Lantus Pen vs. Vial/Vetsulin switch to Lantus

[Tomlin]

Hi. It looks like we may be changing insulins due to significant BG drops as quickly as 2 hours after insulin & also because the Vetsulin is not providing better #s from about 4 hours on. Same drops occur in the evening after his insulin. I've reviewed the website, but checking to see if anyone has done the change & if there is anything major to be aware of/need to know with Lantus.

Also, I have the option of pens vs. the 10ML vial & was curious which people prefer & why.

Thank you! Much appreciated!!

 

[Tracey&Jones (GA)]

Pens are better. You don't have to worry if you drop it, it will not break like a vial. In most cases you can use all the insulin in the pen where it might go bad in the vial before it is finished. You can get a pack of 5 pens and store them in the fridge for use later.

I will leave the dosing questions to the pros.

I think you will find Lantus a lot easier to use.

 

[Tomlin]

Tracey, thank you!! Is it easy to draw the insulin out of it like the vial? I saw a couple 1-2 messages at some point where they got air bubbles or had issue?

Is the standard a pack of 5?

 

[SpotsMom]

Tracey, thank you!! Is it easy to draw the insulin out of it like the vial? I saw a couple 1-2 messages at some point where they got air bubbles or had issue?

Is the standard a pack of 5?

The random air bubble isn’t an issue, you just don’t want to intentionally push air into it before drawing like you would with the vial. If too much air builds up, you can always use a syringe to suck it out if you want to.

And yes. They come in 5 packs, though some pharmacies will split them out individually.

 

[Tomlin]

Hi Spots Mom!! THANK YOU! Very helpful! I see you used Prozinc & now Lantus. How do you like it? I also see Spot has pancreatitis. Has the Bupe been of any benefit?

 

[Tomlin]

The random air bubble isn’t an issue, you just don’t want to intentionally push air into it before drawing like you would with the vial. If too much air builds up, you can always use a syringe to suck it out if you want to.

And yes. They come in 5 packs, though some pharmacies will split them out individually.

How does your vet write the prescription.....Lantus SoloSTAR 1 Box? Just curious.

 

[Gill & George]

Hi and Welcome,

The pen makes more sense, since you can use up all the insulin, with the vial, for a kitty on a 'regular' dose you will end up wasting a lot of insulin since it will go off before you use it all up, so it works out more expensive in the end.

It's easy to use the pen and draw insulin from it with a syringe, as mentioned above, do not, push air into the pen, it's not advisable.

Do read the stickies at the top of the forum, and ask questions, there's no such thing as a silly question. Have a look at the different dosing methods that we use and see which one is the best fit for you and your boy. We followed decided to follow Tight Regulation, since this was the method that gives kitty the best chance of achieving regulation quickly, which in turn increases the chances of achieving remission.

I would recommend that you make the swap at a time where you can monitor the first few cycles, sometimes you can get a strong response to a switch.

As he's already on vetsulin your starting dose should be based on that, looking at the spread sheet, there's not a lot of data to go on, but 2.5u of vetsulin he was getting to 74 on a pet meter, so I would probably take the dose back a notch to give yourself some breathing room, perhaps to 2u or I might even err to 1.5u, given that there is not much data, and I am suspicious that you may have missed some lower numbers on the 2u.
If you are not planning the change for a few days/cycles yet, getting a little more data on what he is doing on the 2.5u of vetsulin may make the decision easier/safer, you would need to get PS test , morning and night, and try and determine the nadirs over the next few cycles, by getting some midcycle tests between +2 and +6
One thing that does worry me, looking at the ss is that you are shooting blind. Are you having difficulty testing? Shooting blind can be very risky, and looking at the numbers I am suspicious that he may be seeing numbers significantly lower than that 74 on the 2.5u. That pink last night makes me think he dropped lower than normal earlier that day and then bounced.

Hopefully with Lantus you will get a gentler drop in BG, your guy does seem to like to be a bit dramatic, or it may be that the current vetsulin dose is a bit high for him?????

 

[SpotsMom]

How does your vet write the prescription.....Lantus SoloSTAR 1 Box? Just curious.

Mine wrote it as 5 pens.

 

[Amanda and a Loudogg]

My vet just wrote me a prescription for glargine, which meant I could choose between Lantus and Basaglar.

