? 07/09 Duke AMPS 243

Hi everyone! I'm brand new here, so please forgive any mistakes as far as proper posting etiquette etc., and don't hesitate to correct me. I'm the director of a nonprofit cat rescue and although I've been doing it for over 6 years, Duke is my very first diabetic foster cat! He was diagnosed with FIP on 6/11/2024 and then diabetes on 6/20/2024. The FIP is actually easy for me, since I have lots of experience! But the diabetes is new and therefore scary. After switching to a low-carb wet food only diet on 6/20, we started Levemir 0.5u every 12h on the evening of 7/7.

Am I correct in my understanding that I do about a week at this dose, do a curve, and then adjust (or not) based on the data I get?

Duke's facts are in my profile & signature, but let me know if you need any further info. Thank you so much!
 
@Elizabeth & Duke WV

Elizabeth have you red all the yellow stickys here about Levemier
https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

You need to be getting a few more tests in after the AMPS and the PMPS
We adjust increase or decrease by how low the cats BG is dropping not by the Pre Shots.

Be sure to read the yellow sticky
https://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/

Can you Add New Member to your title after the ? Mark
Look to the right ,tap on Thread Tools , tap on e
Edit Title and add New Member then tap save

Just wondering do you have the U-100 syringes with the half unit markings?
When we do increase or decrease we adjust the dose by 0.25 units at a time . It's much easier to do with the half unit markings
 
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Hi everyone! I'm brand new here, so please forgive any mistakes as far as proper posting etiquette etc., and don't hesitate to correct me. I'm the director of a nonprofit cat rescue and although I've been doing it for over 6 years, Duke is my very first diabetic foster cat! He was diagnosed with FIP on 6/11/2024 and then diabetes on 6/20/2024. The FIP is actually easy for me, since I have lots of experience! But the diabetes is new and therefore scary. After switching to a low-carb wet food only diet on 6/20, we started Levemir 0.5u every 12h on the evening of 7/7.

Am I correct in my understanding that I do about a week at this dose, do a curve, and then adjust (or not) based on the data I get?

Duke's facts are in my profile & signature, but let me know if you need any further info. Thank you so much!
@Wendy&Neko
@Bron and Sheba (GA)
@Bandit's Mom
@Sienne and Gabby (GA)

Thanks ladies
 
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Elizabeth have you red all the yellow stickys here about Levemier
https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

You need to be getting a few more tests in after the AMPS and the PMPS
We adjust increase or decrease by how low the cats BG is dropping not by the Pre Shots.

Hi, yes, I did read the stickies! This is the part I was going by:
Starting Dose:
  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
  • Generally, shots are to be given 12 hours apart.
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

I can add another test or two per day but I can't measure more frequently than that on weekdays because of work...
 
Hello and welcome. It's not so common to see Levemir kitties these days. It's a great insulin for cats, but the manufacturer is phasing out sales in the US. Stock up if you haven't already.

We determine how a kitty is doing on a particular dose by how low the dose is taking him. With Levemir, the typical low (nadir) is around 8 hours after the shot. The onset (when insulin starts to work) is typically around +4. Note, cats being cats, there are always exceptions. The long haired black and white in my avatar being one of them as she was usually later with both onset and nadir. What this means is that when a cat is on Levemir, you'll probably get your best data initially in the 4-10 hour range after the shot. Meaning end of day. For the PM shot, if you get up a couple hours before shot time, you could test then.
Am I correct in my understanding that I do about a week at this dose, do a curve, and then adjust (or not) based on the data I get?
There are just a couple exemptions to this general guideline. The first if kitty goes under 90 on this dose, in which case you'd reduce immediately by 0.25 units. The second is if there are ketones present. Are you testing him for urinary ketones? Tips to catch and test a urine sample

Also, if it's more convenient for you, you could probably run a curve 5-6 days after starting the dose. Between the curve and the spot checks, you'll get a better idea how he's doing on this dose. Doing a few curves early on also help you figure out when he onsets and nadirs, meaning you can be more strategic about best times to test. Ideally it'd be good to know when his lowest numbers are so you can test then, or if not able, leave some food out for him to keep himself safe. Many of us use automated feeders like the Petsafe or Catmate automated feeders to do that.
 
Hello and welcome. It's not so common to see Levemir kitties these days. It's a great insulin for cats, but the manufacturer is phasing out sales in the US. Stock up if you haven't already.

We determine how a kitty is doing on a particular dose by how low the dose is taking him. With Levemir, the typical low (nadir) is around 8 hours after the shot. The onset (when insulin starts to work) is typically around +4. Note, cats being cats, there are always exceptions. The long haired black and white in my avatar being one of them as she was usually later with both onset and nadir. What this means is that when a cat is on Levemir, you'll probably get your best data initially in the 4-10 hour range after the shot. Meaning end of day. For the PM shot, if you get up a couple hours before shot time, you could test then.

There are just a couple exemptions to this general guideline. The first if kitty goes under 90 on this dose, in which case you'd reduce immediately by 0.25 units. The second is if there are ketones present. Are you testing him for urinary ketones? Tips to catch and test a urine sample

Also, if it's more convenient for you, you could probably run a curve 5-6 days after starting the dose. Between the curve and the spot checks, you'll get a better idea how he's doing on this dose. Doing a few curves early on also help you figure out when he onsets and nadirs, meaning you can be more strategic about best times to test. Ideally it'd be good to know when his lowest numbers are so you can test then, or if not able, leave some food out for him to keep himself safe. Many of us use automated feeders like the Petsafe or Catmate automated feeders to do that.

Super helpful! Thank you so much!
 
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