Novlin N switch to Lantus

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Scarlette & Fluffy, May 4, 2022.

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  1. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    Fluffy is currently on Novolin N and will be switching to Lantus or Basaglar or Levemir. I'm not sure what would be a better fit for Fluffy. 1x a week, usually wed night, Fluffy gets fed at 8, insulin at 9. Typically, Fluffy gets Novolin N @7:30am / 7:30pm. Wednesday is difficult to give him insulin on time. Novolin N is forgiving, but I understand Lantus is not. IDK about the ither 2 options. If I move up his insulin times, it then may interfere with my work. I'm feeling like I'm damned if I do and damned if I don't.

    Any suggestions. I'm looking for a doable solution I can't jeopardize my job.

    TIA
     
  2. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    With Lantus, we usually test/feed/shoot all within 10-15 minutes. So you don't need to have that hour delay in there. Is the timing problem with the AM or the PM. What times are you home?
     
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  3. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Your post is a little confusing about when you give novolin
    You said Fluffy gets gets fed at 8 then insulin at 9
    Which is correct you need to wait 1 hour after feeding then give novolin
    Then you said Fluffy get Novolin atv7:30 AM and 7:30 PM?

    What do you mean Fluffy 1x a week usually wed night?


    Novolin you need to feed 1 hour before the dose. So you test the BG, feed wait 1 hour then give the dose if the BG is high enough. I would not give the dose if the BG is under 250. Post and ask for help if this happens.
     
  4. Corey & Kitty

    Corey & Kitty Member

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    I think what she is saying is that she normally gives the shots at 7:30am/7:30pm but one time (1x) per week (usually Wednesday nights) she has to stray from that schedule.
     
  5. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    Fluffy's regular schedule for insulin is 7:30 in the morning and 7:30 at night except for Wednesday nights in which I have other commitments making it difficult for me to give him his usual 730 insulin shot and it gets pushed back that night till about 9

    Regarding the NovolinN I had two vets tell me differently when to inject him the original vet that diagnosed him on March 18, 2022 said I should wait 30 minutes after eating to inject him. I switched to a new vet that said that I can go ahead and inject him while he was eating but I have typically waited 30 minutes after him eating to give him the insulin.

    Today is the first day that I was able to get a blood glucose reading 586 :nailbiting: he is currently getting 4u.
     
  6. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    Exactly, but soon he will switch to Lantus which I understand isn't forgiving. I'm scared.. I don't want to lose my cat but I don't know how I can rearrange for this Wednesday night if I move the scheduled back then that affects my work schedule if I move it forward and it's affects my work schedule.
    Right now I am working two 10-hour days, 8 a.m. to 6 p.m. more like 8:15 to 6:15... I have to leave for work 30 minutes in advance for traveling time, which means that I leave at 7:30 right after I give fluffy his injection and it's not always 7:30 on the button it could be 7:34 or 7:26.
    Is there another insulin besides Lantus that is supported that is more forgiving? Are Basaglar (generic Lantus), or Levemir more forgiving?
     
  7. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Last edited: May 5, 2022
  8. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Last edited: May 5, 2022
  9. tiffmaxee

    tiffmaxee Well-Known Member

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    Welcome. All the insulins you mentioned as possible ones to switch to are depot insulins and need to be given every 12 hours. Shooting a half hour early or late should not be a problem. Lantus usually onsets (starts working) around two hours after injection. Lev onset is often +3-4.

    Shooting 30 minutes early or late is not going to be a problem. More than that might act like an increase or decrease in insulin. Both are dosed based upon how low they take your cat.

    See what Wendy suggests. @Wendy&Neko aNadirs are often later with Lev so perhaps that’s a better choice. You would want to switch when you have two days in a row to monitor the BG often. Do you work weekends?

    The high reading could be from bouncing because the insulin took him too low or it could be because it’s not the right dose. Since he eats some dry food he would need to follow SLGS.
    When does he eat? Do you have an auto feeder? I’d ge free fed?
     
  10. Larry and Kitties

    Larry and Kitties Well-Known Member

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    If you are going to Glargine (Lantus or Basaglar) I wouod try the generic glargine using GoodRx coupon is you are in the usa. It is less expensive than Lantus or Basaglar. Levemir is good but more expensive.

