7/30 Cobb AMPS 314(No R) +5 279 PMPS 293(2.75uR)

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Suzanne & Cobb(GA)

Member Since 2013
Yesterday

Not sure where today's morning number came from. I didn't have time to give any R, so let's see if Cobb can clear it on his own. Busy morning...

I'm emailing the vet today to see what we can discuss regarding switching to Levemir. I do hope she is open to it. nailbite_smile
 
Re: 7/30 Cobb AMPS 314(No R) +5 279

I didn't know that you were thinking of switching to Levimir. I know nothing about it. What might be the benefit of Levimir for Cobb?
 
Re: 7/30 Cobb AMPS 314(No R) +5 279

Great question, Tina. I'll try to explain it as I understand it. But if I get it wrong, someone PLEASE correct me!!

So, Cobb has IAA. As I understand it, the antibodies his body produces are in response to the Lantus. That is the insulin his body perceives as a foreign invader. He has no antibodies to Levemir, simply because he's never had Lev. That doesn't mean that his body wouldn't react the same way to it or develop a resistance.

Lev is also a long-acting insulin. A lot of people have found that it creates a smoother curve. You'll notice Cobb's curves aren't always an inverted bell. Some people have found that acro/IAA cats can maintain lower BGs without any spikes on Lev because it lasts a little longer than Lantus and so we're able to take advantage of that overlap. I believe it has a later onset as well. So whereas Lantus' onset occurs around +3, Lev may be at +5 or +6, and so it is still in effect at +12 when you're shooting again.

The other advantage, if you want to call it an advantage, to Lev is that it is PH-neutral. I don't notice that the Lantus stings Cobb when I shoot him, but some people have reported that higher doses sting when injected. Lev doesn't sting when injected.

I also believe Lev is a little bit stronger. I've maxed out the syringe with Cobb. I give him 31units. And my 31unit is eyeballed. There's no line for that 31st unit. I just picked a place on the syringe that looks like it is about an extra unit so I call it "31u" on my spreadsheet. I refuse to use 2 syringes every day for the same insulin. (I'm stubborn like that.) But with Lev, the starting dose when switching would be a bit lower. And since it is stronger, I might be able to only give him say 25 units a day instead of 31. And if the antibodies don't bind to it, I may be able to bring his dose down even further.

Right now it's a guessing game because we have no idea how Cobb would react to Lev. It may work incredibly well. It might not work at all. One thing that I think might really help is Cobb has seen some very nice numbers on the 31units. I said I wasn't going any higher and he's responded to that threat. :lol: But part of me wonders...is that right dose really 32units of Lantus? The syringe is only so long and I can only guesstimate and eyeball so much after the 30unit markings, so I haven't tried to take him up. Plus, we're flying through some Lantus right now. I'd love for him to be at a "reasonable" amount of insulin. Not that anything over 10u is really "reasonable" in my mind, but man...if I only had to measure out 20units, I'd be a happy little lady! :lol: :cool:
 
Re: 7/30 Cobb AMPS 314(No R) +5 279

All of that makes a lot of sense to me, and seems worth the effort. It's great that Cobb has been visiting some lower numbers lately. Did I read in your condo the other day, that maybe Sandy wrote, IAA is not a life long situation? In other words, it could turn around and he would be a more 'average' dose kitty one day?
 
Re: 7/30 Cobb AMPS 314(No R) +5 279

you've basically got it, suzanne. the only thing i've heard people take exception with the idea that Lev lasts longer, apparently it's length is about the same. but i have thought it looks on spreadsheets as though it lasts longer too.

yes, iaa is considered self-limiting, usually a year or so. if Cobb has acro as well, that would affect numbers after the iaa broke.

generally when people switch from Lantus to Lev, they start at 70% of the Lantus dose and adjust from there. So if Cobb's dose was at 31u when you switched, you'd start Lev at 21.7, or 22u.
 
Good luck getting your vet on board with trying Levemir. I don't think it lasts any longer in Neko, just her whole cycle is "shifted right" a couple of hours. Where her Lantus onset was close to +3, it's now after +5. The range of nadir times has also shifted over a couple hours. I like that the nadir is around preshot time, cause it means I'm around then. ;-) One advantage to Levemir, for Neko, is that she can be a lot flatter. I've seen cycles (at night of course), where she's varied all of 7 points.

As for Lantus dose vs. Levemir dose, it's ECID. Wendy's Tiggy is on quite a bit less Levemir but Neko ended up around the same.
 
I definitely see longer duration with Gracie on lev. When the dose is right, she gets awesome carryover and overlap which she rarely did on Lantus. She's also flatter and, like Neko, can have cycles where she is almost the same number for hours. Not always...but it never happened on Lantus. The late nadir allows you to shoot low habitually knowing you have some time to the next onset.

Lev is cheaper. Not a ton but every little bit helps. We did decrease Gracie's starting dose on lev 30% from the Lantus dose and we ended up going well above the Lantus dose.
 
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