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Lantus Vs Novolin For Cats

How Do I Get Lantus (or Basaglar Or Levemir) Less Expensively?

How Do I Get Lantus (or Basaglar Or Levemir) Less Expensively?

DCIN has received this question hundreds of times over the last few years. Truthfully, Lantus is actually the cheapest insulin per unit of insulin; the problem lies in the upfront costs. So this article will discuss ways to reduce the upfront cost of Lantus or Levemir. Let’s talk about Lantus. Lantus is an insulin that was designed for once-per-day use in humans. It turns out that Lantus, when dosed twice per day, is excellent at controlling feline diabetes and getting cats into remission. The generic name for Lantus is insulin glargine. There is no true generic version of Lantus but there is a biosimilar drug that was released in 2016 called Basaglar. Lantus is manufactured by Sanofi which is a profit-driven company. Lantus is a U-100 insulin (100 units of insulin per 1 mL of fluid). Lantus comes in 10 mL vials or 3 mL pens. Lantus is prescription only in the United States, OTC in Canada. Lantus should be refrigerated at all times. Lantus should be handled gently. Lantus that is refrigerated and handled gently can last 3-6 months from date of first use. The price of Lantus at a pharmacy in the United States is approximately $220 for a vial and $285 for a 5-pack of the pens. Are you suffering from sticker shock? The price of Novolin N or Vetsulin might seem more doable right now but let’s consider these facts. Novolin N is $26 at Walmart and Vetsulin is about $45 from your vet. Each of them is only good for about 30-45 days from the date of first use. Your annual cost for a cat on a typical dose of insulin is $208-$312 for Novalin and $360-$540 for Vetsulin. Only the start-up costs are lower. The annual costs are much higher, these insulins have less success at remission, these insulins may require dosing more frequently than every 12 hours. The annual price of Lant Continue reading >>

How To Find A Lantus Coupon

How To Find A Lantus Coupon

It looks like this page may be out of date. Please visit NerdWallet’s health hub for our latest content. Diabetics don’t have much of a choice when it comes to taking their insulin, and the costs can be very high, so a Lantus coupon can be invaluable. Paired with diabetic supplies like syringes and blood glucose testing equipment, diabetes is an expensive disease. But with a little bit of information and some resourcefulness, you may be able to save on your monthly prescriptions. Lantus is a long-acting insulin made by Sanofi-Aventis and prescribed to both Type 1 and Type 2 diabetics. Diabetics are unable to naturally produce or use insulin like most people, so they take injections of synthetic insulin to help regulate their blood sugar. Generic Lantus At this time, there is no generic form of Lantus available. However, that may soon change. The patents protecting Lantus from cheaper generic alternatives expired in February 2015, so less expensive forms of the drug may be coming. When this happens, opting for generic will likely be the best way to save on Lantus, and because of FDA requirements, you don’t have to worry about the generic version being less effective or less safe. Although some people avoid buying generics because they are afraid they won’t work as well as the name brands, those fears are largely unfounded. Lantus coupons from the manufacturer One carton of Lantus can cost close to $400 without insurance, according to GoodRx.com, though Lantus may very well be part of your insurance formulary. Currently, the maker of the drug offers a Lantus Savings Card. According to its website, the card can reduce your prescription cost to no more than $25. However, it also says there is a maximum benefit of $100 off each prescription for the duration of the pr Continue reading >>

