could shoot and go out for dinner in the evening. And the early morning nadir checks, if I needed them, corresponded with the time I was getting up for my workout anyway. One thing to consider is that ECID, not all cats are flatter on Levemir, though the majority are, and the times for onset/nadir may vary. My girl liked to be fashionably later with both.

From our experiences here, most people are happy switching to either of the L insulins from Prozinc. Does your vet have experience in either? Mine didn’t so I learned everything.

Any other known health conditions going on with Jack?

Thank you very much Wendy&Neko. Sorry took a guess that GA was General Advice..Oops. All changed now.

You are right. He really does bounce but it is the unpredictability that makes it so difficult. That is very interesting about the nadir and the delayed timing. As we have no idea when his nadir will be or what his readings are going to be, we are setting alarms every 2 hours some nights (just in case) so predictability will help massively as we can target the alarm calls rather than blanket coverage (hopefully ). Also he responds much better with flatter cycles and his water intake is generally much lower.

Our lady vet has used Lantus before but she will also be interested in thoughts from the group.

Good point about other conditions, we should have mentioned that. Our vet tested for absolutely everything in the early days and he has had dental work to rule that out too. Physically he is in great shape and has even egained some kitten like behaviour.

Thank you very much as this is really helpful information

 

[Kate and Geoff]

I switched Murphy from Prozinc to Levemir and wish I had done it sooner. Wendy's right - the cycles are flatter, and I like the idea of a depot.

I switched Murphy from Prozinc to Levemir and wish I had done it sooner. Wendy's right - the cycles are flatter, and I like the idea of a depot.

Hello Carol, thank you. This is really good to know and we very much hope to get the same good results as Murphy. Best wishes. Geoff and Kate (et Jack)

 

[Kate and Geoff]

I started Ti-Mousse on Caninsulin them switched to Lantus. He was always growling when shooting as if it was hurting and the numbers were not doing better. Switched to Levemir, injections are OK no more growling, cycles are flatter so numbers are going down slowly but without too much bouncing. ECID but I feel Ti-Mousse is going a lot better since I switched!

Thank you, very reassuring. Glad to hear that Ti-Mousse is doing better too. Best wishes

 

[Sienne and Gabby (GA)]

Oh my. Jack really does like to bounce! While Prozinc has a longer duration, I'm also wondering how Jack will do on an insulin that has a long duration. I'm guessing that either Lantus or Lev will flatten things out.

I stuck with Lantus throughout Gabby's life. The influential factor for me was the timing associated with Lev. I work full time. Gabby also had an early onset and nadir. This allowed me to shoot early (5:00 shot times) and get a few tests in before I left for work. If her numbers were dropping before I left for the day, I could give her enough carbs to get her through the cycle.Thus, much of my decision making about insulin choice was based on practical issues.

 

[Gill & George]

Hi and Welcome Kate, Geoff and Jack.

I started on Lantus from the start, so no personal experience with changing over insulins. We've been very happy with Lantus, we had some fast drops and bounces at first, but once we got to a good dose he flattened out somewhat, which makes life much easier.

I think that either of the two will probably improve Jacks numbers overall, I've seen a lot of folk make the swap and note the improvement.

 

[Maymay]

Orlando started out with Caninsulin, then Prozinc, then Lantus. We were then referred to a specialist. She prefers Levemir, but says Lantus is also a good insulin and has kept him on that for now. We've still not managed to hit perfect numbers yet, though, but we'll hopefully get there soon.

Both are slow acting insulins, though, and should give softer curves. For Orlando his nadirs lie anywhere from +4 to +8, but again, we're still in the adjustment phase.

 

[Kate and Geoff]

Oh my. Jack really does like to bounce! While Prozinc has a longer duration, I'm also wondering how Jack will do on an insulin that has a long duration. I'm guessing that either Lantus or Lev will flatten things out.

I stuck with Lantus throughout Gabby's life. The influential factor for me was the timing associated with Lev. I work full time. Gabby also had an early onset and nadir. This allowed me to shoot early (5:00 shot times) and get a few tests in before I left for work. If her numbers were dropping before I left for the day, I could give her enough carbs to get her through the cycle.Thus, much of my decision making about insulin choice was based on practical issues.

Hi Sienne - sorry for late response. What you have said here is very pertinent. We also shoot at 5.00 too, with the view to a late start at work after early morning homeworking to see how the numbers go and this gives us a plus 4 reading before heading out the door.

Since we posted we have had some startling lows with the inevitable bounce and flats and think something is afoot after many months. We want to change insulin but these lows big are drops of 12 mmol (220 mg/dl approx) in 1hr 15 mins which is exceedingly fast by comparison with what we have been used to. We are actually going to post a new thread as we are wondering whether we have a spluttering pancreas which makes all of this doubly difficult. Thank you for your thoughts on duration as this is key to decision making.

 

[Kate and Geoff]

Hi and Welcome Kate, Geoff and Jack.

I started on Lantus from the start, so no personal experience with changing over insulins. We've been very happy with Lantus, we had some fast drops and bounces at first, but once we got to a good dose he flattened out somewhat, which makes life much easier.

I think that either of the two will probably improve Jacks numbers overall, I've seen a lot of folk make the swap and note the improvement.

Thank you Gill - We are hopeful to flatten out the numbers somewhat and your comment about both being good is what drives us. I think your mention of the right dose is the key as we wonder whether the Somogyis are from overdosing and the recent drops we have had may show this

 

[Kate and Geoff]

Orlando started out with Caninsulin, then Prozinc, then Lantus. We were then referred to a specialist. She prefers Levemir, but says Lantus is also a good insulin and has kept him on that for now. We've still not managed to hit perfect numbers yet, though, but we'll hopefully get there soon.

Both are slow acting insulins, though, and should give softer curves. For Orlando his nadirs lie anywhere from +4 to +8, but again, we're still in the adjustment phase.

Hello Maymay - Thank you - It sounds like we have similarities in the insulin variations , although we are behind your curve (pardon the pun) as we havent tried Lantus yet. Glad we have moved on from Caninsulin.

Fingers crossed that we both manage to hit those perfect numbers, the endless enigma for all of us feline diabetic souls. Its absolutely not an easy nut to crack. We get the feeling that there is a very slight leaning towards Levemir from most of what we have read but our vet has used Lantus before, so its not an easy one

 

[Wendy&Neko]

The actions of Levemir and Lantus are similar, other than later nadir/onset. Your vet should know enough if you went with either one.