My buddy Lou switched from Vetsulin to Basaglar (Glargine insulin similar in action to Lantus). You can definitely take the Vetsulin dose into consideration. I'm with Gill though, we don't have a lot of information about where the current Vetsulin dose takes Mr T, but I know that Vetsulin can depend on where you're starting. I definitely would not go higher than 2.0u, but 1.5u might be a good starting point to be on the safe side. I ended up switching Lou over Memorial Day weekend last year. Dosed the Vetsulin that morning and then switched over that evening so that I'd have the next 3 days to monitor the change-over. Lou's now on Levemir and he is doing absolutely amazing! My only regret is not switching from Vetsulin sooner. I hope your Mr T will see good results as well!

 

[SpotsMom]

Hi Spots Mom!! THANK YOU! Very helpful! I see you used Prozinc & now Lantus. How do you like it? I also see Spot has pancreatitis. Has the Bupe been of any benefit?

Lantus works so much better for Spot than Prozinc did. His curves were just too dramatic and he didn’t spend nearly enough time in the nice healing numbers. It took us a few months on Lantus to work up to a dose that worked but I think Spot had a touch of glucose toxicity that we had to break through.. and I was afraid to start on the dose the people in the forum recommended so we started on too low a dose. Once he started getting good numbers, he now stays in them a lot longer throughout the day than he did with Prozinc. Without all the dramatic ups and downs, he also seems like a happier kitty. Back to his old playful self

The pancreatitis is another beast altogether. When he has an episode, the bupe does its job.. though Spot is very sensitive to it, so we always start with a low dose otherwise he gets too loopy. I prefer CBD oil for day to day so only use bupe if the CBD isn’t enough. Since he’s started on CBD his episodes have been further apart and MUCH shorter in duration - he’s even back up to his previous weight!

 

[Tomlin]

Hi and Welcome,

The pen makes more sense, since you can use up all the insulin, with the vial, for a kitty on a 'regular' dose you will end up wasting a lot of insulin since it will go off before you use it all up, so it works out more expensive in the end.

It's easy to use the pen and draw insulin from it with a syringe, as mentioned above, do not, push air into the pen, it's not advisable.

Do read the stickies at the top of the forum, and ask questions, there's no such thing as a silly question. Have a look at the different dosing methods that we use and see which one is the best fit for you and your boy. We followed decided to follow Tight Regulation, since this was the method that gives kitty the best chance of achieving regulation quickly, which in turn increases the chances of achieving remission.

I would recommend that you make the swap at a time where you can monitor the first few cycles, sometimes you can get a strong response to a switch.

As he's already on vetsulin your starting dose should be based on that, looking at the spread sheet, there's not a lot of data to go on, but 2.5u of vetsulin he was getting to 74 on a pet meter, so I would probably take the dose back a notch to give yourself some breathing room, perhaps to 2u or I might even err to 1.5u, given that there is not much data, and I am suspicious that you may have missed some lower numbers on the 2u.
If you are not planning the change for a few days/cycles yet, getting a little more data on what he is doing on the 2.5u of vetsulin may make the decision easier/safer, you would need to get PS test , morning and night, and try and determine the nadirs over the next few cycles, by getting some midcycle tests between +2 and +6
One thing that does worry me, looking at the ss is that you are shooting blind. Are you having difficulty testing? Shooting blind can be very risky, and looking at the numbers I am suspicious that he may be seeing numbers significantly lower than that 74 on the 2.5u. That pink last night makes me think he dropped lower than normal earlier that day and then bounced.

Hopefully with Lantus you will get a gentler drop in BG, your guy does seem to like to be a bit dramatic, or it may be that the current vetsulin dose is a bit high for him?????

Thank you for your thoughts! Pancreatitis will make the management slightly more unpredictable because theres no way to monitor what its doing on the daily, but its still all manageable. Goal is definitely get rid of the drop & also get the BG in a better range throughout the day/night. Sounds like Lantus should do it !

