2/28 Weezer AMPS 143,+1 204,+2 282

Status
Not open for further replies.
Linda for Weezer

Linda for Weezer

Member Since 2011
All is well in Weezer World.

Prayers for any in need of healing, strength and comfort today.

Yesterday’s Condo

Recap of yesterday
AMPS 357 (16u Lantus + .5 u R)
+5 290
+6 309 (.5 u R)
+8 298
+10 280
PMPS 315 (16 u Lantus +.5 u R)
+3 252
+5 281
+11 109!

Look at that +11! I retested, it’s no hokey pokey. I wonder what she did between +5 and +11? We thought she was rising at +5 and called off the R watch. Anyway, I gathered up my stockpile of courage and shot her full dose this morning. I will be here for a +1 check and then DH takes over for a +2 check and beyond.

We were planning to switch to Levemir last night but there was a miscommunication with the order. It was shipped yesterday, so Wednesday will probably be switch day. The plan is to start with ½ our current dose. That may be a little drastic but here’s my reasoning. Everything about Weezer’s reaction to Lantus has been atypical. She hasn’t shown improvement on Lantus. That could be the IAA resistance. But also, when we have made larger increases, her BGs go up, and can stay up from one increase to another. That doesn’t seem typical of IAA. We think she may be having a reaction to the chemical makeup of the Lantus. If that is the case, it is possible that a much lower dose of Levemir may be appropriate for her. That’s one reason we would like to know how long the Lantus will still be in her system, so we can tell when she is working only with Levemir. During that period we can keep her down with R. We are ready to quickly go up the dosing ladder, once we know the numbers we are getting are from her Levemir dose, and not influenced by remnants of the Lantus shed. Does anyone see a problem with this line of reasoning?

Wishing a kitty day for all, plenty of purrs, play, sunny spots and lots of love.
 
Re: 2/28 Weezer +11 109, AMPS 143

It all sounds pretty darned good to me!! But then again what do i know about Lev or acro or IAA.....but i'll be here holding your hand when you need it Linda and cheering you and Weezer on as well.

Very nice +11! That looks green to me and deserves a :mrgreen: :mrgreen: I hope she keeps surfing these blues today.

Have a great day ladies ;-)
 
Re: 2/28 Weezer +11 109, AMPS 143

Wow, I couldn't believe it when I saw Weezer's numbers, and I thought it was the lev already working. Lots of good vines for the switch over and the dosing. Have a nice Tuesday, Linda.
 
Re: 2/28 Weezer +11 109, AMPS 143

Wowee - looks like Weezer is putting in a last ditch effort with Lantus, isn't she!?!? What a great start to the day!

I don't know anything about switching other than what I've read on the board, but - at least to me - your plan makes perfect sense. No one knows Weezer like you do!

Have a great day!!

Amy
 
Re: 2/28 Weezer +11 109, AMPS 143

Yowsa wowsa Weezer! That's a great PS. :-D I'm sorry I don't have any advice either. Have a good one!
Liz
 
Re: 2/28 Weezer AMPS 143,+1 204

Good Morning, guys!

It sounds perfectly logical. You know Weezer best and you are prepared, so go for it on Wednesday, when the Lev. arrives.

In the meantime: Weezer, that blue AMPS looks great on you!!

Ella & Rusty
 
Re: 2/28 Weezer AMPS 143,+1 204

Morning! WOW on Weezer this AM! Way to go!

Good luck with the switch. You will need to drain the lantus shed, so at least a day, from what I understand. The people I know that have dealt with this recently are Ann of Ann and Tess, and Marje of Marje and Gracie. They may be able to help you better than I - I've never dealt with Lev specifically. Your plan sounds good. They may be able to help you with that too.

Enjoy your day!
 
Re: 2/28 Weezer AMPS 143,+1 204

She's looking better and better with each day! WOO HOO!!! Go, Weezer!!! :RAHCAT Hoping for some :mrgreen: s for both of you in the very near future!!!
 
