5/18 Heart - AMPS 370, +4 344, PMPS 311

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dodgingwrenches

dodgingwrenches

Member Since 2010
I recently switched my cat to Levemir, so I reduced the dose following the 70% rule. But his numbers are fairly high and he's a long-term diabetic, so I'd like to increase him to 1.75 tonight, rather than waiting an extra (third) day... Thoughts? I have no experience with Levemir
 
Re: 5/18 Heart - AMPS 370, +4 344 - Safe to increase already

You've had 4 cycles at 1.5 -

"General" Guidelines:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Click to expand...

My first thought is that you really need to get mid-cycle tests in every cycle so you know how low the dose is taking him. For example, if he'd gotten into blue numbers last night, I'd think you need to give this dose a little more time. It's not unreasonable to think he might have, given that he's had 2 cycles in the past few days that started off over 300 and got into the 100's. Even yesterday's cycle where he went from 378-197 wouldn't be described as a "high flat cycle."

Does he have a history of ketones? If so, you might want to go ahead and increase, but my general reaction is that you should give him at least 6 cycles at this dose before you adjust the dose.

Perhaps others will have another idea. I haven't personally switched insulins, but we have lots of people who have done it and who might have some other insights for you.
 
Re: 5/18 Heart - AMPS 370, +4 344 - Safe to increase already

I ran your question by a couple of people who have also made the switch, and Marje is thinking that you should go ahead and increase tonight. She doesn't think she'll be able to post, so i wanted to pass it on to you.

I haven't heard from anyone else yet.
 
Re: 5/18 Heart - AMPS 370, +4 344 - Safe to increase already

not giving dosing advise here....since I need some myself, so I don't think I am one to do that! But I wanted to say that I hope Heart's bg's start to come down soon. I know how you feel seeing those numbers.
Good luck!
 
Re: 5/18 Heart - AMPS 370, +4 344 - Safe to increase already

I agree with Julie on the increase. We start a new insulin at a lower dose for those cases where cats have an immediate reaction but it doesn't look like Heart will be one of those. And I'd like to stress again the need for more tests, especially later in the cycle which is when Levemir kitties tend to nadir.

From the Tight Regulation Protocol sticky:
REQUISITES WHEN FOLLOWING A TIGHT REGULATION PROTOCOL WITH LANTUS OR LEVEMIR:

Kitty should be monitored closely the first three days when starting Lantus or Levemir.
Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9.
More monitoring may be needed.

It will be necessary to test kitty's blood glucose levels multiple times per day.
Click to expand...
Use the weekend as an opportunity to test more and find out when his onset and nadir are likely to be on Levemir.
 
Re: 5/18 Heart - AMPS 370, +4 344 - Safe to increase already

Thanks all. I will give him 1.75 tonight since he does have a history of ketones. He had a pretty bad DKA last fall, and had ketones a month ago.
 
Re: 5/18 Heart - AMPS 370, +4 344 PMPS 311

Or maybe I'll do one more 1.5, and spend tonight getting some curve measurements. Decisions, decisions!
 
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