Ready to switch to Lantus need help w/ starting dose

Charia & Hexie

Charia & Hexie

Member Since 2023
Hello. Still new to this forum. This is my second thread so far so please let me know of any forum faux pas.

I got my vet to agree to switch the Glargine. I am getting the 3ml pens from Walgreens using GoodRx. I will also get the correct U-100 syringes (links to specific syringes is helpful).

My vet wants to start over with the dose and was increasing the Vetsulin by 1 unit every time. We ended up at 6 units and it was too much. So I would like help with the switch and dosing due to this. I don’t know what started dose she is wants to start her at but I sent her the AAHA recommendations on Lantus. So I would like help with the switch and dosing due to this.

Hexie is currently on 4.5 of Vetsulin but earned another reduction today as her +3 was just 68 (I will test her again in an hour). I should be getting the insulin today but more likely tomorrow and would like to start her the following morning so I can keep an eye on her better during the day.
 
My Neko was first on Caninsulin - same thing as Vetsulin, it's just branded differently in the US. She got up to 5 units of Caninsulin and I finally got the vet convinced to switch us. Actually, it was a locum vet who agreed with me that Lantus/glargine was a better solution. Anyway, we started back at 1 unit of Lantus. As a result I wasted months trying to get Neko back to the dose she was on Caninsulin.

The above is my long winded way of saying that starting back at the beginning is not a good idea. We look at how kitty is doing on the existing dose of Vetsulin, as use that as an indication. If a Vetsulin dose is a good one, we typically go with that dose. Since Hexie (gorgeous kitty by the way!), thinks 4.5 units is a little high a dose, you could go lower as a start, maybe 4 units or 3.5 if you want to be conservative. But it depends how well you can monitor to start. Some cats have a strong reaction to the insulin switch, so we suggest switching when you can monitor fairly closely for a couple cycles, that means day and night. Not all night, just long enough to see how the cycle is doing.

Have you thought about which dosing method you'd like to use with glargine?
 
I def don’t want to start over. Especially since the remission rates are so high if controlled within 6 months. We are at about 3 months now. The vet was happy with her numbers even at the 6 unit dose but I was not happy with the numbers or dose. My vet typically only wants the BG curve numbers (she insists on AlphaTrak) and then instructs me on dosage. I do want to try and stick with this vet because I’ve been going there for a long time but also she does consider my input. But I will always put Hexie’s health first and will switch vets if necessary in a heartbeat. I figure I’ll send her the human meter numbers or also get AT3 reading with the curves and send the, to her but follow the experienced forum instructions.

I want to go with a starting dose suggested here and increase how you all do by .25 and decrease when needed. Vet was just increaseing by 1 unit and didn’t do decreases. I think I would prefer the SLGS method. TR seems scary to me and I’m so new at testing and the shooting with low numbers seems scary. I also am disabled/chronically ill so there are days I can barely to the minimum. I will always get the pre shot numbers and a bedtime one as a minimum. I would like to start her with the Glargine on Saturday or Sunday morning. Since I don’t work and have no appointments so far next week I will be able to monitor closer.

I just tested her again and she is now 52 so will be decreasing for sure today. She is not showing and major sign of hypo that I can tell. She is alert and walking around. I gave her low carb treats (freeze dried beef liver) after test and put her food by her so she’s eating now.
 
Charia & Hexie said:
x. I will also get the correct U-100 syringes (links to specific syringes is helpful).
Click to expand...
@Charia & Hexie
As for the U-100 syringes with half unit markings
You can get the syringes with half unit markings at a Walmart. Their ReliOn Brand syringes of 0.3 cc (30 unit) capacity come with half unit markings. Cost $12.58 for a box of 100
This is what the packaging looks like: either box is fine
They won't say it half unit on the box but the are . open then and look before you leave the store, can't be ordered on line , need to go into the store
:




upload_2021-9-5_23-18-9-jpeg.62508

Or any of the ones listed here
  • U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Levemir, or the Biosimilars from vials, cartridges, and pens.
  • BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort,
  • Some members like the Sure Comfort or the UltiCare tap on the blue name of the syringe and it will bring you right to the site
  • You will most likely need a script from your vet ,ask him to give you refills
  • If you get them from ADW Diabetes you can call them tell them which ones you want, give them that coupon code every time ,they will get some info from you and then contact your vet and he can fax the script over, then you can just order more if you need them, ask your vet to give you refills
  • If you do not get them from Walmart and you get any of the other ones I listed
  • Here is a coupon
  • DIA10
    adw-coupon-dia10.jpg

    10% off your next order!
 
