Lantus vs Levemir - my vet says Levemir isn't good for cats

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kittybethaustin

kittybethaustin

Member Since 2015
Any idea why I now have two vets saying NOT to use Levemir for my diabetic foster cat? She's been on Lantus since diagnosed in April. We've had 12 pens donated to our special needs cat program but I'm being told it's not as effective for cats and to stick with the Lantus. Both the shelter vet and my private vet are against it. But I haven't found anything online to support their views.

This cat is 10+ years old and was found wandering the streets as a stray. Front declawed at that! She was severely dehydrated. She's currently on 2 units of Lantus twice a day. I haven't been given much detailed information about care so I'll be on this site a lot to figure out some best practices in caring for her.

I haven't posted here yet and will do an introduction soon.
 
To be more precise, the shelter vet says not to change if she's well regulated. My private vet says Levemir isn't as effective period. I don't know what "well regulated" actually means. That's one of the things I'm here to learn about. But this donation is a huge boon for our rescue program if I could use it. It was suggested I sell them on Craig's List and use the proceeds to buy the Lantus pens.
 
Well I'll not tell Dakota I'm now giving him 'bad' insulin...what bs that is. He's a much happier and better controlled cat on Levemir. If I were given the choice of free Lantus or paying for Levemir, I'd pay for Levemir.

I can understand them saying don't change if she's well regulated but I still don't agree....

HUGS!
 
Well that's what I thought from reading posts on this board so far. That many cats actually do better on Levemir. Nibbler is the cat's name. She's super sweet and very tolerant of her injections and ear pricks for BG testing. I haven't done a lot of testing because the strips cost $1 a piece. I check periodically to see if her pre meal levels indicate the 2 unit dose is still correct or if something has changed drastically up or down. I'm guessing she went undiagnosed for a long time before she came into our shelter.
 
Sounds like you're using a glucose meter like the AlphaTrak if you're paying $1 each for strips.

You might want to strongly consider switching to a human meter (that's what most of us here use due to the cost of the strips!) The human meters will have slightly lower test results, but once you understand how to interpret them, they're totally safe as well as a big savings

The favorites around here are the Relion Confirm or Micro from WalMart...about $15 for the meter and a very reasonable $35.88 for 100 strips. They take the same tiny sample size as the AlphaTrak too which is nice.
 
Yes, I was told I had to get an Alpha Trak even though I asked if I could use a human meter and just adjust the readings. I was going to take simultaneous readings and see how much off from each other they are. I have a human one that uses much cheaper strips. It seems like the official advice I've been getting is on how to treat diabetes in the most expensive way possible. I'm a reasonably smart person and good with math and logical deductions and have cared for MANY other medical conditions in animals. New to diabetes though.
 
Welcome and how great of you to foster extra-sweet Nibbler!

Though I've never used Lantus, it is one of the best choices you can get for a diabetic kitty. That being said, my Grayson started out on ProZinc (sold by vet), but because he was insulin resistant, and had another condition (Acromegaly), of which diabetes is a symptom, we switched to Levemir. Both of the "L" insulins are great options. For insulin-resistant kitties, however, where there is usually some extremely high dose given, the pH-neutral qualities of Levemir are preferred. But there are other Acro cats that have been regulated on Lantus and other insulins.

You've likely heard ECID - every cat is different. Some respond better than others. Some (like their human counterparts), experience a sting from high doses of Lantus.

My vet didn't recommend home testing or diet change. These, however, are two of the BEST PIECES OF INFO you will receive here, if you haven't already.

I have another cat that after one week of insulin and food change, became a "diet-controlled" diabetic. He has not required insulin in nearly 2.5 yrs. I've also fostered 2 diabetic kitties. The first, Chloe, never had a drop of insulin while at my house for nearly a year... diet-controlled. Spartacus came to me on Novalin N (sp?), getting 13u at the shelter, and eating dry food. We stopped his insulin, changed his food, and 3 days later, restarted him with .5u Levemir. He has held for over a year between .5 and 1.25u. My guys eat Fancy Feast Classic Pates, and occasionally Friskees - no prescription food from the vet.

