hi jen! what do you think about taking the skinny off the dose if nothing changes by morning?
afaik, this is the only study done to date with levemir and cats:
This abstract was presented at the 2009 ACVIM Forum...
ABSTRACT #41
EVALUATION OF DETEMIR IN DIABETIC CATS
MANAGED WITH A PROTOCOL FOR INTENSIVE
BLOOD GLUCOSE CONTROL
K Roomp1, JS Rand2.
1. Max Planck Institute for Informatics, Germany. 2. Centre for
Companion Animal Health, Uni of Queensland, Australia.
There are no reported studies of long-term use of detemir in
diabetic cats. The aim of this study was to report outcomes
using detemir and a protocol aimed at intensive blood glucose
control with home monitoring in diabetic cats, and to compare
the results to a previous study using the same protocol with
glargine.
Eighteen cats diagnosed with diabetes mellitus were
included in the study. Cats diagnosed with acromegaly were
excluded. Data were provided by owners who joined the
online German Diabetes-Katzen Forum, and followed an
intensive blood glucose regulation protocol for a minimum of
5 months or until remission was achieved. Detemir was
administered twice daily and a low carbohydrate wet food diet
was fed. The insulin dose was adjusted aiming to achieve
euglycemia (50-100 mg/dL as measured using a portable
blood glucose monitor calibrated for human blood). Owners
performed an average of 5 + 2 blood glucose measurements
per day in the stabilization period, and supplied spreadsheets
recording daily insulin dosages, blood glucose concentration
and clinical information.
Seventeen cats in the cohort were initially treated with
another insulin type (16 with porcine lente insulin) for a
median of 9 weeks, but failed to achieve remission prior to
switching to detemir. Most (15/17) of these cats were fed a
low carbohydrate diet while on the other insulin.
The overall remission rate was 67% (12/18). For cats that
began the protocol within 6 months of diagnosis, the remission
rate was 81% (9/11) and for those that began 6 months after
diagnosis, the remission rate was 42% (3/7). The median time
to remission was 1.7 months after beginning the intensive
protocol (range = 10 days to 5.3 months). Nine cats of 12 cats
(75%) achieving remission remained off insulin, and the
median duration of remission was 12.3 months (range = 6.4
months to 2 years). Three cats (25% of remission cats)
relapsed and required insulin again. Only one of these relapsed
cats achieved a second remission.
Six of 18 cats (33%) in the cohort required insulin
throughout the study to control blood glucose concentrations
and did not achieve remission. The median length of time on
the protocol was 10.3 months (range = 5.4 months to 1.2
years). The majority (83%; 5/6) of long-term diabetics were
considered well regulated with a median blood glucose
concentration of ≤150 mg/dL and 17% (1/6) were moderately
well regulated (median blood glucose ≤200 mg/dL). Clinical
hypoglycemia was rare, with only a single event in one cat
which had mild signs. The median maximum insulin dose
administered to cats in the study was 1.75 IU twice daily.
These results are comparable to those of the glargine study.
No significant differences were identified between outcomes
for glargine and detemir, with the exception of a lower
maximal dose for detemir (p-value = 0.045). The median
maximum glargine dose was 2.5 IU (range = 1.0 to 9.0 IU)
compared with a median detemir dose of 1.75 IU (range = 0.5
to 4.0 IU).
http://www.acvim.org/websites/forum/Fil ... sFinal.pdf
Still sneezing but only on 2 full days of Clinda so far.