1/25 Rupert - switching to Levemir tomorrow! ??'s re dosage

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Pip & Rupert

Pip & Rupert

Member Since 2012
Hi gang, haven't posted in a while. Rupert is doing really well, had a successful dental (two extractions) and some good numbers since BUT still bouncier than ever, going from 500's to 70's in the course of two to three hours.. almost on a regular basis now.

Vets are mostly clueless - one vet suggested I dilute the lantus????????????? grrr. Didn't have any idea about Lev and didn't seem that interested in finding out. Sigh, it's a good job she's such a fabulous dental vet. The other vet I saw was an idiot and actually suggested that .25 or .5 variations in dosage really wouldn't make that difference... um.. duh???????? When I showed her my spreadsheets and charts she was completely astonished and confused.

anyway, once I discovered that I don't need a prescription for Levemir I just went and got the stuff. Rupert is looking fabulous and unphased by the daily swings but it's obvious that the lantus really isn't the thing for him. he's on 2.25.. if I up it even the slightest his dives become ever more dramatic, if I lower it, he flattens out in the high pinks and stays there. if he stays at 2.25 he maintains this bouncy cycle.. i will say that it IS regular (!) but not regulated.

Anyway. tomorrow morning he'll get his first shot of Lev and we'll see how that goes. I'm wondering what I should be on the look out for? His nadir lately seems to be at about the 4-5 hour mark... slow slide to two hour mark and then massive dip down after that. I'm guessing that with the Lev it will be a lot later, and hopefully more gentle????

Any thoughts on starting dose? 2u? he's currently getting 2.25 on the lantus.

thanx guys, sorry we haven't posted in some time, life been a tad hectic!

Hope everyone is doing well.
 
Re: 1/25 Rupert - switching to Levemir tomorrow! ??'s re dos

Hi Pip...I'm so happy to see you back. Happy you are going to try Rupie on lev too. I really really hope it stops the terrible bounces that he gets.
Good luck figuring out his nadir....or onset. For Checks his nadir seems to come in about.... umm, 15 hours :roll:
I just can't figure it out. Marje is good at that...hope she sees this.
 
Re: 1/25 Rupert - switching to Levemir tomorrow! ??'s re dos

Normally, when switching from Lantus to Levemir; we say to give 70% of the current Lantus dose.

When J.D. switched back in 2010, he was on 2.50 of Lantus and 70% of that was 1.75, but we chose to go with 2.00 units and within the first week he was down to 1.75 anyway.

2.25 x .70 = 1.575. So, I think I would start with 1.75 and monitor closely and see how it goes.

Good luck with the new insulin!

Everything tends to move a bit later with Levemir timewise.
Lantus Onset is around +2 and Levemir Onset is about +4
Lantus Nadir is close to +6 and Levemir Nadir is typically closer to +8
Every Cat Is Different.
 
Re: 1/25 Rupert - switching to Levemir tomorrow! ??'s re dos

Hi Pip and Rupert, good to see you again.

I didn't switch Rusty to Lev., he was on it already, so I can't give personal experience on that count. But I can agree with Dyana that onset usually begins somewhere around +4 or a little later, and that nadir can be anywhere from +7 to +9, maybe even later, depending on the cat. I hope that Lev. will help with Rupert's swings. I like Lev. a lot (now that I am used to it: Stu was on Lantus). I like being able to shoot a low PS number and know that I have 4 hours, maybe more, for Rusty to rise if he is low at PS. I hope the Lev. cycle will fit into your schedule.

Good luck! How are the horses?

Ella & Rusty
 
Re: 1/25 Rupert - switching to Levemir tomorrow! ??'s re dos

I would agree with Dyana. He's getting into some green on his current lantus dose but he's not running low.

One additional thing, Pip. Some cats (like Tess and Hershey), really rev it up on the first few cycles of levemir even with the reduced dose. So you'll need to really keep an eye on him. In general, lev onsets about +4 and nadirs +8 to +12 but that's not a given and Gracie has typically not followed that pattern. It will take some time getting used to the difference in his cycle and the best way to handle it is to monitor closely. It seems that if they are going to be one of those kitties that really gets to going on their first few doses of lev, they do settle down. So it might take a bit before you'll really know what his cycles will look like.

Good luck!
 
Re: 1/25 Rupert - switching to Levemir tomorrow! ??'s re dos

I switched both of my cats from Lantus to Levemir, and both reracted differently.

Oliver was not near regulated when switched, but I did see a later nadir - his ended up being close to +10 to the next ps. His BG were fairly steady. I did not switch at a lesser amount; his numbers were in the 400s, so the switch was 4u to 4u.

Shadoe was fairly regulated but she had more ups and downs on Lantus, plus she was tense on the insulin. Her switch was also unit for unit, but within days, her numbers leveled out and she relaxed more. After months on Levemir, I did try to go back to Lantus with her, but she immediately became tense and had the bouncing numbers again. When back on Levemir, she returned to her calm self.

Many have switched from Lantus to Lev and followed the 70% less, with quite a few of them ending up at the same dose or close to it, but with better numbers from Levemir.
 
Re: 1/25 Rupert - switching to Levemir tomorrow! ??'s re dos

Good luck with the switch Pip! Hope Rupert will enjoy better numbers with the Lev!
 
Re: 1/25 Rupert - switching to Levemir tomorrow! ??'s re dos

Thinking flatter thoughts to Rupert. Good luck!
 
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