? Dosage suggestions needed.

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Magda

Magda

Member Since 2016
I was considering using R insulin since Menda is going usually at 300s. Was going to start tomorrow morning and tonight he went lower than usual. Unfortunately I'm not around to test more. But was going to be home next week to check. I was holding off changing to 16 units since I wasn't going to be home and needed my husband to be able to treat give insulin without too much of the risk. He had hard time testing couple time.

So looking at current SS any dosage suggestions for just Levemir?
Feeding Purina pro plan True Wild
Relion Prime Glucose meter.
Did vit B12 shot yesterday 0.3ml
 
With Levemir, often the preshot number can be close to the nadir. If you are following Tight Regulation, then a number in the 60's is fine. But if you are unable to get any night time tests it might be a bit high a dose. Many cats go lower at night which is why we always recommend getting a night time test, perhaps just before going to bed. Maybe go back to 15 or 15.5 units until you are home and can do more testing.

I would only try R if you are going to be around to monitor closely, and suggest that you have someone experienced with R help you through it the first couple of times. We have a few people here who have R experience if you want that help. Typically you'd start at a small dose like 0.25 units and test every hour for at least 4 hours after giving R. My Neko never needd more than 0.5 units of R, and when she was on a smaller dose, a drop or two was enough. One of the most important things to learn about R is learning when not to give it. For some kitties, the cycle after the one with R can be active.
 
If you want to use R it's a good idea to make a date with someone who is experienced with it. You'll want them to look at Menda's spreadsheet and make sure it's a good time for it.

What time zone are you in? And what time do you usually shoot, or would you like to try the R? Looking at his spreadsheet just for the past few days, I'm thinking one option would be at amps.

We can find someone to commit to being with you for the 4 hours of the trial. They'll assess if it's a safe time to shoot the R, then check in with you hourly and help you see what's happening. Usually it's good to line it up a day or more in advance. So say when you'd like to try it and I am happy to look for someone for you.
 
I was working with veterinarian with R insulin but Menda doesn't seem to react to it. Can someone look at the chart? Started with just few drops to be safe but now at 4units he is still running high. I'm in NJ.
 
Why did you drop the Lev dose to 10u when you began using R? The Lev lasts a long time, the R is relatively brief in the body, so you want the Lev to be at a pretty good dose, then fine-tune with the R. The R doesn't replace the Lev.

I would go back to the 16u Lev, if Menda were mine, and go from there. I think it will be likely you'll have to increase the dose above 16u since the dose was dropped, in order to get back to the same range you were getting at 16u before. Does that make sense? High numbers cause glucose toxicity, and it doesn't take long for it to mean that you have to increase the dose even more in order to get the blood sugar to move.

We typically start with a 0.25u dose of R, in addition to the regular Lev dose. Here is a post that Wendy recently did that has some discussions about R in it. Also lots of good references to high dose conditions.

Remind me - was Menda tested for iaa?

I'm sorry your post got missed this morning. For some reason things have been slow. It's always good to bump your post up again by adding a reply, if you haven't gotten an answer.
 
This was suggested by veterinarian. If you see his past numbers before I started R he never got steady below 300s. He goes at 300s than drops to lows for a day and goes back to 300s. No matter what I did I'm getting bad readings all the time. I'm starting new job unexpectedly tomorrow so have to figure something out quick.
 
I agree with Julie, dropping the Levemir dose was the wrong thing to do. I too would go back to 16 units. On April 2nd that dose got her to some nice greens, but then you lowered the dose, she bounced and then you lowered the dose even more when you started the R experiment.

I wonder how much experience your vet has with R as an ongoing tool. Most vets are used to using it as a short term aid to handle emergencies, but not as something used as an ongoing basis in the home. And they typically think of using it in larger quantities than we do. Some cats need less R insulin and too much can cause fast drops which means more bounces. Neko never needed more than 0.5 units of R and a typical dose for her was more like 0.25 units. That's why we start with a smaller R dose and work our way up to what the cat needs.
 
should I go straight to 16 or slowly move up? Also if you look at history Menda goes to greens for a day and than goes back up again.
 
I would go up to 16 units - call the reduction to 10 units a failed reduction and go back up. I would put R on the back shelf of the fridge for the moment. It'll take a few days for the depot of the larger dose to build up. Maybe you can experiment again with R after a few days and when you do have time to monitor him.
 
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