Switching from Novalin to Lantus, input please!

[MindyC]

Hi! So Max was diagnosed initially 9-ish years ago. He went OTJ in 6 weeks on Lantus, and has been in remission until about 6 weeks or so ago. He's 17 now, his kidneys are failing (chronic kidney failure going on 3 years now), and he's slowing down overall, but otherwise he's still a pretty "with it" old man. We've made concessions at home to make life easier for him--we have a litter box on the main floor (they've always been in the basement) and he now has stairs to get up to the food table (we have two dogs, they'll gulp that cat food so fast you won't even know what happened!). He sleeps on the couch as our bed is too high for him to jump up to now, and I haven't been able to figure out where to put some stairs in our room without dogs and humans constantly tripping over them.

Anyway...he was really sick when I took him to the vet at the end of February (we thought it was almost time to say goodbye). For a variety of reasons, the vet put him on Novalin. He's had two rounds of antibiotics in the last 6 weeks as well, but seems to be doing better, except with his sugar. We kept him on Novalin because we were going on vacation for 10 days and he'd be getting shots but not tested, and we didn't have time to get reliable dosing data before we left. We're home now, and I'm going to call the vet today to get a new Rx for Lantus.

Depending on which vet writes the script, I don't know what dose they're going to give (one vet is younger and okay with home testing, and the other vet is old school and has no use for home testing ). He's currently on 1.5U of Novalin, but his numbers are still high, though it's possible he's not bouncing as hard with this dose (not enough data again since this was the "vacation dose"). 2U would get his numbers closer to a good range, but I think was causing a hard bounce, and 3U nearly caused a crash. Hence the switch to Lantus. Any recommendations on where we should start? He eating, drinking, grooming, and generally looking pretty good. Shiny coat again, though he still has flaky skin. We feed low-carb Friskies, the same food both cats have been getting for the last 9 years.

I'd also appreciate any info on getting Lantus more affordably. I called 3 pharmacies yesterday and a pen (insert? refill? I don't know what to call it) will cost just over $100. An entire vial of Lantus cost just over $100 when we did this 9 years ago, and we never had to buy another one. I'm not expecting remission this time, but I'd like to get him regulated so that he quits being so fussy about the litter box and stops peeing on the bathroom floor or in the bathtub . Max is also getting Zobaline in the hopes it will prevent/improve any neuropathy that is causing him to not always use the litter box.

Thanks for any input and advice!

 

[Wendy&Neko]

Hello and welcome, sorry you had to return to this dance, but at least you know the steps this time. If you haven’t already, take a look at the yellow starred sticky notes at the top of this forum. The one on insulin info has a suggestion where to get a Lantus cheaper by ordering from Canada. I live in Canada so have no other suggestions for cheaper options, unless you can find a pharmacy that will sell you just one pen. The Supply Closet forum here sometimes has people selling insulin so check that out too.

We typically take the dose of the existing insulin into consideration when switching. 2 units was getting him to low blues so might be a good place to start. Provided you will be around to monitor closely.

 

[Bellasmom]

Bumping u to top tagging some people for u @Judy and Boomer @Marje and Gracie @Bobbie And Bubba @Wendy&Neko

 

[Bobbie And Bubba]

Hey there and so sorry that you are returning here with Max back on the juice.

Wendy mentioned the Canadian pharmacy ( Mark's Marine Pharmacy) a lot of us use. Their single pen price is 49 dollars and then 25 bucks for shipping to the US. You usually get it within 5 days. They pack it to keep it temperate. Also, Walmart sells a single Solo Star pen for about 100 bucks. Also, if you have a Costco in MI, check out their pharmacy prices too, and you do not have to be a member to use their pharm. Their prices fluctuate and are usually within the ball park of Walmart's singe pen. I think you would be better going with a pen as the vial will likely go bad before you can use the whole bottle. It needs to be used up within 6 months of starting it and unless Max hits high doses, you will likely need to discard it before it is finished.

I think you will find Lantus a bit easier to use. Novolin can have hard steep drops causing more bouncing whereas Lantus is longer lasting and more gentle.

Keep posting and asking questions as that is how we all learned.

Oh and Welcome to Lantus Land!

 

[Judy and Boomer]

Hi Mindy; welcome back to you and Max!
I have no experience switching from one insulin to another so i will defer to those with more experience.

 

[Sienne and Gabby (GA)]

All of the info Wendy and Bobbi provided is good.

I suspect that you're seeing those unpleasant high numbers, especially at pre-shot times, is due to Novolin not having the duration that Lantus has and there's no overlap between doses (i.e., no depot). Generally, Novolin begins to poop out at around +8. Hopefully, once Max is back on Lantus, things will smooth out.

 

[MindyC]

Thank you all! I'm currently fighting with the old school vet to get the new Rx. Grrr. He just saw him 2.5 weeks ago for a urinary tract infection but wants me to bring him back in when all he needs to do is call in a new Rx. I'll call again tomorrow, hopefully the other vet is working.

I did find a local pharmacy that will sell a single pen for just over $100, and Walmart was one of the three that I called. We live in the middle of nowhere, so everything is a bit of a challenge. Due to expediency, if I can get the Rx called in tomorrow, I'll get the local one, and use the Canadian pharm for refills in the future.

I do agree, I think the Novolin is causing horrible bounces. I don't think the old school vet agrees with me. The other vet is actually married to the first vet that diagnosed Max, and she was super helpful and more than happy to let me do home testing and just send her the spreadsheet instead of bringing him in. I wish she was still working, but she's doing the stay at home mom thing now, but her husband is a pretty good vet too and didn't seem bothered by home testing for curves instead of taking him to the office.

Anyway, thanks again for the warm welcome. Max is crawling onto the laptop now, so I better give him some love...and a test. LOL.

 

[Marje and Gracie]

Thanks @Bellasmom for the tag I haven’t been on much the last couple days but I see Wendy and Sienne have. I agree that the best course of action is to get Max back on Lantus.