Vetsulin scheduled for 1:00 (eastern) and Lantus to arrive today... Dose at 1:00?

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Rose

Rose

Member Since 2015
Hi!

I've talked with a few of you on the Main Forum and was told when we were ready to go, post here. We are so excited to finally be switching Zoey over to Lantus!! I've checked the tracking on the shipment and it's set to arrive here at my home today. She's scheduled for a 1:00 dose of Vetsulin (2.5 units 3 x day - 8 hours apart). Should I go ahead and keep her on the Vetsulin dosing until tomorrow morning and then move her to Lantus? Or should I go ahead and start her on Lantus tonight? In an effort to not have to monitor her super closely with the unknowns of change throughout the night, I'm thinking I should probably start her in the a.m. Her normal Vetsulin time is 5:00 a.m., but I would like to get her on a 6:30/6:30 schedule with the Lantus. Switching her in the a.m. would also give her the shortest amount of "extra time" without any insulin ... but maybe she needs more of a detox time? My experience with the Lantus is that after 8 hours, it's nothing but high numbers. :/

Based on Zoey's weight of 10.5 pounds, what is the recommended starting dose? I would like to go ahead and get a tight schedule set up and testing should not be a problem.

Please let me know your thoughts!
 
I don't know anything about Vetsulin as Blackie was on ProZinc before I started her on Lantus. From what I remember with Blackie, I started her on the Lantus it was done at the next shot time, like I had given the ProZinc shots, which were 6:00 a.m. and 6:00 p.m. I simply dropped the ProZinc to begin the Lantus. There was never a detox period before starting the Lantus when we started it.

I hope that someone can come by your condo to help answer your question. Good luck, and I think you're going to see better results with the Lantus. :)
 
Just an update ... as I was typing the above it only makes sense to stay on schedule and start her Lantus in the a.m. since I don't even actually have it in hand yet. But let me ask you this: Going to pick up some worm medicine from vet today since I am now seeing worms in her poo. (From fleas, I'm sure.) Will there be any issues with bg levels from the meds you think? Will that play into when I should start something new?
 
Hi there and Welcome :cool:

Is Zoey OK? The reason I ask is that we reserve use of '911' for potentially life threatening situations..

If all is well, please edit your header to something like -
'Switching from Vetsulin to Lantus - dosing guidance needed'

Plenty of folks who have made the switch so someone is sure to be along.
Do you have a spreadsheet set up with the Vetsulin data?
 
Hi there - we usually save the 911 icon for medical emergencies. Have you started a spreadsheet yet? That is the tool we use to help us determine dosing. Here are the instructions.

Lantus is a depot insulin, meaning that the effects build over time. The first shot may or may not be interesting as that depot builds. We still recommend monitoring the first few cycles so whether you start tonight or tomorrow is up to you.
If you'd like to start 6:30 as your Lantus shot time, then I'd give this afternoon's Vetsulin shot then wait until tomorrow morning to shoot the Lantus. I wouldn't worry about a detox time, but it's better to be safe than sorry.

Worming medicine shouldn't make a difference on timing.
 
Hi, Rose and welcome to Lantus and Lev Land!

By any chance, did you start a Vetsulin spreadsheet for Rose? That would help to get an idea of how she's been doing. It would be very helpful if you could follow the instructions in this post and set up a spreadsheet for Zoey.

With a cat that's new to insulin and starting Lantus, there's a weight based formula for calculate starting dose. (Initial dose = 0,25 x ideal weight in kilograms). If a cat is already on another insulin, we take that dose into consideration. In Zoey's case, she's getting 7.5u of insulin per day. That's a good size amount of insulin and without knowing Zoey's medical history (i.e., has she had issues with ketones), I'd be very reticent to suggest that you lower her dose to 1.0 or even 1.25u twice a day. Let me get a few more people to take a look and we can come up with some ideas about dose.

There is no need to "detox" off of Vetsulin. It is not a depot type of insulin so there's no carry over between doses. You could easily start at 6:30 this evening.

