New to Levemir! Hello! Need advice, please.

mosi_yazhi

mosi_yazhi

Member Since 2021
The 411:

Me:
Wendy.
32 years old.
United States.

The cat in question:
Olivia
18 years old, female, calico
Indoors cat
Diagnosed April 22, 2021
Started Vetsulin April 27, 2021 [2 units > 1 unit > 1 drop > 0] (too harsh)
Started Levemir June 2, 2021 [1 drop]
Reli-on Premier Classic
Vet says she might need to have teeth pulled.
CKD stage 3 DX: May 25, 2021

Part 1
Part 2
Part 3

Recently diagnosed with CKD, so I'm still in the process of trying to find a good food match for her. I'm lucky that she'll eat mooooost things I give her, but (1) she's a slow eater/grazer (2) she won't tolerate the same meal too many times in a row (*EYEROLL*)

She's being fed a mix of Tiki cat and Weruva (Trulux, B.F.F., classic) mostly under 8% carbs, and >1% phosphorus.

Anyway. Today's her first day on Levemir. I gave her a single drop. She had 8% carbs for breakfast, and 24% carb at +2 when I got freaked out.
 
Hi, I too am Wendy. :) My kitty was on Levemir a few years. How did you measure that drop dose?

My girl also had CKD (and a bunch of other stuff too). Mostly she got raw food, made with EZComplete premix to make it low phosphorus.
 
Wendy&Neko said:
Hi, I too am Wendy. :) My kitty was on Levemir a few years. How did you measure that drop dose?

My girl also had CKD (and a bunch of other stuff too). Mostly she got raw food, made with EZComplete premix to make it low phosphorus.
Click to expand...

Copy-pasta from last thread: I take the syringe out of the package, pump the plunger to get it unstuck, then push and hold it down. Insert into vial/pen. Release plunger to let it suck up what it will, I dont pull on it. Insert needle into cat, push plunger down, and hold for 10 seconds until I remove it.

I'm considering raw feeding, yes! The EZComplete is all sold out/on backorder right now, though, and I don't have the funds for the switch at this time anyway, so she gets the canned stuff for a while longer.
 
Bandit's Mom said:
Switch to canned with low phosphorous? I'm sure someone must have shared this link with you before. Sorry, didn't read through the last thread! :)
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
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I was using that before, yes, when I was just shopping for low carb, but with the CKD DX, I've been using Tanya's, since it looks like hers might be a little more accurate in measuring phosphorus and up to date anyway? (Catinfo hasn't been updated since 2017, looks like)

https://felinecrf.org/canned_food_usa.htm
 
Hi Wendy! Another option instead of EZ Complete is Alnutrin with Eggshell Calcium. You can request a sample from their website. I've been using it in rotation with EZ Complete. The big difference between the two is you have to add either fresh or freeze dried liver (mine prefer freeze-dried, it's sold as treats at the pet store) and an Omega-3 source like fish oil. There are simple recipes to follow on their site. Alnutrin is less expensive than EZC because you need less of it so it lasts longer and liver and fish oil aren't very expensive to buy. And FWIW, I spend about the same and sometimes less feeding two cats each month on raw meat with the meal completers as I would have on expensive low phos commercial foods. I started with buying boneless ground meat in the supermarket (always vacuum sealed, never the cling film sealed trays because those can harbor bacteria), and if you stick to ground turkey, chicken, pork or beef, you can feed pretty inexpensively. Just make sure that there are no additives like rosemary extract (popular additive in ground turkey as a preservative) and the sodium percentage is below 3-4% (they add salt to make the meat more palatable to humans). I make a batch to last around 10 days, portion, freeze, and thaw as needed. While Weruva helped a little, feeding raw made a big difference in lowering Ruby's kidney values and it's zero to super low carb, so I'm a big fan.
 
125 @ +5.

I'm guessing this might be the 24% I fed her at +2 hitting her bloodstream in ernest? Oops.

@PerfumedCatMom Oooh! I'll look into that one, too! Are you in the US? Where did you get the ground meat when you were getting it as the supermarket, and what brand?