Insulin Products Commonly Used In Dogs And Cats

Insulin Products Commonly Used In Dogs And Cats

Abbreviations: BG, blood glucose; NPH, Neutral Protamine Hagedorn; PZI, protamine zinc insulin; U, units. Additional Information on Available Insulin Products: Lente (U-40 porcine insulin zinc suspension; Vetsulin, Merck Animal Health) is an intermediate-acting insulin commonly used by the Task Force in dogs. It is FDA approved for use in dogs and cats. It has a close to 12 hr duration of action in most dogs and is useful for minimizing postprandial hyperglycemia. Glargine (U-100 human recombinant; Lantus, Sanofi) is a longer-acting insulin commonly used by the Task Force in cats because it has an adequate duration of action in most diabetic cats. Several studies have demonstrated that glargine is effective for controlling blood sugar levels in diabetic cats and achieving high remission rates.12 Glargine can also be used in dogs. It is a human analog insulin with modifications that provide variable solubility at different pHs. Glargine is soluble at a pH of 4.0, the pH at which it is supplied and stored, but in the neutral pH of the body’s blood or subcutaneous tissues it forms microprecipitates, facilitating slow absorption after injection. This results in rapid onset and long duration of action. Glargine is sometimes described as a “peakless” insulin, although peakless does not mean an absence of a nadir in cats but rather refers to glucose utilization rates.4 In dogs, a flat blood glucose curve (BGC) may be seen, so glargine can be referred to as a peakless insulin in that species.13 PZI (U-40 human recombinant protamine zinc insulin; ProZinc, Boehringer Ingelheim Animal Health) is considered by clinicians as a long-acting insulin, and is FDA approved for use in cats. In field studies in cats, mean time of the BG nadir was between 5 and 7 hr and the duration of Continue reading >>

All About Insulin

All About Insulin

-Nyssa Reine-Salz, DVM, DACVIM Insulin is a hormone produced by beta cells of the pancreatic islets of Langerhans.(1) Insulin helps regulate blood glucose. Diabetes Mellitus is the scientific term to describe partial or complete lack of insulin, which results in alteration of blood glucose.  Diabetes in dogs is typically similar to Type 1 diabetes seen in people. It results from an inability to produce insulin, most commonly related to immune mediated destruction of the pancreas. Dogs with diabetes require lifelong insulin treatment. Diabetes in cats more closely resembles Type 2 diabetes in people. A combination of insulin therapy, dietary management, and lifestyle changes are utilized to manage diabetes in caats and can even result in a remission of signs in cats, though often temporary.(2) Most types of insulin used in cats have been associated with remission.(2,3) Several types of insulin are commercially available for diabetes maintenance. Just like with people, there isn’t an insulin product that is effective in managing every patient and individual response to insulin therapy can be unpredictable. The concentration of insulin in insulin products manufactured for people is 100 IU/ml which is abbreviated as U100. The concentration of insulin in veterinary insulin products is 40 IU/ml which is abbreviated as U40. There are specific syringes manufactured to be used with the specific concentration of insulin and it is imperative that these guidelines be followed to avoid errors of administration. The advantage of the use of U40 insulin dogs and cats is that because of the lower concentration, the physical unit is larger; making it easier to see the small doses they typically receive. Human insulins are also divided by their expected duration and onset of ac Continue reading >>

Insulin For Cats

Insulin For Cats

Most diabetic cats will require insulin therapy as part of their treatment. Diet is also an important cornerstone of treatment for feline diabetes mellitus, and a few diabetic cats can be managed with diet alone, but the majority will require insulin. There are a variety of types of insulin available. Some are designed for human use but can be useful in pets, while others have been developed specifically for animal use. The natural insulins produced by cat and dog pancreatic cells have slightly different structures than the natural insulin produced by human pancreatic cells. Insulin types made for human use match the natural human insulin, and may not always be as effective in pets. With any insulin, the goal of treatment is to safely reduce or eliminate the symptoms of diabetes (weight loss with excessive thirst, urination and appetite). There is no ‘best’ insulin for all cats, but some are preferable to others. Many veterinary internal medicine specialists recommend glargine (Lantus®, made by Sanofi Aventis) as a first-line choice. Lantus® is a recombinant human insulin which is usually very effective in cats. In combination with an appropriate diet (canned cat food with less than 7% carbohydrates), glargine has the best chance of inducing a remission, meaning that the cat will no longer require insulin. Lantus® is typically dosed at 1 or 2 units twice daily (BID). In some cats it can be used once daily. Once daily administration is not as likely to induce remission—and won’t control the blood sugar very tightly—but is an option for families or cats who can’t do twice daily injections. The glargine product information for human use recommends replacing the vial every 28 days, but if kept refrigerated, the insulin is effective for cats for at least three Continue reading >>

My Kitty Was Just Diagnosed With Diabetes. I Read A Lot Of Stuff On The Internet But What Do You Do?

