12/27 Chanel AMPS 335 Levemir Advice

Laura & Chanel

Member Since 2019
http://www.felinediabetes.com/FDMB/...switch-to-levemir-advice.223415/#post-2499150

I am thinking of switching Chanel from Lantus to Levemir. If you have previous experience with Levemir and/or switching from Lantus to Levemir, please share it with me. Chanel does not feel well these days, the skin twitching that started with Lantus seems to get worse lately. Also, her bouncing all over the place leaves her exhausted and lethargic. She seems very preoccupied with her bathing that she takes it to the point where she pulls out hairs from her paws and licking her tummy extensively. I sincerely hope that if changed to Levemir, her symptoms will improve, but I need your opinions and advice on the switch.

@Wendy&Neko , I see you actually switched Neko from Lantus to Levemir. Could you please help me understand Levemir when compared to Lantus? I can see from your previous postings that they are not different in dosage. Was Neko also uncomfortable about the injections? Did the bouncing stop or was much more reasonable than on Lantus?
Thank you very much.
 
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Laura -

Why are you contemplating a switch?

Wendy switched Neko due to Neko being a high dose cat. In larger doses, Lantus (which is acidic) can sting. Many people with high dose kitties will make the switch.

In terms of the basic differences, onset and nadir are later with Lev. With Lantus, onset is at around +2 and nadir at around +6. Add roughly 2 hours for Lev. (Do keep in mind, however, that this varies -- ECID. There are some cat's whose nadir is close to PMPS. Take a look at Marje's Gracie's spreadsheet.) Some people feel that the cycles are flatter. That does not mean that cats do not bounce on Lev -- they do. In fact, some cats continue to bounce as much on Lev as with Lantus. This is also an ECID thing.
 
Laura -

Why are you contemplating a switch?

Wendy switched Neko due to Neko being a high dose cat. In larger doses, Lantus (which is acidic) can sting. Many people with high dose kitties will make the switch.

In terms of the basic differences, onset and nadir are later with Lev. With Lantus, onset is at around +2 and nadir at around +6. Add roughly 2 hours for Lev. (Do keep in mind, however, that this varies -- ECID. There are some cat's whose nadir is close to PMPS. Take a look at Marje's Gracie's spreadsheet.) Some people feel that the cycles are flatter. That does not mean that cats do not bounce on Lev -- they do. In fact, some cats continue to bounce as much on Lev as with Lantus. This is also an ECID thing.
She is twitching badly lately. She had no issues before Lantus, but with the time spent on Lantus, she actually is now growing uncomfortable of us touching her and if we do she starts grooming her paw to the point of pulling out fur. I understand that in high doses can be acidic but I am wondering if Chanel is more sensitive even at lower dosage. Also, now she does not like the Lantus shot time to the point where she really sinks her teeth in my hand. If there is another way to make her feel better while still on Lantus, I am open to suggestions. It is not that I cannot cope with the biting, it is about her behavior at the shot time and afterwards that I hope to alter so she can feel better.
 
There's no way to know whether she's being "stung" by the Lantus but those are good observations. Give the Lev a try and you'll know. Thanks for the info.
 
Laura, we switched here very early on. Did not know Ollie was a higher dose kitty at that time. I switched hoping it would work better as lantus didn't touch Ollie at all. And Ollie started getting aggressive on lantus when she reached 4 units. Ollie still bounces, her nadir can be at anytime, mostly the same as lantus though. You do start lev at a slightly lower dose though as it is more potent than lantus. My vet at the time wouldn't script it, had to find it online anywhere I could at first. Now new vet gives me script.
 
Hi Laura, We switched to Levemir last July - and it seems to have leveled Luci off - somewhat. She still likes her lemon tree just about every day - but it appears generally that she's flatter and definitely gets to the lagoon more frequently. Some months, nearly every day...

You can obtain Lantus on the Supply Closet website here within the forum - maybe just to try to see if you notice less twitching/irritation. Poor thing...I feel badly for her that she's reacting this way...I hope she settles down soon.

I do believe you'll need to reduce the dose by 70% when you get started - I'm not exactly sure about that...but I stepped down considerably when I switched. Look at our July SS notations on the switch - perhaps @Wendy&Neko know what the percentages are when you switch.

Best of luck with the change. Be sure to make a nice big colored line on your SS when you switch so that we'll all be able to see the change and the reasoning for the change of dose.

Have a wonderful day Laura!
 
Hi Laura, We switched to Levemir last July - and it seems to have leveled Luci off - somewhat. She still likes her lemon tree just about every day - but it appears generally that she's flatter and definitely gets to the lagoon more frequently. Some months, nearly every day...

You can obtain Lantus on the Supply Closet website here within the forum - maybe just to try to see if you notice less twitching/irritation. Poor thing...I feel badly for her that she's reacting this way...I hope she settles down soon.

I do believe you'll need to reduce the dose by 70% when you get started - I'm not exactly sure about that...but I stepped down considerably when I switched. Look at our July SS notations on the switch - perhaps @Wendy&Neko know what the percentages are when you switch.

