1/30 Milo AMPS -427,+2-381,+3.5 332,+7.5-238,PMPS -344,+3.5-248

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milosmommy

milosmommy

Member Since 2009
Milo yesterday
I'm getting discouraged. ..
Today marks 1 week on Levemir. We had 2 fur shots-one Monday and one Tuesday. Our AMPS are not going down. Since we had fur shots earlier, could it just be taking longer to build up. I know 6 cycles to increase.
In the 6 weeks since Dx we started on Vetsulin. Got off that in 3 days after reading how terrible. Went to Prozinc which got us in remission the first time. His numbers never really stayed steady.
I know this is week 1 into transition, am I expecting too much since this is different insulin. Could being on 3 different ones so fast be causing issues.
All other health is fine, been checked by vet. He is acting f I ne too.
I'm thinking about increase which I know I could do tonight, but I was going to wait until Saturday morning so I can watch numbers all day. Then should I go up to 2U.
A silly question is how long after eating should I test level, does that make a difference? Should I increase?
He is eating low carb FF from the list. The low car Tiki Cat and Natures Variety Instinct that I'm reading are lower carb than FF or am I'm reading that wrong?
Thanks
 
Unfortunately I'm not super-familiar with Lev since Trix was a Lantus girl, but I do think you are good to increase. Since Milo has nadired below 300, I would only increase by .25U, so your new dose would be 1.75. (Others may have different opinions, so weight out all the info you get from us!) You don't want to increase too quickly, therefore missing the "right" dose.

This is from the TR guidelines (are you following TR or Start Low, Go Slow?)
"General" Guidelines:
  • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
  • Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
  • Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

FD can be very frustrating. It's hard, I know, but remember....it's a marathon, not a sprint. You WILL find the right dose for Milo, but you want to do so safely. You're doing a great job!
 
Levemir generally has a later nadir than Lantus, but it's too soon to really know when Milo is going to nadir

I know it can be discouraging, but remember, this is a marathon, not a sprint! It's just going to take time to figure out the best dose for Milo

I'd go up to 1.75 units tonight. Usually it's not going to make a big difference on the first cycle of an increase (plus there could be some New Dose Wonkiness) but he's been at 1.5 long enough and he's still too high

You don't want to hang onto a dose too long if it's not getting you where you want to be

Good luck...Hope the dosecrease helps! (if the threat of a dosecrease doesn't!!....we have seen lots of times when we're just discussing increasing and all the sudden the cat comes down!...LOL)
 
For a week on one of the "L" insulins, this isn't bad at all. You're focusing on the pre-shot numbers. You're seeing decent drops by nadir most days. The fur shots do effect progress. It's always important to remember that Lev is a depot insulin -- unlike the other insulins you've used. It takes 5 - 7 days for the depot to form and then if you miss a shot for any reason -- especially 2 shots close together, there is going to be an effect on the depot. This is why the cycle count starts over after a missed shot.

The other factor to consider, Lev is a gentle insulin with long duration (as is Lantus). What you gain from these properties, you lose with potency. That doesn't mean that it's not strong. it means that it doesn't "squish" the numbers down. As you start to see th pre-shot number or early in the cycle numbers become lower, Lev will be better able to "grab on" and further lower the overall cycle.

I would encourage you to give the process time. No insulin is the magic potion for most people. It took a while for your kitty to develop diabetes. Getting your cat's pancreas to once again get used to being in a normal range doesn't usually happen quickly.
 
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