4/14/22 CALI AMPS 88, +0.5 119, +1.5 124, + 4 111, +8 55, +8.5 79, +9.2 79 , PMPS 127

carlascalico

carlascalico

Member Since 2020
Prior: https://felinediabetes.com/FDMB/thr...-3-5-84-4-5-88-7-3-167-pmps-366-3-273.261969/


4/14/22 CALI AMPS 88, + 0.5 119, +1.5 124, +4 111, +8 55, +8.5 79, +9.2 79. PMPS 127
Cali woke up and quickly alerted us to ‘needs food NOW”. She jumped up for testing at bar. After test, she grabbed food, starting growling and scarfed. Bit fork when I was trying to add more. Ravenous appetite. Then bathed and back to sleep. Not prone to throwing up so should I test in 30 or every hour?
Add MC or stay with LC?

continued to feed LC
 
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Regarding Levemir insulin, would anyone familiar with members who are using Levemir but their cat is not diagnosed as ACRO or IAA, please refer them to me. Helpful to study various spreadsheets while continuing to build my SS data and knowledge. I do recognize that ECID as Cali and Oberon proved once again last night and today. Thanks

@FrostD
@Wendy&Neko
 
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I have variety of MC: Sheba 11% turkey/gravy, Sheba 13% chicken/gravy, FF 15% chicken/gravy
HC: FF BEEF/gravy ready to feed
 
What is the question? 8.5 he's up a fair amount from what you fed, so at this point I would not feed anything if that's the question. Just retest half hour from last test if you can.

So rough guidance for human meters for when you aren't getting quick replies:
Anything under 50 is HC and honey/karo/quick sugar retesting every 15 mins til rising.

50s with some time to go before nadir is HC and test every 20-30 mins (testing earlier than that is fruitless as it takes time for the food to kick in). The earlier it is and the bigger the drop, the higher the carb and amount you feed. If drop, more HC (+honey if below 50). If flat, little more HC. If rise to the 60s, try MC. Above that, let him go. Continue testing.

50s near the usual nadir I'd recommend a small (1 tsp) amount of MC until you get the hang of it. Test again in 20-30 mins. If drop, HC. Below 40, add honey.

Always err on the side of safety and more carbs (and extra testing).
 
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And I actually don't know of any non-acro/IAA cats on Levemir here off the top of my head, but Wendy might
 
FrostD said:
What is the question? 8.5 he's up a fair amount from what you fed, so at this point I would not feed anything if that's the question. Just retest half hour from last test if you can
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Thank you Melissa. My first drop into the 50’s since last year. Thought I was prepared but little bit of panic. I fed, retested and fed LC. Since so new to Levemir, I still don’t know cycles for Cali yet. I posted, then edited. I knew Bhooma out of town, she has been sort of handholding. I will test again +9
 
I will look at your SS later tonight and see if I can help you find some predictability
 
Maverick has been on Lev for a few years now and is neither an Acro kitty nor does he have IAA. Late 2020 and 2021 should give you some reference points. Unfortunately due to some personal issues I have mostly been off the board, and not always entering all my test data from my meter.

Levemir has often resulted in later nadirs for us, which can be at next preshot and sometimes through to +14 or +15. See November 6, 2020.

When you intervene with more than just regular food, it's wise to reference in your remarks so you can get a feel for how the extra carbs influence the cycle and use that data for the future. For the most part, if I see early onset ie. sooner than usual I'll prop up with some higher LC like a 9%. You'll have to find what carbs work best for Cali with Levemir, the patterns will not be quite the same as on Lantus.

Let me know if I can help you with any questions.
 
FrostD said:
I will look at your SS later tonight and see if I can help you find some predictability
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Very kind of you. Right now I am helicopter mom and driving hubby bonkers as it takes two to test this girl. That said, we are both very happy with Levemir and how it is working for her. Lantus had her diving [80 -150 points in two hours], then spiking at end of cycle as if insulin was gone.
 
I think Bandit (Bhooma's cat) may also be on Levemir now but that's a bit of a special case with the CKD.
 
Christie & Maverick said:
Maverick has been on Lev for a few years now and is neither an Acro kitty nor does he have IAA. Late 2020 and 2021 should give you some reference points. Unfortunately due to some personal issues I have mostly been off the board, and not always entering all my test data from my meter.

Levemir has often resulted in later nadirs for us, which can be at next preshot and sometimes through to +14 or +15. See November 6, 2020.