I use an Accu-Chek Aviva meter, order strips on Amazon for 1/3 to 1/2 the cost at Walmart. My syringes and lancets also come from Walmart; $12..80 for 100 syringes, about $4 for lancets.

Several years back, I did side-by-side-by side comparisons of meters for DCIN. I tested my Accu-Chek against a ReliOn Confirm and Bayer Contour. I feel comfortable recommending all three. Though there were some minor variations - RC and BC registered slightly lower at low numbers - they were all within the legally allowed variances - and consistent to themselves. If you use one meter, you will see the trends of your cat's blood sugar. You will identify how low he begins being symptomatic of a hypo, or when he's too high. The benefit of testing is to see and know the trends, so if you have to make a decision (to shoot or not to shoot; to reduce or increase the dose), you have documentation to guide you how they will likely respond.

There's so much to absorb when you're new here. I encourage you to read various threads, post, ask questions, and especially read the "stickies". We've all walked in your shoes. Diabetes can be managed, and most importantly, can be managed AFFORDABLY!

Lu-Ann (& Spartacus)
 
Hi and welcome to you and Nibbler,

Rusty and many of the cats here are on Levemir. I like it very much. I had experience with Lantus with Stu, my previous diabetic cat, and I can assure you that neither Lantus nor Levemir are "bad" for cats. Rusty was on Lantus for a while and later switched to Levemir (although this was before we adopted him, so I have no direct experience with the switch). The two insulins are both "depot" insulins: they produce a depot, or shed, in the cat's body that helps to regulate the insulin absorption. They are different, however, the biggest difference being that Levemir has a much later onset (the hour when the insulin begins to "kick in")--usually about 4 hours after you give the shot. With Lantus a typical onset is 2 hours. This means that the nadir (the lowest blood-glucose number in the cycle) on Lev. is typically later than it is with Lantus. Once you get used to the effect this might have on your own schedule, you can make a better informed decision about whether or not to switch. However, since you are being given 12 free Levemir pens, I think this is a no-brainer!

At ADW (American Diabetes Wholesale) you can find good prices on Arkray meters and the strips for them. The Arkray Glucocard 01 meter is the same as the Walmart Confirm; the Arkray Glucocard 01 mini is the same meter as the Walmart Micro (the Confirm and the Micro are Walmart's branding of the Arkray meters). ADW has great deals on the strips for these meters (Glucocard 01 Sensor plus): you can get 5 boxes of 50 strips for $69.00. Most of the people on the FDMB use human meters and all of our charts and suggestions for raising and lowering dose are based on human meters.

Good luck in the switch to Lev. I don't think you'll regret it.

Ella & Rusty
 
Hello and welcome from me to you and sweet pretty Nibbler. I've had Neko on both Lantus and Levemir. Add me to the list who would rather buy expensive Levemir than cheap Lantus. It takes a little while to learn how your cat acts on the new insulin, as Ella says, the onset and nadir are later. But I much prefer Neko on Levemir to Neko on Lantus. Few vets have experience with kitties on Levemir, that may be part of their reluctance on the switch. As for meters, Neko's own vet uses the Onetouch Ultra in the office. Good enough for me to say the human meters are OK. If you go to the Shopping Page on this site and buy on line from there, the site gets a percentage that helps run things.
 
Thank you for all the fantastic feedback. I really feel like it's a no brainer too! One of the reasons I think Nibbler was late in being diagnosed is that she has dropped hocks. My personal vet said this is from nerve damage from the diabetes. I'm feeding her Fancy Feast at present because it's affordable for me with all of the other fosters I care for. However I'll be looking at other options too if it means I can help lower her dose. But isn't 2 units a pretty low dose? Her readings before a meal are in the low 300s. The chart I have from the vet says if she's in that range, to give 2u. But I haven't been checking after meals, so I don't know what's happening after the meal and when the insulin kicks in. I'll be switching to a human meter ASAP! And I'll be reading as much as I can on the site to get up to speed. I should have reached out for more information sooner but kitten season was crazy as usual and I just didn't think to seek out a resource like this earlier.
 
