Bad insulin? Should we switch to Levemir?

I feel like we are still spinning in circles with this first vial of Lantus. I just can’t tell if it’s even working or if it’s a bad vial. It was the last bottle the pharmacy had and our fridge runs cold at around 34 degrees.

Can someone look at the numbers and give an idea? I know Lantus is a much flatter curve, but we have yet to go below 240, and it’s been a month and a half. I know we aren’t doing overnight and that’s not really possible. I tried once and I don’t think he is bouncing. He is pretty darn steady in the 250-400 range at all times. Our vet was increasing the units by whole units so we started over and got the special half unit syringes.

At this point would anyone recommend switching to Levemir and would anyone know of a way to get it for less? The savings card only seems to be available for those on commercial insurance.

Thanks all-

Lex

https://docs.google.com/spreadsheets/d/1wYg1T-o95GeOVmIi7qrGXdrqsvQIPCoH2UZVA_eS0QM

 

Have you seen this thread on Buying insulin from Canada?

 

I don't think your insulin is bad. I think you just haven't got to good dose yet. Your best bet is to pick one of the two dosing methods we use here, either the Tight Regulation protocol or the Start Low Go Slow method, and follow what the dosing method says per increasing. That means increases of 0.25 units at this point in Benny's diabetes journey. It also means trying to get more spot checks at night. Many cats go lower at night. We determine how to change the dose based on low points, so you could be missing what lows at night. Even a +2 test before going to bed will provide a lot of information. And always test before giving a shot. For safety's sake.

A month and a half is still early days. At that point, my Neko's spreadsheet was a sea of reds and pinks. And I was following Tight Regulation which allows faster increases. You WILL get there, just be patient.

We usually suggest giving Lantus six months before thinking about whether you need to switch. Insulin is a hormone, their little cat bodies need to learn how to work it.

 

Thank you. I’ve been noticing that some cats respond a bit faster to Levemir. I have also heard a few vets recommending that now over Lantus. I just want the best for him since he is still young and has potential for remission.

I would hate to think I wasted these precious first months on a defective bottle of insulin. I know all cats are different, and some may have acro or be insulin resistant. Lots of variables. But I just thought we’d see some blue numbers by now.

We are doing SLGS now. The vet was clueless and increasing by whole units so we had to start back at 1 on our own. We are at 1.75 right now.

 

A couple of thoughts for your consideration...

I don't think that dropping the dose back to 1.0u helped. Usually, when we see a kitty whose doses have been increased by a larger than we like amount and the numbers are higher that you would like, we don't drop the dose back. All that typically ends up happening is that you end up losing time because you have to titrate the dose back up to at least where it was. As Wendy said, you haven't gotten to what would be a "good" dose for Benny.

I want to strongly encourage you to get at the least, a before bed test every night. Many cats drop into lower numbers at night. You have no idea whether some of the pink numbers are bounces.due to Benny being in lower numbers during the PM cycle.

 

I hear you. We did do a couple of spot tests at night and he was still in the 200s. I can’t say 100% for sure but I don’t think he’s bouncing. I don’t see it during the day and this is a long acting depot insulin so I don’t think it’s happening at night.

We started back at 1 because his numbers were skyrocketing at 3. So we figured maybe 3 was too much. The best dose at the time looked like 2.