 
Title amended and I apologize. I was approaching the 1:00 dosing hour and looking for a quick response so I wouldn't cause a delay by doing something I maybe shouldn't. I had to switch back from my cell phone to my computer before I could find the place to remove the alert.

Zoey has been better. Her numbers go back high so she's not feeling wonderful, but she's not as bad as she's been. Her neuropathy was doing a lot better and now I see it taking hold. I am guessing from the BGs of 400 and better (at time for new dose/peak) over the past few days. The vetsulin, even 3 times a day, is not keeping her out of those high numbers at the end of cycle; although since I've added ACV back to her food servings, they are only reaching the high 300s at peak in the last 24 hours. (Coincidence??) The return of her limp makes me very anxious to move on to something better, for sure.

Zoey has not had any issues with ketones. She was diagnosed with Pancreatitis and it is unclear if the pancreatitis caused the diabetes or the other way around. Vet seems to suspect the pancreatitis is the cause. Zoey's been having issues with BMs and after adding Miralax to her food, she's a bit more regular ... although the appearance of it is like clay and is still hard. Zoey has been on Ringers in the past but is not on fluids now. She seems to be doing well since we've been adding a ton of water to her food. I did give her a Vitamin B Complex shot (1 unit - 40 ul) today to see if that will boost her energy. Doc had prescribed one unit a week, but I read that B Complex can have too many unneeded Bs and not to use. It did help her though when we had left the vet and that was over two weeks ago so I gave her another small dose this morning. (She's having difficulty with her left rear hip getting in and out of the litter box). If you have any opinions on whether or not I should give the B-complex dosage weekly, please let me know. I did find some information on Zobaline and will be ordering soon. Zoey has a great appetite ... always hungry (feed 2 cans of Friskie's Special Diet Whitefish daily - spread out 6 small meals) and she drinks a lot of water and urinates a bunch. Sometimes she begs incessantly and I give her bits of scrambled eggs (nothing added) or tuna fish.
 
I do have a spreadsheet and I've attached the current one through this last 1:00 dose. I spent hours reformulating the spreadsheet you all used (to reflect 3 doses a day) and it wouldn't save it and reverted it back to some gibberish so I just gave up. Once I make the switch to Lantus and am dosing twice a day instead of the 3, I will happily use the spreadsheet you all work from. :)

Thank you all for your time and patience!
 

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Hello again - we usually start just one condo (thread where we live) a day, due to the number of kitties. Since we started the dose discussion here, I'm bumping this one up instead of responding to the other one where you asked about the state of your Lantus.

Another question - we have two methods by which people here make their dosing decisions. Have you taken a look at the Tight Regulation Protocol and the Start Low Go Slow Method and decided which one you'd like to use? Once you've chosen, it'll help us help you if you put either TRP or SLGS in your signature so we don't keep asking that questions. The two each use different ways to determine starting dose, so it's important to know which you want to use first. The TR protocol uses a weight based formula with some consideration to the dose of a previous insulin and the SLGS method starts kitties on a wet food diet on 0.5 units.
 
I thought I saw a post earlier that said to start a new thread asking for dosing guidance. Upon closer reading it says to edit this header. I'm really sorry to be so out of line. I have read through the instructions and know to use the same thread and what to label it once we start dosing. I will strive for gold stars tomorrow and won't make the same mistakes twice. :)

I would like to start Zoey on the tight protocol. I've amended the signature to reflect that. If I'm missing anything else in the signature that you find helpful information, please school me now. I want to get it right and be a quick study.

Again, Zoey is 10.5 pounds (vet said 2 units of lantus) and she is on Friskie's special diet Whitefish (2 small cans spread over 6 four hour feedings). Zoey's spreadsheet is two posts up so I won't repost it.
 
Hey, we've all had to learn the new stuff - no worries. Thanks for the making the change. Once you've got a spreadsheet started - you could even start a blank one now, that would go there too.
 
Did your lantus come today? and you're wanting a starting dose on it for tonight, is that right? I see the vet suggested 2u.

how long now until you're wanting to shoot?
 