We've seen cats (including my Neko) do preshots in the 400 and 500's, drop to below 50 in the middle of the cycle, and zoom back up to 400's at the end of the cycle. We dose Lantus based on how low the dose gets the cat, not on the preshot values. Getting a few of those mid cycle checks will be important, somewhere between 4 to 7 hours after the shot. And Lantus likes consistency, as it's a depot insulin. We keep giving the same dose, regardless of preshot values and change dose based on the nadirs or low points. It sounds like your vet might be dosing like was done in the older insulins, or in and out insulin like Prozinc or PZI.
 
No one has mentioned testing at mid cycle to me before so I will be sure to do that over the weekend for sure. I can also do this on my lunch hour if needed during the week until I see what's really going on with her. It's interesting because my vet is a diabetic herself, but I guess it's different with felines than humans. I really like my vet for other conditions she's treated my animals for, but I think there's more to be done for Nibbler. The shelter vets are pretty good too but they don't have time to deal with a chronic condition like diabetes. That's why they put them into foster.

I haven't felt we were getting good control of Nibbler's symptoms but didn't know what to do to improve things. Her appetite and water intake is still very abnormal. It declined when she first got on insulin but has gone up again in the last month. I'm going to go broke buying cat litter for her! I will be getting her some B12 too. What's the dosage for a cat? It makes sense that it would be good for her since it helps nerve conditions in humans.

BTW, I'll take a photo of Nibbler and add to my profile. The one in my profile right now is all I had available when I signed up last night. That's Smudge, a kitten I'm fostering. Nibbler is a tuxedo gal :)
 
This is the Zobaline for Cats that we recommend for the diabetic neuropathy (the fallen hocks) The Xobaline is for humans and we don't want them on that one

You just crush the pill and put in in their food....it's not supposed to have any taste.

It can take weeks or months to get results, but we've seen some miraculous improvements in lots of kitties!

2 units isn't too high but we have lots of cats on lower too....but when starting on Lantus or Levemir, there's actually a formula that's used. It's based on the ideal weight (if the cat is overweight or ideal) or the actual weight (if the cat is underweight)

Usually this means a starting dose between .5 and 1U every 12 hours.

There are 2 protocols we use mostly here...The Tight Regulation protocol gives the best chance at remission, but is an aggressive protocol that's not for everyone. Increases are made as often as every 3 days

The other one is Start Low, Go Slow where increases are only made once a week

You'll need to decide which one's for you....but of course you can always switch if it doesn't work out
 
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Welcome to Lantus and Lev land!

Like everyone else, I'm not sure what motivated your vet to not consider Levemir. (We see lots of vets give negative info about insulin that they're not familiar using. Fewer people use Lev than Lantus.) That said, if your is familiar with the published research, the Tight Regulation Protocol for Lantus and Levemir (the title of the journal article) includes, you guessed it, Levemir!

Dosing for both Lantus and Lev is based on the nadir, not on your pre-shot test values That's why getting spot checks is so critical.

Please let us know if you have questions. The folks here are very generous with their time and knowledge.

 
I'll add a welcome too - Levemir is a great insulin for cats. Lantus is good too - but if you've had Lev pens donated to you, I'd probably switch. Before you do, however, I'd get a spreadsheet going, get some mid-cycle tests in so we can see how low Nibbler is getting on the dose (a before bed test is especially helpful) and let us see a few days of data on the Lantus. That will help us be able to suggest a starting dose on the Lev for you.

Preshot tests have some value in letting us know what the insulin is doing, but both of these insulins work off of a depot, and that means that you dose based upon how low the dose is getting the cat.
 
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