Re: 2/28 Weezer AMPS 143,+1 204

wellllll, you know i don't have personal experience with iaa, but as i recall, tigger did exactly the same type of thing. every time the dose increased he got even higher. i think what you are seeing with the numbers does look like typical iaa. you have to make your own decision, but if i were you, i wouldn't drop below 3/4 of the dose. have you heard from libby/sandy on a suggested starting dose?

here's my thought. you're going to have a lag time on the shed draining from lantus, hopefully continuing to give you these good numbers. it's going to take a while for the levemir action to build up - and during that time you're going to see a lot of high numbers if it's not happening fairly quickly.

but as i said, i haven't done it so this isn't The Rule! this is just me thinking out loud, so let's see what sandy & libby have to suggest.

and way to go on the shooting low. the +2 suggests she might bounce, but you never know.

edited to add: i just saw that libby and elaine both posted on weezer's condo at the end of the day yesterday. so you've gotten input from several people with experience. you know weezer best and you know we'll all support you however you do it. there's no protocol to follow on making the switch and i'm sure it will go fine. have a great day!!!
 
Oh My! Where's my pink Weezer? I sure LIKE this color MUCH better! Just LOOK at that AMPS!!! WOW!!!

Linda - I'm waiting on pins and needles for the same answer on the Lantus. I've asked that same thing before and can't seem to find a good solid answer. Lantus precipitates based on the ph of the body but does it dissolve ALL of it when it starts? I've been thinking about changing from Lantus also as it's just not regulating KT. I'm thinkin' Lev may be better for him too.

BIG HUGE HUGS to EVERYONE in Miss Weezer's house,
 
Hi guys .. wowwie weezer! That +11 brightened up my whole day! I have no advice on the lev but I hope the change goes smoothly for you .. have a great day guys!
 
I honestly don't think dropping the dose by half is a great idea. What you are seeing -- the initial response to a dose increase and then a flattening out -- is the IAA. That's how antibodies work. The only way to deal with IAA is to get the insulin dose ahead of it.

In addition, the point of R is not to "manage" high numbers. Using R to beat down numbers is best done only when a cat is hooked up to an IV because the cat is ill. The rationale behind home use of R is to take the edge off of the higher numbers so the basal insulin (Lantus or Lev, in this case) can better latch on and bring the numbers down. It's the dose of the basal insulin that is the more important component.

Reducing the dose a little with the switch to Lev may make sense. Some cats to have a marked response to a switch in insulin. Dropping by half will only mean that Weezer is going to be in high numbers for that much longer.

Both Libby and Elaine (Pinky's bean) gave you good information yesterday.
 
I just wanted to say hi to you two! Weezer's number looks great, and I hope you can figure out which variables to keep/change to keep her in those pretty blue jeans more often. Have a wonderful day, guys!
 
Hi Linda,

I'm not sure if you saw my recommendation last night:

Libby and Lucy said:
When I switched Jazzy to Lev, I reduced her dose just a little bit, I think just a couple of units. Her numbers did flatten out almost immediately.

What I'm thinking is that you could try starting at about the same dose (14u-16u) but leaving out the R for the first few cycles, just in case Weezer responds to Lev right away. What do you think?
Click to expand...
The pattern you're seeing (sometimes an immediate response to a dose, then going higher) is something I've noticed in many acro cats as they move up the dosing ladder. Actually, it's not uncommon even for non-acro cats until they get to a good dose. The usual pattern for Lantus seems to be a whole lot of flatness, no movement dose increase after dose increase, until one day all of a sudden there is GREEN everywhere. IMHO it just means you're not at Weezer's good dose yet.

You probably don't really need to reduce her dose at all when you switch, especially because you are currently using Lantus *and* R to hold her numbers in this range. If knocking off a unit or two would make you more comfortable then go for it. I would definitely skip the R at first just until you know how she is responding to Levemir.
 
hi linda. just wanted to pop in to add my 2 cents for whatever it's worth...

based on what we've seen when kitties make the switch from lantus to levemir i wouldn't reduce the initial starting dose of lev to anything less than (edited to correct) more than a 30% reduction from the current lantus dose. we've never recommended a reduction of 50% in when switching. we have recommended a slight reduction *just in case* kitty shows a big response to the switch because it's happened often enough for us to have taken notice, but not with every kitty making the switch.

however, humans pretty much make the switch unit to unit. imho, you could easily do that with weezer considering she's currently getting R in addition to lantus.

personally, i'm not seeing much that i would consider "atypical" in weezer's response. if you want to start conservatively, i would think about a levemir starting dose of a couple units less than weezer's current dose. initially, i'd withhold R. i believe starting a couple of units less was what libby did with jazzy.

just my thoughts. good luck with the switch!


edited to add: i see libby posted while i was gathering my thoughts.
 
Hi Linda,

Following up on what Jill said.

