? Switching from Vetsulin to Lantus later this week

Hello all! I'm really excited to be switching Cameron to a depot insulin in a few days. I've been stalking this forum, read snd reread all the stickies a few times. Going with the SLGS method.

Two clarifications/questions -
I'm thinking of starting at 0.5u, what do you think? (I know I've been terrible about getting the evening +3 lately)
If I'm understanding this correctly - the goal is to be in the blue even at shot time, potentially dipping into dark green mid cycle (light green earns an immediate reduction). That would be the ideal scenario and what we're all working towards?

I know it'll be a while before (if) we get there, but is my thinking correct? Because this up & down crap with vetsulin just isn't great

 

This is the best place for you to get help from very experienced people. I recommend you read the yellow stickies - more than once! There's a ton of useful info there. I'm sure someone will weigh in about dose soon. Meanwhile, if you could take the GA off your thread title it would prevent us from feeling sad. It stands for "gone ahead" or "guardian angel" for kitties that are no longer with us.

Add the blue question mark icon to your title instead so your post grabs more attention.

 

Oh no! I thought it was for general advice!

 

No worries!

0.5U sounds fine, given SLGS guidelines for starting dose, although his Vetsulin dose is a bit higher at present. Given that, and given that he's still up in pink and yellow numbers, you could consider starting him at the higher dose if you were able to monitor closely for the first few days, but I don't think it's unreasonable at all to back off back to 0.5U when starting on the new insulin.

I hope you guys have a good experience with Lantus!

 

It's a common mistake.

 

Welcome! My buddy Lou started on Vetsulin as well and we switched to Basaglar (glargine like Lantus) over Memorial Day weekend. He's been doing beautifully on a depot insulin. I think Nan gave you good advice. That's also why I ended up starting on Memorial Day weekend, so I'd have 3 days in a row to test and see how he was doing. My vet wanted to go down to 2 units or something when he was at 3.5 or 3.75u, but I didn't want to start so low and work my way back up. Best of luck on the switchover!!

 

Thanks for the advice! I'm currently a stay-at-home-mom, so I'll be around quite a bit to monitor. I'll think about it over the next few days, but i don't see a problem with the 1 unit.

 

Oh, I didn't mean to push you towards the higher dose, just that I think it'd be OK (but only with monitoring).

One other thing in favor of the 0.5U starting dose is that even though Cameron has been on a somewhat higher dose of Vetsulin recently, you really don't have a ton of data about how he's responding other than those pre-shots. And as you say, Vetsulin can lead to a lot of ups and downs, so the 0.65-1.0U might be more than he needs.

 

When switching from a short acting insulin, such as Vetsulin, to a depot insulin, you do not need to reduce the dose. That said, some cats do have a marked response to a change in insulin.

What would be helpful is if you could get some PM tests in prior to making the switch. Many cats tend to experience lower numbers at night. Having a better sense of what Cameron's numbers look like throughout both AM and PM cycles would be helpful with regard to making a recommendation about a starting dose. I'd probably lean toward a 0.75u dose but I'd like to see some PM data. Actually, I'd like to see more data from both cycles.

There is a significant difference between Vetsulin and Lantus that's reflected in dosing strategy. It will take a bit of getting used to.

• Dosing is based on the lowest number in the cycle (the nadir) -- not the pre-shot numbers. As such, you do not slide the dose. The dose is the dose unless your cat earns a reduction.
• You will need to gather test information so you know where onset and nadir fall and how much duration your getting. What you learned with Vetsulin will be different than with a depot insulin.
• Dose changes are typically made in 0.25u increments.

 

Thank you all for the advice! His new Rx arrived today, so I'm all set for switching him tomorrow morning. Looking at his daytime numbers with 0.5 in August, as well as reviewing his July numbers (other tab on the SS), I am going to start at 0.75. All stocked up on test strips, safe treats, lancets, and a new box of syringes with half-unit markings

When would you do a full curve? And should I just spot check as much as possible thursday & friday, trying to vary the + times?