8/21 Alex AMPS HI

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Caryl & Sebastian & Alex (GA)

Caryl & Sebastian & Alex (GA)

Member Since 2009
Happy Caturday Everyone!

Well not so much for me. This PS number is driving me insane. I have no idea how to get it down. Libby suggested feeding at +1,2 and 3 but the fact is that I'm not here 4 days a week at those times. By +4 he has plummeted. I was examining Alex's ss and looking for hints.

Question...

Has anyone ever switched from Lantus to Levemir only to find that the Lantus was actually better for their kitty? I don't really know if this is true for Alex but it seems that his PS numbers have gotten worse since the switch. Is it possible that duration isn't as long for him? Does anyone know? Just a thought.... :YMSIGH:

Alex is fine albeit a little whiny with all of this bouncing. His appetite is great. All p's are in order, well except for the whining. He gets a little acetoney now and then from the high numbers but well..... I'm not even gonna' go there right now (the jinx factor) :lol:


He and Jackson had a big beffis and they're taking naps now.

Have a great day everyone... :-D

2 Days Ago
 
I see on your SS that you increased his dose this morning.... 4.75u
I have no ideas regarding the Lev vs Lantus but maybe someone will be along who knows the answer to that.

A lot of people have had success with changing the meal amounts and times...maybe you would see something during the days when you are at home ....why not try it and see if anything changes?

Just wishing you Alex and Jackson a Happy Saturday in spite of everything...and sending some HUGS... :YMHUG:
 
sorry about these amps, they just suck.
Have you thought about buying an automatic feeder? I just got one recently and it's worked out well. I know some cats don't take to them but it might be worth a shot if you haven't tried it already
 
I'm sure there are some cats who have switched back to Lantus. Can't think of them off the top of my head. At one time Jojo was thinking of switching SD back to Lantus, but I don't know if she did.

I agree with Pat, there might be a solution to be found by rearranging his meals, so you'll be able to give more insulin without dropping him too low. Alex drops fast and early, so he probably needs more food in the beginning of the cycle and less in the last 6 hours.
 
Libby and Lucy said:
I agree with Pat, there might be a solution to be found by rearranging his meals, so you'll be able to give more insulin without dropping him too low. Alex drops fast and early, so he probably needs more food in the beginning of the cycle and less in the last 6 hours.
Click to expand...
i agree with pat and libby. food manipulation is a great tool. loading up the first part of the cycle may help...
 
Hey Alex, sure do hope you get your #'s in check soon buddy. And, glad to hear you feel grrrrrrreat too!

Regarding Lev to Lantus: I think Milo switched towards the end before going OTJ. And I too recall reading about Jojo contemplating switching back as the common belief that Lantus stung when injected was perhaps not so & one other reason that I can't remember. I'll search for that link & post if I find it.

ETA: Milo's post viewtopic.php?f=9&t=14578&p=147066&hilit=Jojo+lantus+levemir#p146249

ETA: this is in regards to ACRO hi doses but still may be of interest...
Re: 10U BID Lantus- Acro?? - Levemir??
by jojo and bunny » Sat May 15, 2010 8:38 pm

hey dr lisa! nice to see you, have missed talking to you...but as you know i've been out of the box pretty much 24/7 lately.

