8/9 Noodle PMPS 340 Too soon to consider Levemir? Desperate!

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Christianna

Member Since 2014
I am at wit's end with all the pinks I'm seeing for Noodle. No matter when I test him, he is always just a few points different from his highs. He has been on Lantus approx. 3 weeks with several dose increases. If anything, it seems the higher his dose, the higher his BG numbers. I have tested him with 2 different meters and they came within 5 points of each other. The vet says he should be responding significantly by now and is pushing Vetsulin, which I know from my reading on the forum is very harsh for cats. Noodle is allergic to salmon so can't use any insulins with protamine. One member told me she thinks I haven't given Lantus a long enough test. I am desperately considering Levemir (but the vet is hell-bent on Vetsulin) as I feel we are running out of options for Noodle and I'm afraid of what all these 300s are doing to him, or will in the long run. Please advise, I just do not know what to do next. Thanks so much.

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

hi christi
i have to tell you that tibbs has been on lantus for 4 weeks and today i was shocked to see his nadir went down to 64!! i had mostly pinks too so i didn't expect that. i am certainly not an expert but maybe it is too soon to tell.
these folks will tell you what to do and i'll tell you what they always tell me. "breathe" it will be ok. they will help u figure it out. take time.
hugs
nadine
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

I normally post in the TR group, but when you wake up to a cat staring you in the face, its a wee bit unsettling :P So here I am!

Feel free to take a look at Skooter's spreadsheet. It took him awhile for the Lantus to start working for him as well.

The thing to remember is that Noodle didn't become diabetic overnight and he won't start getting better overnight. It is a very frustrating process, I know and I haven't been doing it that much longer than you, but patience is something I had to learn (still learning) with this sugar dance. Also remember, Noodle is used to higher numbers being normal, so when he goes what his body thinks is too low, it will try to compensate by making insulin which makes the numbers go up. His body needs to learn that the lower numbers are ok, and once it does, you should see the results.

Skooter got up to 5u BID on dry food, went to 4u BID when he was getting a mix of the two and then down to 2u BID when he completely transitioned to wet. Currently (knock on wood) he is currently at 1u BID and hoping we don't need to increase to 1.25u BID.

Noodle's spreadsheet actually looks BETTER than Skooter's did in the beginning, he spent his first 5 weeks on insulin in the 400s and 500s. I see your Noodle is also an IBD baby like my Skooter. Is he on medication for that, and if so, what?
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi MollynSkooter,
Thanks so much for your encouraging words and for sharing your own experience. Yes, patience is certainly something I'm in short supply of, especially these days :? It seems like when I look at other peoples' spreadsheets I can see that their kitty at least has drops of 50-100 points, so I can see that they are making some progress. Noodle rarely has any kind of real drop at all and I still haven't discovered his nadir. I could understand his liver kicking in to pour out more glucose if he dropped low and was in danger but to my knowledge, he's never even dropped low enough to be significant. I have also worried that maybe my Lantus has gone flat, even though it is only 3 months old and has been carefully handled and refrigerated at all times. It doesn't help that my vet is pushing Vetsulin so hard and I've read some bad comments about it on here. My sister-in-law has an unopened Lantus pen she will bring over this evening and I'm thinking about using it to see if it helps Noodle. But I really don't think the vial I have is flat. Still, that's one thing to rule out.
Yes, Noodle had severe IBD for 4 years (we got him at a shelter and they didn't tell us). A previous vet kept recommending all kinds of prescription foods, hypoallergenic, etc. and each made him worse than the one before. I tried my own food elimination diet but could never hit upon the culprits causing the diarrhea. Finally a different vet suggested food allergy testing and turns out Noodle is highly allergic to tuna, salmon (which of course are in TONS of wet food), soy and corn. So I went shopping with my magnifying glass and stocked up on all wet food without any of those ingredients. It was like someone waved a magic wand. Noodle has not had one episode of bloody, mucusy diarrhea since and his poops are perfectly formed just like our other cat's. Some vets and people too don't put much stock in food allergy testing for cats but it was a miracle for Noodle. What do you do to treat Skooter's IBD? Has putting him on wet food helped?
Sorry, didn't mean to write a book but wanted to thank you for your valuable advice. Hugs to you and Skooter :smile:

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Lantus definitely takes patience! But my Sunshine also had issues with Lantus seeming to do nothing, no matter what the dose. Very low, or rather high, she was in the same, not good, numbers all the time. Levemir made a rapid difference with her, though her numbers recently aren't great. She's still getting over a stressful situation, and I expect them to move back down eventually. Do give Lantus a long enough trial, but it may not be the right insulin for Noodle, just as it wasn't the right insulin for Sunny.
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi Nadine,
Thanks so much for telling me about your experience. Wow--dropping to 64, that is amazing. I can't even imagine such a number for Noodle. I have begun to wonder if my Lantus has gone flat although it isn't that old so am trying a new pen tomorrow to at least rule that out. My vet is pushing hard for Vetsulin which I really don't want to do, based on some of the comments here. May I ask, how many units of insulin are you giving Tibbs right now? I'm so glad he is making progress and I'll try to remember to breathe :-)

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi matya13,
Thanks so much for answering my post and telling me about Sunshine. I guess I wouldn't be so impatient with the Lantus if I could just see SOME improvement. I wonder if Noodle is going to be like your Sunshine and just need a different insulin. I'll be getting a fresh Lantus pen tomorrow in case mine has gone flat but I really don't think that's the problem because Noodle seems to feel worse after dose increases so the insulin is having some effect (bad) just not enough to budge his numbers :sad: I hope Sunshine's numbers get better and thank you so much for your message.

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Christianna said:
I could understand his liver kicking in to pour out more glucose if he dropped low and was in danger but to my knowledge, he's never even dropped low enough to be significant.
Click to expand...

Keep in mind that you are basing this on YOUR definition of low, not Noodle's. Look at July 2 and 3 for Skooter...now I wouldn't call these numbers low, but it was only the second time Skooter hit the 100s and BOOM AM cycle on 07-03 bounced up and spend a couple of cycles up there. Also look at 06-24, I was only testing AMPS and PMPS but again a bounce. I do not really consider 143 low, but at the time, Skooter's body did. Dropping low is a relative term at this point and you have to go by Noodle's definition of low, which could be a 200 number. You can also see bounes around the 17th and 18th of July.

Remember that ECID and is it possible the Lev would not work as well for Noodle as it has for some others. I think you just need to give it time, it has only been three weeks and in the grand scheme of things that is not a lot of time to give the Lantus a chance.

I would also recommend getting some PM cycle tests in if you can....cats tend to go lower at night and depending on how low he is going at night, could be causing the bounce on the following cycles.

Christianna said:
What do you do to treat Skooter's IBD? Has putting him on wet food helped?
Click to expand...

Skooter was on a rx dry food and predisone, which probably caused his diabetes. Once he was dx'd with diabetes, he was switched to budesonide. And he started his transition to wet food July 4th and fully transitioned by July 11th (you can see the difference in his numbers around that time)
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

hi christi
tibbs is on 1.5 units of lantus. i don't have any idea where the 64 came from since all of his nadirs have been much higher. i definetely think that 3 weeks is no where near long enough to tell if it's working. i think noodles body is still adjusting. hopefully you'll see something soon. hang in there. :YMHUG:
nadine
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

I am wondering if Noodle's problem is too much insulin. Too much and not enough often look the same. The increases you have done thus far are not producing results. Let's see what Mel thinks.
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi Christie

First off you're dose hopping way too much. Poor Noodles body can't settle on a dose before you're cranking it up again.

Lantus is a depot insulin and because of that it develops a shed. Every time you change dose it takes 3-5 days for that shed to adjust during that time you don't count those days in how long you've head a dose. Once the shed adjusts then you hold that same dose for another 3-5 before deciding if you need to increase or not. Some cats will take even longer to settle on a dose and really show what its doing.

Personally if Noodles was one of mine I'd drop back to .5, hold for 10 days then if still too high increase to .75 hold for 10 rinse and repeat as necessary.

