Switched to Lantus - Khloe

[Sara & Khloe]

Previous Post

Hello everyone, I can't thank everyone enough for all the advice and knowledge. I truly don't think Khloe's journey would have been successful without it.

Since joining the forum:

• Khloe switched to a 100% low carb, wet diet
• Khloe gets 4 meals a day vs 2 meals
• I switched from PetTest to ReliOn meter to test way more often
• I started home testing for Ketones
• I continue to learn new information everyday

And the best news of all:

• Khloe has switched from Vetsulin to Lantus
• My vet and I seem to finally trust each other and work together, instead of against each other.

While it's still too early to tell if Lantus is the right fit for her in the long run, I'm very optimistic about what I see so far & proud at how far Khloe and I have come since the beginning.
We still have alot to learn but one day I hope to pay forward the same kindness you've all shown me to newbies. Thank you again!

 

[Wendy&Neko]

First observation, her Lantus dose is too low. We take into consideration how they were doing on the previous insulin dose. You don't start back at the beginning because she's not starting insulin for the first time. 1.5 units would be a better start. If she's still above 300 tonight, I would increase tomorrow morning. This from someone whose vet suggested starting back at 1 unit after being on Caninsulin. It was a huge mistake for us.

 

[Sara & Khloe]

First observation, her Lantus dose is too low. We take into consideration how they were doing on the previous insulin dose. You don't start back at the beginning because she's not starting insulin for the first time. 1.5 units would be a better start. If she's still above 300 tonight, I would increase tomorrow morning. This from someone whose vet suggested starting back at 1 unit after being on Caninsulin. It was a huge mistake for us.

Can you explain what you see in the previous insulin data that suggest 1.5 would be better? Is it how she reacted to 1.5 of Vetsulin/Caninsulin?
I was under the impression that you should start Lantus at a lower dose than the previous insulin and should hold that dose for a minimum of 5-7 (10 max) days as a precaution. I'm honestly terrified of her going hypo, it's my #1 concern.

 

[Wendy&Neko]

Is it how she reacted to 1.5 of Vetsulin/Caninsulin?

Yes. We don't start Lantus at a lower dose unless they are seeing under 100 on Vetsulin/Caninsulin. One of our Lantus dosing methods allows you to increase after three days if kitty is high and flat (ie. above 300), hence my comment that you could increase after tonight if still above 300. You are right to be concerned about hypo, we all are. You could always increase to 1.25 units if you want to be extra cautious. I just don't like seeing her so high.

Are you home testing for ketones? With a drop back in insulin it is best to test for them.

 

[Sara & Khloe]

Are you home testing for ketones? With a drop back in insulin it is best to test for them.

Yes I'm home testing for ketones. 6/03/2026 urine ketones were negative.

I just went back and re-read the Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR).
And I think I see what you're saying now. Her 1 unit on Lantus mid-cycles are similar, if not slightly higher, than 1 unit on Vetsulin mid-cycles which is why you think she would be safe to go to 1.5 units Lantus (Due to Lantus being less potent). Correct me if I got that wrong. I'm still trying to learn this wild balancing act.

With all that being said, I think I'm most comfortable testing for ketones today and if they are still negative than I'd like to do the SLGO method and hold the dose for 7 days before adjusting. I'm just nervous the depot hasn't built up enough yet and rushing to up the dose may push her too far (Maybe that's the Vetsulin dips scaring me)
If the ketones are trace or higher, then I'll up the dose to 1.5 units tomorrow morning. Does that sound like a good plan?

I also want to point out that while on paper her numbers look terrible, shes acting like she feels the best she has in months.

Also, should I be posting in Lantus / Levemir / Biosimilars going forward?

 

[Wendy&Neko]

Lantus isn't more potent, but longer lasting. That's why we switch from one insulin to the other at about the same dose, depending on what nadirs they are getting on the original insulin. With the longer lasting insulin, she should get longer stretches of good numbers.

I've look at quite a few spreadsheets in my time of kitties starting on Lantus, and Khloe's is screaming "not enough insulin" to me. You hold the syringe, it is your choice. You definitely need to increase if there are any ketones present. With her in these high numbers, you need to test for them every day.

I can imagine that with the wild swings of Vetsulin, she didn't feel good. Looking at the night of 6/3, it must feel awful to drop 400 points in four hours. . High and flat is also not good longer term. The longer she stays at high numbers, the harder to get regulated. Her body gets used to those high numbers.

Feel free to post in Lantus forum now. You will get more eyes on you and you are all set up. I encourage you to look around and other threads too, especially of newer people who probably have similar questions and concerns. Take a look at their spreadsheets too. It's a great way to learn.

 

[Sara & Khloe]

I encourage you to look around and other threads too, especially of newer people who probably have similar questions and concerns. Take a look at their spreadsheets too. It's a great way to learn.

I spent the last few hours looking around the Lantus threads and spreadsheets. And after seeing todays numbers, I'm going to trust you and up the dose to 1.5 units.
I usually prefer to start new treatment/dose in the AM cycles, but if you recommend I start tonight I can. I'll just set a few alarms to wake up and check BG if need be.

I haven't been able to collect a urine sample today (but will keep watching her until she goes) so I'm looking into a blood ketone monitor to get instant results.

 

[Wendy&Neko]

Tomorrow is fine.