? Considering trying Cabergoline and not sure yet if to switch to Levemir or continue with Semglee

Talked to my vet about Cabergoline as a possible better and affordable choice for my Micio and she pretty much agree on that; because she's retiring anytime soon, she's trying to find another Dr. in the same clinic that will work with me with this medication: would I need to go back and forward with the vet for dosage or so? Where do I find all the info (form, dosage..) about this med, please?

Also, still undecided if to switch insulin or not...I thought about trying Levemir (currently using Semglee) but my vet is not recommending it saying I should stay with Glargine and that "The Levemir is so potent that a minor dose change can have disastrous results"...really?!
I am a bit confused now as I don't recall hearing anything like this in here about Levemir, I actually know from many that this insulin may be better suited for acrocats, isn't?
Any help would be appreciate it, tnx

 

We can tell you the dosing for the cat. It typically doesn't change much though sometimes there are small increases if the acro symptoms aren't well controlled. You don't need the vet for anything other than the prescription. A quote from one of the many posts on this forum on cabergoline.

. Some people/researchers have done every other day, but the dose is pretty much the same ratio for all. And most of those on every other day have ended up on every day. There have been one or two cats with GI side effects that did better on EOD for a while before going to every day.

Maybe true for dogs, but not for cats. Most people end up around the same dose, though we start you a little lower as some cats have a strong reaction to the switch. You might want to send this paper to your vet Management of Diabetic Cats with Long-acting Insulin Note, there are no differences in the protocol for Lantus or Levemir for cats. Or this one under the "Treatment for Cats" section: (2018) AAHA Diabetes Management Guidelines for Dogs and Cats. Note that table 1 in that paper says it's potent for dogs and starting doses for the two species are quite different.

 

Thank you, very good info.

 

BTW, we've heard the "levemir is too strong" from vets lots of times.

 

Interesting how it can be too strong for dogs (especially small dogs) but not cats...
Not sure I understood correctly but, while reading through the file, I notice hypoglycemia was mentioned a few times...maybe because, if not enough home testing, hypo could likely happen with Levemir?
Based on Micio's numbers and how he reacts to increases, what should I do? continue with Glargine (try Lantus) or switch to Levemir?
But then I'm thinking, if we start Cabergoline which may help with decreasing the insulin dose, should I even be worried about switching anything?
P.S.: reason why I want to get Lantus if I stay with Glargine, it's cost wise since I'll be using the discount card

Sorry for all of these questions, just trying to do the right thing

 

Hypos can happen with Levemir, Lantus, Prozinc, pretty much all insulins if you aren't home testing. With Levemir, kitties often have flatter cycles, which to me less diving and less surprise lows. However, Micio is already pretty flat on Lantus. I think the only compelling reason to switch to Levemir for you is whether he's reacting to the acid base of Lantus when he gets his shots.

 

The one advantage with Levemir is that humans say glargine injections seem to sting at higher doses. Does Micio react to the current glargine injections? If not I would not change since glargine is much less expensive than Levemir.
If you do change I would not start cabergoline and change to Levemir at the same time.

 

Good point on not switching insulins while adding Cabergoline at the same time: I haven't start my last Semglee pen yet (will soon) and, because of the constant increases, I'm getting concerned about possible stinging in the near future. Over a week ago I thought he was starting to react to the insulin stinging but instead a realized he was reacting to me and the way I was poking him (ended up getting magnifying glasses with led light and finally I can see better now).
Meanwhile, because I've got ahold of Lantus and Levemir savings cards, I'd like to use the discount if possible (I don't even know how much Cabergoline will be yet).
But switching from Semglee to Lantus shouldn't be a problem, right?

 

I started Cabergoline and used it for three weeks before starting Levemir. We did start at a reduced dose, but then increased back up a bit. However, he never got up to the higher dose that he had been getting on Lantus. Who knows if it was the Levemir or the Cabergoline starting to kick in or both (which seems more likely.). Anyway, Cabergoline and Levemir combined worked very well for us.

There should not be a problem switching from Semglee to Lantus since they are bio-equivalent. I think if I were doing this I would shoot a slightly reduced dose at first just to see if there was any difference - out of an abundance of caution.

 

Lantus started to sting Mr Kitty right around 9-10U. I like Levemir a lot, but Wendy is right he's doing really well on semglee.

Whatever you buy next, I'd consider buying a smaller volume/fewer pens. Because if it does start to sting, you don't want a bunch of insulin laying around that you can't use. I know you can donate but sometimes that's difficult to do.

 

Well,if Levemir has a higher chance of working better with Cabergoline, I would like to try that.
As of right now, it looks like I have about a month worth of Semglee supply so I could possibly have my vet to get me started on Cabergoline with in a week and see how it goes ...although that may push me too close to the timeline on ordering either Levemir (or Lantus) and don't want to take a chance of not having any insulin...Ughh hate this kind of situations

 

Totally agree with you and what Wendy said at first over a week ago, I'm just afraid the dose will soon reach the "stinging" point and didn't want to get stuck with several pens of Semglee/Lantus (I don't think the pens can be purchased separately, at least not Semglee that I know of)....I'm a that "limbo" point right now and don't know what to do still

 

No problem at all switched these. However, why switch to Lantus when Semglee is really the same as Lantus and Lantus is more expensive.

 

Cause Lantus is part of the Sanofi discount card program but Semglee is not. I paid about $130 for 5 pens Semglee at Costco with membership, Lantus would be $99 for up to 2 packs of 5pens per month. Same for Levemir, $99 for 5 pens