Switching from Caninsulin to Lantus

[tinaloverdou]

Dear all,

My 15 and a half year old cat was diagnosed with diabetes a year ago. As we live in the UK the vet prescribed Caninsulin and after a couple of months Stevie went in remission late April 2015. Unfortunately he relapsed in September and has been on Caninsulin ever since. He has been fairly well regulated up to now but not so much lately and in any event I have always wanted to switch him to Lantus. His current readings pre-shot are anything between 9 and 14 (usually between 11 and 13). He has never taken more than 1 and 3/4 units of Caninsulin even with readings of 28 (when he was initially diagnosed). I have done a lot of redaing on this forum but would like your advice as to the starting dose of Lantus and whether, in your view, Lantus is better than Caninsulin. According to the vets here, he is well regulated on Caninsulin so I should not change insulin. I am not convinced as I know that they could well be saying this simply because Canisulin is the legally prescribed insulin in the UK for cats. Any help would be greatly appreciated.

Thank you all in advance,

Tina

 

[Larry and Kitties]

His current readings pre-shot are anything between 9 and 14 (usually between 11 and 13).

Those are excellent PSs with Caninsulin. How low does Stevie go between shots? That is how does is determined.

Lantus typically works better than Caninsulin (Vestsulin USA). However, for Stevie Vetsulin may be good. It depends on how low Stevie is going between shots.
You will likely have a better chance of remission with Lantus though since Lantus typically has a flatter curve (less drop between shots) while Caninsulin typically has a steep drop between shots

 

[tinaloverdou]

Those are excellent PSs with Caninsulin. How low does Stevie go between shots? That is how does is determined.

Lantus typically works better than Caninsulin (Vestsulin USA). However, for Stevie Vetsulin may be good. It depends on how low Stevie is going between shots.
You will likely have a better chance of remission with Lantus though since Lantus typically has a flatter curve (less drop between shots) while Caninsulin typically has a steep drop between shots

Hallo Larry and Kitties and thanks for the response. I inject twice daily every 12 hours. At +2.5 hours he goes down to 4.9, at 3.5 hours to about 3.6 and back up again.

 

[MrWorfMen's Mom]

I am not from the UK but I understand there are "rules" in place regarding when Lantus can be prescribed for a cat. I think there has to be some proof that Caninsulin is not working for your cat, but just how objective or subjective that proof has to be, I have no idea.

Are you using a human or pet meter to measure BG? The numbers you are quoting seem pretty good to me but if you are using a pet meter then a 3.6mmol at +3.5 hours is right at the edge of what is considered too low and the possibility of a hypo event occurring. Our low number alert here for pet meters is 3.8mmol. When do you take the next reading to see if he is rising when he is that low? Have you taken any readings at +4 to see if he goes any lower than the 3.6?

I'd suggest you could edit the title of your post to include that you are in the UK to get some folks from there to chime in with more specifics about the regulations.

 

[Larry and Kitties]

Going from high 11 to 4.9 (USA 198 to 65) is very good abd I would not really want to go lower than 65. I would switch to Lantus when yo run out of Vetsulin

 

[Elizabeth and Bertie]

Hi Tina @tinaloverdou ,
Waving to you from a crisp and sunny Surrey!

Those are great numbers for Caninsulin if using a 'human meter'. But the numbers at peak leave very little margin for error if, for example, kitty pukes up his food and goes lower than is typical for him. (And Caninsulin has a bit of a reputation for dropping the blood glucose quite steeply.) If you're using Alphatrak then these numbers at peak are, in my view, too low.

Whilst it is generally considered that the longer lasting insulins (Lantus/glargine, Levemir and (in the UK) Hypurin bovine PZI) work better for cats there is no guarantee that this will be so. (We have a saying here that 'The best insulin is the one that works best for the cat'...) But you may find that you get gentler blood glucose drops with a longer lasting insulin, and he'd have insulin in his system for more of the time.

I wonder if, before considering changing insulin, it might be worth looking at your kitty's diet to see if it's possible to lower the carb content...? You'd probably need to reduce the Caninsulin dose at the same time as lowering the carb content of his diet (in case he drops too low), and monitor very carefully, but I wonder if that might nudge him further towards remission...

If you post your question on the main Health forum you will probably get more responses.

Eliz