? 9 Nov | Girlie | AMPS 392; +1=266 Starting Levemir Fri PM US time: Dose ?

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Girlie's mom

Girlie's mom

Member Since 2017
Condo: http://www.felinediabetes.com/FDMB/...s-112-pm-2-65-alphatrak2.186444/#post-2070410

AMPS 392 not surprising after the AM and PM shark dives yesterday. Thanks again to everyone who jumped in to give support. :bighug: As I have to be away from her AM+3:30 until AM+7:30/8, I think I'll try to give her some higher LC food, just in case, and - depending on where she is at +3 - leave some MC. Better an hour too high, eh?

The vet gave me a script for Levemir, and I think I will try it starting Saturday AM (Friday PM in the U.S.). The vet suggested 0.5 U Levemir as a starting dose, but that seems a little low to me. Girlie is now on 1.0 Unit Lantus. I'm not good at ALL with numbers, though, so I appreciate any advice. @Marje and Gracie , what do you think?

I look forward to any and all suggestions from those who've switched over to Levimir. @Osha , I look at your SS and dream that kind of steadiness might be in our future... We'll see, though. ECID :-)

Max is going to see the specialist dentist this morning; I really think it's some sort of abscess or other infection, but we'll see. Poor boyo.
 
AMPS 392 (6%): that was a bad call, carb-wise!
+1 = 266 (12%): why not start the day with a 126-point drop in the first hour, I say, when I have to be away most of the day? :banghead: :rolleyes:
 
+2= 211, so a drop of only 55

I gave her a 1/2 tsp of 13%; I wouldn't do that if I were staying at home and able to monitor all day, but because I have to be away - and given what she did yesterday! - I've decided to err on the side of being overly cautious. I may regret this, but at least I'll be able to leave knowing that she might go a bit high, but she'll be safe. Hope I'm not being too bad of a cat mom here! :nailbiting: :eek:
 
Girlie's mom said:
Super - thanks for that info - much appreciated. @Kris & Teasel , if you have any tips or suggestions about switching to Levemir, please let me know. I'm a little nervous about it, but I think Girlie and I have reached our diving and trampoline limit... :)
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Yes, I switched Teasel to Lev on September 23. However, Teasel NEVER follows the crowd and in him Lev just doesn't act like a depot insulin. It's a lot more like an in and out insulin for him. If you look at his SS since the switch you can see very few long flat intervals. He still spikes and dives. I'm sticking with it though because he feels SO much better on it than he did on Lantus.
 
Darrah, so glad your vet agreed to let you switch, I hope it's a whole new (regulated) world for Girlie! Healing thoughts to Max, hope it's nothing too crazy and is easily treatable. Looking forward to following your new Levermir journey. :cat:
 
Susan&Felix said:
I hope Levemir lays a carpet of blues and greens at Girlie's feet.
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What a beautiful thing to say! Lovely words, thank you so much!

Toebeans said:
Darrah, so glad your vet agreed to let you switch, I hope it's a whole new (regulated) world for Girlie! Healing thoughts to Max, hope it's nothing too crazy and is easily treatable. Looking forward to following your new Levermir journey. :cat:
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Boy, I so hope it makes a difference. Knowing Girlie, she'll probably be unpredictable, but I have to give it a try, at least.
 
Kris & Teasel said:
Yes, I switched Teasel to Lev on September 23. However, Teasel NEVER follows the crowd and in him Lev just doesn't act like a depot insulin. It's a lot more like an in and out insulin for him. If you look at his SS since the switch you can see very few long flat intervals. He still spikes and dives. I'm sticking with it though because he feels SO much better on it than he did on Lantus.
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Well, if all it does is make Girlie feel better, that's good enough for me! I'll take a long look at your SS later today. The more data I can look at and info I can get, the better I feel. With just a quick glance, though, I can see what you mean about the spikes and dives. Fingers crossed... and thanks for the info, Kris. :-)
 
Even with the carbs she's down to 97 at +4. Girlie, Girlie, Girlie - looks like you're on a mission, but today isn't a good day, sweetie. :rolleyes: :stop:
 
@Marje and Gracie and @Wendy&Neko : I have the Levemir and hope to do the first shot on Friday PM (U.S. time, which is Sat AM Oz time).