 

[Tomlin]

Lantus works so much better for Spot than Prozinc did. His curves were just too dramatic and he didn’t spend nearly enough time in the nice healing numbers. It took us a few months on Lantus to work up to a dose that worked but I think Spot had a touch of glucose toxicity that we had to break through.. and I was afraid to start on the dose the people in the forum recommended so we started on too low a dose. Once he started getting good numbers, he now stays in them a lot longer throughout the day than he did with Prozinc. Without all the dramatic ups and downs, he also seems like a happier kitty. Back to his old playful self

The pancreatitis is another beast altogether. When he has an episode, the bupe does its job.. though Spot is very sensitive to it, so we always start with a low dose otherwise he gets too loopy. I prefer CBD oil for day to day so only use bupe if the CBD isn’t enough. Since he’s started on CBD his episodes have been further apart and MUCH shorter in duration - he’s even back up to his previous weight!

Amen to the "pancreatitis is another beast". T's is chronic & only able to be kept under control using Pred. MANY attempts to even reduce the dose significantly resulted aggravation of the disease, so we manage with it. I guess thats why the Bupe was a definite no go from all the vets involved with this case. His pancreatitis won't be ok. He's was never able to have an episode & then be off the medication. You've given me great hope about the transition. I'm totally leaning on my experts from the University setting to guide me with dosing because I trust them. Fortunately my guy has no clinical symptoms (thank God) so its all numbers at this point....& of course making sure NOT to stress the crap out of him which would aggravate the pancreatitis! Moderation & balance!

 

[Tomlin]

My vet just wrote me a prescription for glargine, which meant I could choose between Lantus and Basaglar.

My buddy Lou switched from Vetsulin to Basaglar (Glargine insulin similar in action to Lantus). You can definitely take the Vetsulin dose into consideration. I'm with Gill though, we don't have a lot of information about where the current Vetsulin dose takes Mr T, but I know that Vetsulin can depend on where you're starting. I definitely would not go higher than 2.0u, but 1.5u might be a good starting point to be on the safe side. I ended up switching Lou over Memorial Day weekend last year. Dosed the Vetsulin that morning and then switched over that evening so that I'd have the next 3 days to monitor the change-over. Lou's now on Levemir and he is doing absolutely amazing! My only regret is not switching from Vetsulin sooner. I hope your Mr T will see good results as well!

Awesome! Thank you for the info. Will make sure i'm around to monitor!

 

[Olive & Paula]

As others state then pens are the best IMO. Besides getting more (15 ml v 10 ml), they don't break if dropped, you always have a back up of needed.

do not inject air into pen or any extra insulin back in it.

 

[Tomlin]

As others state then pens are the best IMO. Besides getting more (15 ml v 10 ml), they don't break if dropped, you always have a back up of needed.

do not inject air into pen or any extra insulin back in it.

Thank you for your thoughts. Back up....thats a very good thing!

 

[Chester’s Dad]

I’m very curious to hear about your experience moving from Vetsulin to Lantus. I may be in that same boat soon with my cat, and I’m wondering how you find the overall difference in monthly cost between the two.

 

[Tomlin]

Hi. I'm being told if you use the 10ML vial you can use it well beyond the 28 days it says without any issue--so it will last several months. I haven't been able to ask specifically about the pens yet, but I am thinking it would be the same. Its nice that each is only 3ML, so less puncturing the seal with the syringe before moving onto a new pen. I do have pet insurance & I confirmed that they will cover it. I did call multiple pharmacies in the US & the 10ML vial was anywhere from $295-$321. This board has also mentioned Marks Marine Pharmacy in Canada as a place many have turned to for it.

 

[Tracey&Jones (GA)]

I do have pet insurance & I confirmed that they will cover it.

I had insurance with Jones...a life saver that was. Who are your through? Trupanion covered 90% of all his diabetic supplies and medication.

Wish you luck with the switch!

 

[Tomlin]

Trupanion ! IF ONLY I could get on the plan . They are so much better than the human plans...or should I say, not so human !!

 

[Tomlin]

I had insurance with Jones...a life saver that was. Who are your through? Trupanion covered 90% of all his diabetic supplies and medication.

Wish you luck with the switch!

Since you have the same plan, did you get the pens or vial? If you got the pens, did you have your vet write for 1 or how many at a time?? Also, THANK you for noting about the supplies! Didn't even think about submitting those!
Thank you for the best wishes!! We need those right about now!

 

[J.J. and Phoebe Squeak]

Pens are better. You don't have to worry if you drop it, it will not break like a vial. In most cases you can use all the insulin in the pen where it might go bad in the vial before it is finished. You can get a pack of 5 pens and store them in the fridge for use later.