My mom has a grinder somewhere. IN THEORY, I could grind something myself, but I would worry about doing it wrong lol.
 
mosi_yazhi said:
125 @ +5.

I'm guessing this might be the 24% I fed her at +2 hitting her bloodstream in ernest? Oops.

@PerfumedCatMom Oooh! I'll look into that one, too! Are you in the US? Where did you get the ground meat when you were getting it as the supermarket, and what brand?

My mom has a grinder somewhere. IN THEORY, I could grind something myself, but I would worry about doing it wrong lol.
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Lol yes depending on the method you choose, we generally don't break out the hard core HC until closer to 50, but always better safe than sorry.

When do you start your new job? Realistically I think she has a great chance at remission if you use the TR method, but that requires more testing and sometimes some stressful days/nights.
 
mosi_yazhi said:
125 @ +5.

I'm guessing this might be the 24% I fed her at +2 hitting her bloodstream in ernest? Oops.

@PerfumedCatMom Oooh! I'll look into that one, too! Are you in the US? Where did you get the ground meat when you were getting it as the supermarket, and what brand?

My mom has a grinder somewhere. IN THEORY, I could grind something myself, but I would worry about doing it wrong lol.
Click to expand...
Wendy, good rule of thumb here is when the cat is in the 50s, feed something medium carb (10-15%) and when the cat dips to 49 and below, break out the honey and HC. You can always post here whenever you get a number that's lower than you're used to and we can help you decide what to feed and when to test again. That's what we're here for! :bighug:

I am in the NYC area, and usually tried to get grass fed or organic from Whole Foods or Trader Joe's. Once I got the hang of raw feeding and discovered my kitties liked it, I started buying larger quantities of boneless ground from Hare Today and Raw Feeding Miami. You pay for shipping, but these raw pet food purveyors keep everything frozen well and test their batches for bacteria so I know they're safe to feed. The BEST thing though is if you can grind your own (I don't have the kitchen space for it). Dr. Lisa Pierson has a whole section of her site devoted to making your own cat food with discussion about grinding that has been followed by probably thousands of cat parents around the world: https://catinfo.org/making-cat-food/
 
FrostD said:
Lol yes depending on the method you choose, we generally don't break out the hard core HC until closer to 50, but always better safe than sorry.

When do you start your new job? Realistically I think she has a great chance at remission if you use the TR method, but that requires more testing and sometimes some stressful days/nights.
Click to expand...

Oops. Lesson learned. I just got freaked out because what the Vetsulin would do/knowing nadir was still a ways off.

I'm not sure when Im suppose to start, tbh. It's a little aggravating.

Technically speaking, my new job is in the tourism industry, but my local government has closed down the tourism opportunities in an effort to stop covid community spread from outside factors.

Ordinarily, I would think it was a good move, but personally, I just wanna get back to work lol. Like, it's great that I have time to do all this and run around/monitor Olivia more closely, but at the same time I'm watching my dwindling funds with a bit concern.

Do you think remission is possible, even with her needing dentals? I'd be willing to try if it's a real possibility.

I'll steel myself for tonight and try to keep from interfering and let her and the insulin do their thing.
 
PerfumedCatMom said:
Wendy, good rule of thumb here is when the cat is in the 50s, feed something medium carb (10-15%) and when the cat dips to 49 and below, break out the honey and HC. You can always post here whenever you get a number that's lower than you're used to and we can help you decide what to feed and when to test again. That's what we're here for! :bighug:

I am in the NYC area, and usually tried to get grass fed or organic from Whole Foods or Trader Joe's. Once I got the hang of raw feeding and discovered my kitties liked it, I started buying larger quantities of boneless ground from Hare Today and Raw Feeding Miami. You pay for shipping, but these raw pet food purveyors keep everything frozen well and test their batches for bacteria so I know they're safe to feed. The BEST thing though is if you can grind your own (I don't have the kitchen space for it). Dr. Lisa Pierson has a whole section of her site devoted to making your own cat food with discussion about grinding that has been followed by probably thousands of cat parents around the world: https://catinfo.org/making-cat-food/
Click to expand...

