Question for those who switched to Levemir about 1st dose

Hello everyone in the Levemir group. I have a question about those of you who switched to Levemir from another insulin and how you made the switch. I know one person already told me they gave Levemir the next dose and didn't skip any doses. They did reduce the dose and start at .5 units.

Is this how others did it or did any of you do a detox period from your previous insulin?

Thank you for any information. I'm very nervous about changing insulin. I sent my vet an email last night and am waiting to hear back from her, but I want to try Levemir because Lantus is not working for Gus. Please ignore our spreadsheet because Gus didn't feel good when he was on a higher dose of Lantus (3 units) and getting all those great numbers. Also - his fructosamine test came back with bad results. We have tried adjusting the dose down and he is all over the map - swinging from the mid 100s to the 400s in one day.

Gus will never be a tightly regulated cat because he has triads disease, but I would like for him to be a stable cat that feels good. If I could keep him in the low 200s I would be happy as a clam.

Thank you again!

 

Re: Question for those who switched to Levemir about 1st dos

I switched from PZI to Lev- mainly b/c I knew she was going to be a high dose cat.

I decreased around 66%- mainly because she was throwing ketones and going too low would be an invitation to spend a lot of money I didn't have :lol: . Most do 50% of current dose unless there is a reason to have it closer to 75%. It looks like his starting dose was 2.5u- is that correct? Why was it started at that dose? And there is nothing on there past the first of February, which is way out of date.

I don't know what triads disease is but that might be effecting the levels some.

What meter do you use? I am asking because you say the numbers said he was doing great but he was acting like he didn't feel good and the fructo test said he wasn't doing that well, either. That used to happen with the freestyle lite meters with the butterfly strips and the generic brands with TRUE in the name. Have you ever checked yours against another meter?

Lets get to work on getting Gus feeling better.

 

Re: Question for those who switched to Levemir about 1st dos

Thank you for the reply. I keep a chart of Gus's numbers, but I'm not counting them at this time because he had dental problems. I had to have a cardiologist check his heart before we could do the dental surgery to remove the last of his teeth so all of this took time over the summer. He definitely feels much better since that which was at the middle of August. He was a bit of a wreck after the surgery because he had to be on antibiotics for two weeks so I can't count those weeks in his numbers either.

Gus was started on 1 unit of Lanuts and we worked up to 3 units very slowly over a 6 month period. When he dips too low then I reduce the dose slightly because I am afraid of a hypo when I'm gone during the day at work. His numbers are so unpredictable on Lantus. My vet isn't that familiar with Levemir and I think she has hesitation about using it - although she has clients who do use it.

I now have both an Alpha track and a Relion Meter. I have tested my Relion against my Alpha track several times and it is always 45-50 points off no matter if we are high or low.

Back when those numbers were taken we were using the TrueTrack and I found out after that it was 70 points off after testing against my vet's meter. Gus's numbers were still pretty good, but he gained a lot of weight and the vet thinks we were in a possible Somogyi effect, however, when we reduced to 1.5 units his numbers were still decent, but the fructosamine came back worse.

I think Gus is probably a higher dose cat, but he doesn't feel good on a high dose of Lantus. A few people I've talked to on this board said their cats didn't feel well on Lantus and I've also read some humans have the same problem. There are also people and cats that don't do well on Levemir and do better on Lantus as well - it is just a matter of figuring out what works.

Since Gus has pancreatits (part of triads disease) I cannot push him into tight regulation because yes - it does effect his numbers. It is possible it will effect his numbers on Levemir as well. I don't know. I just know I would like to have a smoother line of numbers than what we have now as I am always worried with the plummets and the highs.

 

Re: Question for those who switched to Levemir about 1st dos

You don't need to "detox" him off lantus, just switch to lev with the next shot.

As for starting dose, because he is "all over the place" and the vet suspects Somogyi, maybe 1u? Just make sure you are testing for ketones and be prepared to raise the dose systematically, but quickly - meaning, let it settle 2-3 days, curve and raise on the 4th or 5th day, if necessary. You want to at least be getting spot checks in somewhere in the middle to see how low he is going. Vary the time as you can. I know a curve is not possible when you work all day, but lev doses should be raised 9an dlowered) based on the nadir more than the PS numbers.

Gus has had some things change since he started lantus that may also mean he needs less insulin than he did when you were raising him up to 3u - namely eliminating the mouth issues and bacteria/infections there.

Have you considered/tried raw food? There are two women who post here on and off who feed/fed raw food to their kitties with possible triaditis. Vicky's Gandalf had chronic pancreatitis and raw helped with that. Pamela's Tigger had some liver issues. She feeds raw and gives supplements to support his liver function.

My Beau had pancreatitis issues up until a little before he went OTJ. He always had elevated liver numbers when he had pancreatitis. He has had intermittent IBD symptoms. I have found adding digestive enzymes to his food has helped with them. I use Animal Essentials Plant Enzymes and Probiotics (from Amazon - be sure to use the DCIN link so they get a commission). I also add wild salmon oil (Natural Factors - also from Amazon) which is supposed to help with intestinal inflammation - in addition to all the other health benefits we know about from the omega oils. I add 2000 mg to a two day batch of food for three cats now because I recently read they need at least 250 mg/day.