few things on this thread...
"My question to you guys is a pretty general one - have there been many cats that seem to be resistant to Lantus but do much better on Levemir?"
~not at that dose. not with what you are looking for, magic bullet as far as lev vs lantus for this cat. yeah sure can get slight temporary improvement when switching from one L to another (my cat was one of the first lantus to lev switch cats) but it doesn't last and you are not going to have a 10 units lantus cat turned into a 1.5 unit lev cat just cause of insulin switch. (sometimes the timing of a switch from lantus to lev for an acro corresponds with one of their many rev downs (GH fluctuations) and it could look like the switch was the cause rather than the GH levels).
why are mostly all the HD cats on lev? cause once they got over a certain dose back when we were getting the first HD cats in LL, i would start recommending the switch, my reasons being that very large doses of lantus *might* sting some cats (haha, and some of that was cause i *thought* it did in my own not low dosed cat, he was so bad for his lantus shots, turns out he is just as bad for his lev shots, dis cat just don't like needles, lol), and that when i originally started that recommendation we were under the impression from lack of data that lev lasted longer than lantus, was more 'fragile' which now vet med studies have proven the opposite (oops)and hence the HD cats could use lev vials rather than lantus carts for $$ savings, and...cause of the warning on lantus about rats and cancer and super super high mg/kg doses happening one in blue moon. eh i was being way over cautious, really have no worries about that nowadays. really either is fine, but if you are looking at an acro (which you prolly are) then i would go for lev just in case he ends up being an acro like say girlcat and her top doses of 60 something units bid and the possible sting thing. (most acros do not 'go there' with their doses though, there are plenty of "low-dose" acros around, meaning under 10-15 units). HD cats being on lev has just become part of FDMB culture rightly or wrongly i would not draw a firm medical opinion on (and what part i played in that i hope it ends up being rightly, lol). i havela been toying with idea lately of switching my cat back to lantus, it is a once a day insulin in humans vs. lev's twice a day in humans and i have to wonder if maybe lantus has a stronger shed than lev (longer overlap/better depo)? and cats that have switched the other way, from lev to lantus have noticed the same temporary improvement. push comes to shove the action is so similar in the end~ whichever as far as a choice for most cat, however if this cat is going to continue up the dosing scale with no end in sight, then go with lev for possible comfort reasons. last thing one needs is a larger dose cat that doesn't like his shots...trust me on that one.

~the IAA question, yes test for it, they can start off at first shot being resistant to whatever insulin they were injected with, after all they built up a resistance to their own natural insulin, right? ;) and from what we have seen, which is very data poor being that IAA is truly rare and we do not have a large data base here (or anywhere! trust me i looked, there is crappus as far as feline IAA info out there anywhere ), IAA is crossover to all insulin, with the exception of one IAA cat that is (or was, i have not checked in quite some time) able to get R somewhat past the antibodies. the tx plan for IAA cats is very different than acrocat's.

"Come to think of it...I probably should post this in Levemir so I will put a link there also."
~the HD lev cats hang out here, don't know that you will get any hands on current experience posing question there.

you got all the info on all testing, nice job everyone.

as far as when/how to do the switch~ owner must be home for whole cycle. first shot big action has been seen on plenty of occasions among acros and reg diabetic cats when switching (like first shot of any L insulin this has been noticed, we like owner home and full hypo tool box. often total non-event but always like to err on side of caution). with the blue this cat has been getting i personally would drop a couple of units off first shot and then be prepared to go right back to the 10 unit prior dose immediately after if numbers call for such. SS looks like getting closer to needed dose there, maybe not too far away from getting the all blue acro curve that is desired, if this cat is an acro of course. getting the blue, just need to lose the pink, so nice job getting that close.
~jojo

(if you can....check your e-mail later, i have an FIV+ feral question for you, k?)

eta: man i type too slow, been 10 new posts since i started this? geez. gotta go out and feed my ferals, will be back to read...
FDMB member since 2000.

jojo and bunny

Joined: Mon Dec 28, 2009 2:58 pm
Click to expand...
 
sehjak (Susan & Lanky) said:
Hey Alex, sure do hope you get your #'s in check soon buddy. And, glad to hear you feel grrrrrrreat too!

Regarding Lev to Lantus: I think Milo switched towards the end before going OTJ. And I too recall reading about Jojo contemplating switching back as the common belief that Lantus stung when injected was perhaps not so & one other reason that I can't remember. I'll search for that link & post if I find it.

