Question- switching to Lantus

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Deena and Malby

Deena and Malby

Member Since 2016
Hello,
We've made the decision to switch to Lantus (malachai was on Vetsulin). My vet didn't tell me much except 1unit every 12hrs apart.
Can I go straight from Vetsulin to lantus or do I need to take him off insulin for a day two to "start fresh?"
Any suggestions for a newbie on Lantus would help.
Thanks!
 
Vetsulin is an "in and out" insulin, meaning it's effects are in and out in the one cycle. So you can give it one cycle, and start Lantus the next. That's what we did. Lantus, on the other hand, is a depot insulin. Meaning it's takes several cycles to build the depot and see what a dose can do. As for suggestions, start with reading the Sticky Notes at the top of the forum. And please ask questions, there is lots to learn.

Did your vet suggest a starting dose on Lantus?
 
Yes, he suggested starting him on 1Unit. Malachai is currently taking 3units on Vetsulin and I still can't get his numbers below 300's. I'm going to order the insulin from Marks in Canada… I'll start him after I received it.
 
Usually we suggest taking the dose of the current insulin into consideration when we switch to Lantus. But it's hard to tell from Malachai's spreadsheet what a good dose would be. Are you giving insulin twice a day? I don't see any dose in the U (unit) column in the PM. Also, it's a really good habit to get into testing blood sugar every time before you shoot insulin, to make sure it's safe to give the insulin. Getting night time tests are also important, as kitties often go lower at night. A test right before bed is often a good one.
 
Yes I shoot him 2X a day. 7:15am &7:15pm. I have only done a few PM tests. I'm currently not worried about testing in the PM yet or really doing many pre-tests as he's always in the 600's pre shot. He's really never gone below 300 so I currently have zero concern for him going hypo.
I'm hoping with Lantus I can get his numbers down and then I will definitely start testing his BG before shots.
Do you think starting him at 1unit is the right call? Especially since his BG is always so high?
Thanks for the input!
 
Do you think you could get a couple of preshot tests at this dose, as well as a before bed test? I think starting at 1 unit might be too low, but I'm not sure what to suggest unless I see what this current Vetsulin dose is doing.
 
Hi wendy,
We just started him on the 3units two days ago so I'm not sure if the numbers are even valid for this dosage. I've heard it can take the new dosage several days to take effect? The vet wanted to see his numbers on 3units for a while and if they weren't lower we were gonna try lantus(I think that's where we're headed though). You're right though, 1unit will probably be too low. I can do a pretest tonight but if I'm right, it will be back in the 500-600's already.
 
Can you update your spreadsheet to indicate when lantus was started? Also, there are hardly any tests on the PM cycle - are you getting any tests then? It is hard to say with so limited data. Nadir (peak) varies in each cat and can change/vary. Malachi could be getting lower numbers in the evening/PM cycle and bouncing during the AM cycle.
 
Lantus has not been started yet. We are switching over soon but still on Vetsulin. I just took a PM shot and it was 670. This is usually why I don't do pre-tests as his numbers are always high in the mornings and evenings. Even when he peaks he's around 300+ so I've never been concerned about him going hypo. Once I can get him regulated or atleast get his numbers down I will start doing pre shots.
 
Deena Traina said:
Lantus has not been started yet. We are switching over soon but still on Vetsulin. I just took a PM shot and it was 670. This is usually why I don't do pre-tests as his numbers are always high in the mornings and evenings. Even when he peaks he's around 300+ so I've never been concerned about him going hypo. Once I can get him regulated or atleast get his numbers down I will start doing pre shots.
Click to expand...
Understand! I thought you had started. My mistake.

Gizmo's nadir is +5.5 - +6

Here is a explanation of a Lantus cycle

Example of an ACTIVE, but NOT necessarily typical Lantus cycle:
NOTE: Until kitty is pretty well regulated, the description below is NOT not what you'd consider a "typical" Lantus cycle. It takes time and patience for kitty to achieve a "typical" cycle! The example below is what you're working towards (a nice shallow curve). A relatively flat cycle is the ultimate goal.

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number. You'll probably see an active cycle if the +2 is the same/similar OR lower than the preshot number. Continue testing!
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle. NOTE: ECID. Not every cat has a mid-cycle nadir. Adjust the hours on this example to fit your cat.)
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

An active Levemir cycle will have an onset at approximately +4 and a nadir around +8 - +10. However, please keep in mind every cat is different (ECID). Data collection will offer you a better picture of YOUR cat's response to either of these insulins.

Initially, don't expect to see "active" cycles after every single shot whether you're using Lantus or Levemir. Chances are, your kitty had diabetes for some time before diagnosis. It requires time for kitty's body to become used to dropping into lower numbers than their bodies have become accustomed. Don't expect immediate results! Regulation takes time and patience:

More at this link:

LANTUS & LEVEMIR - THE BASICS: NEW TO THE GROUP? START HERE!
 
@Wendy&Neko
Preshot last night was 677. +4 was 422
This wouldn't be considered bouncing would it?
Usually when I curve him, his numbers fall nice and slowly, stay in the 300's for a while and then start to go back up.
 
Deena Traina said:
@Wendy&Neko
Preshot last night was 677. +4 was 422
This wouldn't be considered bouncing would it?
Usually when I curve him, his numbers fall nice and slowly, stay in the 300's for a while and then start to go back up.
Click to expand...
You're still using Vetsulin, correct? For Vetsulin, that +4 would be typical, even it is not 100% typical for Malachai (love the name by the way!)

As an FYI, because Vetsulin is an in/out insulin, bouncing will be a little different then the bouncing you'll get with Lantus.
 
OK thanks. And just to clarify, the 422 reading was at +3 not +4. I wish I could get his numbers lower. Everyone on the vetsulin board tells me the dosage is really high but the vets are suggesting I go higher to get his numbers down more. Very confusing.
 
Deena Traina said:
OK thanks. And just to clarify, the 422 reading was at +3 not +4. I wish I could get his numbers lower. Everyone on the vetsulin board tells me the dosage is really high but the vets are suggesting I go higher to get his numbers down more. Very confusing.
Click to expand...
I found the same isses with Vetsulin. It works great for a small number of cats, but most change to different insulins. (The board recently had a kitty go into remission while using it though, so that's awesome.)

The depot insulins typically will help bring the cats down gently. And the insulin stays in their bodies to help out more, whereas Vetsulin 2ears out completely.

I know its confusing, but we'll be here to help! :)
 
Neko got up to 5 units of Caninsulin (Vetsulin) and it got her into the mid 100's. But it didn't last very long. She was howling for food hours before dinner time. I think you'll like the switch to the longer lasting Lantus. But know that some cats need more insulin than others.

You asked earlier about when cats peak or nadir on Lantus. It's ECID (every cat is different). I've seen it as early as +2 and Neko liked to nadir usually from +7 to +9 but did once at +13. Though "typical" as Lizze posted above is around +6.
 
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