The Glargine is in! I will pick it up today, unless monsoon floods the roads. I would like to start her on it in the morning either tomorrow or Sunday. Please let me know if you all need anymore info in order to figure out the best starting dose.

Hexie has earned earned another reduction with a reading of 64 at +4. I am going to wait to go into town for Rx until I can get another reading or two. That’s what I should do right, wait til she’s going back up? I’d prefer to leave now as the storms are worse in afternoon/ evening. She will have/has food available while I’m gone.

Suzanne & Darcy said:
And if you can get another test or two this afternoon that would be so helpful.
Click to expand...
Sorry I didn’t get those numbers you requested. I had layed down for awhile before I had to do all the evening things.
 
Hi there! I do wish you could wait until about +6, but that's just me talking about a perfect world (which it is not.) If it's a safety issue and you must leave before a big storm or localized flooding or something, then maybe you can test in only 1 hour from that 64? (how many more minutes is that?) to make sure she's not dropping further -- and then perhaps give her a snack and leave other food out and then go out yourself? If she's pretty stable in her BG, then you will feel good about it and we will also feel good about it. How long do you think you will you be gone?
 
I meant to say this above -- and you perhaps already did this:

You should give her a snack of her wet food with that 64. Perfectly safe number, but a small snack of that food can help her to do what we call "surfing" which means staying in the green longer (which is desirable in the "good greens" because it's healthy for her pancreas -- you sometimes may see people call these the "healing greens."
 
Suzanne & Darcy said:
Hi there! I do wish you could wait until about +6, but that's just me talking about a perfect world (which it is not.) If it's a safety issue and you must leave before a big storm or localized flooding or something, then maybe you can test in only 1 hour from that 64? (how many more minutes is that?) to make sure she's not dropping further -- and then perhaps give her a snack and leave other food out and then go out yourself? If she's pretty stable in her BG, then you will feel good about it and we will also feel good about it. How long do you think you will you be gone?
Click to expand...
I will wait to go until after +6 and the numbers are going up. I appreciate your feedback. I tend to be a worry wart and play it in the safe side. Your feedback means I was thinking of the right thing. Worst case with the roads flooding is I get stuck in town longer. I will be gone a minimum of 2 hrs but prob closer to 3 hrs.

I just tested her and her +5 was 66. She has food set out and just ate some a few mins ago. I really want to change her food too. Should I wait to switch until she’s been on Glargine awhile?
 
Picked up the insulin and the Relion needles with half markings. Thank you Diane for mentioning the Relion at Walmart. I got some UltiCare ones that didn’t have half markings when they should have.

I am ready to switch tomorrow morning however the vet is starting her over at 1 unit. What would you all suggest? I will get a few more readings today with the Vetsulin if that helps. She is down to 4 units. She is around 10.8 pounds if that matters. I would like to do the SLGS method. I will be home all day the next few days so I can monitor her.

Also picked up some of the suggested Fancy Feast Classic pate food. I only got the ones on the list. Nothing that had gravy. Can I switch with the insulin or should I wait? Do I need to do it slowly?
 
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I started Hexie on Glargine this morning. I started her at 3units. I used Wendy&Niko's advice. Wendy mentioned 4 or 3.5 when she was at 4.5 Vetsulin. Since Hexie's down to 4 units of Vetsulin I used the conservative 3 units. I will post a separate daily Lantus thread regarding her first day and BG tests. Below is the link to the new thread.

Thank you all for your help.

https://www.felinediabetes.com/FDMB/threads/9-3-hexie-first-day-on-lantus-amps-381.281166/
 
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