Lantus to Levemir, why did you switch?

[Mocha'sMom]

I am just trying to figure out if I should try to switch Mocha from Lantus to Levemir. We are continuing to battle diarrhea, and Lantus has been reported to cause diarrhea in humans. Less than 11% of people experience this, but it is a possibility. So, I am just wondering if anyone else has had this experience, did you switch, and did it help? Some human diabetics have reported feeling "cloudy" and "lethargic" on Lantus, once again a small percentage. Mocha dose sleep a lot and I have just been writing that off to him being an old man. I am now wondering if maybe this is related too. My other question would be, if I am going to switch, is there any special process I have to go through to switch from one long lasting insulin to another?

 

[Larry and Kitties]

Re: Lantus to Levemir, why'd you switch?

I switched my Tonis from Lantus to Levemir because I was not getting much response when I got up to 5 units. Levemir did not work any better but I could maintain his BG under 120 with about 8 units Levemir and 5 units N twice daily.
My MurrFee came to me on Levemir and I continued to use Levemir since I still had some left from Tonis. He was up to about 8 units twice daily. I then switch to Lantus since my other cats were using Lantus. However, I could not get consistent BGs on Lantus and his does got to above 11 units. I even used some N when his BG was high. I then switch back to Levemir and am getting more consistent BG with 11 units twice daily.
There is a University of Queensland article that says that Levemir dose is about 70% of Lantus. That link does not work anymore.

 

[Sue and Oliver (GA)]

Re: Lantus to Levemir, why'd you switch?

Larry, would it be wise to preface your posts about large doses of insulin for your cats with an explanation that these are not usual amounts and that most cats usually get one unit or so? I would hate for a new person to see this post and assume these are usual amounts of insulin. I also would hate for new people to assume that adding N to Lantus/Levemir is usual practice.

 

[Mocha'sMom]

Re: Lantus to Levemir, why'd you switch?

I switched my Tonis from Lantus to Levemir because I was not getting much response when I got up to 5 units. Levemir did not work any better but I could maintain his BG under 120 with about 8 units Levemir and 5 units N twice daily.
My MurrFee came to me on Levemir and I continued to use Levemir since I still had some left from Tonis. He was up to about 8 units twice daily. I then switch to Lantus since my other cats were using Lantus. However, I could not get consistent BGs on Lantus and his does got to above 11 units. I even used some N when his BG was high. I then switch back to Levemir and am getting more consistent BG with 11 units twice daily.
There is a University of Queensland article that says that Levemir dose is about 70% of Lantus. That link does not work anymore.

When you switched from one to the other, did you do anything special? Like when I switched from the short acting to the long acting insulin my vet had me skip 2 doses (24 hrs with no insulin). Also, when that Queensland article says that Levemir is 70% of Lantus does that mean 1.25U Lantus = .88U Levemir? So by switching I would have to reduce how much insulin he gets?

 

[Wendy&Neko]

Re: Lantus to Levemir, why'd you switch?

I switched my Neko from Lantus to Levemir in September. She was driving me crazy only doing her lows at night and I had changed everything else I could. The switch didn't change that. :roll: However, her cycles are sometimes flatter so I think it's better for her. I didn't notice any physical difference when we made the switch. Some people notice that their cats experience a sting with Lantus and switch for that reason. Neko used to be on higher doses on Lantus but I didn't notice any difference in how she reacts.

I just switched from one cycle to the next. And Larry is right, the recommended new dose when changing insulin types is 70% of the previous one. Some cats need more, some need less when switching so it's good to start on the low side. If you switch, do it when you can monitor for a few cycles as some cats have a quick response. For your 1.25U Lantus ose, round down to .75U. I use calipers for measuring, so it was easier for me to find an in between dose.

 

[Mocha'sMom]

Re: Lantus to Levemir, why'd you switch?

I use calipers for measuring, so it was easier for me to find an in between dose.

Calipers, huh? Do you just hold the caliper up to the side of the syringe, and measure that way? Or is it a different kind of caliper?

 

[KPassa]

Yep, pretty much exactly that. Here's a great post written by Marje for help dosing with calipers.

 

[Mocha'sMom]

I just want to make sure there is no special process to switch from Lantus to Levemir. I need to get a new vial of insulin next week, and I think I want to try out Levemir. Is there any side effects of switching that I should know about? It seems like not many people use the Levemir support group. How many people actually use this insulin? I am wondering how much resistance I am going to meet from my vet when I start asking about Levemir, given it is a relatively new insulin.

 

[sophie]

Hi!
No experience with Lantus, but switched from ProZinc to Levemir due to shortage of ProZinc. Good experience with both insulin. Please remember that it's always safer to start low & go up in dose. My second point: better to buy Levemir flexpens than a vial. If one has an accident with a vial, the entire bottle may be spoiled, with a flexpen only the single flexpen.
Best wishes,
Sophie

 

[Wendy&Tiggy(GA)]

I wouldn't switch quite yet - his numbers are looking good - nice healing numbers mostly. You even got a recent dose decrease and it looks like it might be holding well!

I would keep the 1 unit a few more days and see how it goes. Drop to 0.75 if he goes under 50. Get some night tests to make sure he isn't dropping low then as I suspect he might be dropping too low at night and bouncing..

Wendy

 

[Mocha'sMom]

Okay. I will try sticking with the Lantus for awhile longer and get a nadir tonight. I hadn't realized how long it's been since I actually got a PM nadir.

 

[Wendy&Tiggy(GA)]

You are doing a great job go night testing, i just find that I wonder if he is dropping lower at any point. Maybe try and get a +7 or +8.. especially if your pre shot and before bed seem to be constantly dropping. i know its a pain in the xxxx but you might be surprised and find more greens in there.

and if you start to see low blue or green I would almost test hourly - day or night - because you want to know how low he is going. anything under 50 is a dose decrease and every dose decrease gets you closer to OTJ!!

Wendy

 

[Shari and Max]

Thanks for the info. I'm planning to switch soon too. Just to verify, use the 100ul syringes - the same ones you would use for Lantus, correct?

 

[Mocha'sMom]

Maybe try and get a +7 or +8.. especially if your pre shot and before bed seem to be constantly dropping. i know its a pain in the xxxx but you might be surprised and find more greens in there.

I will get that +7 or +8 tonight. I had never noticed that I have never gotten a +8 day or night :? What is so magical about that hour that I have managed to miss it thus far? Well, we will see what tonight holds...

 

[Deb & Wink]

Not all cats nadir at the typical +5 to +7 time frame. Some are earlier, around +3 to +4 like my Wink. Some are much later, around the +8 to +9 time frame.

At this point, you are still gathering some data, so having a couple of tests at other times then you have gotten before, helps to fill in the big picture and helps us to see more of a pattern.

Also, remember that the nadir can change and might not always be at the same time. ECID.

If you do switch, you need to take into account the dose of the prior insulin used. It's only when you have not used any other insulin that you want to start out at a dose based on the cat's weight, which usually ends up being that 1U dose.

I'm not positive of the formula, but I think you only want the starting dose of Levimir to be 70% of what the Lantus dose was. Hoping a Levimir user can verify this.

 

[Mocha'sMom]

I'm not positive of the formula, but I think you only want the starting dose of Levimir to be 70% of what the Lantus dose was. Hoping a Levimir user can verify this.

Wendy said the same thing. I will give Lantus a little longer to prove itself :roll: I am just trying figure out what is giving him diarrhea. I will do another vial of Lantus (not repackaged this time) and continue to try diet changes for now.