My Kitty Was Just Diagnosed With Diabetes. I Read A Lot Of Stuff On The Internet But What Do You Do?

I get questions like that via email/Facebook PM several times per week. While everyone has different experiences because every cat is different, I can share my experiences. I will do my best to answer the most common questions I get. This post is about insulin questions. What insulin do you use? I have three diabetic cats and I use three different types of insulin. Pumpkin was my cat before he had diabetes. I tried him on Prozinc and Novolin N and neither worked for him. He has done very well on Lantus. He did have several months of being in remission (aka "off the juice" or "OTJ) but after a third bout of nearly life-ending pancreatitis, his pancreas has not recovered and likely never will. Tucker came to me for care after he was already diabetic. I tried him on Lantus and it didn't work well for him. I switched him to BCP PZI and it did work well. I then tried Levemir and it was not good for him so he is back on BCP PZI. He has periods of being OTJ that ranges from a couple of days to a few weeks. Sunshine came to me twice. I had her while her foster mom was on vacation. She had been on Lantus for several years. It didn't seem to be the best insulin for her and I switched her to Levemir. She did great with Levemir and went back to her foster mom on it. Unfortunately for Sunshine, she went into a very severe DKA and nearly died. I took her home with me as a "last chance" and treated her as aggressively as possible. Today, she is OFF insulin and has been for several months. (Side note - switching insulin should be done in consultation with your veterinarian. Your data from home testing, along with behavioral observations, is what will be used to explain why a particular insulin may not be working for your cat.) While Novolin N and Vetsulin/Caninsulin are NOT recommended Continue reading >>

Compare Types Of Insulin For Dogs And Cats

Compare Types Of Insulin For Dogs And Cats

Whether you need insulin for cats or insulin for dogs, you know diabetes is serious and can how it can greatly affect your pets. The inability to regulate one’s own blood sugar seriously alters the way diabetics go through life -- they have to be careful about what they eat and keep an eye on blood sugar levels, and they're going to need to take some type of insulin for the rest of their life. However, the world of insulin is much more varied than most people realize. It is not as simple as getting a prescription for ‘insulin,’ going to the pharmacy, and starting your diabetic pet on their treatment. There are insulins designed to act fast. There are other insulins designed to last a long time. Some insulins are natural, while others are synthetic. This article should help highlight the key differences between the four different types of insulin most commonly prescribed to pets. Neutral protamine hagedorn (NPH) insulin Intermediate-acting Frequently combined with other, faster acting insulin to create a longer-lasting insulin that gets to work quicker Dosage: 0.5 - 1 unit/kg taken SQ 1-2 times a day A combination of fast acting NPH insulin (70%) and the longer lasting, regular, human insulin (30%) Man-made substances similar to, but not, organically produced insulin Dosage: 0.2 unit/kg taken SQ 1-2 times a day Long Lasting Insulin glargine -- structurally identical to, but not, human insulin Long-lasting - up to 24 hours MUCH more reactive in dogs than cats. Dosage: 0.1 unit/kg taken SQ once a day Insulin detemir -- an artificially crafted insulin made from ingredients not found in nature, but designed to behave like natural insulin A very powerful, long-lasting type of insulin Similar to Lantus in that it is MUCH more reactive in dogs than in cats. Dosage: 0.1 un Continue reading >>

