5/17 Smokey - we have started our switch to Lev

[Melanie and Smokey]

Well we reached the end of our vial so we have started the switch. Hoping to find a lower dose on Lev to settle in to. After her surgery, there isn't a lot of room under that skin for over 9U of insulin! Of course when we hit 9U right before the switch she started to run some good numbers again ohmygod_smile

It looks like she is might actually be reacting to the Lev a little better. There's not much movement, but after her first where-the-hecks-my-insulin! reaction on the first shot, I am seeing some downward movement where she was meandering everywhere regardless of her shots for so long. Not a lot to go on yet, but I am hopeful.

Vet wants to hold the 1U for a week for her body to adjust to the change and then we will see if we go a little quicker on the ups if she remains seeing 300s. I was a little surprised to see ketones register so high on the meter yesterday. It had been so low lately the meter would register and I thought it was broken.

Here you can see she's growing hair back on her belly! She's so happy and grooming her fuzz like crazy :lol:

 

[Sienne and Gabby (GA)]

Melanie:

Typically, with switching from Lantus to Lev, you reduce the dose by 30%. Dropping the dose from 9.0 to 1.0u is a bit extreme. Please test for ketones religiously.

Have you gotten Smokey tested for acro or IAA? It looks like it's time.

 

[Melanie and Smokey]

Yes, the dose drop was a lot, but that is how my vet switches insulin. She doesn't want to take the chance of a much different reaction and we can put more in, but can't take it out. If we go soaring off into the yonders of high or see signs of DKA, we won't hold the 1U, but she would prefer to let the new insulin settle at 1U before we move. She also knows that we test a lot and I will change the dose on my own if things aren't looking right.

We are hoping to find the absolute lowest dose possible. Sometimes I only get half of a dose in before she runs off and I have to put the other half in somewhere else. Her skin is REALLY tight right now and getting her shots in are uncomfortable for her. The only place it is loser is up close to her spine by her scruff and armpits and I don't like giving a lot a shots close to the spine.

Smokey eats like a pig, drinks like a fish, and we've antibiotic'd her like crazy since the surgery Apr 20th so we should be clear of a lot of the issues the contribute to DKA and any changes in behavior will be noticed quickly.

We did not test for IAA or acro. The biopsy showed a 2cm dark green mass on her pancreas and other small irregular growths, plus her liver was slightly irregular. The surgeon and oncologists and other consults there all believe she has nodular hyperplasia and that is what is causing her diabetes to have resurfaced (age related changes and the pancreas is most likely never going to work normal again). They didn't believe any further testing was necessary, finding an insulin dose that keeps her in a reasonable range is really all we can expect to do at this point.

 

[Sienne and Gabby (GA)]

My only concern is that you had things checked out and it sounds like you did.

You may have more success with Lev if the dose goes back up. Lantus can sting -- Lev doesn't.

Have you tried a flank shot? You may have looser skin there.

 

[Melanie and Smokey]

Yeah, what I thought was going to be a small, quick little nip of a piece of her pancreas was apparently a stroll through her whole stomach cavity :shock: Gave us a lot of information for going forward though. Dr Uhl did quite a bit of observation on her pancreas, liver and intestines while he was in there.

I have tried flank. I've gotten it maybe twice there, but it is more uncomfortable for her to have me tenting and she tries to bite if I don't get it quick. Eventually all of the skin should stretch back out some and it will be more comfortable for her. In the meantime we try to work around it.

Hopefully we won't have all the other health distractions this time up the dosing scale and can do it more scheduled and find her a good dose.

 

[Marje and Gracie]

Good luck with the lev, Melanie. I hope it works for her better than lantus.