Switching From Caninsulin to Lantus - Advice, Tips ...

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Toeknee

Toeknee

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Hi all, have decided to switch to Lantus, currently using Caninsulin. Have the Lantus and the proper U100 syringes and am almost finished my Caninsulin. Currently dosing 3.25IU twice daily . Buddy's nadirs are normally in the yellow zone, rarely below 10 (180) but he is doing very well . Reason for switching is I am hoping to be able to get his readings a bit lower and a flatter curve.
From reading the Lantus information my understanding is that I should use the same starting dose (3.25IU) with Lantus as I am using now with Caninsulin. Is this correct ?
Are there any issues that typically occur when switching insulins ? Should I expect to see similar glucose readings at the beginning although the depot hasn't been formed yet ?
 
Yes, start at the same dose of Lantus, or you back down to 3.0 units if you would feel more comfortable there. Good to hear you have the U-100 syringes and are ready to go. I didn't bother finishing my vial of Caninsulin, just donated the rest to a dog rescue that could use it. Pick a day to switch when you can monitor fairly closely the first few cycles. Some cats have a stronger reaction after the switch, Neko did not, but the vet gave me bad advice to lower the dose when we switched.

ECID, every cat is different, but it may (or may not) take some time for you to see similar numbers as the depot builds. It could depend if he's bouncing when you do the switch. With Lantus we are looking at dosing decisions based on nadirs. A good habit to get into is a before bed test every night, as many cats go lower at night.
Toeknee said:
Are there any issues that typically occur when switching insulins ?
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Wondering why you waited so long to switch.:p
 
Thanks for making that more clear. Yes pretty much ready to go. I remember you mentioned you swapping over. Yes I will look at that SS again that you referenced. So his glucose will still drop as he gets into the cycle but will produce a lower nadir after about a week or so as the depot builds up ?
Wondering why you waited so long to switch.:p Part man - part chicken:)
 
I suspect Buddy may like Lantus better. The Caninsulin wasn't giving him good duration from what his pre-shot numbers look like.

Lantus is not as harsh or fast acting as Caninsulin. As a result, once you get to a better dose, you'll see flatter curves, although that's variable given your cat's metabolism. Where you can see an early drop in numbers with Caninsulin, most cat's nadir is at around +6 (give or take) with Lantus. It generally takes 5 - 7 days for the depot to build up and stabilize. However, that doesn't mean you shouldn't get a few tests in so. you start to get a feel for how Lantus is working for your cat.
 
Yes I want to get his numbers lower but was reluctant to push it with Caninsulin. His system seems to be tolerating lower numbers better now and so if I can avoid big swings I thing it will make a big difference. Overall his pre diabetic personality has returned in spite of the poor numbers. The 31 gauge syringes are a HUGE improvement as he barely notices the shots now and he used to wince when the 28 gauge U40's were being used. Just started using them yesterday with Caninsulin to get a feel before switching insulins. If I had known earlier how easy the dose conversion was I would have switched sooner. Would have been more precise too.
Started Lantus this morning, Started at 3IU. Thanks for the info.
 
The change in needle size made a huge difference for us too when we switched. Good luck with the Lantus.

Can you do us a favour and put a blank line in the spreadsheet, in between the day you stopped Caninsulin and started Lantus, and label it something like "start Lantus". That makes it easier for us to see the change at a glance.

We strongly recommend getting another test in the night time after PMPS if you can. Many cats go lower at night. Getting a test just before you go to bed (if at least 2 hours after shot time), can tell us a lot.
 
Thanks Wendy, it seems to be going well so far. I added a separator line to the spreadsheet now. The Lantus is working quicker than I was expecting. Just shot his PM @16.2 (291) , would never have done so with Caninsulin. I will need to get a +3 test tonight as he's been very mellow since mid afternoon. It looks like he had a smooth, long cycle today
 
PMPS last night was 8.5 (153) +14 was 10.4 (187) so I skipped dose. He was really hungry at +14 so I fed him Friskies pate and he ate about half a can. This morning +23 he's at 29.1 so I gave his usual dose 1 hour ahead of schedule (+23). I couldn't do any tests yesterday in between doses but there didn't appear to be anything unusual in his routine or behaviour yesterday to my knowledge, As I am new to using Lantus I have a couple of questions hopefully someone can shed some light on.
Was this long duration a sign that the "depot" has been built up ? If so then does the high value indicate the depot has been used up ?
I suppose it's possible that he dropped below 100 but is it likely that it occurred, or more likely that he cruised longer and never dropped that low ?
Also please reference World ss as there seems to be a spreadsheet issue where US doesn't update so world is the accurate SS. As an example, when I added blank row to signify Lantus switch I noticed a day or 2 later that US did not show it and so I had to manually add to US. And today I tried to add data to US SS and it didn't appear on world so I erased US entry and posted data to World and this data doesn't appear on US ss.
 
Toeknee said:
Was this long duration a sign that the "depot" has been built up ? If so then does the high value indicate the depot has been used up ?
Click to expand...
The depot takes 5-7 days to build, yesterday was day 5, so depot was almost built. The long duration is a sign of a better insulin than Caninsulin and fairly typical for Lantus. The high value after that was either because of the skipped dose (duration ran out) and/or a bounce from however low he went yesterday.

If you find yourself having to skip doses more than once due to lower numbers than you are comfortable shooting, you might want to back the dose down to 2.75 units, so you can avoid skipping shots. With Lantus, and longer duration, you will eventually have to shoot lower numbers than you did with Caninsulin. Once you have the data to do so.

Toeknee said:
Also please reference World ss as there seems to be a spreadsheet issue where US doesn't update so world is the accurate SS. As an example, when I added blank row to signify Lantus switch I noticed a day or 2 later that US did not show it and so I had to manually add to US. And today I tried to add data to US SS and it didn't appear on world so I erased US entry and posted data to World and this data doesn't appear on US ss.
Click to expand...
Yes, you will have to make manual changes such as adding blank lines to the US spreadsheet. The US spreadsheet can only convert numbers entered on the World SS. It won't add blank lines and the conversion doesn't work from the US back to the World version. So, enter all data on the World version. Spreadsheet structural changes, like adding blank lines, will have to be manually done on the US spreadsheet. Similarly, if you enter more than just a single data element on the World SS cell, you'll have to manually enter it into the US one. For example, if you did two tests in an hour. Or add any text to that cell.
 
He had been getting some unusualy long durations occasionaly from Caninsulin but by +14 it was always heading back up fast. I didn't know what to expect with Lantus so I opted for no dose this time. In hindsight I could have gave 1 unit to tide him over. Now I now it's to be expected and the long duration itself is fantastic. Will run a few more cycles and then decide if a .25 reduction is needed. All is well, thank you.
I rarely look at US SS and was only because I am trying to get comfortable with converting numbers that I decided to enter numbers on US SS this morning and noticed extra line missing. Thanks for the explanation.
 
The majority of people here who help with dosing suggestions are from the US, so it's a good idea to keep that spreadsheet up to date too.
 
I will be taking your advice and reduce regular dose .25IU right away after this drop. Lantus lowers glucose level in Buddy much more than Caninsulin. Lower and lomger. AMPS 19.9 (358), +3.5 9.2 (165) +6.5 4.3 (77).
He's purring though. He's been to 3.3 once before about a month and a half ago and that was followed by a big bounce. He is tolerating lower numbers well now compared to before.
 
Lantus has more gentle action, so he's probably not getting the big drops he got on Caninsulin. Those big drops also cause bounces.
 
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