? Why Lantus or Levemir? "Guidelines" for switching insulin?

Hello everyone!
I initially posted my question about "guidelines" for switching insulin on the Main Health forum HERE. It was suggested I post my question here because of the wealth of knowledge of the users here. Lou has been a diabetic for almost 9 months now, and is currently on Vetsulin. After a failed OTJ trial, I have not been able to get him regulated.

Are there official guidelines or steps for switching insulins? I'm honestly not sure if he absolutely needs a change, but I'm willing to get some information and opinions now. I do his BG checks and insulin shots, and my job currently is 10-hour days 4 days a week. I enjoy the freedom of Vetsulin because I occasionally have to work doubles (12-14 hour days), and I have had to dose up to 3 hours late. I have seen so many success stories of kitties on an L&L insulin, but I am not sure a depot insulin could work with my schedule. What are your thoughts on switching?

Thanks in advance!

 

Hello and welcome Amanda and Lou. My Neko was on Caninsulin (rebranded as Vetsulin) for two months before we switched. She was getting horrible duration off of it - classic Caninsulin/Vetsulin problem for a lot of cats. On this forum, we suggest giving an insulin 6 months to see if it's working. Looks like Vetsulin has had a good run, including that one brief OTJ trial. Very bummer on that.

We typically take the dose of the existing insulin in mind when switching, so you'd start around 2.5 or 2.75. You'd do the switch on a day when you can monitor closely for 24 hours. Some cats have a strong initial reaction to an insulin switch. So have plenty of strips and HC around for that. You also need U-100 syringes, if you aren't using them already for Vetsulin. You stop Vetsulin one cycle, and start the L insulin the next.

I personally preferred Levemir over Lantus - I switched a second time, as it gave Neko flatter and somewhat more predictable cycles. She also had a couple of high dose conditions and Lantus' acid base can sting at higher doses.

If you shoot later due to work, or whatever reason, you can move the clock back on the shot by 1/2 hour once a day or 15 minutes once a cycle. I used to have a monthly meeting that was on during Neko's PMPS. I would plan ahead a few days moving her shot time up, then move it back after the meeting. If you know you'll be working a little later, you can plan around moving shot times. I also found Levemir a bit more foregiving for moving shot times. The down side with Levemir is that the onset and nadir are later than Lantus. It worked for my life, but not all. And I did manage to finally convince my husband to test and shoot with guidelines. Made my life much easier. Any second person around your place?

 

Thanks for your response! My husband has given Lou insulin before, but Lou no longer lets him test his BG. He used to way back in the beginning, but after a few failed attempts, he will absolutely not sit still for him. When I had my surgery, we had to lower the dose and Caleb shot blind. Obviously not ideal, but I didn't want to skip doses. We both want Caleb to try to work on getting on Lou's good side again, but I think my DH has been rather spoiled with me taking care of everything, haha. I think if we decided to switch to an L&L insulin, Caleb would need to help with BG checks and shots. Those stupid doubles are at a pediatric walk-in clinic, so it's "only" once a week for a month on and a month off, but sometimes it can be 3 hours after his shot time before I get home (and I've been gone since just after his am shot). Basically I'm done when the walk-in is done, so my end time is never exact (SOO frustrating!). We'd have to move things around, so perhaps it's not impossible, but it'd definitely be a change (of more than just insulin, haha).

 

The start with Caleb just rubbing Lou's ears and giving him treats for a while. Get him on Lou's good side again. Not always easy I know.

 

definitely you want Caleb to be giving treats for tests, shots, ear rubs....

and there are many different varieties of freeze dried treats out there so one of them is likely to become Lou's favorite.
in my own example, mine didn't like freeze dried chicken ( it motivated no cooperation at all)
and you would think turkey wouldn't have been any better but it turned out turkey was much much better.
And then of course, freeze dried shrimp were even better.

there are so many new ones now.... you just have to hunt until you find The One....