Tip is switching to Lantus

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Cindy & Pets

Cindy & Pets

Member Since 2012
Yay! :) Finally made it through to the vet to switch Tip off humulin N, and I called today, but I guess she isn't in on Thursdays, so I'll be calling again tomorrow. The question I was given is if I'd prefer it getting called in or getting a prescription. Is there much of a difference? Also, anything special I need to do when switching?

I didn't get Tips morning shot in as my alarm clock has apparently completely puttered out on me. Will that make a difference? I figure not considering she'll be getting her evening shot.

And Lantus is a U100 insulin, right? So I can use the same syringes as I have been with Humulin N? And what's the difference between tight regulation and relaxed? Which is suggested here, or should I just discuss what's best with the vet tomorrow?

So happy about this! :D
 
Get the prescription for the pens- more initial upfront cost but each vial is singular, opened only when you stick the syringe in and lasts a long time. The bigger vial, while cheaper, may become contaminated over time (or just plain pooped out because of time).

When my vet gave me Humulin it was a 40u, and lantus is a 100u- different syringes for both but check and make sure what strength your current humulin is. There is a conversion chart to use if you have a bunch left.

You should be able to purchase the syringes at Wal-Mart- get the ones with the 1/2 u markings. Before purchasing, open the box and pull out one of the bags to look at the markings before buying. If you wait until after the purchase and they are wrong they will NOT take them back. Around here they cost $13/100.

The vet probably doesn't know ANYTHING about the TR unless she has bothered to look it up and actually read it. And lantus users can chime in on the difference as I have no clue :lol: .

Great you are being able to switch to a better insulin that lasts a whole lot longer.
 
Alright. Should be able to do that. Can I get the insulin from walmart too? I know I have been, well Sam's Club, for humulin N.

The concentration for the Humulin that I was given is 100u, so at least I have the right syringes and can use the last 12 or so up. I really need to get more, so I'll do that when I go to get the Lantus.

Yep, I usually get 100u, 1/2 marking, 31 gauge, 3/10cc syringes. :) Haha, and the day I got the wrong syringes(current gauge is 30, but they bother her a bit, so I'll be switching back) is the day I cut off the tab from the old box to bring in, which is also the same day I memorized it. :lol:

Yeah, I'm hoping to finally get her regulated! Thanks for the tips and whatnot. :)
 
Sayania said:
The question I was given is if I'd prefer it getting called in or getting a prescription. Is there much of a difference?
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Either works. Your vet call the prescription in or give you a written prscription so you can find a pharamcy that sells Lantus for a slightly lower price.

Ask the vet to call or write the prescription for the Lantus SoloStar pens, not the 10 ml bottle. The SoloStar pens are 3m l each and come in a box of five. That's at least a 5 month supply you will have on hand. The 10 ml bottle may poop out in a month or so and you'll end up throwing away most the the insulin which is a waste.

You can use insulin syringes with the SoloStar pens. Read this Lantus sticky for how: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151



Also, anything special I need to do when switching?
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You can stick with the current dose of insulin. Some people feel more comfortable with starting at just 1 unit twice a day.

Don't expect much of a bg response for the first few days. Lantus needs time to "build up a shed". There's more info about this on the Lantus board.

And Lantus is a U100 insulin, right? So I can use the same syringes as I have been with Humulin N?
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Yes, Lantus is a U100 insulin. So is Humulin N. You can keep using the same insulin syringes. Are the 3/10 cc? Do they have half unit markings?

And what's the difference between tight regulation and relaxed? Which is suggested here, or should I just discuss what's best with the vet tomorrow?
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"Tight regulation" and "relaxed" are FDMB words. I doubt your vet would know what they are.

The tight regulation protocol many people here follow is http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581 It's based on the Tilly protocol.

The "relaxed" regulation protocol is also know as the Start low, go slow approach.
 
Hi guys .. well first I recommend reading the "stickies" at the top of both the relaxed and tight regulation forums for lantus .. but they are kinda how they sound .. Tight regulation (we used it for mocha) is for sticking to 12/12 insulin shot times, doing frequent spot checks, being more aggressive with the overall treatment I would say (but not in a harmful way!) Relaxed regulation is more for those who may not be able to stick to the 12/12 schedule or get in a lot of spot checks whether it be to work, school, etc.

With tight regulation your kitty has a better chance of going OTJ (off the juice) but even with tight, it's not guaranteed .. read up on the boards and see which one you feel most comfortable with .. I am sure you'll find the one you want to use :-D
 
Alright....this feels like I'm learning about feline diabetes all over again. So much info! That's why I didn't respond yesterday, was taking it in, reading the stickies, and whatnot. I'll probably just opt for getting a written prescription. I mean, I think walmart will be cheapest, I hope so, but cost is important. So I think it'd be best to shop around.

I might want to restart the dose, I'm not sure. I just know that she's been running in the high 300's to low 400's on humulin N. Alright, I'll keep that in mind.

Yep, they're 3/10cc with half unit markings.

Okay, I'll look in to both approaches to see which one would work best for me.

I've read the stickies once, but I'll definitely be reading them again. :) I'm hoping to get Lantus today, if not, then tomorrow for sure. I want her switched ASAP.
 