    To get the Good Rx:
    https://www.goodrx.com/semglee?dosa...ulin glargine&quantity=1&sort_type=popularity
    Select a pharmacy and click on Get Free discount. If it has a pet restriction, then click on I don't qualify, show me other options. That will list a price hight that the restricted price but should be less expensive than real Lantus from Canada
    upload_2022-5-5_11-34-37.png
     
  11. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    First of all, wed nite feedings are typically delayed because of church. Before I left I put a small amount of dry food in the community bowl. When I got home last night at 8:45p I gave him a seafood flavor FF of wet because that's all I have on hand currently. He barely touched it He did go out to the community dish and nibble on some dry food. I didn't know if he was bored with it or if you just wasn't that hungry.
    I got concerned because it was time to give him insulin and he hadn't eaten much so I gave him some fresh chicken breast in chicken broth and I mixed about 1/8 of a cup of dry food in with it and he licked all of the broth from it and nibbled on some of the chicken and dry, but needless to say he did not finish it. I was not sure what to do, so I waited a while to see what would happen deliberating, contemplating what to do. FInally, very late @11P I decided I should just give him his insulin. Maybe that's why his insulin was so high this morning. He has been behaving just fine. He's not doing anything out of the ordinary. He was pouncing on one of the other cats this morning which he doesn't normally do. I think he's just feeling a little bit more frisky since he's been on insulin.
     
    Last edited: May 5, 2022
  12. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    What is SLGS?
    He currently usually eats at 7 a.m. and 7 p.m. and gets his insulin at 7:30 a.m. and 7:30 p.m.. Except Wed pm is delayed. I have a total of 7 cats and they have a community dish where they free feed however I no longer keep enough food in the dish that doesn't disappear Within 3 to 4 hours. The reason why I started doing that is because I was trying to, and want to switch him completely to wet food so I can get him off the insulin. I was with the understanding that if I want him to go into remission that he totally has to be on a wet food diet. Prior to his diagnosis of diabetes [3.18.22] I had been researching a raw food diet to see if it was feasible and financially affordable for me to do so with seven cats. Meal preparation time and storage space as well as the financial aspect are very real considerations that I have been mulling over. It's just not in my current budget to switch all of these cats over to wet food that would cost well over $100 a month and it is just not doable. Prior to his diagnosis I was spending about $40- $45 a month on food for 7 cats.

    For the last nine months or so I have had much problems getting the type of dry food I feed them as well as the Friskies Seafood variety is always out at Walmart or other local stores and I've had to order it online the prices have gone up by $4 to $5 on what I usually buy and the same thing for the cat litter that I use it is hard to come by. It is a big ordeal that I have to spend so much time researching online and local stores to find the products that I use for these cats both in food and litter, so I thought if I resolved it by giving them raw food they would be healthier for it and I could control it.
    I am not sure how much food each cat needs to eat on a daily basis between two feedings a day. They are all senior cats 12yrs+ and over except for one which is 6 yrs old. I am also not sure how to interpret the amount of food that they need to eat a day converting. In xx lb of chicken and other ingredients for raw food and then to calculate further how long recipe batch would last for seven cats and finally how frequent would I be needing to make a batch and stick it in the freezer and freezer space could be another issue.
     
  13. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    Currently I work two 10 hour days, 8 a.m. to 6 p.m. give or take 15 minutes. Wed pm feedings are usually delayed till 8:45p. I don't know enough about the insulin to know which one would be a better fit for Fluffy's health or our schedule. The three in consideration are: Lantus, Basaglar or Levemir.

    Any guidance is appreciated! The entire household of cats and myself have to make quite a bit of adjustments because of Fluffy's diagnosis of feline diabetes. He's my Miracle cat [ yes, there's a great story] and we have a special bond and he is worth it!
     
  14. tiffmaxee

    tiffmaxee Well-Known Member

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    We use two dosing methods here. I will give you a link to read about them. I don't think raw is doable with 7 cats. I pay a small fortune for just two. With senior cats you want to limit the phosphorus. Do any have CKD?

