Novulin N conversion to Lantus

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Sylvia

Member Since 2010
Moka had been on Novulin N for about six years. He was having varying highs and lows and I couldn't get him stabilized for any long period of time. So, my vet had us switch to 3 1/2 units Lantus almost three weeks ago. Moka weighs 17 pounds. His first curve after that was pretty good. High was 399 12 hours after shot and low was 136 12 hours after shot. After the readings began to drop during the second week, we dropped his dosage to 3 units. He was still getting big drops at Nadir (7 hours after shot) The next curve he was down to getting 2 units, and the readings were (437 +12, 292 - 4, 258, -7,
298 -8, and 276, 12 hours after shot. The next curve was still at 2 units, and the highs were 480, and low 332. The vet had me increase to 2 1/2, and I was still getting 446 - 526. Raised him to 3 units yesterday, and his reading at +12 hours was 321. At four hours after the next 3 units, he dropped to 38, and in one hour more is at 31. He began eating right away and has had two servings of FF with gravy, then Karo after the 31 reading. I am waiting to hear from my vet.

LONG STORY - SORRY! My question is - has anyone else had this much difficulty getting the dose right. Seems that just 1/2 unit makes a big difference. Thanks for any advice you can offer.
 
Hi,

Insulin is powerful stuff as I'm sure you know.
Because of this and the fact that Every cat is different, the ethos of this board is to start insulin at 1 u and increase in .25u increments.
This accounts for not missing the ideal dose and cats who show varying degrees of sensitivity to insulin.

It's quite hard to follow your nu,mbers, but the 38 and 31-very low, I hope you've had some help?
Cat needs glucose or 25% carb food straight away to bring his bg's up and monitor closely until above 40 and stays there (above this).Reason I say 40 is because he is a long term diabetic.
Lantus is long acti8ng-nadir approx at +6, but cats can also surf or have a dip at the end of the cycle.

Way we write for ease:
AMPS
+1
+"
+6
ETC to
PMPS These are pre shot morning/evening. You decide which hours you need to test inbetween.Obviously with tyese low numbers, you need to be testing every 15-30 minutes to avoid a serious hypo.

Lantus is very different to Novulin N as it is long acting and builds a shed (like a petrol engine)this is why you can suddenly get a drop.
Would recommend you read the stickies at the top, your vet may not understand fully how this insulin works.
Plenty of people on here who will help you.
I would cut the dose back to at least 2u and start again, hold the dose for 5-7 days, then increase in .25u increments.(yes this means you have to guesstimate it from 1/2 u marked syringes). You hold these doses for usually 3-5 days. This does all depend on your numbers. If you can post, people will advise and help you with your dosing and way forward.

Good change of insulin (honestly! :mrgreen: )
Good luck
 
Hi, Welcome to LL (LantusLand)! You've gotten some good advice already. Giving the dose a chance to build up the shed is really important. We do not adjust the dose daily, it has to have a chance to settle in. Also, when we do adjust doses it is based on the nadir, not the preshot number. We always test then, but just to make sure our cats are not too low to give insulin. It will take some getting used to, especially since you have been giving another insulin for so long.

And finally, yes, after all my babble, it can take a while to find that ideal dose. Then hopefully something will click in the pancreas and you start down the dosing scale. That's when the fun begins!
 
The vet is having me do a curve once a week, and we have been adjusting the dosage accordingly.
 
hi there

welcome to the Lantus forum.

You've gotten good feedback. Take some time to read our Lantus forum stickies up top.

If you'd like to share the Protocol we use as a guideline here, do make a copy for your vet.
Tilly's Protocol: Modified Version

What we have learned with Lantus is that it requires patience and consistency, and it likes smaller dose increase increments.
We do suggest .25u increments as previously suggested.

Would you be willing to create a spreadsheet for Moka? Spreadsheet Set Up
This will help others see how Moka is doing, have a look at other threads/condos and kitties spreadsheets.
Don't let the testaholics scare ya!
We are a data collecting forum and some of us take it too far! :lol:

However, the more data you can collect given your schedule, the easier it is to offer you our suggestions and thoughts.


How about a Profile of Moka? This way we don't ask the same questions over and over :-D
This one is for when you lots of free time, have fun with it.
Who's Your Kitty

Hope to see you posting again!
 
Hi Sylvia,

time zone difference here :-D

Lantus dosing works much better if you can get those preshots/nadir tests.
You can often find (as I suspect with your 38/31) that kitty will suddenly drop in a cycle, or their preshot will be way way low (like 65). In such an instance you would need to hold off giving the shot until you get a much safer number or you could put kitty in harms way.

Are you being consistent with your shots? Lantus also works best if giving as near to 12 hours apart as possible. Short acting insulins are far more forgiving-Lantus isn't (but it's still the best in my view with Levemir and the size of this group is testament to that)

I hope Moka is ok now?

Are you in a position to hometest before each shot?
It's just we find an awful lot of vets are woefully lacking in their knowledge and treatment of Feline Diabetes. If they have got some brains, they can then treat the cat as if it is on a short acting insulin when it's on a long acting-that stores up trouble for owner and cat!
None of us are medical experts (except Jojo/Jess who are vet techs and Dr Lisa who is a vet), but we have all gained knowledge and experience from treating our own cats, learning from each other and doing our own research. If it wasn't for this board, my Lucky would have passed quite possibly after her first shot! (vet gave 5u!!).It's good to work with your vet, but bear in mind other sources of advice and info. When we finally found one I could work with, in the end she left me to decide on the dosing and testing!

It does all get very routine very quickly and the board and particularly this isg is a great little community to be a part of.
Good luck :mrgreen:
 
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