I will leave the dosing questions to the pros.

I think you will find Lantus a lot easier to use.

Hi, does the pen only do 1 U doses? If you need a .25 do you need to use a syringe or do you know of a pen that does smaller doses? Thanks.

 

[Tracey&Jones (GA)]

Hi, does the pen only do 1 U doses? If you need a .25 do you need to use a syringe or do you know of a pen that does smaller doses? Thanks.

I just used the pen like a vial. Drew up the dose using a syringe. I didn't use the needles that came with it after coming here and getting serious with Jones' FD.

 

[J.J. and Phoebe Squeak]

I just used the pen like a vial. Drew up the dose using a syringe. I didn't use the needles that came with it after coming here and getting serious with Jones' FD.

Thanks very much. The doctor I'm working with at the moment doesn't believe in .25 increments for dosing and I think Phoebe Squeak needs to be between 1U and 1.5 units. She said a pen will allow .25 dosing increments but from what I find online that isn't true. I told her I have calipers and an 11X magnifying glass, but she's not buying it so far. Very frustrating. But I trust the folks here and I know dosing can be tricky and not always fall at a .5 mark. Anyway, sorry for rambling, I really appreciate you answering my question so quickly. I hope to find a doctor who "gets it" soon. I've tried 4 so far.

 

[Tracey&Jones (GA)]

I hope to find a doctor who "gets it" soon. I've tried 4 so far.

That may be the hardest part of this. My vet was wonderful about it. The literature she gave me included the website for this forum. Once I started taking over his FD journey, things improved greatly. She loved the spreadsheet, loved his numbers and let me go. She handled all the other stuff.

Insulin is not a drug but a hormone. You don't necessarily need the same each day especially if the pancreas is decided to work again. PLUS - all meds should be at the "minimum effective" dose. So if that is a .25u then so be it! That is my soap opera rant for today.

Are you in a state that requires a script for the syringes? If not, you could just pick them up and use the pen the way you want. I found the syringes easier to use as well for giving the injection. Not as big or clumsy in my small hands.

 

[Tomlin]

Tracey-remind us again which syringes you used please

 

[J.J. and Phoebe Squeak]

That may be the hardest part of this. My vet was wonderful about it. The literature she gave me included the website for this forum. Once I started taking over his FD journey, things improved greatly. She loved the spreadsheet, loved his numbers and let me go. She handled all the other stuff.

Insulin is not a drug but a hormone. You don't necessarily need the same each day especially if the pancreas is decided to work again. PLUS - all meds should be at the "minimum effective" dose. So if that is a .25u then so be it! That is my soap opera rant for today.

Are you in a state that requires a script for the syringes? If not, you could just pick them up and use the pen the way you want. I found the syringes easier to use as well for giving the injection. Not as big or clumsy in my small hands.

Thanks again for the reply. Yes I do need an RX for syringes. I think I'd like to join you on your soapbox! Meeting with Dr. #5 on July 7 (soonest I could get in).

 

[Tomlin]

Thanks again for the reply. Yes I do need an RX for syringes. I think I'd like to join you on your soapbox! Meeting with Dr. #5 on July 7 (soonest I could get in).

Where do you put the Freestyle Libre & more importantly how does it stay on? I'm seeing it mentioned in a published study but have this image of my cat ripping that thing off!

 

[J.J. and Phoebe Squeak]

Where do you put the Freestyle Libre & more importantly how does it stay on? I'm seeing it mentioned in a published study but have this image of my cat ripping that thing off!

Funny you should say that because it's exactly what happened! A doctor put it on between Phoebe Squeak's shoulder blades with NOTHING at all covering it. I questioned this, but she said cats leave it alone. WRONG! I had to go back to the animal hospital because P.S. scratched it off within 15 minutes. I also had to pay for another sensor because you cannot reuse them after they come off. The next time they used extra glue and sent her home covered in a mesh stocking kind of thing that she promptly got stuck in her teeth. So first I put her in an inflatable e-collar and then switched her to this: https://www.amazon.com/gp/product/B00NHNF5L6/?tag=felinediabetesfdmb-20.

