11/13 Zeus Switching to Lev - Dosing question, please

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knolet

knolet

Member Since 2012
11/12 Condo

Good morning, LL ~O)

Wow, I crashed hard last night... Had planned to get up for a +7, but I slept all night on the couch. When I woke up, it felt like it was still the middle of the night so I thought I could sneak in a test and go to bed.... Until I looked at the clock and it was 5 minutes before I normally get up :o how did that happen?

I guess it was a good time for me to crash since Zeus was in the pinks last night, and pink again this morning, ugh! He didn't eat too much this morning, but enough for his shot... And

I talked with Zeus' Vet yesterday... He thinks it is time to switch insulin. He was all set to give us ProZinc, until I asked about Levemir. He hadn't heard of it before and said he would research. I did send him some stuff that I found here, hopefully he will check it out today and make a decision. I just want to do whatever is best for Zeus. For those that made the switch away from Lantus... What was your deciding factor to choose one insulin over the other?

Hope you all have a great day,
Kathie
 
Re: 11/13 Zeus AMPS 343 ? Switch to Lev or ProZinc

Hi Kathie! Well at least you got some sleep, must have needed it. I have no advice on the switch but I know many people on here probably have some advice, we have only been on lantus and it worked for us the first time. Sorry about the stinky pinkies! Hope you get some answers today! Have a good one!
 
Re: 11/13 Zeus AMPS 343 ? Switch to Lev or ProZinc

My two cents as far as insulins go....I really like Lev. Spot switched from Humulin N to Lev and had some wonderful results! I chose Lev for specific reasons, ie: that it was a less fragile insulin and I could pre-fill syringes...with my work schedule, sometimes I can not be home at shot time and my mom can give him his shots but can't see well enough to fill the syringes.
My vet also did not know anything about Lev, but she was great and did her research and her exact words were "I do not know anything about Lev and cats so we will be learning together". She was awesome - I'm sad that she is no longer with the practice I go to :cry:
All I can say is do your research, which it seems like you did, and make an informed decision!
Good luck!
 
Re: 11/13 Zeus AMPS 343 ? Switch to Lev or ProZinc

A couple of observations...

Some cats will have a marked positive response to Lev -- Marje's Gracie is one cat that did better switching to Lev. With Barb's Checkers, it didn't make that big of a difference. I disagree with Deb. Pre-filling syringes is not recommended with insulin.

Regardless of which insulin you opt for, I think you need to pay attention to how long you are sticking with a dose that may not be having the desired effect on numbers. If you hold a dose overly long with numbers in higher ranges, you risk glucose toxicity developing. This makes it harder to get the numbers to come down and it encourages bouncing.
 
Re: 11/13 Zeus AMPS 343 ? Switch to Lev or ProZinc

Hi guys .. I have no advice as far as switching insulins go .. but I hope you can get something figured out and that zeus starts putting out nice numbers all the time! have a great day guys!
 
Re: 11/13 Zeus AMPS 343 ? Switch to Lev or ProZinc

Thanks everyone :smile: So... The Vet decided that we should switch to Lev. Need dosing advice, please. He said to not give Zeus insulin for 24 hours and then start Lev at basically the same dose as Lantus. Ideal weight somewhere around 10 pounds = 4.5 kilo * .25 = 2.25. Zeus is at a fat 2.25 Lantus now. I thought I read that I should reduce it to 50% - 70% ? I don't remember reading anything about no insulin for 24 hours... Besides wouldn't the Lantus shed still come into play? Any suggestions?

I haven't picked up the Lev yet, I was thinking about waiting until the weekend to start it so that I could be home to monitor... Any thoughts?

Thanks everyone!
Kathie
 
Hi Kathie,
I've read that if you were switching from a depot insulin like Lantus, to something like Prozinc, you should skip one or two shots. I'm guessing that is to remove the depot from the equation? When going from a "P" to an "L", there's no need to skip a shot since the Prozinc is pretty much gone by 12 hours after the shot.

But I haven't seen anything that says to skip a shot when going from one L to the other. I looked back at when Marje switched (9/6/11) and it doesn't look like she skipped.

I'm sure she'll be along to tell you what she did as far as shot timing or dose adjustments when she made the move to Lev.

Carl
 
Thanks Lisa and Carl... I will go check out Marje's SS to see if there are any notes.

Apparently the Vet hadn't read my email from last night, which included that the recommended starting dose is 1u (I copied and pasted from the sticky) so he called to tell me to try that instead of the 2.25u. He did say that he is unsure whether that was meant for a newly diagnosed cat or if it was to include a cat already on insulin and just making a switch. He asked the same about the protocol of holding for three days... I think he wants to hold the first dose for a week. I would be ok with 3 or 5 days... I do think that Zeus took a little longer to settle into a dose.

The Vet sort of thanked me, LOL... He doesn't have really good people skills, but I think he knows his stuff.... Anyway, he said he hadn't heard of Lev, and was happy with the info that I sent him... And we could both learn from it. I was a bit irritated though because he gave me a bit of a lecture about how he just didn't have time to read through the message board, and that if he did that for all of his patients he wouldn't be able to do anything else.... But HE asked me for the link yesterday. I can't win, :lol:

He did fight me a bit about the pens vs. the vial.... But when I explained it he said the only thing he would recommend is to check the expiration date first to make sure it has a long life.