When you intervene with more than just regular food, it's wise to reference in your remarks so you can get a feel for how the extra carbs influence the cycle and use that data for the future. For the most part, if I see early onset ie. sooner than usual I'll prop up with some higher LC like a 9%. You'll have to find what carbs work best for Cali with Levemir, the patterns will not be quite the same as on Lantus.

Let me know if I can help you with any questions.
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Oh thank you Christie. This is a totally new learning cycle and I will need to adjust test times and feeding as I learn LEVEMIR. Since diagnosis and conversion to 100% wet, LC pate [3-5%] I have only made a few adjustments [and many misteps] in attempt to “feed the curve”. I will definitely look at Mavericks SS and quizz myself. Thank you so much.
 
FrostD said:
I think Bandit (Bhooma's cat) may also be on Levemir now but that's a bit of a special case with the CKD.
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You are correct. I have looked at Bandit’s SS and she is especially unique. Bhooma is so kind and helpful to us but shares few insights/post on her sugar baby. I inquire how Bandit is doing periodically but certainly respect her privacy.
 
Marje's Gracie was on Levemir, as is Sasha's Mauer. There are a few others, but not posting or posting much. And honestly, how a cat uses Levemir doesn't really differ much if they have acromegaly. You definitely have to get used to shooting lower numbers. Nadir often can be at preshot time or a bit later.
 
carlascalico said:
Very kind of you. Right now I am helicopter mom and driving hubby bonkers as it takes two to test this girl. That said, we are both very happy with Levemir and how it is working for her. Lantus had her diving [80 -150 points in two hours], then spiking at end of cycle as if insulin was gone.
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So, I'm kind of ignoring the first week on Levemir because the depot was building and you had the frequent dose changes.

And here comes me thinking out loud-

What I see (at least based on 3 days of data lol :rolleyes:) is that her onset seems to be in the +2 hour, and nadir tends to be about +8. I think what you saw today was a bit of a double whammy cycle. She bounced from the lows yesterday - I think all that extended time in green and blue caused a bounce which is why she came up to that 167 by +7, otherwise she may have stayed flatter or nadired later (pure speculation). But she did bounce as evidenced by PMPS - and we know bounce breaking cycles often have a long slide down and late nadir. So I suspect AMPS was just after nadir (because the rise from 88 to 119 is a little more than I'd expect if she was at or before nadir). Rather than BG continue to rise as the PM shot wore off, her next cycle onset around +2/3 and you got the usual nadir close to +8. Sometimes cats "stack" cycles where the next cycle nadir is pushed later as well, but that wasn't the case for Cali, at least today.

Now, the disclaimer we always give - onset and nadir are never guaranteed BUT they can help you pinpoint when to test and how to navigate low numbers.

So what to do with this? When you see a bounce incoming, know she's probably going to nadir much later in the cycle, possibly at shot time. And expect the next cycle to do pretty much what happened today - so you'll want to test a bit earlier to help intervene a little sooner with less carbs if needed.
 
Thank you Wendy. I will review the two additional Levemir members you mentioned above. Shooting the lower numbers doesn’t alarm me [I tested, fed and shot 88 this AM] and followed stickies. My biggest concern is learning these new cycles so as I monitor I can optimize testing and feed times/quantities. I feel the mistakes I have made in the past could have compromised Cali’s organ health. She has been unregulated far too long, including above renal threshold. A more experienced caregiver such as yourself would have achieved remission with Cali far sooner I think. I want this fresh start “do over” to succeed for my girl so I may err on the side of two many questions and request earlier intervention than I did in the past. I know TR protocol works, I have see the successes. Your support is invaluable.
 
I think her onset may be closer to +3. Today and 2 days before that in the AM cycles, her +2 was still higher so onset is after that. But getting a few tests around the +2 and +3 time frame will nail that down. I found nadirs tended to wander around a bit, so didn't focus so much on nailing down the exact hour, but rather the range of times when it could be. Plus it also changed based on a number of things, such as whether it was a flat cycle, dropping, etc. Neko had a later onset and I could tell by it when it was a good idea to get the next test.

By the way, I felt like a brand newbie all over again when I switched to Levemir. It's like I had to learn all over again. So I get that. :bighug:
 
Yes that's why I said "+2 hour", because with the few +3s she normally has dropped by then. But it's all so fluid and shifty
 
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