 

[AmandaE]

Where do you put the Freestyle Libre & more importantly how does it stay on? I'm seeing it mentioned in a published study but have this image of my cat ripping that thing off!

I feel the same way about the freestyle libre! there is a post about it right now on the main health forum. definitely interesting. It looks like they put it on the neck which is prime scratch location... no thanks

 

[AmandaE]

Funny you should say that because it's exactly what happened! A doctor put it on between Phoebe Squeak's shoulder blades with NOTHING at all covering it. I questioned this, but she said cats leave it alone. WRONG! I had to go back to the animal hospital because P.S. scratched it off within 15 minutes. I also had to pay for another sensor because you cannot reuse them after they come off. The next time they used extra glue and sent her home covered in a mesh stocking kind of thing that she promptly got stuck in her teeth. So first I put her in an inflatable e-collar and then switched her to this: https://www.amazon.com/gp/product/B00NHNF5L6/?tag=felinediabetesfdmb-20.

OMG YES!!! SO CUUUUUTE!! PLEASE! post a pic of PS wearing it!

 

[Tomlin]

Its awesome if you have a cooperative cat. I have a cat who won't use energy to meow let alone get a device off of him, but of course, he's NOT the one with the issue. My guy would sulk & then go to town to get it off. I'll check out the post of the main health forum. SO curious!!

 

[Tomlin]

Funny you should say that because it's exactly what happened! A doctor put it on between Phoebe Squeak's shoulder blades with NOTHING at all covering it. I questioned this, but she said cats leave it alone. WRONG! I had to go back to the animal hospital because P.S. scratched it off within 15 minutes. I also had to pay for another sensor because you cannot reuse them after they come off. The next time they used extra glue and sent her home covered in a mesh stocking kind of thing that she promptly got stuck in her teeth. So first I put her in an inflatable e-collar and then switched her to this: https://www.amazon.com/gp/product/B00NHNF5L6/?tag=felinediabetesfdmb-20.

OMG!! Like the insulin & BGs aren't enough?! UGH! How is she doing in that? My heart goes out to you & Phoebe! Is she in camo? I will say you made me laugh.....sometimes you just have to laugh in these situations!!

 

[Tomlin]

PLEASE post a picture!! You & Phoebe ROCK!

 

[J.J. and Phoebe Squeak]

OMG YES!!! SO CUUUUUTE!! PLEASE! post a pic of PS wearing it!

Here she is! Camo Kitty!

 

[AmandaE]

OMG I CAN'T!!! I'm dying right now wanting to maul her! she's so a little Human! LOVE IT!!!!

 

[AmandaE]

Also she has a look like: eff you mom

 

[J.J. and Phoebe Squeak]

PLEASE post a picture!! You & Phoebe ROCK!

Also she has a look like: eff you mom

She still has that look several days later!

 

[AmandaE]

She still has that look several days later!

I wouldn't even care... the cuteness pays for the dirty looks!!

 

[J.J. and Phoebe Squeak]

OMG!! Like the insulin & BGs aren't enough?! UGH! How is she doing in that? My heart goes out to you & Phoebe! Is she in camo? I will say you made me laugh.....sometimes you just have to laugh in these situations!!

As you can see in the photo, she's not loving it. But we eventually rolled it up so it's more like a midriff top and it's a bit better for her. I totally agree about needing humor to get through all of this!!

 

[Tomlin]

As you can see in the photo, she's not loving it. But we eventually rolled it up so it's more like a midriff top and it's a bit better for her. I totally agree about needing humor to get through all of this!!

LOVE, LOVE, LOVE!!!!!! Tell her I said she's catwalk ready in her camo. Very ON TREND !!! Where is the mid driff pic?? Please share .

How was it getting her IN it??

 

[Tomlin]

I like the idea. Do you just pull down the back of the shirt or un velcro it to get the reading? I'm guessing the vet needs to put a new one on every 14 days or how does that work? I'm looking to minimize stress with the readings & this may actually be less stressful for my guy. Thank you for sharing the pictures & seriously, making me smile. She's beautiful!

 

[J.J. and Phoebe Squeak]

LOVE, LOVE, LOVE!!!!!! Tell her I said she's catwalk ready in her camo. Very ON TREND !!! Where is the mid driff pic?? Please share .

How was it getting her IN it??

