2/22 Oscar amps 322 +6 224 +9 121 dosing ??s

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Kelly & Oscar

Kelly & Oscar

Member Since 2010
previous condo: viewtopic.php?f=9&t=37299

Recap from yesterday:

amps 245 fed 1oz
+2.5 fed 1oz
+6 95 fed 1oz
+8 109
+10 173

pmps 147 fed 1oz
+3 fed 1oz
+4 54 fed 1oz
+5 57 fed 0.5oz
+6 56 fed 0.5oz

So this morning's number was quite a shocker. He doesn't really see pinks much at all, even when he is not on insulin. I am seeing a pattern of increasingly higher and higher amps numbers after runs of greens in the evening. I am wondering if he has bottomed out during the past few nights while I have been sleeping. I'll try to get a reading today at +9 to see which direction he is going. I am not sure if I should take a reduction to 1u tonight just in case - since he is trying to clear the bounce during the am cycle and it is the actual dose working on him without the liver's glycogen at night when I can't monitor as closely.

WCR - he obviously doesn't like the 300s - he has spent the morning sleeping so far. Appetite is healthy and normal though.

I'll have this posted over in the Lantus ISG also, since we have been over there for a long time now. The link to the lantus thread: viewtopic.php?f=9&t=37372&p=393682#p393682
 
Wow, those are really interesting numbers. On the face of it, I'd say yeah the pink is a bounce from the lows overnight and go ahead and drop the dose, but I see you have already dropped the dose considerable since the 17th. Four times? And he is still dropping low.

I guess see what the 1u does for him over a few days. Of course, keep dropping the dose if he keeps hitting lows.

Was your old lev really old? Any chance it was ever frozen? It seems like the numbers really changed with the new pen - like the new is so much more potent than the old.
 
Thanks for the input Sheila! We switched from Lantus to Levemir this past friday. I think some of the really low numbers initially were due to the lantus working along side the levemir. By this point we should solely be on the levemir, which is why I dropped it again tonight. We were on lantus for 8 months, and while it got a heck of a lot better regulated than the prozinc we started out with, I still felt like we could do better, which is why I decided to switch. I have high hopes for my boy with this one :-D

Oscar works heavily off of momentum, so once the shed gets going, it takes a while to drain it down when reducing. With lantus I would feed MC food and try to take dose reductions every few days so that they would hold, but right now he is just dropping into the 30s whenever he feels like it, which scares me! We might see high numbers once his shed catches up to the dose reductions, but I figured that was better than him seeing a number really too low.
 
Kelly & Oscar said:
Thanks for the input Sheila! We switched from Lantus to Levemir this past friday. I think some of the really low numbers initially were due to the lantus working along side the levemir. By this point we should solely be on the levemir, which is why I dropped it again tonight. We were on lantus for 8 months, and while it got a heck of a lot better regulated than the prozinc we started out with, I still felt like we could do better, which is why I decided to switch. I have high hopes for my boy with this one :-D

Oscar works heavily off of momentum, so once the shed gets going, it takes a while to drain it down when reducing. With lantus I would feed MC food and try to take dose reductions every few days so that they would hold, but right now he is just dropping into the 30s whenever he feels like it, which scares me! We might see high numbers once his shed catches up to the dose reductions, but I figured that was better than him seeing a number really too low.
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OK - I totally missed that you switched to lev on the 18th. And you did reduce the starting dose to about 70% of the old dose, right? I don't have your SS open right now, but you were at 2.75u, so that would be 1.9u, but he is now at 1u, so even that would probably not have been enough reduction anyway.

Well, looks like Oscar really likes lev! Beau had some similar numbers when I switched to lev - quite a reaction to the first shot and then 30s by the third shot (but he was on a much lower dose). That is why we suggest the dose reduction. I cut Beau's dose to 55%. I wonder if 50% might be a saver starting dose...?

Hope Oscar will stay out of the 30s for you :mrgreen:
 
Yes, we dropped Oscar from 2.75u of Lantus to 2u of Levemir when we first switched. Currently we are on his third cycle of 1u. From our experience, and others that have chimed in over in lantus land, I think a 50% starting dose may be safer for people switching from lantus. Even that would have been too much for Oscar, since 1u is almost a third of his lantus dose. I am guessing that his body just isn't fighting this insulin for some reason ***knock on wood anti jinx*** With prozinc he fought the insulin hard with high, flat curves, until all of a sudden he would give in and his numbers would dive. He did the same thing on Lantus until we reached around 4u. I couldn't reduce his dose too quickly otherwise we would soon see yellows again, but I also couldn't give him too much MC food either. It was such a balancing act. Levemir seems to be working from the start, which is a nice change.

His pmps was 128, which is still falling from the am cycle. We had a little mini bounce today briefly into the 200s, but he quickly came out of that. He probably saw some green last night while I was sleeping, but it wasn't low enough to cause an immediate high bounce. Looks like the 1u may hold him for a little bit! I sure do hope he evens out soon @-)
 
Hi Kelly,
I want to say thank you for posting here in the Lev ISG! With your experience I hope you will chime in from time to time on others posting about Levemir or switching, etc.

As for numbers - I think those are great! The 50s are not uncommon on a good Levemir dose, but usually a little lower than people are comfortable with. You are seeing steady numbers midcycle which is important, although obviously feeding those 50s probably kept them from going lower, so lowering the dose a little will keep him on track.

Good job and glad the Levemir agrees with Oscar!
 
Kelly, I wonder if he was getting too much insulin on lantus? The numbers and pattern you describe sound just like the description of Somogyi rebound on petdiabeteswiki.

Anyway, glad he is doing great on lev and you are on top of the dose decreases. Looks good.
 
I am sure it is some type of Somogyi rebound. His liver was constantly panicking and the insulin had to fight the constant glycogen release. We started ultra low and slow though, so it wasn't starting the dose too high. On prozinc we started at 0.5u since his pre-insulin numbers were in the mid 200s. We raised the dose 0.5u at a time after holding the dose for about 5 days. A month into it I got u100 syringes and was able to adjust the dose 0.2u at a time. On prozinc we got up to 3.5u and did a rebound check too. When switching to lantus, we went from 2.2u of prozinc to 2u of lantus. He had the occasional break through to greens - nothing too low, but in general he was high and flat until we were in the 4u range. He was fairly controlled at 2.25-2.75u of lantus. Initially his curves looked like acro/IAA curves and I had many acro moms asking about that until we had the semi-regulation break through around 2.5u of lantus.

My boy just reacts to insulin weird. His body sees it as something not normal and sends out the glycogen stores a lot more than other cats I think.

I am thinking about upping the dose from 1u to 1.25 tonight. This morning's preshot was 280 and he went up to 308 by +4. He is coming down from there and is at 272 at +6, but I think his body has finally caught up to the dose decreases (it takes his shed a REALLY long time to catch up) and we aren't getting a good duration on this dose so the 4 hour onset is leaving 4-5 hours with too low a shed level for him. Does this sound right/logical to anyone beside myself? :lol:
 
Yeah, it makes sense. And I agree that the 1.25u dose wasn't given enough settle time to see how it really woudl work for him - so give it a try. You are in the ballpark, now you just need to fine tune the dose.
 
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