Best of luck with the change. Be sure to make a nice big colored line on your SS when you switch so that we'll all be able to see the change and the reasoning for the change of dose.

Have a wonderful day Laura!
I do not have hopes of getting some miracles just by switching from Lantus to Levemir. I figured out by now based on FDMB readings that most of OTJs happened on Lantus and TR. My expectations are to decrease her pain level at the injection sites and consequently her stress level. If we add the fact that I try to get her off the dry food, do teeth brushing and gums maintenance twice a day to the fact that she has to take famotidine every 12 hours for her tummy issues given by the dry food, oh well she is under a lot of stress. From what I read, the dose reduction has to happen by 70% as you said (reading previous postings on the topic). I want the most to have her stop biting and grooming her paw excessively (she does that to only one paw).
Maybe, if is gentler on her, she will have a better demeanor which means she can shake off the pink.
 
Laura, we switched here very early on. Did not know Ollie was a higher dose kitty at that time. I switched hoping it would work better as lantus didn't touch Ollie at all. And Ollie started getting aggressive on lantus when she reached 4 units. Ollie still bounces, her nadir can be at anytime, mostly the same as lantus though. You do start lev at a slightly lower dose though as it is more potent than lantus. My vet at the time wouldn't script it, had to find it online anywhere I could at first. Now new vet gives me script.
Thank you so much for the feedback Paula. For Chanel Lantus seemed to work ok but the increasing dose definitely changed her behavior at injection times. My vet is a darling but doubt she will give me a script on that, she might be in vacation. Also, her experience is with Lantus, although her Lantus knowledge does not come close to FDMB's experience. If I would recommend something to my vet would be to forget what they were taught in school and read through FDMB. They would be enriched and learning is a process that should never stop, especially when the results come from year of focused experience and various feline health backgrounds.
 
Good luck if you try Levemir. I hope it makes her feel better.
Thank you Carla. I hope so too. I try to train her to eat wet food from a bowl and since that was not our thing, she takes a bite or two and then she starts licking my fingers so we go back to baby bird feeding. She does that when she feels really low and wants more attention.
 
Try using a plate. Has food changed that maybe he is allergic to something in it? Nails trimmed? No splinters? Try washing foot with water only, maybe there is some kind of residue on it, possibly litter stuck to it.
 
Try using a plate. Has food changed that maybe he is allergic to something in it? Nails trimmed? No splinters? Try washing foot with water only, maybe there is some kind of residue on it, possibly litter stuck to it.
I usually use the can of Fancy Feast for her to eat (she eats the Natural ones, not the pate, she has tummy cramps because of the pate and took us a while to figure out that after the dental cleaning). I tried everything, including staring at her paw for some fleas or something. Then I realized that every time I do something that she finds stressful, she goes for her paw, always the same one. No nail trimming, she cares for them. As for the litter, I clean her paws as well and since she does not like it, she again goes for that paw. I also checked it for infection or bites, nothing I could see until now and hopefully I will be able to decrease her stress level with Levemir. She is pretty upset about the dry food although I do not understand how her addiction to it can override the intolerance the food gives her :(
 
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My cats all had digestive upset with the Young Again. Very noisey gurgling and gas constantly. Not that I condone all dry food diet, I do know some cats just can't be total off it.

That being said, if Chanel is a die hard dry food addict (I got one) maybe try Dr Elseys Clean Protien. It's 4-5% carbs. It might help.

Also VE has freeze dried dehydrated raw in kibble and patties that might fit the bill. It's how I got my addict off completely, until husband decided she needed commercial dry back. So we compromised on Clean Protien 1/8 cup per day in addition to the VE and FF. Chewy sells both.

https://www.vitalessentialsraw.com/cat/food/?filter_pa_product-type=mini-patties
 
My cats all had digestive upset with the Young Again. Very noisey gurgling and gas constantly. Not that I condone all dry food diet, I do know some cats just can't be total off it.

That being said, if Chanel is a die hard dry food addict (I got one) maybe try Dr Elseys Clean Protien. It's 4-5% carbs. It might help.

Also VE has freeze dried dehydrated raw in kibble and patties that might fit the bill. It's how I got my addict off completely, until husband decided she needed commercial dry back. So we compromised on Clean Protien 1/8 cup per day in addition to the VE and FF. Chewy sells both.