I really didn't have a clue about where to begin with the levemir. But I latched onto a sentence in the Rand Protocol that said cats require 30% less of detemir (levemir) as compared to lantus.

http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf

"Mean medium maximum dose in cats on determir is about 30% less than cats on glargine. ( 1.7u/cat BID : range .5 to 4 iu versus 2.5/cat BID: range 1 to 9iu BID)."

Pinky was at 15.5u lantus which would have meant approx. 11u. ( a 30% reduction) So I started a tad lower at 10u but jumped it to 12 almost immediately. With hindsight I would have started it around 13u.

Before starting I also looked up what people do when switching and it was a unit for unit as Jill mentions. (see lev. box insert)

I am sure no matter where you start you will stay on top of the data and adjust accordingly. Good luck. Elaine and Pinky
 
Good luck with the Lev! You are in great hands here and I have no experience with any of it but wanted to give you a hug and wish you luck!!
 
Linda..
having made the switch, I echo the thoughts of the others. Gracie was on .75u lanntus and I dropped her to .5u lev........wish I hadn't and that's why I took her up so fast. So I agree that if you feel the need to drop back some maybe just a couple units.
 
hi elaine. thanks for weighing in with your thoughts.

that line from the protocol has been a great source of confusion for many, including myself... until a light bulb finally went on. :roll:

"NB Mean median maximum dose in cats on detemir is about 30% less than for glargine (1.7 U/cat
BID; range 0.5 to 4.0 IU versus 2.5 U/cat BID; range 1.0 to 9.0 IU BID)."
http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf

my interpretation:
they're not talking about a starting dose here. the TR protocol from roomp and rand does not differentiate between lantus and levemir to determine a starting dose. they're comparing the average maximum dose of levemir to lantus. when i think about a maximum dose, i think about the highest dose of insulin reached to bring kitty down into pretty numbers. weezer's data shows she is not at a good or you could say "maximum" dose yet. her maximum levemir dose may in fact end up to be approximately 30% less than a maximum lantus dose had she stayed on lantus, but right now i don't think we have be concerned about a 30% reduction. jmo.

anyway, that's how i read that statement from the protocol. someone please correct me if i'm wrong. i've certainly been wrong before... and i most certainly will be again. :mrgreen:
 
Hi there :cool:
Those were some pretty blues this morning!

I think a unit or 2 less, to provide a margin of safety/comfort for the unknown, would be the most I would decrease.
I agree with Jill, hold off on the R until any dust from the changeover settles.
 
What wonderful numbers this morning! She looks beautiful in blue. I hope you all have a great evening in store, and good luck with all the dosing decisions!
 
Hi Jill, I knew they weren't talking about starting doses but I still interpreted it to mean that since the final levemir mean maximum doses were 30% less than the lantus it wouldn't hurt to apply that fact to an existing huge lantus dose.

This may be screwy logic but I was really just searching for some sort of justification (however lame :smile: ) to begin somewhere. I was afraid to go 1 unit to 1 unit.

Take care, Elaine and Pinky (IGF-1 367, IAA 68)
 
Jill & Alex said:
hi elaine. thanks for weighing in with your thoughts.

that line from the protocol has been a great source of confusion for many, including myself... until a light bulb finally went on. :roll:

"NB Mean median maximum dose in cats on detemir is about 30% less than for glargine (1.7 U/cat
BID; range 0.5 to 4.0 IU versus 2.5 U/cat BID; range 1.0 to 9.0 IU BID)."
http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf

my interpretation:
they're not talking about a starting dose here. the TR protocol from roomp and rand does not differentiate between lantus and levemir to determine a starting dose. they're comparing the average maximum dose of levemir to lantus. when i think about a maximum dose, i think about the highest dose of insulin reached to bring kitty down into pretty numbers. weezer's data shows she is not at a good or you could say "maximum" dose yet. her maximum levemir dose may in fact end up to be approximately 30% less than a maximum lantus dose had she stayed on lantus, but right now i don't think we have be concerned about a 30% reduction. jmo.

anyway, that's how i read that statement from the protocol. someone please correct me if i'm wrong. i've certainly been wrong before... and i most certainly will be again. :mrgreen:
Click to expand...

That makes sense, Jill.

I reduced a little when we switched from Lantus to Levemir. But ECID. I think starting a couple units less makes sense.
 
Well done on your morning shot! All fingers and toes and paws are crossed in our household for Weezer's successful transition to Lev tomorrow, Linda. :YMHUG:
 
Status
Not open for further replies.
Back
Top