ETA: Milo's post viewtopic.php?f=9&t=14578&p=147066&hilit=Jojo+lantus+levemir#p146249

ETA: this is in regards to ACRO hi doses but still may be of interest...
Re: 10U BID Lantus- Acro?? - Levemir??
by jojo and bunny » Sat May 15, 2010 8:38 pm

hey dr lisa! nice to see you, have missed talking to you...but as you know i've been out of the box pretty much 24/7 lately.

few things on this thread...
"My question to you guys is a pretty general one - have there been many cats that seem to be resistant to Lantus but do much better on Levemir?"
~not at that dose. not with what you are looking for, magic bullet as far as lev vs lantus for this cat. yeah sure can get slight temporary improvement when switching from one L to another (my cat was one of the first lantus to lev switch cats) but it doesn't last and you are not going to have a 10 units lantus cat turned into a 1.5 unit lev cat just cause of insulin switch. (sometimes the timing of a switch from lantus to lev for an acro corresponds with one of their many rev downs (GH fluctuations) and it could look like the switch was the cause rather than the GH levels).
why are mostly all the HD cats on lev? cause once they got over a certain dose back when we were getting the first HD cats in LL, i would start recommending the switch, my reasons being that very large doses of lantus *might* sting some cats (haha, and some of that was cause i *thought* it did in my own not low dosed cat, he was so bad for his lantus shots, turns out he is just as bad for his lev shots, dis cat just don't like needles, lol), and that when i originally started that recommendation we were under the impression from lack of data that lev lasted longer than lantus, was more 'fragile' which now vet med studies have proven the opposite (oops)and hence the HD cats could use lev vials rather than lantus carts for $$ savings, and...cause of the warning on lantus about rats and cancer and super super high mg/kg doses happening one in blue moon. eh i was being way over cautious, really have no worries about that nowadays. really either is fine, but if you are looking at an acro (which you prolly are) then i would go for lev just in case he ends up being an acro like say girlcat and her top doses of 60 something units bid and the possible sting thing. (most acros do not 'go there' with their doses though, there are plenty of "low-dose" acros around, meaning under 10-15 units). HD cats being on lev has just become part of FDMB culture rightly or wrongly i would not draw a firm medical opinion on (and what part i played in that i hope it ends up being rightly, lol). i havela been toying with idea lately of switching my cat back to lantus, it is a once a day insulin in humans vs. lev's twice a day in humans and i have to wonder if maybe lantus has a stronger shed than lev (longer overlap/better depo)? and cats that have switched the other way, from lev to lantus have noticed the same temporary improvement. push comes to shove the action is so similar in the end~ whichever as far as a choice for most cat, however if this cat is going to continue up the dosing scale with no end in sight, then go with lev for possible comfort reasons. last thing one needs is a larger dose cat that doesn't like his shots...trust me on that one.

~the IAA question, yes test for it, they can start off at first shot being resistant to whatever insulin they were injected with, after all they built up a resistance to their own natural insulin, right? ;) and from what we have seen, which is very data poor being that IAA is truly rare and we do not have a large data base here (or anywhere! trust me i looked, there is crappus as far as feline IAA info out there anywhere ), IAA is crossover to all insulin, with the exception of one IAA cat that is (or was, i have not checked in quite some time) able to get R somewhat past the antibodies. the tx plan for IAA cats is very different than acrocat's.

"Come to think of it...I probably should post this in Levemir so I will put a link there also."
~the HD lev cats hang out here, don't know that you will get any hands on current experience posing question there.

you got all the info on all testing, nice job everyone.

as far as when/how to do the switch~ owner must be home for whole cycle. first shot big action has been seen on plenty of occasions among acros and reg diabetic cats when switching (like first shot of any L insulin this has been noticed, we like owner home and full hypo tool box. often total non-event but always like to err on side of caution). with the blue this cat has been getting i personally would drop a couple of units off first shot and then be prepared to go right back to the 10 unit prior dose immediately after if numbers call for such. SS looks like getting closer to needed dose there, maybe not too far away from getting the all blue acro curve that is desired, if this cat is an acro of course. getting the blue, just need to lose the pink, so nice job getting that close.
~jojo

(if you can....check your e-mail later, i have an FIV+ feral question for you, k?)

eta: man i type too slow, been 10 new posts since i started this? geez. gotta go out and feed my ferals, will be back to read...
FDMB member since 2000.

jojo and bunny

Joined: Mon Dec 28, 2009 2:58 pm
Click to expand...
Click to expand...