https://www.vitalessentialsraw.com/cat/food/?filter_pa_product-type=mini-patties
Oh my, what you are telling me is EXACTLY what Chanel has. My husband says that while he was struggling to pet her, the only spot she would let him touch was the belly and he could hear the gurgling and the tummy being so bloated that it was tensed. We tried the Dr. Elsey's CleanProtein Chicken Formula and actually she refuses to eat it and if she eats, she has the same symptoms. That is why I was assuming that maybe she has food intolerance to the hydrolyzed pork (1st ingredient in YA and 3rd in Dr. Elsey's).
If I can get her off the dry food completely, that would be the best thing for her health. It will take a while. Now she is upset in the closet because on her routine check she realized I took away the 3 bowls of dry food, so we are not in speaking terms for now.
I just came back from the butcher where I got chicken breast ground (they do the grinding on the spot). She seemed to like it as is but I have the chicken liver and beef liver supplement and will mix it later for the pre-shot 6 pm mean. Hopefully, I will make her forget her dry food, or at least I can mix some of a dry food (not powder, more like small pieces) with less carbs (not using YA and Dr. Elsey's) with the raw one and give her the 'crunch' feeling. Who knows, maybe in time she will learn to get back to what my grandparents' cats used to do, chew on chicken bones (hey, those cats lived to be 20 year olds and never knew what a dental cleaning is). Oh well...
I would like to try and see if she likes the other dry food you recommended. @Olive & Paula One question, I hope you do not mind me asking: why did your husband decided Olive needs the commercial dry food back?
Thank you very much for the insight into YA. That food as well as Dr. Elsey's are definitely off menu for Chanel so she can get rid of her tummy issues (I really do not think giving her Famotidine for like 2 weeks twice a day is a good thing, it would be great to check that off her medication list as well).
 
Cats don’t like their whiskers touching anything when they eat. Eating out of the can would be uncomfortable. Have you tried using a raised shallow bowl? Chicken and beef are more common allergens than pork.

As for Lev, we start at 70% of the Lantus dose, not reduce by 70%. Some cats react strongly to the change, so it’s a safety thing. You may end up around the same dose. I switched Neko when she was on 1.25 units, so not a high dose. She had what some people call high dose conditions, secondary endocrine conditions that cause some cats to need high doses of insulin. At a couple points in her life she was on higher doses, but not for the majority of her time on insulin. Neko’s Lev dose did end up a hair under her Lantus dose. Your starting dose, if you were to start tomorrow, would be 1.0 units.

We have had a number of people on lower doses of Lantus notice their cat react to the sting. Neko was happier about her Lev shot than her Lantus shot. She also did go a bit flatter, but she had already been on insulin over a year and a half at that point, and was starting to get less bouncy anyway. Or more properly, her cycles were flatter, less fast drops, so fewer of those types of bounces. She still bounced though.
 
Cats don’t like their whiskers touching anything when they eat. Eating out of the can would be uncomfortable. Have you tried using a raised shallow bowl? Chicken and beef are more common allergens than pork.

As for Lev, we start at 70% of the Lantus dose, not reduce by 70%. Some cats react strongly to the change, so it’s a safety thing. You may end up around the same dose. I switched Neko when she was on 1.25 units, so not a high dose. She had what some people call high dose conditions, secondary endocrine conditions that cause some cats to need high doses of insulin. At a couple points in her life she was on higher doses, but not for the majority of her time on insulin. Neko’s Lev dose did end up a hair under her Lantus dose. Your starting dose, if you were to start tomorrow, would be 1.0 units.

We have had a number of people on lower doses of Lantus notice their cat react to the sting. Neko was happier about her Lev shot than her Lantus shot. She also did go a bit flatter, but she had already been on insulin over a year and a half at that point, and was starting to get less bouncy anyway. Or more properly, her cycles were flatter, less fast drops, so fewer of those types of bounces. She still bounced though.
@Wendy&Neko Chanel raises her whiskers when she eats. I can try again with a shallow bowl (we have so many of them since we tried to convince her lately to eat wet food by herself). I know that pork intolerance is not as often as the chicken one. However, she seems to do very well on chicken and beef (her Fancy Feast is Chicken and Beef in Broth) and I did not expect her to have so bad reaction to pork.
I hope for her to feel better about the insulin time on Levemir. Again, I am not going to criticize Lantus because it is obvious it is a very effective product. It is just that Chanel needs to have less stress about the shot and about being touched (she used to like being brushed twice a day, now we are doing that maybe once every 2-3 days and I do not like it because the hair that does not get brushed gets into her mouth).
Levemir is supposed to come next week. Does this mean I should continue and increase to 1.75U BID on Lantus for the next week or maintain the 1.5U BID and try my best to keep the dry food to the minimum (and maybe substitute with raw food gradually; I do not expect to switch her completely off dry food by the time Levemir is here, so TR is out of question until she is 100% on wet food)?
Would be safe to say that the bouncing can be also a result of stress and pain? I saw that Luci was doing much better before the cast and although she does not seem bothered by it, her body seems to consider it stress enough. I just try to connect the dots, sorry if my assumption is wrong. It is just Chanel seemed better after the dental cleaning that was anyway a traumatizing experience, still she would play at night and be happy. These days...oh well...she hides in the closet and runs away from us when we want to touch her.
 
I would follow what your current plans for Lantus dosing, increase if she need it. The starting Lev dose would also increase as a result.

Bouncing is caused by lower numbers than they are used to, or fast drops. Nothing else. High numbers can be caused by stress and pain. Those are not bounces.
 
I would follow what your current plans for Lantus dosing, increase if she need it. The starting Lev dose would also increase as a result.

Bouncing is caused by lower numbers than they are used to, or fast drops. Nothing else. High numbers can be caused by stress and pain. Those are not bounces.
oh, OK. thank you for clarifying it for me. So, if her tummy will start feeling better, might be that she can get more stable in numbers and not trying to become the rainbow of them all.
 
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