Update On Insulin Treatment For Dogs And Cats: Insulin Dosing Pens And More

Update On Insulin Treatment For Dogs And Cats: Insulin Dosing Pens And More

Authors Thompson A, Lathan P, Fleeman L Accepted for publication 19 February 2015 Checked for plagiarism Yes Peer reviewer comments 3 1School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia; 2College of Veterinary Medicine Mississippi State University, Starkville, MS, USA; 3Animal Diabetes Australia, Melbourne, VIC, Australia Abstract: Insulin therapy is still the primary therapy for all diabetic dogs and cats. Several insulin options are available for each species, including veterinary registered products and human insulin preparations. The insulin chosen depends on the individual patient's requirements. Intermediate-acting insulin is usually the first choice for dogs, and longer-acting insulin is the first choice for cats. Once the insulin type is chosen, the best method of insulin administration should be considered. Traditionally, insulin vials and syringes have been used, but insulin pen devices have recently entered the veterinary market. Pens have different handling requirements when compared with standard insulin vials including: storage out of the refrigerator for some insulin preparations once pen cartridges are in use; priming of the pen to ensure a full dose of insulin is administered; and holding the pen device in place for several seconds during the injection. Many different types of pen devices are available, with features such as half-unit dosing, large dials for visually impaired people, and memory that can display the last time and dose of insulin administered. Insulin pens come in both reusable and disposable options. Pens have several benefits over syringes, including improved dose accuracy, especially for low insulin doses. Keywords: diabetes, mellitus, canine, feline, NPH, glargine, porcine lente Introduction Insulin the Continue reading >>

Converting Feline Patients To Vetsulin

Converting Feline Patients To Vetsulin

Evaluate reason for switching insulin products. Is the cat adequately regulated on its current insulin or is one of the following factors causing problems: Is human error occurring? Is the insulin out of date, improperly stored, or misused? Does the cat have a concurrent disorder? After identifying any resolvable issues and ruling out possible concurrent disorders, simply discontinue use of the current insulin and begin administration of Vetsulin® (porcine insulin zinc suspension) at 1 to 2 IU per injection, twice daily. Evaluate your patient 2 to 4 weeks after starting Vetsulin or earlier if clinical signs of hypoglycemia develop. Check factors including water consumption, urine frequency and volume, activity level, and weight changes. Generate serial blood glucose curve to determine if patient has achieved good regulation or if any of the following problems have developed: Hypoglycemia Poor regulation Somogyi overswing If clinical signs of polyuria, polydipsia, and weight loss have not resolved, you may need to increase the cat’s dose by 1 IU per injection. To learn more, read the Transitioning Feline Patients with Diabetes Mellitus to Vetsulin® conversion chart. Continue reading >>

Feline Diabetes Message Board Community

Feline Diabetes Message Board Community

5 Steps to Regulating Your Diabetic Cat (the "Start Low - Go Slow" approach) Developed by the Feline Diabetes Message Board community Equipment: One cat with a confirmed diagnosis of diabetes (without complications such as diabetic ketoacidosis) One bottle of long-acting insulin .3 cc syringes with 30- or 31-gauge needles (with half-unit markings if you can get them) Instruments for measuring blood glucose, such as a home glucometer and test strips Lancets One bottle of Karo or other glucose syrup A printed copy of Melissa & Popcorn's Treating Hypoglycemia document One bottle of Ketostix or Ketodiastix, for monitoring urine for ketones Low-carbohydrate treats to reward the kitty One very large bar of chocolate to reward the human (bottle of wine or carton of ice cream may be substituted or added as needed) Before you start -- How Diet Affects Regulation: This document is a description of a safe and conservative procedure for determining the proper dose of insulin for your cat. However, what and how you feed your cat are very important to this process. Some important dietary principles are: Always be consistent in what you feed your cat in terms of protein, fat, carbohydrate, and fiber content of the diet, and when you feed your cat relative to the insulin dose. Make sure that the type of insulin matches how you feed your cat. A shorter-acting insulin such as Vetsulin/Caninsulin often requires meal-feeding (or at least not feeding your cat after about 6 hours post-dose); longer-acting insulins such as PZI, Lantus, or Levemir may be more suitable for a cat who free-feeds. Consider the content of the diet. Cats on diets which are low in carbohydrates (around 5-10% of total calories) usually require less insulin than cats on high-carbohydrate diets. In addition, a substanti Continue reading >>