Mel and The Fur Gang
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Dear MommaofMuse,
Thanks so much for your thoughts and suggestions! I must have gotten something wrong. I mistakenly thought that I was supposed to hold each new dose for Noodle 3 days (or 6 cycles) then increase .25 unit again. Oh, boy. What am I doing???!!!
Today's +5 was 370, almost the highest he's ever been, so I've clearly botched up somewhere. Oddly, when Noodle was off the insulin altogether for a couple of days (at vet's advice) he was in the 250-280 range. Yet the vet keeps telling me to increase half a unit every 4 days. I feel so bad, making Noodle bounce around. I'm going to do what you said, starting tonight.
One other question--in the past Noodle had trace ketones but has not had any for about 2 weeks. I check every day. During the next 10 days of going back to .5U, what should I do if the ketones come back? Thanks so much. I can't tell you how I appreciate your response and advice.

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi LindaMS,
Thanks so much for answering my desperate post. I heard from Mel and she agrees with you so I'm going back to .5U for 10 days. I'm about to have a nervous breakdown over this so this clear-cut advice is really welcome. Thanks so much!

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi Nadine,
Noodle's BG just hit 370 today at +5, the highest he's been for a long time. I had a great post from Mel and also from LindaMS that may be of interest to you on this subject too, as your numbers with Tibbs are kind of similar to Noodle's. I guess I have been raising poor Noodle's dose too often and bouncing him all over the place. I am so mad at myself for putting him through that. I am going to follow Mel's suggestion because whatever I'm doing is going from bad to worse :sad: I hope things are going better for Tibbs too :smile: .

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

If you see a trace or higher on the ketone strip then we'll have to fast track the insulin up but as long as Noodle is eating and drinking well and your testing for them daily you shouldn't have an issue.

Oh one other thing...BREATHE!!! It does get much easier, so much so I've adopted 4 more after my first sugarcat passed away. :-D

Mel and The Fur Gang
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi MollynSkooter,
Thanks for clarifying some of my issues and explaining the examples on your spreadsheet. I am so confused as to how a person knows whether to raise or lower if either one can cause a bounce. I know I need to get in more tests after the PM shot but my mom broke her hip July 26 and I have moved in temporarily with her for a month till my sister can take over. Noodle and my civie Maggie are with me but our schedule has been kind of difficult, not like if we were at home under normal circumstances :sad: I am so grateful for your help and that of everyone here. All my vet can say is raise, raise, raise the dose and clearly that's not working for Noodle, at least on this timetable. Thanks again!

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi MommaOfMuse,
Thanks so much. I will keep a close watch on the ketones although Noodle has been eating and drinking great but I have learned here how fast ketones can become dangerous.
Oh, I'm trying to remember to breathe but I don't think I've exhaled since Noodle became ill in May :sad: I am so glad it will become easier and my hat is really off to you for giving so many sugarcats a chance at life. They are VERY lucky to have you as a Mom!

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

There are also 13 civies here as well. Lol

Mel and The Fur Gang
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Totally off topic....BUT

Mel can I come to your house and play?!??!

Christi - Learn to trust your gut!!! I know it is very difficult to go against a vet, we are programmed that they are the "experts" in their field because their name starts with a doctor and they went to school and all...My guess however, if you asked the vet how many diabetic kitties they have treated and how closely the monitored those kitties, you would find the experience of the member's on this board far outweigh the vet's experience.

It is hard not to see the results you want to see when you want to see them.....just remember we are working a marathon here, not a sprint.... :-D

Tonight I give you the Power of Greyskull to help Noodle and his BG....It worked for Skooter last night so, here ya go:

giphy.gif
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Yippee! Mel said exactly what I was thinking. During those ten days, certainly watch the 5P's (peeing, pooping, purring, playing and preening). Test for ketones (and YEAH YOU that you have already been doing so!). Do your BG tests, and try hard to get those tests at the nadir, the more data you have about the LOWS the better.

Remember that the pre shot number is not about knowing how HIGH the cat is. It is about knowing how LOW they are.... as in we dont want to give insulin to a cat that is too low or we risk hypo at nadir. We take the pre-shot test to know if it is safe to shoot.

Things will settle down: the pancreas starts to heal, and the liver stops spitting out glucose in reaction to a perceieved emergency (a liver that has been in a diabetic body for a while thinks high BG is normal and strives to keep it that way. This is what a bounce is).

