2/6 Ruby AMPS 115/+3 104/+6 103/+10 78 Levemir for Ruby?

Katherine&Ruby

Katherine&Ruby

Member Since 2020
https://www.felinediabetes.com/FDMB/threads/2-4-ruby-amps-132-7-129-pmps-58-3-63.258881/

So I'm a bit embarrassed. :oops: After I made all of that fuss for the past few days about Ruby's poos being dark and tarry, I watched Ruby make a really big one in the box. It turns out that the dark tarry poos I found in the litter were from my civvie Olive, who is due for an annual exam and was found after an ultrasound last July that she has early stages of IBD. I switched up their raw food from pork to a bison and goose mix two days ago and it seems like the poos are back to a lighter color. She gets Cerenia EOD and I give her B12 EOW.

Adequan was not causing Ruby any GI issues. I'm going to continue with the twice a week for a month regimen.

Otherwise Ruby's been getting some ok numbers. Seems like she is prone to bouncing a lot these days. I add MC to her LC raw whenever we get those low preshots to prevent bouncing but we still get some high numbers at AMPS, until we don't like this morning. ¯\_(ツ)_/¯

Hope everyone is having a nice Sunday. It's so freaking cold! Can't wait for spring to come! ⛱
 
Oh my god Katherine, at least you got to the bottom of it.
I'm so glad the adequan is making a huge difference for Ruby.
I'm glad Olive's poops are back to a lighter color ,that it was the food making it darker. I hope you and the kitties have a nice day and yes you can say that again, it's freaking cold!!! Warmer temps coming our way starting Wed. :bighug::bighug::bighug::cat:
 
Hallelujah! It is so much better when things make sense!!
I am very happy that you see improvements in Ruby's movement. Have a beautiful Sunday, Katherine. The ice is almost melted here in north Texas, and the sun is shining.
Relax when you can, but still give your girls kisses from me:kiss::kiss:
 
It's interesting looking at Ruby's numbers lately. Going down at the end of the AM cycle, staying low through PM preshot at +2/+3, then heading up again. The pred is definitely affecting duration, we don't see 12 hour up, down, and up cycles anymore. It's like a 24 or 36 hour cycle.

With all of the talk of how great Levemir is, and the fact that I have to order more Lantus as we're down to 1 ½ full cartridges, I'm wondering if Ruby's vets would be willing to go out on a limb and prescribe Lev for her and if she would do better on it. I had always hesitated because of the late nadirs, but if I got up a half an hour earlier at 7:00 AM, I could get a +10, do her shot before I leave for work at 9:00, get a PM+2 before I head to bed.

Just talking out loud here but would be interested to hear thoughts, keeping in mind that we will do another ultrasound in June, and depending on the results we may taper her pred down and get her off it.
 
Katherine&Ruby said:
https://www.felinediabetes.com/FDMB/threads/2-4-ruby-amps-132-7-129-pmps-58-3-63.258881/

So I'm a bit embarrassed. :oops: After I made all of that fuss for the past few days about Ruby's poos being dark and tarry, I watched Ruby make a really big one in the box. It turns out that the dark tarry poos I found in the litter were from my civvie Olive, who is due for an annual exam and was found after an ultrasound last July that she has early stages of IBD. I switched up their raw food from pork to a bison and goose mix two days ago and it seems like the poos are back to a lighter color. She gets Cerenia EOD and I give her B12 EOW.

Adequan was not causing Ruby any GI issues. I'm going to continue with the twice a week for a month regimen.

Otherwise Ruby's been getting some ok numbers. Seems like she is prone to bouncing a lot these days. I add MC to her LC raw whenever we get those low preshots to prevent bouncing but we still get some high numbers at AMPS, until we don't like this morning. ¯\_(ツ)_/¯

Hope everyone is having a nice Sunday. It's so freaking cold! Can't wait for spring to come! ⛱
Click to expand...
Well, this is good news! Ruby is not having problems with the Adequan! Excellent! And even Olive’s poop is back to a better color - so it was only food. Good news. I’ll take it!
 
Thanks for the pred times. You are right, hard to tell when it starts to impact numbers, ie. pred effect onset.

Things to consider when switching to Lev for Ruby, is that her nadirs will likely be later, by maybe a couple hours. She already has shown that she might nadir after preshot, eg. PM of 2/2 may have been a nadir of +14. Or just an early nadir of the following cycle at +2? I don't see many +1 tests since you started BID pred, especially in cycles when she's dropping all cycle like she did on 2/2, so it's hard to tell what you saw that night.

With Neko I spotted a +15 nadir a couple times on Lev. If you get a +2 on Lev and Ruby's lower, than preshot, she might not be done dropping. Anyone else home after +2?
 
Wendy&Neko said:
Thanks for the pred times. You are right, hard to tell when it starts to impact numbers, ie. pred effect onset.

Things to consider when switching to Lev for Ruby, is that her nadirs will likely be later, by maybe a couple hours. She already has shown that she might nadir after preshot, eg. PM of 2/2 may have been a nadir of +14. Or just an early nadir of the following cycle at +2? I don't see many +1 tests since you started BID pred, especially in cycles when she's dropping all cycle like she did on 2/2, so it's hard to tell what you saw that night.

With Neko I spotted a +15 nadir a couple times on Lev. If you get a +2 on Lev and Ruby's lower, than preshot, she might not be done dropping. Anyone else home after +2?
Click to expand...
During the daytime DBF is home 95% of the time.

What would +1 tests tell me? These days, Ruby rarely eats right after her shot. She usually makes a drive by at the feeder around +2 or +3, so +1 wouldn't show a food bump.
 
Wendy&Neko said:
Possibly pinpoint when her nadirs are and whether they changed with pred BID. Even better she's not eating right away so no food influence.
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Good point. I’ll try to get a few +1s in the next few days.

Ruby was almost always going low early, usually by +4, before the pred. I started dosing the pred BID to even out the cycles because she was always higher in the mornings when I gave it to her in the AM only, but it didn’t really do that. That’s why I think the pred has done something to the duration of Lantus.
 
Id been waiting for a Ruby post because I didn't want to bump this, but I'll forget if I don't...

So, one of the things I'm wondering is if Lev has enough "cutting power" to offset the current "uneven pred bump" or whatever you want to call it. The difference between her AM and PM numbers drive me a little nuts because I'm not quite sure why it's there. Because she's more active in evening/night? Maybe the pred effect somehow times with her meals?

I mean I love Levemir, but I'd almost play with pred timing before changing insulin. Almost like it needs to be given middle of the day or night or something but that's not really feasible.

Tl;Dr I think you have nothing to lose by trying a switch, but Lantus is giving you pretty darn gentle curves right now.
 
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