Should I increase the dosage of Levemir? Is it advisable to switch to Lantus?

Alisia Evans

Alisia Evans

Member Since 2025
Hello everyone from Ukraine. My cat Asik is 8 years old. 3.5 months ago he was diagnosed with diabetes, complicated by chronic pancreatitis with very severe diarrhea, herpes virus infection. We switched to diabetic food, gradually moved from dry food to canned food. In Ukraine, it is quite difficult to find a good endocrinologist for animals, I did not meet any special knowledge of drugs and interest in researching the topic. First, we were prescribed caninsulin, then protaphane. I myself asked to switch to Levemir. Asik has been on it for 2 months and so far there is positive dynamics, but we are far from remission. The condition is complicated by constant exacerbation of conjunctivitis, feline acne. He takes antivirals for herpes on a regular basis.
Today, the new doctor suggested switching from Levemir to Lantus, but did not prescribe a dosage, because he has to read the literature on this subject. It is scary.
Currently on Levemir 0.3 units twice daily. Weight 5 kg
Any advice would be appreciated. Thanks for taking the time to read this to the end
Асік
 
Привіт і ласкаво просимо Alisia. Ukraine is my family's homeland and I send you all lots of love. Welcome to the FDMB.

I know that Levemir is being discontinued by Novo Nordisk, so you might have to switch anyway. Lantus is a great choice of insulin, and the typical starting dosage is based on weight. I think you will have the opportunity to educate your vet ;-)

This post has information about the two dosing methods that are used here for Lantus, including how to calculate the starting dosage for both methods.

I wanted to ask you about the veterinary diets, because generally we avoid them, as there are much better diet choices for diabetic kitties, which are low carb but with a better quality of ingredients. I don't know what you have available in Україна, but there are less expensive and better options for us in North America, and I hope there are for you too.
 
Laura is correct, sadly Levemir is being discontinued, in stages around the world, as per the attached older PSA Info - PSA: Levemir phasing out, by region of the world

I actually preferred it over Lantus. We would usually consider a reduced dose of 70% at the time you are making a switch between long acting insulins, since some cats can have a strong reaction to the switch in insulins. I’m afraid I don’t understand your dose of 0.3 units, are you using U100 insulin syringes?
 
As for current insulin needs, it would be worth getting tests in the evening if you can, at least one each day since right now you are missing half of the picture. Levemir typically has onsets later in the cycle, most kitties typically onset around +4 and nadir around +8, but sometimes you'll find that the preshot number is the nadir, or even sometimes a little beyond. Getting spot checks other than +6 during the day is useful as well.
 
Christie & Maverick said:
Laura is correct, sadly Levemir is being discontinued, in stages around the world, as per the attached older PSA Info - PSA: Levemir phasing out, by region of the world

I actually preferred it over Lantus. We would usually consider a reduced dose of 70% at the time you are making a switch between long acting insulins, since some cats can have a strong reaction to the switch in insulins. I’m afraid I don’t understand your dose of 0.3 units, are you using U100 insulin syringes?
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Yes, we use syringes u100. And we started with a dosage of 0.25 per kg of body weight. That was 1.25 units twice a day. Gradually we reduced it by 0.25 units and reached 0.25-0.3 units twice a day
 
Christie & Maverick said:
Що стосується поточної потреби в інсуліні, варто було б проходити тести ввечері, якщо є така можливість, принаймні один раз на день, оскільки зараз ви не маєте жодної картини. Левемір зазвичай починає проявлятися пізніше в циклі, у більшості кошенят зазвичай починається приблизно на +4, а найнижча температура – приблизно на +8, але іноді ви можете виявити, що кількість інсулінів до уколу є найнижчою, або навіть трохи вище. Також корисно проводити вибіркові перевірки протягом дня, окрім +6.
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Thanks. I'll go back to more frequent measurements. We're currently measuring AMPS, +6, and PMPS. But the high readings right before the injection are what worries me the most.
 
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Lara & Luciole (Lu) said:
Привіт і ласкаво просимо Alisia. Україна є батьківщиною моєї родини, і я посилаю вам усім багато любові. Ласкаво просимо до FDMB.