THANK YOU, Susan!!! A lot of information that has been very helpful to my head in here!!!!
Thank you, thank you, thank you :-D ♥
 
HI Caryl! Just wanted to pop in. I know this is two days old and you'll probably have a new condo sometime today...just not sure I'll be able to get in here and see it later.

Anyway, and this is totally off the cuff, and you should definitely talk about this idea with someone that has more knowledge than I do...but in that post Susan copied in, there is a reference that Lantus is 1x/day for humans and Lev is 2x/day for HUMANS. Well, if we make Lantus a 2x/day for a cat, wouldn't that mean that Lev needs to be 3 or 4x/day for a cat? Maybe? Going with your shorter duration theory, I just wonder if maybe Alex needs to get Lev 3x's/day to help keep his numbers a little more even. To me it would make sense that giving a lower dose more often for him might help with keeping him from the giant drops you're seeing at +4/5, in addition to keeping his PS numbers from going so high.

Anyway, just a thought. Maybe you've already thought about this...I dunno. I haven't been around much, work has been kinda crazy lately. Give your boys some love from Max and me. :YMHUG:
 
I'm really not sure where Mindy is getting her information.

According to the NIH website for consumer information:
National Institute of Health said:
"Insulin detemir comes as a solution (liquid) to inject subcutaneously (under the skin). It is usually injected once a day, with the evening meal or at bedtime, or twice a day...
Click to expand...

According to the manufacturer:
Novo Nordisk said:
Levemir® is a long-acting basal insulin that is a treatment option for the management of diabetes. Levemir® insulin can provide up to 24 hours of blood sugar control.
Click to expand...

And then, of course, there is the Tilly Protocol which is specific to the use of Lantus and Levemir in cats.

The above information is in regard to humans. There are a very small number of cats who are on specialized dosing regimens of TID dosing. I'm not sure the issue with Alex is one of duration.
 
Sienne and Gabby said:
I'm really not sure where Mindy is getting her information.

I believe she took it from the information quoted by Jojo from May 15th.."been toying with idea lately of switching my cat back to lantus, it is a once a day insulin in humans vs. lev's twice a day in humans and i have to wonder if maybe lantus has a stronger shed than lev (longer overlap/better depo)? "

It's all very confusing and I have no idea why this is happening with Alex because I have addressed all of his other issues. To see him starting to rise upward at +7 or 8 is downright maddening. angry(2)_cat angry(2)_cat I do know that I won't be giving him injections of anything three times a day though :o ..that's for sure (although I thank you for your brainstorming, Mindy)

Sienne, I do understand all of what you're saying and you know that Alex is a multiple problem kitty. It just seemed to me that if I've tried everything else, and I never had this kind of problem with Lantus, by process of elimination, it might be the next best step, because there are certain things that can't be done due to his medical conditions....
Click to expand...
 
Thanks for clearing that up for me Caryl--sorry, I always forget to use the quote function. And like I said, it was just the next step in my thought process as I do know a select few kitties get TID dosing...but I sure as heck wouldn't want to deal with that scheduling nightmare if I could avoid it. ;-) BID was hard enough, I can't even imagine trying to work in TID dosing!

Anyway, my point for stopping in in the first place was just to say "HI" and let you know I'm still trying to check in on you and your boys even if I can't help you problem solve much. :mrgreen: You three are regularly in my thoughts even if I'm not here posting.
 
Caryl and Alex said:
Lisa and Do Lou said:
Hi been not sure how long you have been on Lev but I am wondering the same thing for Do Lou today actually
Click to expand...

