Switching from Prozinc to Levemir need advice Please

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DebG

DebG

Member Since 2016
@Marje and Gracie
Hello Marje, I am switching Fritz from Prozinc to Levemir and I just received the insulin today.
My I have questions:
First do I store it in the fridge?
I bought U100 syringes with 1/2 unit markings.
How much insulin do I start Fritz out on?
He is up to 4.25, 4.5 units of Prozinc it was not lasting the 12 hours and his #'s are high.
Any advice you can think of.
Thank you!!!!
 
Hey Deb!!!

Glad to see you and Fritz here in Lantus and Levemir Land. I think you will love Levemir....it's a great insulin.

Yes, it should be stored in the frig. You need U100, 0.3 cc, syringes. Good that you got the half u it markings but make sure they are 0.3cc...that's very important. Did you get a vial or did you get pens?

He's shown some green on 4.25u of PZ even though he's not doing much on 4.5u now although the 192 would likely be a lower blue on a human meter. Sometimes we see a big response from lev the first cycle or two so I think I'd start him on 4.25u and we can fast track him up if we need to.

It's a good idea to read the stickys at the top of this forum. We dose Levemir and Lantus different than PZ. The odds are based primarily on the nadirs and not so much on the preshots. In this forum, we do not do sliding scale dosing with the L insulins.

How long you hold the initial dose depends on whether you are wanting to follow the TR protocol or the SLGS approach.

Levemir onsets about +4 and nadirs somewhere between +8 and +12. We will have to watch his patterns to see where he lands. For tomorrow, I would test a little more just to see what he will do so after his AMPS shot, I'd test at +2.

Welcome and let me know if you have questions! Also...if you like, I can modify his SS to indicate when you start Levemir.
 
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Marje,
I bought Monoject 3/10cc 31g X5/16" U100 I don't see 0.3cc are these the wrong ones? I'll try and get a picture to you
 
I think 3/10cc is the same in fraction form as 0.3cc (which you would say is 3/10th of a cc.) So I think you've got the right thing.

Do you know if you're going to follow Tight Reg or Start Low Go Slow? Both are described in yellow boxed stickies on the top of the Lantus/Lev group page.

You might find this link helpful for finding info in this group. Lots of handy links: "Where Can I Find?"

Make sure you start Lev on a day when you can be home to monitor. Some cats do have a marked response to the first day with a new insulin.
 
julie & punkin (ga) said:
I think 3/10cc is the same in fraction form as 0.3cc (which you would say is 3/10th of a cc.) So I think you've got the right thing.

Do you know if you're going to follow Tight Reg or Start Low Go Slow? Both are described in yellow boxed stickies on the top of the Lantus/Lev group page.

You might find this link helpful for finding info in this group. Lots of handy links: "Where Can I Find?"

Make sure you start Lev on a day when you can be home to monitor. Some cats do have a marked response to the first day with a new insulin.
Click to expand...
Thank you! I would like to do the TR. Oh yes I will be home all day to monitor close :)
Ok I think Marje said to start Fritz on 4.25u where is that on the syringe I see #5 as the start
 
I feel so stupid so I asked my husband and he looked at me they way I looked at the syringe. I have no clue where 4.25 is on that syringe. Could you please show me on a U100 syringe? I see on the right side 5 lines farther apart on the left I see on the left side 5 lines closer together. then #5 so where is 4.25u????
 
Marje and Gracie said:
Hey Deb!!!

Glad to see you and Fritz here in Lantus and Levemir Land. I think you will love Levemir....it's a great insulin.

Yes, it should be stored in the frig. You need U100, 0.3 cc, syringes. Good that you got the half u it markings but make sure they are 0.3cc...that's very important. Did you get a vial or did you get pens?

He's shown some green on 4.25u of PZ even though he's not doing much on 4.5u now although the 192 would likely be a lower blue on a human meter. Sometimes we see a big response from lev the first cycle or two so I think I'd start him on 4.25u and we can fast track him up if we need to.

It's a good idea to read the stickys at the top of this forum. We dose Levemir and Lantus different than PZ. The odds are based primarily on the nadirs and not so much on the preshots. In this forum, we do not do sliding scale dosing with the L insulins.

How long you hold the initial dose depends on whether you are wanting to follow the TR protocol or the SLGS approach.

Levemir onsets about +4 and nadirs somewhere between +8 and +12. We will have to watch his patterns to see where he lands. For tomorrow, I would test a little more just to see what he will do so after his AMPS shot, I'd test at +2.

Welcome and let me know if you have questions! Also...if you like, I can modify his SS to indicate when you start Levemir.
Click to expand...
I got the pens, I'll watch the video on how to draw it out. I did read the stickys great info. I plan on doing the TR. I have no clue where 4.25 u is on the syringe. I see on the right side 5 farther apart lines then the #5 on the left side 5 closer lines then the #5 where is 4.25U? I feel really silly asking but I don't want to be giving the wrong dose.
 
Ok I 'm thiking that you count down 4 lines on the side with lines farther apart then 1 line down on the closer lines. Am I right? That would make 4.25u????
 
image.gif

Look at the diagram on the left which is U100. It has 0.5u markings. The very top line is 0. The small lines on the left are 0.5u. The large lines on the right are 1u lines so the "5" is five units. The line on the right below (towards 0) 5 is 4u. The line on the left below 5 ( towards 0) is the 4.5u line. So 4.25u is between those two.
 
DebG said:
I feel really silly asking but I don't want to be giving the wrong dose.
Click to expand...
Never feel silly asking! That's why we all stick around to help new people - because these things aren't always obvious. It's so much better to ask!

Hopefully Marje's picture and description will help, but if you aren't sure, take a picture of your own syringe and post it and we can describe it from that. There have been far too many times when someone gave too much because they didn't understand their syringe markings, so definitely ask.

If you watch the video, you'll get to hear Punkin's gravelly voice. He was such a sweetie. Hopefully it'll be helpful to you.

When you get a chance, add "TR" to your signature so everyone doesn't ask you endlessly which one you are doing.

DebG said:
Ok I 'm thiking that you count down 4 lines on the side with lines farther apart then 1 line down on the closer lines. Am I right? That would make 4.25u????
Click to expand...
Almost - yes on counting down 4 lines on the side with lines farther apart, but then the 1 line on the closer lines is measuring 0.5u. You want 0.25u. So you'll have to measure a little more than 4.0u and a little less than 4.5u. You'll be between the lines on the syringe. Doesn't matter if your 4.25u is the same as someone else's, you just want to be able to replicate it again so you can keep your dose consistent.

Once you have a used syringe, you can draw up colored water and use it as a comparison to your next shot.

Here are your guidelines from the Tight Reg sticky for starting out:
REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:
  • Kitty should be monitored closely the first three days when starting Lantus or Levemir.
    Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
    More monitoring may be needed.
  • It will be necessary to test kitty's blood glucose levels multiple times per day.
  • Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
  • Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
  • Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
  • Feed a high quality low carb canned or raw food diet.
  • Feed small meals throughout the day. Although, some kitties will adapt well to free feeding.
 
Marje and Gracie said:
View attachment 21291
Look at the diagram on the left which is U100. It has 0.5u markings. The very top line is 0. The small lines on the left are 0.5u. The large lines on the right are 1u lines so the "5" is five units. The line on the right below (towards 0) 5 is 4u. The line on the left below 5 ( towards 0) is the 4.5u line. So 4.25u is between those two.
Click to expand...
I see I'd like you to change the SS to reflect the change to Levemir.
Ok here gies the first dose to hopefully regulating and even remission ;)
 
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