Yes, the Lantus came! Looking at her current Vetsulin schedule, if I start her in the morning, she'll only be 1/2 hour later than her Vetsulin dose so I plan to start at 5:30 in the a.m. The vet suggested two units, 2 x daily, but he has also forgotten that he okayed Zoey to go to 3 doses of Vetsulin per day since it wasn't lasting and each of those were at 2.5 units. So ... I am waiting for this group's expertise to weigh in.

Zoey's numbers at mid-day shot was 391 and then were 230s at +4 and she just hasn't seemed to be feeling well today. She's eating/drinking, pooping/peeing, but she's not getting around as well as she has been since starting the insulin. She's not able to get in and out of the litter box due to her left hip and it seems to be getting worse. I gave her a Complex B injection this morning but I've seen no benefit.
 
Really glad I watched the video on how to draw the insulin. Learned lots of new information that I already "thought" I knew. :)

I'm trying to monitor the thread so I can reply if you have any questions ... but it's getting near my bedtime. You know, early to bed, early to rise... I will definitely check in before I turn in, and then when I get up for her four hour feeding, and then, of course, before her 5:30 insulin shot to see what the verdict was on the insulin dose. I guess if I don't hear any different, I will go with the vet's recommended 2 units. I'm up for another hour though.

Thank you again for posting the sticky on the taking care of Lantus. It was great information!
 
Sandy, Amy, Sienne, Wendy & I have been talking about a suggested starting dose for Zoey. Hopefully some of them will chime in if I've missed anything.

Here are some of the factors we're looking at:

Following the TR weight-based starting formula, Zoey would start at about 1.19u per shot.
You're currently seeing greens on about 2.5u of Vetsulin. 1.75 seems to get her to about 100's.
When a cat is switching from another insulin, the dose on that insulin is considered when figuring out a starting dose on Lantus.

You want to be fairly close to a good dose, but also don't want to immediately send a cat into low numbers.
It's easier to draw up a dose on the line of a syringe.

Wendy also looked at the spreadsheets of a couple of other cats who switched from Vetsulin to Lantus and noted that the dose that got the cat to greens on Vetsulin seems to be fairly close to the dose that got a cat into green numbers on Lantus.

We're thinking that we'd suggest you start either at 1.5u or 2.0u per dose. Your vet suggested 2.0u as well.

We'd also suggest that you test for urine ketones 1-2x per day during this transition time, just for safety. I also noted that someone mentioned that you need u-100 syringes for Lantus - it sounds like you're aware of that and have those, right?

Once you've started the Lantus, if her blood sugar goes high and flat (constantly over 300), the dose could be increased before the usual starting week is up. Here are the directions for starting out on Lantus, following the Tight Reg Protocol:
REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

  • Kitty should be monitored closely the first three days when starting Lantus or Levemir.
    Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
    More monitoring may be needed.
  • It will be necessary to test kitty's blood glucose levels multiple times per day.
  • Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
  • Feed a high quality low carb canned or raw food diet.
  • Feed small meals throughout the day. Some kitties adapt well to free feeding.
Many Lantus and Levemir users in this forum have been successful following a somewhat modified version of this Tight Regulation Protocol for the last few years. These "general" guidelines are based on anecdotal evidence and personal experiences of laypersons frequenting the forum.
  • (Revised 10/28/2013)

    "General" Guidelines:
    • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
    • Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
    • Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
How does all of that sound to you? Any questions?
 
It all sounds great and I understand everything I need to do tomorrow. Since the vet recommended two units and it wasn't vetoed, I will start there; and yep, I have the u-100 syringes. I do have to go into the office tomorrow but I am able to take Zoey with me so I will check her at the preferred times. I do check her ketones almost daily and they've only shown trace once and that was questionable since I didn't check/compare in the time window suggested. I will continue to check them and try for twice daily.

I've just given her the last dose of Vetsulin she will ever take as far as I'm concerned. Tomorrow starts a new adventure ... :D

I'll check back in four hours to see if anyone added anything.

Thanks so much!
 
Hi Rose!

Just wanted to extent a welcome to you and and Zoey! I switched Eddie from ProZinc to Lantus and was glad to have made the switch. Fingers crossed that Zoey likes her new insulin!
 
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