    If you were to shoot at 6:00 you would be able to get a test at least an hour plus before you leave for work and could then shoot at 6:30 at night. I know that means waking up very early but the best chance for remission if possible is to get the fd under control asap. The reward would be a diet controlled cat. Is there any way to isolate her while you are at work? You could also get an auto feeder that opens with a chip so only Fluffy could eat from it. I am just throwing out possibilities here.
     
    Last edited: May 5, 2022
  15. tiffmaxee

    tiffmaxee Well-Known Member

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  16. tiffmaxee

    tiffmaxee Well-Known Member

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  17. tiffmaxee

    tiffmaxee Well-Known Member

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  18. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    UPDATE ON FLUFFY'S BG
    I've been trying to take his BG every 2 hours as best as I can. His first reading ever was this morning at 8am @ 586 next reading was at 1:20 @ 535. I just took the reading at 3:30 and the ReliOn meter said HI! :nailbiting: What do I do? Is this an Emergency?? The community dish has had small amounts if dry food in it. He has grazed on it off and on.
     
  19. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    "HI" blood sugar readings are not an emergency. Hi just means above 600. There are many reasons his blood sugar could be higher. If your reading of "Hi" was about 8 hours after shot time, it just means the insulin has worn off. It could also mean he had lower blood sugar than he's used to at some point, and he has done what we call bouncing. That's just a reaction of their body to either fast drops or lower numbers than he's used to. Getting into really high carb food might be a factor as well.

    More in the next post.
     
    Last edited: May 5, 2022
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  20. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    OK, back to the schedule. Let me see if I have this right. For all mornings the current schedule is to feed at 7:00am and give the shot at 7:30 and then you head out the door to be at work at 8:00am. For evenings, except Wednesday, you get home around 6:30, feed at 7:00 pm and give the shot at 7:30 pm. With Lantus, you could start the test/feed/shoot cycle at 7:15 and be done by 7:30 or 7:00-7:15 for all AM shots and most PM ones. Shooting later on Wednesday night is not so much a problem, but the shooting early Thursday morning would then be as it would be quite a bit sooner than 12 hours after the PM shot. If you could shoot by 8:45 pm, you could still shoot at 7:30 am Thursday morning, but that is still 75 minutes early or 45 minutes sooner than you should shoot. We do allow some wiggle room of 15 minutes per shot or 1/2 hour once per day. Shooting a lot earlier can act like a bit of an increase. When he's in high numbers that isn't so much an issue but as he becomes regulated it could become so.

    The limits on trying to shoot as close as possible to 12 hours apart are for Lantus, any of it's biosimilars (Basaglar, Semglee, generic glargine) or Levemir. Prozinc, another longer lasting insulin and more appropriate for cats than Novolin, might have a bit more wiggle room.
     
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  21. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    I took his first ever blood glucose reading just before 8 this morning before he ate and it was 586 -> 7hrs later its HI I will retest him again at 5:30 and then again at 7 p.m. just before he eats and then 7:30 he will get his last dose of the day. This is so quite overwhelming and I'm very challenged to focus on doing other responsibilities here at the house because I feel like I'm glued to the phone for help and answers to my questions. This is a very nerve-wracking but I really appreciate all the help and support in the comments. At least fluffy is not displaying any alarming Behavior he was even playing with me earlier so that's comforting. I don't know what the Rangers are supposed to be but I decided to take one of my other cats blood glucose reading because I feel like she has lost some weight she's just under 8 lb and she is 15 years old but her blood glucose reading was 93 on a ReliOn. Does that mean that she's okay?
     
  22. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Between 50 and 100 is a great place for normal blood sugar. I've had my own non diabetics also test just under 50.

    Novolin is in and out in 6-8 hours, so testing that late in the cycle won't tell you much. Testing around 3-4 hours after shot time might give you a better idea how low he's going on a dose of Novolin.
     
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  23. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    You have understood my situation exactly! So let me recap to see if I understood your response correctly. So you are saying that on a Wednesday evening when typically it's delayed if I could give him a shot between 8:30 and 8:45 precisely we would be in the clear to operate on a normal schedule Thursday morning at 7:30 for his first injection of the day? Did I get that correct?

