1/25 Tess just switched to Lev

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Ann & Tess GA

Ann & Tess GA

Member Since 2010
We switched to Levemir on Monday, This is the start of our 3rd. day. Tess has been on Lantus for a year with a very early nadir (between +3 and +4) and big drops and bounces on a dose of .25u. We switched to try to level her out and get rid of those nasty swings.

We lowered her dose to .1u when we switched. Tess's first cycle went low and stayed there, so I was advised to skip the PM shot and let the Lantus shed empty. The second day Tess started high and went down all the first cycle, going into the low 40s at +11, I fed a little LC and she came up to the 50s then started to drop again. So we skipped her shot again last night. I know this is keeping her Levemir shed from filling so until I can shoot consistently we won't see what is really happening with her. I think I can shave another drop off the dose and still have something to shoot and that is what I am thinking about for tonight.

Any extra advice would be welcome.

today's condo

1/24 condo

1/23 condo
 
Re: 1/25 Tess just awitched to Lev

I'm about to switch to lev so your condo is fascinating stuff to read. Good luck and I hope you get some good feedback from the experts soon.
 
Re: 1/25 Tess just awitched to Lev

Hi, Ann. I wonder if Tess still has some lantus circulating... but she is sure getting a big, fast drop on .1u of lev right now.

You are right that you can bring that dose down to .05u to try and get a consistent 12/12 dose (rather than skipping shots). see these photos: viewtopic.php?f=10&t=34424&p=360982#p360982

and here is how I get the "drops" - see how it compares to how you are doing it:
The drop method I use is to practice with a used syringe and water or expired insulin and draw up 1u, then twist the barrel (clockwise if the needle is pointed away from you) slightly until a drop forms on the end of the needle. It will be about the size of the end of a straight pin. Flick it off and twist to form another one. Practice until you get 10 drops that size from one unit and 5 drops that size from a half unit. Those would be .1u drops, so you can dose fairly easily in any increment of .1u. If you want to perfect that, try for a drop HALF that size. Those would be .05u drops. Loads of fun to draw! I have to take off my glasses to see to do that.

I am wondering if Tess isn't fighting to go OTJ. It seemed like she was really close in April and has flirted with it ever since. When Beau was going OTJ, I found I had to set a do not shoot number and let him go until he hit it - so skipping shots is part of the process. I had to do that because he could drop into the 30s on .05u from even the low 100s. Take a look at his SS - mid Aug 2009 to mid Sept 2009 (there are 6 days he didn't get any shot because I was out of town and set a higher do not shoot number for the sitter to be on the safe side) to see what I mean.
 
Re: 1/25 Tess just awitched to Lev

Hi Ann,

Welcome to the Lev board!

I can't really tell if the high numbers are bounce from going so low the cycle before or the need for still getting some insulin, just not as much.

If it were me and I could be home all day, I think I would try shaving that last stitch off the insulin shot and see if .05u might even out the numbers.

If Tess doesn't go too low on that .05u but gets some higher numbers, I would suggest holding the does for 3 days or more to let it settle before judging if it is a good choice or not.

If you can't be home to test, I think if it were me, I'd still lower ths dose but shoot only when the numbers get high enough- like in the last few mornings...

others will be along though the day to weigh in, I'm sure. ;-)
 
Re: 1/25 Tess just awitched to Lev

Things are looking better today, Tess has been surfing the 60s for the last 4 tests. :mrgreen: 1/25 Tess AMPS~349 +1~435 +3~186 +4~97 +5~67 +6~67 +7~62 +8~69 +9~106 I had been feeding her MC until +5. No food since then though. I try not to feed after nadir, but since I don't know when that is yet......... If she starts dropping again I will give her a litt snack to keep her numbers up. Sorry Tess, it looks like a full day of testing again.

Sheila, thank you that link is great. I do pretty much the same thing, but I think I need to practice a little more. I use colored water and put the drops on a white plastic lid, then I can see if they are all even. What I am calling .1u now is a drop out of the .25u w/ just a hair of light between the plunger and the 0 line, touching the line would be .05u to me. The key is consistency, even if peeps call things differently.

And yes, I've wonder if the Lantus has totally cleared out too. It should definitely be gone by tomorrow though. What do you consider a no shoot number? On Lantus for us it was low 50s if she was surfing or rising and no food. At least 2 rising numbers 20 and 40 minutes after a LC snack to get her out of the 40s.

Melissa, I think it's impossible to tell if it is simply a bounce from the low numbers or from the skipped shots, probably both. A skinnier dose tonight is what I'm aiming at. Either DH are always home w/ Tess, we are both retired, so the poor thing can't get away from the testing.
 
Re: 1/25 Tess just awitched to Lev

A "no shot number" will be different for different cats AND their caregivers (depends a little bit on comfort level). And it can change. At first I had Beau at 100, then I raised it to 130 and someone posted "shoot low to stay low", so I shot an 89 and he dropped to 35. I went back to 130.

You have to look at how low they will go from a certain PS on a certain dose. When they are getting an ultra-microdose and you don't have room to decrease, you have to start setting a do not shoot if they drop too low.

Yes, whatever you call your dose, consistency is the key.

Nice day in the 60s! I will be interested to see the rest of the cycle.
 
Re: 1/25 Tess just awitched to Lev

Thanks Sheila, I am of the "shoot low" school, but I've learned to monitor and control drops w/ food if I do. But yes , no shoot numbers are needed, which is why I skipped last night. And yes the option of a BCS shot dose seem to have dwindled to nothing.

So a brief recap:
AMPS~349 shot .1u
+3~186
+4~97
+5~67
+6~67
+7~62 Nadir?
+8~69
+9~106
+11~137
PMPS~160 shot.05u
 
No in the morning we shot .1u. Tess is bouncing up now so it looks like the Lantus shed is done. Now I wish I ha stayed w/ the .1u. I have a feeling the morning isn't gong to be pretty. Now to build the Levemir shed.
 
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