You getting higher preshot #'s and shorter duration with Lev too?
Click to expand...

I switched in hoping to help with his bouncing we have not been on it yet a month yet but for the most part yes and he just has been acting a little different but then something else maybe be going on but its only been a month since his dental and bloodwork and all was OK then. But I am starting to think he maybe needs to go back to Lantus
 
Lisa and Do Lou said:
Caryl and Alex said:
Lisa and Do Lou said:
Hi been not sure how long you have been on Lev but I am wondering the same thing for Do Lou today actually
Click to expand...

You getting higher preshot #'s and shorter duration with Lev too?
Click to expand...

I switched in hoping to help with his bouncing we have not been on it yet a month yet but for the most part yes and he just has been acting a little different but then something else maybe be going on but its only been a month since his dental and bloodwork and all was OK then. But I am starting to think he maybe needs to go back to Lantus
Click to expand...

I was doing a bunch of reading today and lots of things can affect the way the two work for different cats...from what I can see. Body chemistry for one. Possibly whatever meds a kitty is on...Alex is on several heart medications also that he isn't going off of that shouldn't affect insulin usage but who knows? I am switching foods now for a while but that's just as of this week..that doesn't explain why he's had about 4 red-free cycles since he started lev in May.!!! His numbers go lower in the middle but he comes right back up at PS time. And he is very very whiny and extremely hungry all of the time. He must feel crappy. So while i don't know for sure at all what is causing this to happen, I don't imagine that it can hurt to try the switch back to see if it improves things. I've got about 1/3 of a Lev pen left to see if things improve.
 
I have been reading a lot about Lev again today too

Do Lou is on heart meds and blood pressure med as well and overall he has acted a little different since being on Lev but I was just thinking it was more the up and down of numbers but I did wonder if its insulin vet did not really think so when I asked tonight when I talked to him since Do Lou is not having a good day today been vomiting and will not eat so we may be seeing the vet tonight. He seemed to think it was more number related as to how he felt but I still kinda wonder especially since you have seen something similar with your cat.
 
Sooo... I'm updated the master LL SS, and I thought, maybe i can find other kitties who switched from Lantus, and then back again.

Sure enough, I see.... Libby and Jazzy! I know Libby already weighed in and didn't mention this. Maybe the SS is wrong?

Also, Amber & Meadow. I see a typo in her entry, but maybe you could IM her.

Hugs.
 
i've found for some kitties with big drops that it's useful to feed slightly higher carb food (not necessarily hi carb per se, just higher than their normal carbs) at shot time or by +1 or so. it can tend to level out their numbers a bit more.
eventually after they've stabilized the higher carb food at shot time might no longer be necessary.
 
Kathy and Kitty said:
Sooo... I'm updated the master LL SS, and I thought, maybe i can find other kitties who switched from Lantus, and then back again.

Sure enough, I see.... Libby and Jazzy! I know Libby already weighed in and didn't mention this. Maybe the SS is wrong?

Also, Amber & Meadow. I see a typo in her entry, but maybe you could IM her.

Hugs.
Click to expand...

But ya' didn't change Alex's name! And ya' didn't mail me the Bruce STORY! :)

I'll check the spreadsheet now..thanks!!!
 
chriscleo said:
i've found for some kitties with big drops that it's useful to feed slightly higher carb food (not necessarily hi carb per se, just higher than their normal carbs) at shot time or by +1 or so. it can tend to level out their numbers a bit more.
eventually after they've stabilized the higher carb food at shot time might no longer be necessary.
Click to expand...

Because of some problems that Alex is having with his Urinary tract his vet wants him to try an RX food which is LC unfortunately. He has blood in his urine which he has had for a while and this helped my other cat for a while...so i gotta do this for a while because with all of Alex's other problems he doesn't need to become anemic :( :YMSIGH:

But Thanks :YMHUG:
 
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