Levemir Vs. Lantus: Similarities And Differences

Levemir Vs. Lantus: Similarities And Differences

Levemir and Lantus are both long-acting injectable insulins that can be used for long-term management of diabetes. Insulin is a hormone that is naturally produced in the body by the pancreas. It helps convert the glucose (sugar) in your bloodstream into energy. This energy is then distributed to cells throughout your body. With diabetes, your pancreas produces little or no insulin or your body is unable to use the insulin correctly. Without insulin, your body can’t use the sugars in your blood and can become starved for energy. The excess sugar in your blood can also damage different parts of your body, including your blood vessels and kidneys. Everyone with type 1 diabetes and many people with type 2 diabetes must use insulin to maintain healthy blood sugar levels. Levemir is a solution of insulin detemir, and Lantus is a solution of insulin glargine. Both are basal insulin formulas. That means that they work slowly to lower your blood sugar levels. They’re both absorbed into your body over a 24-hour period. They keep blood sugar levels lowered for longer than short-acting insulins do. Although the formulations are slightly different, Levemir and Lantus are very similar drugs. There are only a few differences between them. Children and adults can use both Levemir and Lantus. Specifically, Levemir can be used by people who are 2 years or older. Lantus can be used by people who are 6 years or older. Levemir or Lantus can help with daily management of diabetes. However, you may still need to use short-acting insulin to treat spikes in your blood sugar levels and diabetic ketoacidosis (a dangerous buildup of acids in your blood). Learn more: All about diabetic ketoacidosis » Administration Both Levemir and Lantus are given through injection in the same way. You can gi Continue reading >>

Insulin Therapy In Cats (proceedings)

Insulin Therapy In Cats (proceedings)

123Next Few diseases are as frustrating for a veterinarian as diabetes mellitus. Realistically, control of hyperglycemia is rarely accomplished, and clinical signs of diabetes often persist. The landscape is changing in feline diabetes, however, and as clinicians learn more about new insulin preparations, diets, and treatment monitoring strategies, cats with diabetes may be better controlled. Insulin Therapy There are many different types of insulin that vary with species of origin and with chemical modifications and formulations that affect onset and duration of action. Unfortunately, no feline insulin formulation is currently available, so human, bovine, or porcine insulin are used in treating diabetic cats. Data concerning the pharmacokinetics and pharmacodynamics of insulin in the cat are difficult to interpret. Most published studies have been conducted in normal cats, and some have been done in cats with diabetes. In either case, it is difficult to determine the effects of endogenous vs. exogenous insulin. Determinations of potency, time to peak activity and duration of activity, factors that influence choice of doses and dosing intervals, vary widely from cat to cat. In fact, there is no reasonable way to predict the kinetics of an given insulin preparation in any given patient. The most commonly used insulin preparations in cats are Regular insulin (Humulin-R™ ), NPH insulin (Humulin-N™ ), porcine lente insulins (Vetsulin™ ), PZI, Insulin glargine (Lantus™ ), and insulin detemir (Levemir™ ). Regular insulin is not used for chronic treatment of diabetes in cats, but is commonly used in the treatment of diabetic ketoacidosis. NPH, PZI, and Lente NPH is considered an intermediate-acting insulin, and is available as a human recombinant product. NPH is used Continue reading >>

Choosing The Right Insulin

Choosing The Right Insulin

Protamine Zinc (PZI/ProZinc) and Glargine (Lantus) are the only insulins recommended by the American Animal Hospital Association (AAHA) for use in felines. Since the AAHA Diabetes Guidelines were written (2010), another insulin came into use for felines called Detemir (Levemir) that works similarly to Lantus and it's now also a recommended insulin for felines. In the US, you will need a prescription from your vet for Lantus or Levemir but you can buy them at your local pharmacy. Unless your kitty is a high-dose cat, buying the pens is less expensive per usable unit than buying a vial. If you are using it in pen form, you will need to make sure the prescription states it's for the pen (and not the vial). Depeding on your state/country, you may also need a corresponding prescription for syringes (u100, 3/10cc with 1/2u markings). You do not use the pen needles with the pens but instead treat each pen as a mini vial and insert the syringe into the end. The reason for this is that the pen needles only dispense full unit doses and many times our kitties need half unit or even quarter unit doses (i.e. 1.25u). For further reading on the depot-style insulins, Lantus and Levemir, check out the Lantus Tight Regulation Protocol and Levemir 101. Other ways to get Lantus and Levemir less expensively, including from Canada. PZI is the original version of Protamine Zinc and is usually bovine (cow) based. There are several different types of PZI, but the most common are Hypurin Bovine PZI (in the UK) and BCP PZI (in the US). ProZinc, on the other hand, is a genetically-modified human insulin version of Protamine Zinc created specifically for cats and is (usually) available throughout the US. These should be available directly from your vet or through a compounding pharmacy. Some Costco