Thanks to everyone here for the collective knowledge, and shared experiences, and to those that created the sticky notes.... You've helped to educate another Vet :smile:

Now I hope that Lev will bring more consistent numbers for Zeus :smile:



Kathie
 
Kathie --

There's no need to skip a shot. We do suggest that you reduce your current dose of Lantus by 30%. This would put your Lev dose at 1.58u so you could shoot either 1.5 or 1.75u. Some cats will have a marked response the first couple of cycles to a new insulin. Reducing the dose this way allows for a margin of safety.

And, you do know that you can continue to post here, right? There are a number of Lev users in LL and we'd love to have you continue to stick around.
 
Kathie

I'm out right now but will send you a better response when I get back. But do not stop lantus. You will shoot lantus until the cycle that you shoot lev. I will have to look at his SS but normally the starting dose is 70% of the lantus dose. So please hold tight and I will be home in an hour. If your shot time is before tht perhaps you can shoot lantus tonight. I'd start lev on a morning when you will be home all day.
 
Thanks Sienne... I didn't realize that there were Lantus and Lev users here until I really started looking today. I am happy about that, I really enjoy this group... I have learned so much from all of you. Thank you :smile: I will continue to post here.

Marje, no rush - but thank you :smile: I am going to start the Lev this weekend. I wanted to be sure I could be home to monitor the switch.

Hope everyone is having a nice evening.
Kathie
 
Hi Kathie,
Good luck with the switch to Lev. Rusty was switched from Lantus to Lev before he was re-homed with us, so I have no direct experience with the switch. But both Marje and Ann (Tess) switched because of major bounciness and both think that Lev has evened out the bounces enough that it was worthwhile to switch. Once you get used to the difference in a Lev cycle from a Lantus cycle, I think you will like Lev a lot. It took me a while to get used to Lev (with Stu we used Lantus). Onset is later (somewhere around +4 or later, rather than +2), and the nadir tends to be later, too (Rusty's is usually between +7 and +9, but not always, and every cat is different). If it works into your schedule, there are real benefits. For example, you can shoot a low PS because Zeus will have about 4 hours before the dose begins to kick in. In those 4 hours his bgs will most likely be rising.

I would definitely buy Lev. in the FlexPens rather than the vial. Even though Lev. lasts longer than Lantus (42 days according to the manufacturer, as opposed to 30 days), the Flex Pens are more economical. And just about everyone gets many more than 42 days out of a pen, as long as the pens are kept refrigerated and not allowed to freeze. (I use them until they are virtually empty.) I have had good luck ordering Lev. online from Canada (much cheaper), but that is no longer possible because of a new Canadian law about shipping medicines that need refrigeration. I see that you live in NH, and if you ever travel to Canada, you can buy Lev there without a prescription (in boxes of 5 3 mil. cartridges, rather than 5 3 mil. FlexPens). If I go to Montreal in the future, that's what I am going to do.

I know that Marje will get back to you about the switch and it's effect on the Lantus shed while you build the Lev. shed. She really knows this stuff! But definitely do not stop Lantus for a day before beginning Lev. The hiatus would not be a good idea.

Best of luck,

Ella & Rusty
 
Hi Kathie,

I usually take a look every day at the bottom of the index page to see, but didn't today until just now....


Happy Birthday!

Carl
 
HAPPY BIRTHDAY KATHIE!!​
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Thanks Ella & Rusty... That was a helpful bit of info about the onset and nadir... I noticed when I changed injection sites to the flank from the shoulder blades I saw a later nadir with Lantus... +8 or +9. It was great for the day time cycle, but tougher in the PM cycle. Looking forward to using Lev and hopefully seeing more consistent umbels for Mr. Zeus.

Thanks Carl and Marje for the Happy Birthdays :smile: It was a good day.
 
Kathie

Glad you are having a nice birthday :-D

I'm surprised the vet wants to change insulin already. Zeus hasn't really been on lantus very long. However, I think lev is a great insulin and Sienne is right....Gracie has done much better on it (at least until she had the bile duct infection and I'm still trying to get her back on track). But....there is no guarantee that Zeus's numbers will look any differently. They might but even if they do, it will mostly likely take weeks or longer for you to see it.

Gracie's lantus dose was .75u when we switched. I started her on .5u of lev and took her up fast. She ended up going all the way up to f1.25u before she started getting really regulated. Unlike some (Hershey, Tess) who react quickly thenfirst few cycles to levemir, Gracie did not. We have no way to know which cats will and which won't thus we use the 70% starting dose for most ( but not all....ECID).
 
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Happy Birthday! We switched form Lantus to Lev nearly 2 years ago and I'm really glad that we did. It wasn't so much bounciness for Tess, but that she had really early onset and nadir on Lantus. She dropped like a rock by +2 frequently. She still bounces but we got rid of those early screamers.

It's good that you plan to be around for the day when you switch. Most cats have a smooth transition, but you do have one shed draining and another filling. Tess took us on a roller coaster. (Yes, she had had a UTI, but that was cleared up a month before.) If you are prepared for it , it isn't a problem.

And yes, too many friends here! :-D :-D We couldn't leave LantusLand either.
 
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