 

Re: Question for those who switched to Levemir about 1st dos

Thank you for the additional info Sheila.

Gus is on probiotics and Milk Thistle since the hepatic lipsidosis incident last year.

Gus isn't a candidate for raw food - although I did have him on it for a while. Even our holisitic vet who does his acupuncture and chiropractic treatments doesn't want Gus on raw (and she is a believer in it for certain cats). I do understand it has helped a lot of cats. He does well on DM (I understand people here bash it all the time, but Gus does well and his fur is 10 time softer on this food). He also gets Avoderm chicken. Other foods that are low carb raise his blood glucose because for whatever reason they probably cause inflammation which triggers higher numbers. Believe me - I feel like I walk on egg shells with this cat - but he and his sister are the loves of my life so I will do anything to help them.

Gus does get freeze dried turkey and chicken meat sprinkled on top of his food as a treat. I have even taken this away just to make sure it wasn't causing the higher numbers, but it wasn't so he is getting it again.

My vet reiterates to me constantly that Gus has a complicated medical picture - that's what she calls it. I don't know if Levemir is the godsend we are searching for, but I have read through several stories of people who have switched to it with great success.

My own personal experience has taught me that medications aren't a one size fits all after having been on 4 thyroid medications. My numbers were fine on all of them - but three of them cause horrible side effects and made me feel terrible. Kitties can't talk to it makes it so much harder to figure everything out

I did try Salmon oil, but Gus won't touch his food if I even put a drop of it on there! I ended up taking it myself since he wouldn't.

Ahhhh.....all of this is so exhausting and stressful at times. When everything is going well life is wonderful, but when it falls apart it can be so nerve wracking.

Thank you for all of your suggestions and info!

 

Re: Question for those who switched to Levemir about 1st dos

Hi Rachel & Gus,

Just wanted to (((HUG))) you and tell you that ur a wonderful bean for all that ur doing for ur boy.

Dante was on 2u PZI before he came to me, w/#'s in the upper 400's. I knew I wanted him on Levemir 'cause I had used it before. With the advice of Sheila, I started him on 1u. He didn't have a shot the morning of his traveling to me and I gave him Levemir that eve.

IMO, it's pretty gentle.
Of course, ECID, lol.

But Dante has come a long ways in the 1 week that I have had him.

I hope you can give it a try, and that it works wonderfully for your boy.

 

Re: Question for those who switched to Levemir about 1st dos

Rachel, I am sorry that he is adverse to things that might help (like salmon oil), but I completely agree about needing to do what you can. I had a cat with hyperT that both could not tolerate the medication or tolerate being pilled. I tried the transdermal gel but she freaked out over that too as well as not being able to tolerate the medication. I found I could hide a tiny piece in pill pockets and she would gobble it up but I could not give her the proper dose, only about a fourth of the dose she needed, so that was what I did. She was happy, not stressed by the process and did not have an adverse reaction to the small dose. I don't know if it did her any good, but she lived to be 18-1/2, so it was "good enough".

I also agree about meds not being a one size fits all. I hope that you find lev a gentler insulin for him. It seems like many are finding that out lately. And their kitties act less grumpy almost right away. Switching to lev made a big difference to Beau. He did not have terrible numbers on vetsulin, but he could not sustain lows for more than a few minutes it seemed, so lots of bouncing. Lev was more steady and I think that makes a big difference in how they feel.

 

Re: Question for those who switched to Levemir about 1st dos

Thank you Sheri for the support! I really do appreciate it. Sometimes I just need to vent because it is overwhelming when I can't get things under control.

That is such great news about Dante and I appreciate you sharing this hopeful story with me. I hope he continues to do well. It is so shocking and scary to see those numbers in the 400s! When Gus had dental surgery he was at 600 that night! I almost went into heart failure. Fortunately that is the only time we have seen that number and I never want to see it again.

I will keep everyone posted on what's going on. I am still waiting to hear from my vet, but she probably won't answer until evening when she has a chance to read her email.

 

Re: Question for those who switched to Levemir about 1st dos

Sheila - you are not alone with the thyroid medication problems you had with your kitty. One of my vets has a cat that cannot tolerate any of the medications either and she is considering the iodine treatment to destroy her thyroid, but is still on the fence with what to do. Even vets struggle with treating their own animals. The fact that your kitty lived to be almost 19 is pretty darn good!

 

My vet is going to prescribe Levemir.

My vet is going to prescribe Levemir. She acknowledged that he is a very challenging diabetic and said that he still may have fluctuations on the levemir, but that we can give it a try.

I took Gus's blood glucose when I got home (+11) and it was 339 (this is with Alphatrack) and he is currently getting 1.25 U of Lantus. Although not a great number, it was very welcomed after three days of 400s! He was also playful and running through the house. Yesterday he looked and felt terrible so I'm glad for this turnabout. Maybe I can get a little sleep tonight!

Thank you all!