Switching to Lantus from Caninsulin

Discussion in 'Lantus / Levemir / Biosimilars' started by Dasha and Kabosu, Jan 22, 2021.

  1. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    I will be finally switching my kitty from Caninsulin to Lantus.
    He was diagnosed a month ago, was treated for pancreatitis a week ago, and is now on antibiotics for an UTI.
    We have just switched him from 2 to 3IU of Caninsulin.

    I've managed to get Lantus for him today, and want to start tonight. The dose our vet recommended is 2IU twice a day. I've heard that Lantus is highly effective, and I am a bit scared to start with that dose in the evening, as I will be sleeping during the night and may miss him going hypo! I am considering setting up a few alarms during the night to test his BG, but I'm afraid that won't be frequent enough.

    I'm thinking of either starting tomorrow morning, and then monitoring him frequently, or starting tonight with just 1IU. My worry is that it is probably not recommended to increase the dose straight away if I see that 1IU is not doing anything (like the 3IU of Caninsulin was only getting him to 18mmol/l).

    Did anyone have similar experience?
    Thank you!
     
  2. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I would start in the morning. It will take time for the depot to build but some cats have a strong response to the first dose.
     
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  3. Christie & Maverick

    Christie & Maverick Well-Known Member

    Joined:
    Aug 1, 2017
    Usually when switching from Vetsulin to Lantus, you'd consider how the previous insulin was working, but there aren't any night time tests, so it would seem to me that 2u of Lantus is a good place to start, but perhaps @Wendy&Neko can offer an opinion.

    With Lantus, it may take 5-7 days when first starting out to let the depot build, and to see what the dose can do. Tomorrow morning is a good time to start Lantus, and perhaps monitor a little more closely over the next few days, including getting some mid cycle tests both during the morning and evening cycles. What you are trying to gauge is how low the dose is taking the kitty. Some kitties do react quickly to the change in insulins. I'd suggest putting a big break in your SS with the remark that you are starting Lantus.

    Some of the suggestions you get regarding how long to hold the dose and when to reduce will depend on which dosing method you would like to follow. Have you had a chance to look at the sticky on dosing methods?

    If you haven't already, please make sure you have the U100 insulin syringes, most of us like the ones with 1/2u markings. Vetsulin is a U40 insulin, so put those syringes away, you'd be giving more Lantus than you think if you mistakenly use those. With Lantus, it is important to note that we don't roll or mix the insulin before using it. Another difference between Lantus and Vetsulin is with Lantus, we test, feed, and shoot all within about 10-15 minutes. Lantus usually onsets (when insulin begins to enter the bloodstream and begins to lower blood glucose) around +2 for many kitties, although it can vary. With Vetsulin you likely would have waited 20-30 minutes after food before shooting, to make sure there were carbs on board, since it quite often has a quicker onset.

    Good luck with the switch.
     
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  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello and welome. I see you are in Ireland, pretty country. :)

    My girl started on Caninsulin and we switched her to Lantus. I started back on 1 unit per the vet and that was a huge mistake. A three month long mistake. :oops: As others of said, we do look to see how your kitty is doing on the current dose of the current insulin, and switch to a similar dose, based on a few factors. I would start with at least 2 units of Lantus. We don't have enough data on 2.5 or 3 units. We can help you with dosing if you'd like, so you can get to a better dose faster. Agreed with the others, wait until the AM to start. Some cats react strongly to a switch in insulins.

    Are you testing at home for ketones? When kitty is in higher numbers and switching insulin, it's a good thing to check regularly.
     
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  5. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    Thank you all so much!

    I've decided to start tomorrow and will give Kabosu-san 2 units. Good thing it's going to be Saturday, so I will have plenty of time to monitor him closely.

    I have U100 insulin syringes, but without 1/2u markings, and even those were extremely hard to find. So weird, but here in Ireland most pharmacies have no syringes at all!

    I'm not home testing for ketones, but you're right, I probably should.
    He was checked by the vet about a week ago or so.
     
  6. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
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  7. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    I've started today. He was 22.5mmol (405) in the morning, only got to about 18.1 (326) a few hours after the shot, and now he's back to 22 again (still one more hour until his PM shot). I know it is probably too early for Lantus to start working, we will need a few days to see any effect.
     
  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    A cats reaction to an insulin switch does vary, though I suspect you will eventually need an increase. Let's evaluate where you are after 3 full days on this dose, we might be able to increase a little sooner if he stays all high.
     
  9. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    Thank you, I will come back with the results after a few days.

    I also just wasted almost 10U of Lantus, and 3 syringes, as I could not draw 2U without an air bubble! Every time I draw insulin, there will be big air bubble inside the syringe, that does not go away even if I start pushing (I guess it does go in the end, but it's the last bit to go). Anyone knows what to do? I ended up injecting the 2U with a bubble..

    This is how one of the attempts looked, I drew 5U, in hopes that when I push to 2U the bubble would go away, but no, it stayed :/ So it all went to the kitchen sink (at least now I know how the insulin smells).
    upload_2021-1-23_19-28-47.png
     
  10. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Before you load the syringe, make sure you push the plunger up and down a few times to spread the lubricant around and make the plunger easier to move. To get rid of bubbles, first draw up a bit more insulin than you need. You'll get an idea over time how much that is, but maybe start with 1/2 a unit. Then point the needle up like your picture, draw the syringe down a little bit, making a bigger bubble. Tap the syringe. Little bubbles like to join bigger bubbles. That should leave you with one big bubble at the top. Then slowly push the syringe up. It may actually be easier to twist the syringe - that allows you more control and a slower movement. You might want to practice with coloured liquid first.
     
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  11. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    Thank you! I will try!

    It was happening to me with Caninsulin too, but only with some syringes. I've found a few that did not create any bubbles, but now I'm using different syringes, so back to this issue again. I was afraid to tap the syringe, as I read I should not shake or roll Lantus, but I'm guessing a tap on the syringe is just fine. Thank you again!
     
  12. Dasha and Kabosu

    Dasha and Kabosu Member

    Joined:
    Jan 3, 2021
    Managed to get no bubbles today! :D
     
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  13. Hercule's mum

    Hercule's mum Well-Known Member

    Joined:
    Jul 27, 2020
    Hi Dasha,

    I believe it is fine to tap the syringe to get the bubbles out. Lantus was created for humans to put inside a pen and walk around with it, so I am sure a few taps to get the bubles out would be fine. Someone might correct me if I am wrong, but I tap my syringe with lantus everyday, and it still has its normal effect?
    Hopefully that will save you stress and money!
     

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