Я знаю, що компанія Novo Nordisk припиняє виробництво Levemir , тому вам, можливо, доведеться перейти на інсулін у будь-якому випадку. Lantus — чудовий вибір інсуліну, а типова початкова доза залежить від ваги. Думаю, у вас буде можливість проконсультувати ветеринара ;-)

У цій публікації міститься інформація про два методи дозування препарату Лантус, які використовуються тут, зокрема про те, як розрахувати початкову дозу для обох методів.

Я хотіла запитати вас про ветеринарні дієти, бо зазвичай ми їх уникаємо, оскільки є набагато кращі варіанти кормів для кошенят з діабетом, які мають низький вміст вуглеводів, але кращу якість інгредієнтів. Я не знаю, що у вас є в Україні, але у Північній Америці є дешевші та кращі варіанти для нас, і я сподіваюся, що для вас також.
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As for the diet, we spent a long time choosing one that would be adequate in composition and had a good taste. Currently, it is Purina Pro Plan Veterinary Diets DM St/Ox.
Typical analysis
Component content
protein 13.9%
fat 5.5%
ash 2.2%
fiber 0.4%
moisture 77.3%
vitamin A 1200 IU
vitamin D3 170 IU
vitamin E 180 mg
Composition
Meat and animal by-products, fish and fish by-products, oils and fats, vegetable by-products, minerals. Additives per 1 kg: vitamin A 1200 IU, vitamin D3 170 IU, vitamin E 180 IU, ferrous sulfate 11 mg, calcium iodate 0.43 mg, copper sulfate 1 mg, manganese sulfate 2 mg, zinc sulfate 21 mg, taurine 1500 mg. Carbohydrate content: starch 0.4% and sugars 0.5%. Carbohydrate source: corn starch.
 
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Christie & Maverick said:
Що стосується поточної потреби в інсуліні, варто було б проходити тести ввечері, якщо є така можливість, принаймні один раз на день, оскільки зараз ви не маєте жодної картини. Левемір зазвичай починає проявлятися пізніше в циклі, у більшості кошенят зазвичай починається приблизно на +4, а найнижча температура – приблизно на +8, але іноді ви можете виявити, що кількість інсулінів до уколу є найнижчою, або навіть трохи вище. Також корисно проводити вибіркові перевірки протягом дня, окрім +6.
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Do you mean the measurement after the evening injection? Because now we are consistently determining AMPS and PMPS
 
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Hello Alisia, could you please respond in English. It is the language we use on FDMB as the system is hosted in the US and the common language of most users.

Here is Google translate version of what was said above:
post #7: Thanks. I'll go back to more frequent measurements. We're currently measuring AMPS, +6, and PMPS. But the high readings right before the injection are what worries me the most.
post #8: That's right!
post #9: As for the diet, we spent a long time choosing one that would be adequate in composition and had a good taste. Currently, it is Purina Pro Plan Veterinary Diets DM St/Ox. Followed by list of ingredients and breakdown.

@Alisia Evans Note that the Purina DM is called dietetic management, not diabetic management. It isn't a special food for diabetics. The wet food is low enough in carbs so you can feed it, but we do find that cats grow tired of it over time. I'm not sure how easy it is for you to find low carb food there, but this food list contains many suitable brands that are available in Europe. You want less than 10% carbs: UK Cat Food List
 
Wendy&Neko said:
Hello Alisia, could you please respond in English. It is the language we use on FDMB as the system is hosted in the US and the common language of most users.
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Yes, sorry, my browser translated everything I wrote in English into Ukrainian, and I didn't notice it right away.
 
Wendy&Neko said:
@Alisia Evans Note that the Purina DM is called dietetic management, not diabetic management. It isn't a special food for diabetics. The wet food is low enough in carbs so you can feed it, but we do find that cats grow tired of it over time. I'm not sure how easy it is for you to find low carb food there, but this food list contains many suitable brands that are available in Europe. You want less than 10% carbs: UK Cat Food List
Click to expand...
We tried all the low-carb canned foods available in Ukraine, and so far the cat has the biggest appetite
 
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