6/5 Loudogg AMPS 70 +3 69 - Follow-up About New Levemir

Amanda and a Loudogg

Amanda and a Loudogg

Member Since 2017
June 4, 2019 Condo - Temp issues w/new Levemir Shipment

Morning everyone,
So I just got off the phone with one of the pharmacists at Marks Marine Pharmacy about Lou's recent Levemir shipment. All three circles on the temperature indicator were red, indicating prolonged temp exposure at over 77F (25C). As I said in my post yesterday, the shipment was delayed 2-3 days leaving Marks Marine last week and so when it arrived on Monday, we were having a 90F day. Helen thought that the Levemir would be okay, based on its longevity, but obviously I voiced my concerns considering this is Lou's supply for the next year. She was surprisingly well-versed on feline diabetes in the sense of not being surprised and she asked about home testing (thanks Chris! @Chris & China (GA)). I told her I home tested frequently throughout the day. She asked if I would be okay opening a pen from the new lot and using it to check the insulin's efficacy. So I'll use the new pen for the next couple of days or so and give her a call back to see how it went.

I am hoping it still works well, and Lou being regulated makes this a much easier process than it would have been even a few months ago. My fear though is that the insulin might work well now, but will that still be the case a few months from now? Or even a year from now? Has anyone else ever used insulin that had been exposed to heat and not had any long-term issues? I was hoping it might be an easy fix, but if it's not working properly I hope that they would offer me a replacement.

On the flip side, Lou is still doing brilliantly well. What I'm loving the most about him finally being regulated is he is SO much happier, and so much of his pre-FD self has been shining through. He used to cuddle with me on the couch almost daily, and I hadn't realized until he started doing it again how long it had been since he'd really done that. It's absolutely amazing. It's like I have my buddy Lou back, and with the teeth extractions last year, he's like a kitten again (even though I never had the pleasure of seeing his kitten self). All-in-all, I couldn't be more pleased with his progress. I just hope beyond hope this shipment snafu is just a blip in the radar. I don't want him to backslide.

I hope you all have a wonderful day and your kitties surf safely. I'll keep you updated with the new lot trial. Sending vines to all those kitties and beans in need. :bighug::bighug::bighug::bighug:
 
I'm curious why you don't buy the insulin from the Supply Closet / Alan ? I've ordered Levemir from him & received it in several days. Everything was fine & the price was too!

Also, what is considered "Regulated" ? This is what I read on the forum , "Lantus curve, once a cat is tightly regulated, is flat. Your cat would be in almost entirely green numbers which means, by definition, your shooting numbers that are below 100."

Although Ravan is doing good I don't consider him regulated because he still goes above 100 & sometimes below 50. Am I incorrect about being regulated?
 
JoyBee&Ravan said:
I

Also, what is considered "Regulated" ? This is what I read on the forum , "Lantus curve, once a cat is tightly regulated, is flat. Your cat would be in almost entirely green numbers which means, by definition, your shooting numbers that are below 100."

Although Ravan is doing good I don't consider him regulated because he still goes above 100 & sometimes below 50. Am I incorrect about being regulated?
Click to expand...

Hi @JoyBee&Ravan , hope you're doing well:)
From the sticky the basics: new to the group, start here:

"What is Regulation?':

There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":
  • Not treated - blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs
  • Treated, but not regulated - often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs
  • Regulated - generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia
  • Well regulated - generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia
  • Tightly regulated - generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin
  • Normalized - 60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin"
(I've been reading lots of stickies lately lol)

With love, nikki
 
You should be able to tell if the Lev is good in 2-3 days. If it is bad, Mark's will indeed make it right. Yes a lot of people at Mark's Marine are very familiar with Feline Diabetes - a good portion of their customers have 4 feet. :)

JoyBee&Ravan said:
"Lantus curve, once a cat is tightly regulated, is flat. Your cat would be in almost entirely green numbers which means, by definition, your shooting numbers that are below 100."
Click to expand...

A perfect Lantus curve will always be a gentle smile if you charted it off ssheet numbers. The first 2 hours after a shot, the bg will continue rise then turn and head the other way. At the next shot time, there's still a just a bit of the previous cycle still working but finishing allowing that rise to show.

A perfect Levemir curve will indeed be flat and maybe a bit of a BELL curve - that's one of the HUGE things I like about Levemir. BUT there's a huge brain change between Lantus and Levemir. It's easiest to realize you will actually have 2 'cycles' - the shot/ssheet cycle and the actual insulin cycle. Until fully regulated, the onset for Levemir is so long that numbers go UP to about +5 - almost half way thru the 'spreadsheet' cycle. When you shoot the next cycle, you're usually close to nadir of the previous INSULIN cycle. That make sense? It sounds confusing but it's not. It took months for me to not tend to panic shooting a lower number than Lantus.

JoyBee&Ravan said:
I don't consider him regulated because he still goes above 100 & sometimes below 50
Click to expand...

Glucose is never going to be a stable number - even my non-diabetics vary throughout the day by what's happening. If it's a normal lazy day, with no excitement, no exercise, Snowshoe runs 45-50. If there's been excitement, lots of dogs barking outside, a thunderstorm, group of squirrels running in the yard, he is sometimes as high as the 90's. His pancreas and associated systems work fine.
 
JoyBee&Ravan said:
I'm curious why you don't buy the insulin from the Supply Closet / Alan ? I've ordered Levemir from him & received it in several days. Everything was fine & the price was too!

Also, what is considered "Regulated" ? This is what I read on the forum , "Lantus curve, once a cat is tightly regulated, is flat. Your cat would be in almost entirely green numbers which means, by definition, your shooting numbers that are below 100."

Although Ravan is doing good I don't consider him regulated because he still goes above 100 & sometimes below 50. Am I incorrect about being regulated?
Click to expand...

Alan can't get lantus anymore.
 
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