Switching from Novolin to Lantus friday morning 8/4.

We have been on Novolin since diagnosis in April and now I have some Lantus ordered so we can hopefully finally start seeing some regulation without so much bouncing.

Have already been told, same dose of Lantus as we are doing of the Novolin, but is there anything else we need to be aware of for the switching of insulins? Have read through the stickies in this forum, but nothing really there on the switching. Zeke gives us enough surprises with his bounces so don't want any others lol.

 

Hello and welcome. What dose are you thinking of starting on? He saw some low numbers on 2.75, so I might start a touch lower, maybe 2.5. The biggest changes you will see is the depot, it takes several days to build and you may not see good numbers until the depot builds. Or Zeke may decide to be a cat and respond strongly in the first couple cycles to a change in insulin. Some do. We recommend making the change when you can monitor closely the first couple of days.

We have two dosing methods here. I would recommend reading the Sticky Notes on Tight Regulation and Start Low Go Slow and decide which suits you. Then put TR or SLGS in your signature so we can help you.

 

Thank you. Ok, will read both of those stickies. I run my business from home so monitoring is never an issue for us plus my daughter (Zeke's momma) is a night owl so she does the later testing. I just started today backing him back down to 2.5u since I figured with this blacks lately, the 2.5 would be a better place to sit for several days to see if he would stop some of his bouncing. Zeke loves to bounce too and makes things crazy for trying to figure out any sort of patterns. Hubby has been even looking at his SS and is starting to see some of my frustrations I have been having with this. Zeke is leading the dance alright, he is leading it all over the place lol. Was reading the one on the depot so will definitely be reading up more on that so I can understand it better. Sounds like that could be a good help for those times you have to skip a shot, but could also make things wonky too.

 

There is always so much to learn, that why I really grateful I found this site. Everyone here is very helpful and happy to guide you through. You will have a lot of questions as you experience and see how your kitty reacts. Don't be afraid to ask. I must have asked the same questions a few times, there was so much to take in and my kitty had his own challenges which we overcame thanks to all the support for people here

 

Yes, I am very glad we found this forum too. Our vet who diagnosed us didn't want home monitoring and increased doses in 1u increments. With Zeke hating car traveling as bad as he does, so majorly stressing the crap out of him, it wouldn't have taken long and we would have been having a horrible hypo event. The vet didn't even tell us on that or on checking ketones or anything. I was trying to research things myself when I found this site. Talked to the vet about home monitoring and he tried to talk me out of it!

 

On the TR and SLGS methods, thinking the TR will work for us because we are able to monitor so easily. Question though, going by what it states, you would figure out the dose to start on going by his weight, which would put the dose just under 1.5u. So would it be better to start with that one then build back up if/when needed, or go ahead and start with the 2.5u which is what his dose will be at on the Novolin at the time of the switch?

 

When changing from one insulin to another, we take into consideration the dose they were at before instead of "starting over".....We might suggest starting a little lower, but not dropping all the way back to 1.5

 

Ok. I will post on that the day before we start for suggestions on starting dose so that way his current numbers will be there for reference.

 

Welcome Meridith! OMG I'm struck by such a cute photo of your boy Zeke. What a cutie!!!!

 

Thanks. He is actually my daughter's baby, but he clings to me when he is mad at her, like now because she was gone the past 2 weeks at her grandmother's lol.

 

Ok, got tracking so we will be starting Lantus on Saturday. Looking at doing TR, so someone let me know if I am understanding correctly at this point or not please.

I don't want to start him at the same dose as Novolin so start at either 1.5 or 1.75?

I will need to test often for plenty of data to help in understanding adjustments and how Lantus is affecting him. So minimum tests will be his AMPS, PMPS, +1 or +2, +4 +5 or +6, +10 or +11. So at least 8 tests a day starting out, then more or less as needed?

Hold numbers steady because of how the depot works, so unless real low, will not adjust the dose.

I will be rereading (probably many times) the stickies again to make sure I'm catching everything I need from them.

Is there anything else I need to be aware of before we start?

 

You have been testing very well on the previous insulin. Some cats nadir later, so you may want to change the +6 to (+7, +8) on certain days to see where is actual nadir is. I haven't used TR, so am sure more experience folks will chime in to assist re:holding dose, agree with decrease, just think increases happen more often with TR.

 

Hi Meredith, Glad to see you getting settled in here in L&L land and to hear you will be starting Zeke on Lantus on the weekend.

I don't think you need to reduce the dose quite that much if at all. Did you come up with those doses by calculating based on weight? Those calculations are for kitties that have not been on another insulin before. In Zeke's case, you could start with the same dose as the Novolin. If you are more comfortable reducing a bit how about 2u? It will take a few days for the depot to get built up and the curve with Lantus tends to be much gentler.

I'm excited for you and will be watching to see how you and Zeke are doing.

 

Hi, Linda, and thanks! I think I would feel more comfortable with 2u starting out, just in case he reacts very well out the starting gate with it. I ordered the Lantus that @Yong mentioned from the supply closet so very happy to finally be getting Zeke on a better insulin.

@Marvin's Mom - Nat Zeke would peak normally around +4 to +5, so I will probably start out randomizing tests from +5 to +8 just to start getting an idea on his peak with Lantus.

How soon after switching to Lantus should I do a curve? About a week so the depot has had a chance to build?

 

I think 2U would be a reasonable starting dose

There's really no need to do an official "curve" on TR......getting random tests at different times during the cycles (like you have been doing) will give a pretty clear picture of what's going on.

The idea is to think of your spreadsheet like it's a puzzle....the more "pieces" you have sprinkled around, the easier it is to see the whole picture......If you look at your spreadsheet and see a big bunch of white, try to get a test in there somewhere

While most cats take 5-7 days to establish a depot, some react much sooner, so as long as you're testing 4 or more times a day, you'll be fine!

One of our "Tricks" is getting a +2 on each cycle if you can.....it can act a lot like a crystal ball to predict where they're going later in the cycle (although for some cats, a +3 is better)

If the +2 is about the same as the PS, it's usually going to be a pretty normal cycle....gradually down to nadir and then gradually back up

If the +2 is higher than the PS, that usually signals a bounce is starting and those are the cycles where you can take a pokey break and catch up on some sleep

If the +2 is lower than the PS, that's your "early warning system" that he might be planning something silly later in the cycle, so those are the times when you'll want to make sure to get more tests later in the cycle

 

That definitely helps explain on the testing a bit better. Looking at China's SS, do you ever sleep @Chris & China? lol My daughter, Zeke's mommy, does the testing in the middle of the night, I do most of it during the day though. Hubby can also test when I need, which might be having him grab a test a few mornings before he leaves for work when we are first starting to catch the end cycle.

With the way Lantus works, do we still need to pull food a couple hours before PS testing? Zeke is a grazer, so we just leave wet food out all day/night and refresh as needed.

 

Yes...you always want PS tests to be without the influence of food for at least 2 hours

Sleep? What's this "sleep" I hear people talk about??.....LOL

 

When my daughter was at her grandmothers, I was starting to wonder what sleep was lol.

 

Planning something silly hehe I like that.

 

Zeke is great at doing the silly things when it comes to his numbers lol

 

Hope Zeke does well with Lantus!

 

Thank you, We do too!

 

Tracking got updated to delivery today, so will be starting Lantus tomorrow morning! Will have lots of reading for tonight so everything will be fresh first thing in the morning still lol.