Selecting The Best Insulin For Diabetic Cats When Cost Becomes Factor

Selecting The Best Insulin For Diabetic Cats When Cost Becomes Factor

I have an overweight (16 lb; 7.3 kg) male DSH cat who has been fairly well regulated on 3 units of glargine (Lantus) administered twice daily. He has been diabetic for over a year and has done well on a low-carbohydrate diet (less than 10% of calories as carbs). However, the owner reports that the cost of glargine has risen again (now to just over $200 at our local pharmacy), so the owner wants to switch to another insulin preparation. Glargine has always been my first choice of insulin in diabetic cats so I'm not sure of which insulin would be the best (and cheapest) for this owner to switch to. Any advice would be greatly appreciated. I'd still like to get this cat to go into remission, but I'm afraid that this will never happen if I stop the Lantus and change to another insulin preparation. My Response: The rising cost of all of the human insulin analogs, such as glargine and detemir, are indeed becoming a problem for many owners. If you and the owner decide to switch to another insulin preparation, you have 4 insulin preparations that could be considered (all should be given twice a day): Levemir (insulin detemir), another long-acting human insulin analog ProZinc (Protamine Zinc Insulin; PZI), a long-acting veterinary insulin preparation Humulin N or Novolin N (NPH insulin), an intermediate-acting human insulin preparation Vetsulin (porcine insulin zinc suspension; lente), an intermediate-acting veterinary insulin preparation Cost comparison Levemir (detemir): As far as cost, the retail price of Levemir will be about the same or even more than glargine (~$200 per vial), so that's not a good option for this owner. ProZinc (PZI): A 10-mL vial of ProZinc insulin will be a bit cheaper than either a 10-mL vial of glargine or detemir. Most veterinarians will charge ~$125 Continue reading >>

Diabetes Mellitus In Dogs And Cats (proceedings)

Diabetes Mellitus In Dogs And Cats (proceedings)

Previous 12345678910111213Next The options with human insulin include ultra short acting, short acting, intermediate acting, and long-acting insulins. The short acting insulins are primarily used for ketoacidosis, and therefore, are not covered in this article. The intermediate acting insulins are classified as either NPH or Lente. It is important to note however, that even though they are classified as intermediate, they do not behave the same way in the dog or cat. Lente is actually a mixture of semi-lente and ultra lente, which results in a bimodal onset of actions. This is helpful in some patients because is helps block post- prandial hyperglycemia. Conversely, a lente insulin is not recommended for use in an animal that does not develop post prandial hyperglycemia. It is recommended that NPH be used in the majority of dogs and cats with diabetes and it is also understood that most patients will require two injections a day to achieve glycemic control. On July 6, Eli Lilly announced that it was discontinuing 4 of its insulin products: Humulin L Lente insulin, Humulin U Ultralente insulin, Iletin II Regular pork insulin, and Iletin II NPH pork insulin (see attached announcement). Less than 2% of human patients with diabetes mellitus will be affected by the change since most have been switched to newer insulins and/or insulin analogs. To meet this challenge we will need to switch patients currently taking these products to comparable insulin preparations and change the way we approach the newly diagnosed dog or cat with diabetes. Therefore, we have put together the following suggested guidelines: Canine Patients Newly Diagnosed Patients 1. Vetsulin (porcine origin lente): A zinc, porcine, intermediate acting insulin. Canine and porcine insulin have an identical amino Continue reading >>

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