I'll make sure to look at that! I'd just be worried about accidentally contaminating the food somehow. I know shes a carnivore by nature, she can probably handle it, but the fear is still there. I dont have access to Whole Foods/Trader Joe's, so Walmart meat is about as good as it gets.
 
Also, since I messed up this cycle with my hair trigger worrywarting, I'm just gonna check bg every other hour now until the PM cycle starts, I suppose.
 
mosi_yazhi said:
I'll make sure to look at that! I'd just be worried about accidentally contaminating the food somehow. I know shes a carnivore by nature, she can probably handle it, but the fear is still there. I dont have access to Whole Foods/Trader Joe's, so Walmart meat is about as good as it gets.
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Read the Dr. Pierson link. She provides tips on food safety that are great. Grinding your own is the safest way to go. Walmart meat is fine. With any supermarket meat, just pay attention to the sell by date and the other things I mentioned about additives and you will be golden!
mosi_yazhi said:
Also, since I messed up this cycle with my hair trigger worrywarting, I'm just gonna check bg every other hour now until the PM cycle starts, I suppose.
Click to expand...
Don't be hard on yourself, you're doing great! I can't tell you how many times I whipped out the honey when I saw greens the first time. And Olivia's numbers don't seem to have suffered too much from it, so consider it a learning experience. When did you feed the HC? At +2? Any other food since?
 
PerfumedCatMom said:
Read the Dr. Pierson link. She provides tips on food safety that are great. Grinding your own is the safest way to go. Walmart meat is fine. With any supermarket meat, just pay attention to the sell by date and the other things I mentioned about additives and you will be golden!

Don't be hard on yourself, you're doing great! I can't tell you how many times I whipped out the honey when I saw greens the first time. And Olivia's numbers don't seem to have suffered too much from it, so consider it a learning experience. When did you feed the HC? At +2? Any other food since?
Click to expand...

I give her some chicken PureBites after every test, just to incentivize her to put up with me poking her ear, but that shouldn't raise her bg, I dont think. It's just chicken.

I'll go try to dig out the meat grinder o7
 
mosi_yazhi said:
I was using that before, yes, when I was just shopping for low carb, but with the CKD DX, I've been using Tanya's, since it looks like hers might be a little more accurate in measuring phosphorus and up to date anyway? (Catinfo hasn't been updated since 2017, looks like)

https://felinecrf.org/canned_food_usa.htm
Click to expand...
Hi Wendy! FYI @Diane and Kierra recently did an update (thank you!), check out this post in the Think Tank
https://felinediabetes.com/FDMB/threads/food-chart-comparison.245538/
 
mosi_yazhi said:
Oops. Lesson learned. I just got freaked out because what the Vetsulin would do/knowing nadir was still a ways off.

I'm not sure when Im suppose to start, tbh. It's a little aggravating.

Technically speaking, my new job is in the tourism industry, but my local government has closed down the tourism opportunities in an effort to stop covid community spread from outside factors.

Ordinarily, I would think it was a good move, but personally, I just wanna get back to work lol. Like, it's great that I have time to do all this and run around/monitor Olivia more closely, but at the same time I'm watching my dwindling funds with a bit concern.

Do you think remission is possible, even with her needing dentals? I'd be willing to try if it's a real possibility.

I'll steel myself for tonight and try to keep from interfering and let her and the insulin do their thing.
Click to expand...
Its always a bit hard to say...but she's only on a single drop and she was practically just diagnosed. Best chances of remission are soon after diagnosis. The dental would help, but I know it's not in the cards for you right at this moment.

If it were my cat, I would go for TR and aim for remission. Remission is a distant pipe dream for Mr Kitty lol

Like Katherine said, we usually feed MC between 50-60, and HC under that. If we see big drops, we'll often feed some extra LC to help slow it down. If it's a really nasty drop, sometimes MC depending on the numbers and where it is in the cycle. But those are much more unusual on Levemir vs Vetsulin.

The goal is to spend as much time in green as possible, that's where the pancreas is healing.
 
