? Advice needed on starting doses, switching from ProZinc to Levemir

[CheriB]

I have my Levemir and I'm ready to go. Meggie was diagnosed May 2016 and has been on ProZinc. I have a Relion Confirm micro tester that I am using. She has been completely converted over to wet pate food as of Jan 25th. She is currently at 4.75U (see her spreadsheet for BG numbers--I just started checking them as of 1-25...the vet did not recommend testing but I am doing this on my own now after following message boards and support groups and learning more about feline diabetes.) Her numbers are still in what I would call a high range and she is rarely in the 100-199 range. I did go through trying to use Novolin R in combination with the ProZinc to get the numbers down, but I knew I was switching to Levemir, so I stopped doing the R and subsequently increased her ProZinc levels. I think I can do the Tight Regulation Protocol. I know that I need several days that I can monitor her closely. She weighs 12.4 lbs. Since she is already at 4.75 U of ProZinc, do I still need to begin with just 1U of Levemir or less or more? I noticed there was the protocol of shooting 0.25U per kilogram x the ideal weight of the cat but there is also the note about the starting dose should be increased or decreased based on taking prior data into consideration. She's 12.4 lbs and has been that weight for several years. That would indicate starting at 1.4U

I'm a little nervous about changing insulin because she has never gone low to my knowledge with the ProZinc--just nervous that she will go low on the new Levemir--I am not nervous to get this under control, so I want to switch so I can get her numbers down. I also currently try to give her shots every 12 hrs but with my schedule, it could be anywhere from 10-14 hrs apart. ProZinc is somewhat forgiving in that it wasn't lasting that long--I think it was out of her system easily by 8 hrs. I'm nervous because the Levemir stays in the system longer and it is a depot. Just need some advice here too (shooting in the 10-14 hr time frame)...along with what kind of dosage I need to start with.

Maybe 1 more thing. I have a pen. From what I've read, it's better to use a U100 syringe and extract the insulin instead of using the pen needles that come with the pen. I do have U100 syringes with 0.5U marks. I also read that you were to inject no air into the pen and only use the needles once. If there is anything else that I need to watch out for, you can let me know about that too. There's so much information, it's hard to take it all in...I did read through all of the stickies though.

https://docs.google.com/spreadsheet...lv1zalGcRpwWCRC_prxlQqiUE/edit#gid=1131435116

 

[Wendy&Neko]

Here is the link to your last post here, for context.

I'm glad you were able to get some data without the influence of R. Looks like she's getting to high blues on this dose. We would typically start at around the same dose of Levemir as Prozinc. Provided that you will be home to monitor closely for the first couple of cycles of Levemir, in case your cat is one of those that has a strong initial reaction to the insulin switch. If you want a little margin of safely, you could always take it down to 4.5 units.