One of the things I'm really wondering about is the dose for Levemir vs. my current Lantus dose. Right now it's clear that she is on too high a dose of Lantus at 1 Unit - either that or the depot is really kicking in with a vengeance.

Yesterday she did shark dives AM and even PM after the reduction to 1 Unit. And today it was very clear that she would have done another AM shark dive. The only reason she didn't is because I really carbed her up early with 12 - 16% carb each hour from AM+1 to AM+4, when I had to leave. As she'd dropped down again at +4, I was really concerned, so I did two things that were guaranteed to shoot her BG levels up: I gave her 1.5 ml glucose syrup AND I left her with 1/2 can of 22 carb food which was gone by the time I returned.

I was sure that when I got home four hours' later that she would be sky high, but she wasn't: she was only 236 @ +8:30. That tells me that she would have dropped significantly without that massive load of carbs and glucose syrup.

I'm sure this means another long night unless I carb her up again tonight. So I'm not sure what to do or what this means for the transition to Levemir by Friday PM U.S. time (Sat AM Oz time). Should I
  • try to keep her on the 1 Unit of Lantus until then by using MC and even HC food if necessary as I did last night and today?
  • use LC 6 - 9% food and let her earn a reduction if she wants to - not intervening even if she does a deep dive?
I'll be able to monitor very closely the first 2 1/2 days of Levemir, but then I'll be away every day at work in the afternoons. If it turns out that she does do the Levemir thing and nadir later, then I can switch my 1/2 day at work to the mornings for the next two weeks so I can monitor her closely in the afternoons.

My vet suggested a starting dose of 1/2 Unit of Levemir as Girlie is on 1 Unit of Lantus at the moment, but that doesn't seem right given that the Levemir is usually 70% of the current Lantus dose. And how does this work when the Lantus seems too high currently, as it takes lots of carbs to keep her from diving into shark territory?

I'm finding this tricky to figure out on my own, so I'd really appreciate your very experienced advice, if that's okay! Many thanks in advance for any suggestions you might have. I wish there was a chocolate or flowers emoji, but I'll send a hug instead... :-) :bighug:
 
Good luck with the switch - I hope Lev makes a difference (in a good way) in Girlie's numbers.

Girlie's mom said:
One of the things I'm really wondering about is the dose for Levemir vs. my current Lantus dose. Right now it's clear that she is on too high a dose of Lantus at 1 Unit - either that or the depot is really kicking in with a vengeance.
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The depot can influence 4-6 cyles. Your option is to go 70% and try .75 units or try 0.5 units and be prepared to take it up quicky after about 4 cycles, if her numbers are soaring. What you do may depend on your ability to monitor after you switch. Some cats, but not all, have a strong reaction to the change, hence going with 70%.
Girlie's mom said:
So I'm not sure what to do or what this means for the transition to Levemir by Friday PM U.S. time (Sat AM Oz time). Should I
  • try to keep her on the 1 Unit of Lantus until then by using MC and even HC food if necessary as I did last night and today?
  • use LC 6 - 9% food and let her earn a reduction if she wants to - not intervening even if she does a deep dive?
I'll be able to monitor very closely the first 2 1/2 days of Levemir, but then I'll be away every day at work in the afternoons. If it turns out that she does do the Levemir thing and nadir later, then I can switch my 1/2 day at work to the mornings for the next two weeks so I can monitor her closely in the afternoons.
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We don't know what she'll look like on 1.0 unit of Lantus yet. Let's try to keep her on it at least 4 cycles. Your first 2.5 days, test as much as you can to try to figure out the Lev onset and nadir. It could mean less sleep and it could also not be clear right away.
 
Have you tested for ketones lately? Just a gentle reminder if you have not. I would try and get one before the switch just as a base line in case she is high for a few days during the switch. Good luck. I am really excited to see what Girlie does with Levemir.

How is Max?
 
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