My Luci has been on Lev for a couple of years now. It's a nice gentle insulin...builds a nice solid depot over a few days...and there's no 'knee-jerk' reaction to the dose. Usually takes a couple of hours or more for it to reach therapeutic levels when the depot is full.

Over the next few days if you test every few hours you'll see when she hits her lowest numbers and you can go from there to adjust the dosage accordingly.

It'll take a while for the switch from Vet (a harsher faster acting insulin) to Lev - a nice gentle slow moving hormone. I think you'll like it. I switched from Lantus to Levemir to help minimize Luci's big bounces...I think it helped...
 
FrostD said:
Its always a bit hard to say...but she's only on a single drop and she was practically just diagnosed. Best chances of remission are soon after diagnosis. The dental would help, but I know it's not in the cards for you right at this moment.

If it were my cat, I would go for TR and aim for remission. Remission is a distant pipe dream for Mr Kitty lol

Like Katherine said, we usually feed MC between 50-60, and HC under that. If we see big drops, we'll often feed some extra LC to help slow it down. If it's a really nasty drop, sometimes MC depending on the numbers and where it is in the cycle. But those are much more unusual on Levemir vs Vetsulin.

The goal is to spend as much time in green as possible, that's where the pancreas is healing.
Click to expand...

I feel like I'm gearing up to go into battle, not going to lie, lol.

So - I read the thread on TR, and it seems like the method is just... making sure to shoot every 12 hours on the 12 hours mark, even if she's between 50-150, monitor monitor, and be ready to catch them with MC/HC when the numbers dip low/under 50?

How do you even know she's in remission when you're shooting at such low numbers?

Like, just based on the trial run I did today with the single drop -- do you think maybe she dropped too low too quickly? Like, 146 to 68 at 2.5 dropped her quicker than the Vetsulin, I feel. I know you said to feed her mini meals at +1 and +2, that should help, right?

And will the depot soften the fall the longer it builds?
 
Sue and Luci said:
My Luci has been on Lev for a couple of years now. It's a nice gentle insulin...builds a nice solid depot over a few days...and there's no 'knee-jerk' reaction to the dose. Usually takes a couple of hours or more for it to reach therapeutic levels when the depot is full.

Over the next few days if you test every few hours you'll see when she hits her lowest numbers and you can go from there to adjust the dosage accordingly.

It'll take a while for the switch from Vet (a harsher faster acting insulin) to Lev - a nice gentle slow moving hormone. I think you'll like it. I switched from Lantus to Levemir to help minimize Luci's big bounces...I think it helped...
Click to expand...

I have no idea how to adjust her dose from a single drop, that's the tricky part lol. I hope it works. I have no idea what to do if this flops :banghead:
 
mosi_yazhi said:
I feel like I'm gearing up to go into battle, not going to lie, lol.

So - I read the thread on TR, and it seems like the method is just... making sure to shoot every 12 hours on the 12 hours mark, even if she's between 50-150, monitor monitor, and be ready to catch them with MC/HC when the numbers dip low/under 50?

How do you even know she's in remission when you're shooting at such low numbers?

Like, just based on the trial run I did today with the single drop -- do you think maybe she dropped too low too quickly? Like, 146 to 68 at 2.5 dropped her quicker than the Vetsulin, I feel. I know you said to feed her mini meals at +1 and +2, that should help, right?

And will the depot soften the fall the longer it builds?
Click to expand...
Basically yes, and the length of time you hold a dose for before increasing and decreasing as well.

That was a bigger drop than I was expecting, but like I said earlier some cats just have a strong reaction to Levemir at first (and then hopefully level out). She was still in ok numbers, it's possible that MC instead of HC would have kept her surfing/held her in green numbers longer.

As far as I know, you don't get smaller than a drop. It may just be you have to prop her up with food during the cycle/feed the curve in a way that she stays green all day for awhile. You've got some expert eyes on this so I'd listen to them before me!

Edit: I believe (?) most here start OTJ (off the juice) trials after a few days of PS under 100, and very few/no numbers in the blue. The trial lasts for 14 days, and as long as they stay under 100 for the most part it's considered remission. I'm sure someone will pop in and correct me if I'm mistaken lol
 
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FrostD said:
Basically yes, and the length of time you hold a dose for before increasing and decreasing as well.