    Another question I have is more in the way of being proactive or just knowing what to do in an unexpected situation, for example, if I were to get a flat tire on my way home and fluffy missed his 8:30 to 8:45 shot or it could be any day for that matter, what do I do then? Or maybe there's a traffic jam on the freeway on the way home and I'm delayed 40 minutes, what do I do then? Do I entirely skip the dose and then resume his normal injection time at 7:30 the following morning?

    In this process if Fluffy decides he doesn't want to eat his wet food 1 feeding or another, how long do I try to get him to eat or what do I do, and how do I handle that situation in terms of giving his injection on time?

    From what you understand about fluffy and my situation is there a better fit in terms of insulin between Lantus, Bargalas or Levemir? When my vet calls I need to know which insulin would be a better fit for our situation so that she can write a new script. Or do I ask this question to my vet or does this form have a vet that can advise me? Since my vet is a new vet to me I don't know if she will be on board with my decisions to consult The Forum or seek alternative resources in treatment of fluffys FD.
    I've read that not all local vets are willing to collaborate or work with someone like me looking into alternative resources for help.

    Thank you very, very much for your time in responding and guiding me. It means everything! I am very grateful! :bighug:
     
    Last edited: May 5, 2022
  24. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Let's start with the easy one. Lantus doesn't kick in or onset, for a coupe hours after the shot. So you have a bit of time to get food into him. As long as he eats a bit of food and you think he will eat more later, you are good to give the shot at the usual time.

    No difference, they all have the same issues with your schedule. Basaglar is a cheaper glargine biosimilar to Lantus, the action is exactly the same as Lantus. Levemir onsets and nadirs typically a couple hours later than Lantus, but similar types of action. There are a couple differences between the glargine insulins (Lantus, Basaglar, generic) and Levemir that might be important for your situation. First, Lememir onsets a little later than Lantus, typically around 4 hours after the shot. That is both good and bad. With later onset you have a bit more time to get food in them before the insulin action start to happen, should your cat be fussy. The down side is that it's harder to see what the following cycle will look like. We generally suggest a +2 or before bed test with Lantus, to give you an idea if he's dropping fast in that cycle, meaning you have to test more or leave higher carb food out for him to be safe. With Levemir, and a later onset, that could mean staying up even later to get that test that tells you it's going to be an active cycle. The upside to later action with Levemir is that often you get get lower numbers or nadirs closer to preshot so you can tell if it was a good cycle. Levemir personally worked better for me, as several days a week I was up at PM+9 for a workout, and testing then was a really good time to tell how my kitty was doing on a particular dose. But, each persons situation is unique.
    No. Shooting at 8:45PM means it's 75 minutes earlier when you shoot at 7:30AM the following day. Ideally you'd like the time to be 30 minutes or less, so at 8:15 or later. So that leaves you 45 minutes earlier than is best. Shooting that much earlier can act a bit like an increase in dose. Once he gets to a dose that gets him regulated, those 45 minutes might make him go lower than you want him to. Again, this is something you'd have to experiment with. Not all cats are as sensitive to time changes.

    As for life happening (traffic, etc.), sometimes you just have to skip a shot. As long as he's not ketone prone, that's OK. The same could happen not on a Wednesday, and as long as you are within that 1/2 hour window, you should be OK. Once you miss a shot for any reason, you are OK to give it anytime as long as it's at least 12 hours (or 11.5 hrs) later than the previous one. The nice thing about the depot style insulins is that there will still be some Lantus in the system that would help tide him over some skips.
     
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  25. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    Not to belabor this, but I want to get it right. So on a Wednesday night I would need to get home and give him a shot between 8:15 and 8:30 once he is on the Lantus or the Levemir? So if I can manage that then he can still have his normal morning dose at 7:30 AM, is that correct?
     
  26. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    It'll still be a bit late, 8:00 would be better, but at least for the first while that should work.
     
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  27. Scarlette & Fluffy

    Scarlette & Fluffy Member

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    Ok..that helps me out . Thank you!
     
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