Even more dramatic can be when cat gets too much insulin, the body overreacts and protects itself by releasing even more sugar.

You have changed the cat's diet to low carb. That in and of itself can bring BG down a lot.

So, we are going to be expecting Noodle to take a while to adjust to his dose being dropped. He may seem better, he may seem worse. New Dose Wonkiness might well show up too, where he seems to be all over the map. Hold steady, friend. Ten days, unless ketones show up. Its going to be okay.

And Breathe. We are all here for you.
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi LindaMS,
Oh what a wonderful post! I feel hope again. Plus there is so much good information that I really needed. I've read it twice already just to absorb it all and I know will refer back to it when I get bummed out, as there will no doubt be some ups and downs as Noodle adjusts. I would be lost without the members on this board. I have no confidence in the vet advice I've been given and that would be a lonely and desperate place to be were it not for this wonderful board and members such as yourself who jump in at all hours of the day and night to help us in panic. From the bottom of our hearts, Noodle and I thank you!

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi MollynSkooter!
The Power of Greyskull! I love it! It's the first time I've chuckled out loud for quite a while. Now I KNOW Noodle will have better BGs! I looked at Skooter's spreadsheet and I would kill for Noodle's numbers to be like that. And all this time, you and Skooter had Greyskull on your side :-D Thank you so much for all your help and advice throughout my panic and especially for this light, fun post!

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi MommaOfMuse,
To me, your house with all those kitties sounds like my idea of heaven :smile:

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Christi -

Just remember to look at the TOP of Skooter's spreadsheet as well....those numbers weren't so pretty, but it TOOK TIME for him to get where he is now....

Also, your version of frustrating numbers will change as well....right now I am pretty frustrated he can't seem to get out of the high 100s and 2 or 3 weeks ago, I would have KILLED for a high 100 number....

All about perspective :)
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

hi christi
i see that you have found out that this board is the place to be. if you follow the advice of the people here your cat will have the best chance ever. they are truly experts at this. it is going to take time. it won't happen over night. so i would just recommend to take it easy, lower your stress and just do what they tell you to do. you are already helping your baby alot and Noodle will get there. as they said it's a marathon not a sprint. these folks do know more than alot of vets out there so be confident about their recommendations and trust yourself. we are all here for you anytime you need us. big hug to you and noodle :YMHUG:
nadine
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

It only sounds like Heaven until you realize it comes with 17 litter boxes to clean and I go through 120 cans of Friskies and 120-160 lbs of litter per week. ROFLMAO. Not to mention the pounds of fur I vacuum off everything per day.

Mel and The Fur Gang
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

oh Mel. i def. feel ur pain. i only have 11 and i am sure my house has a 6inch layer of cat hair under the couches. i'm really afraid to look at this time of year. lol i only have 11 litter boxes to clean. it's crazy haha_smiley
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Mel - that is the beauty of it...I would get to play wif them and then go home to my one cat lolol

Tibbs5 (sorry I don't know your name) ...ONLY 11 lololol

I wish Skooter wanted siblings.....
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Hi Nadine,
You are so right--this is the best place to be. I have gotten so much valuable help here. If I was simply relying on my vet, I'd be in a mess. I so appreciate your words of encouragement. You can probably tell by most of my posts that I've been a basket case, with Noodle's numbers so stubborn, and then going up when I raised the insulin. Mel and LindaMS straightened me out on that so now I feel like I at least have a sensible plan. What the vet told me sure wasn't working :-x
I wonder how your baby Tibbs is doing. I remember you posted a couple of days ago that he had some numbers in the 60s but now is back up in the 300s again, just like Noodle. It's frustrating isn't it? nailbite_smile I sure hope you see some good BGs on Tibbs very soon. Thanks again for all your help and support.

Christi
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

hi christi
yes it is hard to understand what is going on with his numbers but i am just following the advice i've gotten here. we'll both do ok. it will get better. we are doing the best that we can for our babies. hopefully soon we will both have kittys that are regulated.
hugs to you :YMHUG: :YMHUG:
nadine
 
Re: 8/9 Noodle PMPS 340 Too soon to consider Levemir? Desper

Please start a new thread with Noodle's current status so we can more easily see it and support you. Thanks.
 
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