That was a bigger drop than I was expecting, but like I said earlier some cats just have a strong reaction to Levemir at first (and then hopefully level out). She was still in ok numbers, it's possible that MC instead of HC would have kept her surfing/held her in green numbers longer.

As far as I know, you don't get smaller than a drop. It may just be you have to prop her up with food during the cycle/feed the curve in a way that she stays green all day for awhile. You've got some expert eyes on this so I'd listen to them before me!

Edit: I believe (?) most here start OTJ (off the juice) trials after a few days of PS under 100, and very few/no numbers in the blue. The trial lasts for 14 days, and as long as they stay under 100 for the most part it's considered remission. I'm sure someone will pop in and correct me if I'm mistaken lol
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Ok, cool cool cool.

Gave her the drop. Gearing up for a long night. I suspect there will be little sleep on my end until we nail this down. Tempted to go buy a crate of redbull lol
 
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My favorite example of a kitty gone OTJ is Tyler. It took Diane two years to get him there but he was pretty solidly green for a long time before she took him down doses and eventually completely off insulin: https://docs.google.com/spreadsheet...fuYRd2GEbaSAQYgIZdP1MStkxlkWJt_8GYHlm/pubhtml

ETA: There are others who go off the juice much faster, but their spreadsheets are a little more...dramatic. Simba's caregiver did a diet change and that was enough to take his numbers low and quickly. https://docs.google.com/spreadsheets/d/1xk8mpRya4ODwSc9Khmjssjo-tHPSJvw1EDAoJMx0mkU/edit#gid=0
 
PerfumedCatMom said:
My favorite example of a kitty gone OTJ is Tyler. It took Diane two years to get him there but he was pretty solidly green for a long time before she took him down doses and eventually completely off insulin: https://docs.google.com/spreadsheet...fuYRd2GEbaSAQYgIZdP1MStkxlkWJt_8GYHlm/pubhtml

ETA: There are others who go off the juice much faster, but their spreadsheets are a little more...dramatic. Simba's caregiver did a diet change and that was enough to take his numbers low and quickly. https://docs.google.com/spreadsheets/d/1xk8mpRya4ODwSc9Khmjssjo-tHPSJvw1EDAoJMx0mkU/edit#gid=0
Click to expand...
Wow! Look at all those greens! :D

Hoping and praying this happens for us! Ahhh!

Shes at 125bg at +1. Hoping I didnt accidentally do a furshot. The needles are 8mm and a bit smaller than the ones I was using initially. Suppose we'll know in another hour.
 
Yeah, I think I accidentally gave her a furshot. Shes not really budging. 129 @ +4

fml /facepalm

Will test again in 2 hours, and if shes still in the 120 ballpark, I'm going to sleep and will try anew tomorrow morning. Sigh.
 
Think you can head to bed. I don't think she is going to drop lower this cycle. :)

Btw, we encourage members to post a new thread every day. That way the threads don't get too long to read!

The thread title nomenclature is:
<Date> - <Kitty's Name> - <AMPS/PMPS number and any other BG numbers you may have for the day> - <Question, if any>

Use the the '?' prefix in the thread title if you have a question, so people know that it's not just an update.

For e.g. "? 10/18 - Olivia - AMPS 285 - How much do I feed?"

We also ask that you link your previous post to the current post.
 
Bandit's Mom said:
Think you can head to bed. I don't think she is going to drop lower this cycle. :)

Btw, we encourage members to post a new thread every day. That way the threads don't get too long to read!

The thread title nomenclature is:
<Date> - <Kitty's Name> - <AMPS/PMPS number and any other BG numbers you may have for the day> - <Question, if any>

Use the the '?' prefix in the thread title if you have a question, so people know that it's not just an update.

For e.g. "? 10/18 - Olivia - AMPS 285 - How much do I feed?"

We also ask that you link your previous post to the current post.
Click to expand...

Noted! Thank you! :smuggrin:
 
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