Just wanted to give an update, so sorry for the double post. But I just came back from the pharmacy. Walmart gave me a heck of a time about the pens. D: Ugh....they insisted that you absolutely cannot and should never use a syringe with the pens and absolutely insisted I buy the pen needles with the pens or nothing at all. So I begrudgingly agreed, Tip needs insulin, and bought the $9 needles. I'll give them to my diabetic friend since they're universal and he uses one of the pens on the back.

Currently I'm wondering how to update my spreadsheet. And next time I need to get more lantus pens, I'll just say I have the needles to keep them from insisting I buy more. :/

OH! But what should I do with the humulin N? I have 2 vials left of it(one's quality is questionable, the other is fine) and don't have a clue on where they should go, if I should keep them, or what. I don't want to waste them by throwing them away.
 
First, when switching insulin, some cats have a marked response. We recommend that you reduce your current dose by 30%. I'd recommend that you start Lantus at either 1.25u or 1.5u (a 30% reduction in dose would be 1.4u). You'll want to get a mini-curve (i.e., testing every 3 hours) the first few days so you have a sense of how Tip is responding.

Unlike Humulin N, Lantus is a long-acting insulin. You will need to test at pre-shot and get at least one spot check per cycle. Lantus dosing is based on the nadir, not on your pre-shot values. That will be a major shift in the way you need to think about dosing. In a sense, you will be re-learning some information since there are definitely differences between N and Lantus. For example, doses are held for 3 - 5 days. This is because Lantus (and Levemir) are depot-type insulins. The insulin depot is what gives Lantus its duration and allows for overlap and the cumulative effects of the dose.

You can always hold on to the N -- it lasts forever. Alternatively, you could try to sell it on Craigs List. Several people have bought Lantus from Craigs List so there's no reason to not try to sell it there. If you have an unopened vial, you could post something at your vet's office and see if there are any takers.

As far as updating your SS, I'd change the background color of a line, merge the cells and write in the area that you switched to Lantus.

One of the differences between Tight Regulation (which is a recognized term) and Relaxed (which is an FDMB term only) is that there is a well researched protocol that has had excellent outcomes with newly diagnosed cats. In fact, the protocol was published in one of the leading veterinary journals. FWIW, there are several people who are using the Start Low Go Slow (SLGS) and post in the Lantus Tight Regulation forum since there is usually someone around if you need a hand.

If you have questions, please feel free to post on the TR board. The people there are very generous with their time and information.
 
Sayania said:
Currently I'm wondering how to update my spreadsheet.
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You can do it the way Sienne suggested or you can create a new sheet in your SS :smile: At the bottom of your SS (when you are editing it to add numbers) is a button that probably says Numbers and there is a little arrow. Click on that button. Select Duplicate. A new sheet with the copied SS will appear. At the bottom of the page you will see a button that says Copy of Numbers (or something). Click on that and choose Rename. Name this as "BG numbers on Lantus started on 7-21-12" (or something so people will know what insulin is being used). Now highlight all the data and comments and delete them since you want a blank SS to use for the Lantus numbers. All the auto color coding will remain. The sheet with the Humulin N numbers are not affected by anything you do on the Lantus sheet.
 
Oh, sorry, I didn't mention there was a dose change. As per vet order, we restarted back down to 1 unit.

When I update the SS tonight, I'll decide between the two methods. Probably just adding a line.

I'll definitely have to refer back to here then often to remind myself that it's the nadir, not the preshot until it becomes second nature. I'm sure it'll throw me off. I can at least get a +5 or +6 tonight, probably a +3. But I'm trying to stretch the strips until I can get more, which I should do tomorrow.

Unfortunately both vials are open. I should actually just throw away the questionable one. I'll hold on to the good one. Just in case.

I'm still debating between each method. I'm especially concerned about when I go back to class for the semester. I tend to get worked pretty hard(computer program a week in each computer class, I'm taking 2 this time a round), so I'm not always permitted the time to get a lot of tests and curves in. So would the relaxed method be best for me? Or?
 
Why not start with tight regulation and see how that works for you. Honestly, you don't have to do curves, I never did a real one. As long as you can test during the cycle, you should be fine. And if you can more or less keep to a 12.12 schedule you also should be fine.

If you find you are having issues, then you can always move to the relaxed.

as for the pharmacy insisting you buy the pens - I would tell them, thanks but no thanks, I have it covered. I wouldn't get into what you are or aren't doing, it's their job to fill the script and to advise, but they can't force you to buy something you don't want.

If it comes up again, as the pharmacist how using a syringe in the pen is different from using it in the vial? That may stump the person for a while, cause, I don't see how it's different. Except that it is a different container that holds the insulin.
 
Alright, I can start with tight regulation. :) If it doesn't work well for me, I'll switch over to relaxed. And I don't have to do curves....? Huh. Just spot checks then mid cycle and preshot? Though the last few curves, was the vet requesting I do them at home then deliver them. I've just been delivering them by hand, even though they're fine with email. It's only a mile away, so it isn't a bit deal.

Yeah, I had tried. :/ But I'm just going to mention that I have them already and that all will be fine. Figure that'd be easiest for me.

And....my SS should be updated now. :) I think I know how to do it now. I'll also have to change the batteries in my meter....I've been putting that off, so it's been complaining for almost a solid week for me to get new batteries.
 
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