It took 2 of us to get her in it. Here's a photo of her sleeping in her camo mi driff. Her coloring is very similar to the camo but I think you can still see where the shirt ends and her tummy starts.

 

[Tomlin]

Thank you for sharing. She is adorable & looks more peaceful with the midriff. Are you finding this less stressful for her vs checking her ears? My boy is such a sensitive soul & then the stress aggravates his chronic pancreatitis. I'd love to find a way to make this less of an issue for him.

 

[Tomlin]

BTW-She needs her own twitter page or something! Seriously.

Please let me know if this requires vet to apply it & if then the vet has to change it out?

 

[Gill & George]

Hi, does the pen only do 1 U doses? If you need a .25 do you need to use a syringe or do you know of a pen that does smaller doses? Thanks.

Most of us will use the syringes, to draw any dose rather than the pen needle, to make the insulin last longer we keep it in the refrigerator, but I believe if you are using the pen needle you are not able to refrigerate it since it interferes with the dosing mechanism in the pen.

I'm guessing the vet needs to put a new one on every 14 days or how does that work? I

Don't quote me on this but I seem to remember that they are not able to repeatedly attach the freestyle libre, most of the members that I've come across that started on the libre moved to just testing the ears with a regular meter.
I don't know about your kitty but a fortnightly visit to the vet office to get the device attached would be far more stressful for BFG than poking his ears ever was, and cute as the camo outfit is...... trying to get my 16lb boy into it would have been interesting to say the least

Personally I would concentrate on making the ear poke a happy experience for your guy, lots of cuddles, strokes, treats, whatever rocks his boat. I started by just fondling my guys ears and giving him a little treat, I use Freeze dried 100% chicken breast, others use a little poached chicken breast. He used to come and sit on my lap ready to be tested when I rattled the test strips and he purrs through the whole procedure. (he doesn't come inow because he's deaf but he gets excited when he sees me holding the meter)

 

[J.J. and Phoebe Squeak]

BTW-She needs her own twitter page or something! Seriously.

Please let me know if this requires vet to apply it & if then the vet has to change it out?

Thanks!
I don't know if it's the same everywhere, but here it required a RX so the doc asked me to pick it up and bring it in so she could place it. She said it's a temporary tool to help find the right dose and not something we'd do long term. You can actually get the reading through the shirt -- no need to pull it up. I think P.S. is the opposite of Mr. T. She had almost no stress with ear testing, but wearing this shirt has stressed her out.

 

[J.J. and Phoebe Squeak]

Most of us will use the syringes, to draw any dose rather than the pen needle, to make the insulin last longer we keep it in the refrigerator, but I believe if you are using the pen needle you are not able to refrigerate it since it interferes with the dosing mechanism in the pen.
Thanks for this info. Could you please tell me if you use the pen needle will the dosing system measure in .25 increments?


Don't quote me on this but I seem to remember that they are not able to repeatedly attach the freestyle libre, most of the members that I've come across that started on the libre moved to just testing the ears with a regular meter.
I don't know about your kitty but a fortnightly visit to the vet office to get the device attached would be far more stressful for BFG than poking his ears ever was, and cute as the camo outfit is...... trying to get my 16lb boy into it would have been interesting to say the least

Yes, our doctor said the Libre meter is just to help us find the right dose, not a long term thing. The camo outfit comes in a bigger size, but I'm not sure about 16 pounds
I think you've got a great situation without it!

 

[Tomlin]

Thanks!
I don't know if it's the same everywhere, but here it required a RX so the doc asked me to pick it up and bring it in so she could place it. She said it's a temporary tool to help find the right dose and not something we'd do long term. You can actually get the reading through the shirt -- no need to pull it up. I think P.S. is the opposite of Mr. T. She had almost no stress with ear testing, but wearing this shirt has stressed her out.

Very interesting! Good to know about the stress with the shirt. I'm making strides with the BG testing being a little less stressful for him by using treats after. Unlike most cats, he does NOT want a ton of love & affection before the testing or his insulin. He knows its coming & his attitude is "don't freeze the kicker"!! He just wants you to do it & be done. The more you rub him the more upset he becomes--opposite of most, but its his own unique personality!! He's always been on the dramatic side! So much so that it made his initial pancreatitis diagnosis confusing because he was more like a dog about it. They had to make sure nothing else was going on with him.