Need Input - Finally Switching over from Vetsulin

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SayHiToMichelle

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I haven't been on this board in a couple of years since my cat Tabby has been regulated on Vetsulin. Well, our last bottle is running out and I will have to switch him within the next week. Unlike a lot of people's experience, Tabby does GREAT on Vetsulin and I could not have been more happy with it. Anyway, Tabby's internist gave me three choices of insulin to choose from: NPH, Glargine or 70/30. I am aware of the pros and cons of each of them and am having an incredibly hard time choosing. I would probably choose the glargine except for the fact that Tabby, prior to becoming regulated on Vetsulin, had two almost back to back ketotic episodes (and an extreme case of pancreatitis) which just about killed him. It is an understatement to say that he does not do well with inadequate insulin in his system. Even if he misses a dose (do to not eating enough or the occasional vomitting episode) he becomes visibly restless and is a regular at the water bowl.

I have a knot in my stomach about this decision. If I go with glargine there could be such a delay in action that it makes him sick again....if I go with 70/30 (I probably would not choose N) then the duration could be too short (I would not really worry about hypoglycemia as he has been a diabetic for almost 4 years now and has done well on Vetsulin for most of that time).

I would really appreciate any advice or input that I could use to better make this decision - I don't have a 'gut' feeling at this point in time. BTW - Tabby is regulated on 5 units 2/day and I will be able to home test once the switch is made. He is also recently diagnosed with and being treated for high blood pressure.

Thanks everyone,

Michelle
 
I've got to agree that N is not usually the best choice although I managed 2 cats on it long term before we had good long-lasting insulins to readily chose from. My sister-in-law has been managing her cat on it for over a year and it has done well with N and being monitored with ketodiastix on a daily basis.

Personally, I would go with glargine as it has lots of good research behind it to show that it is very effective.

Anyone here done the vetsulin to glargine switch and can give some "real" advice?

_Rebecca
 
With one of my other diabetic cats I have switched from Vetsulin to Lantus. I found when I switched that her dose was lower and she responded better to the Lantus. If you switch to Lantus, you may want to start with 1 to 1 1/2 units twice a day. Since you are hometesting, you will be able to tell how well it is working. It usually takes about a week for the body to adjust to a new insulin or dose, so you will probably get more accurate numbers towards the end of the first week.

What are you feeding Tabby? As you probably already know, food affects the BG levels also.
 
Thanks Rebecca and Lisa,

Tabby, and all of my other cats for that matter, eat Wellness grain free canned food and get a little Blue Buffalo Wilderness grain free dry on the side.

Lisa, how did your cat handle the week of the switch? Did she have any negative high BG reactions or symptoms?

Also, does anyone know if it is possible/probable to deveop ketones during the transition time to a glargine-type insulin? That really is my biggest fear...
 
With the potential for ketones from the history, I might even suggest a 2u starting dose, as long as you will be home testing. With a switch to glargine, there is still usable insulin in the system from the first shot, you will just see better duration and better numbers toward the end of that first 5 day waiting period. 70/30 and N work pretty much the same in a kitty system - they are both fast acting insulins, much more so than vetsulin. Glargine/Lantus would be a much better choice imo.
 
SayHiToMichelle said:
Lisa, how did your cat handle the week of the switch? Did she have any negative high BG reactions or symptoms?

Also, does anyone know if it is possible/probable to deveop ketones during the transition time to a glargine-type insulin? That really is my biggest fear...
Click to expand...

I had no problems switching her dose. Since she was on a low dose of Vetsulin anyway, 2.5 units, there was very little change in her BG levels. When I switched I started back at 1 unit and over the next couple of weeks ended up raising it to about 1.75 units. 2 units was too much and 1.5 was too little.
 
Thank you so much for your input guys! Pretty much everyone (my vet included) is suggesting Lantus. Maybe what I'll do is get a blood ketone monitor just to be safe since he does have a history of developing them at the drop of a hat! Then at least that way if he has a problem during the transition I can get him in to the ER vet where my internist works asap. :smile:
 
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