Swtiching from Vetsulin to Lantus dosing advice

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by georgecat, Oct 12, 2018 at 9:12 AM.

  1. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    Hi all, great website... thanks to all the posters for sharing the wealth of information.
    George ..diagnosed 5 months ago was started on Vetsulin. Have had issues getting him stabilized, all over the map with BG numbers, usually a sharp rise in numbers in last few hrs.
    Tried the gradual increase of dosing to find the sweet spot, to giving 3 shots a day to aid in stabilizing numbers. Finally settled on 2 units+- 2x daily however PS numbers usually end up over 400 up to 600.
    He has had several infection issues , urine problems and developed neuropathy, all are fine now, hind legs slowly recovering. I give him B12, abit of Miralax and D Mannose(cranberry) several times a week (all in solution).

    SO, I am going to try Lantus now. Is there any correlation to dosage...ie 2 units (U80) Vetsulin (5 using U100) translates to x units Lantus? Or should I just started out based on weight? I am leaning towards starting him using TR method over SLGS. Any input is welcome
     
    Last edited: Oct 12, 2018 at 10:54 AM
  2. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Hello and welcome. My girl switched from a Caninsulin/Vetsulin to Lantus. I much preferred Lantus as Neko was sky high by preshot time too.

    I tried looking at your spreadsheet but it says I need permission. We base the starting dose on how they were doing on the old insulin, so we need to see the Vetsulin data. I went back to the beginning, and wasted time getting back where I should have started.
     
  3. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    thanks for your reply. Not sure why the spreadsheet isn't accessible. I will try to reattach it my profile. The spreadsheet is quite wacky, trying to find the right dosage for george with lots of BG testing: varying dosages, starting over and slowly increasing dosage (in case of rebounds or possibly having bypassed the correct dosage), to giving 3 shots per day. This was over the course of 5 months. Finally settled on around 2 units (U80) or 5 units (using U100).
    Still got high numbers after 8 plus hrs, ending up at 400-600 at the 12 hr/preshot period.

    I bought a Lantus pen today and did his first shot (PM). Started at 2 units (U100 syringe). I chose this number based on his dosage on Vetsulin and also his weight (around 8-9 lbs). He had an immediate reaction with abit of head shaking. Gave him some honey and then fed him. He settled down. Will start collecting a few BG numbers tonite. Tomorrow I think I will move his am shot down to 1.5 units and do a BG curve every 2-3 hr. I couldn't find any info on the internet on transitioning over to a different insulin...ie..if they need to be weened off one and gradually introduced to the new insulin.

    If you have any words of advise from your experience, please share them. I am hoping to get George on a consistent daily dosage (time and amount). Maybe even lucky enough to have him go into remission.
     
  4. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi
    Did you use a syringe which looks like the below ones?
    It sounds like he got too much insulin so I would reduce the dose

    ETA you don't need to wean off the vetsulin to start the Lantus..Just start the Lantus when the next dose is due.
    We test first to see it is safe to give the insulin, then feed some food, then give the shot.

    IMG_0965.JPG IMG_1019.JPG
     
    Last edited: Oct 12, 2018 at 10:44 PM
  5. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    I use the relion U100, 3/10 ml, 31G, 8mm, gave him 2 units of the Lantus this evening (PMPS 498).
    He had 5 units (U100) of Vetsulin this am. (the same type of syringe).
     
    Last edited: Oct 12, 2018 at 11:56 PM
  6. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    I can see your spreadsheet now. :)

    Can you test every three hours tonight? I might have started his dose at 1.5 units of Lantus. It's better to start a little lower and work your way up. However, now that you've started, are you able to monitor closely the next few days? You may or may not see much action, as the depot takes 5-7 days to build.

    You didn't need to start a new tab on the spreadsheet. You could just put a blank line after the last Vetsulin day with the work "start Lantus" on it, then show the Lantus readings the row after that. Sometimes it's handy to be able to go back easily.

    As for the head shaking, where did you give the shot? Some cats notice a sting with Lantus acid base, though usually not until higher doses. With that high a preshot number, the honey was probably not necessary. It does take 2-3 hours after the shot before the insulin onsets and starts working.
     
  7. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    I can see your SS now. I couldn't see it earlier.
    Good luck with the Lantus.
     
  8. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Has anyone mentioned that D-mannose is a simple sugar? You may want to stop it for a bit and see if there's an improvement in numbers.
     
  9. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    Gave the shot in the shank area, thanks for mentioning about the acid base!
    George was ok this am with shot, no shakes. AMPS..383, gave 1.8 units this am.
    No problem watching him closely for the next week as I work from home. Will test him all day today.

    George has had urinary issues/...infection, blood in urine. I prefer to give him a touch of D Mannose (less than 1/8 t) to keep any infection at bay than have him go thru another round of antibiotics. Fortunately it is working:cat:. Once he gets regulated, I will watch to see if it
    effects his numbers at all on the days that I give him the mixure.
     
    Last edited: Oct 13, 2018 at 8:31 AM
  10. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    Hi There and Welcome to you and George.
    Your first shot was 2u, with both dosing methods with TR the trick is to hold the dose, shooting consistently allows the depot to build and stabilize, we look to the nadirs for dosing decisions, and don't really worry about the PS values, other than to be sure that they are high enough to shoot in the first place, we don't use a sliding scale for dosing. Flip flopping with the dose destabilizes the depot making the cycles more unpredictable.

    With TR you would re-evaluate the dose every 6cycle, looking to the nadirs to help you make the dosing decision. It's important to be patient with the dose and allow it enough time so that you see the full effect of the dose, as the depot slowly builds so will the effect of Lantus on his BG.


    Can you explain what you mean by this?
    Were you using U100 syringes to shoot vetsulin?
     
  11. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    This morning I lowered the dosage for George to 1.8 due to the headshakes yesterday...right after his first dose (2.0) last night.
    Didn't realize until after dosing him this morning that it may have likely been a reaction to the acid sting. I will be consistent for the next week of dosing. Thanks.

    Spreadsheet comment.
    I settled at 2 units (-+.02) of Vetsulin based on the fact that I was dosing more than twice a day many times...when his numbers got too elevated.
    Vetsulin just wore off too quickly for him. In the last few weeks of using Vetsulin I realized that either I needed to get a new bottle of Vetsulin...maybe it lost some potency or switch insulins. Switching seemed to be a wiser choice for him...especially after reading comments on this board.
    I started out using U80 syringes and then got some U100 when I realized I need to do some finer tuning on smaller increments. On his spreadsheet all Vetsulin doses are based on using U80 (if I used a U100 syringe to dose, I converted the units back over to U80 dosage for the spreadsheet).
     
    Last edited: Oct 13, 2018 at 10:52 AM
    Gill & George likes this.
  12. georgecat

    georgecat New Member

    Joined:
    May 22, 2018
    Question?? George has only been on Lantus 1 day. His numbers are great so far. Soooo much better than Vetsulin.
    He probably hasn't built up an insulin depot yet. Should I be concerned that he
    might be overdosed once his depot is built up in a few days and reduce his next dosage abit...or just keep the dosage at 1.8??? He is now a much happier cat!

    20181013_112840.jpg Thanks

    I started a new threat on this question, as it is getting close to PM dosing time
     
    Last edited: Oct 13, 2018 at 6:07 PM

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