? Dose advice - Theodore 10/19 131 +6

NadineTheodore

Active Member
Does Levemir have a different curve then for example Lantus?

It seems his Nadir's tend to be later and sometimes very close to the shot time?

Also I increased his dose by .25 as it seemed his glucose was still high. Just wondering if I made the right decision this morning? I've had to adjust as he was on Clavamox since October 8, 2024 for a UTI. We are seeing a cardiologist Tuesday....I'm just so worried with his weight decline. He is skin and bones and become fussy although he is eating but I've had to switch from Dr. Esleys to Squarepet and just giving him ALMO+Tiki wet... Fancy feast won't do it for him anymore
 
Levemir's typical onset and nadir both tend to be later than that of Lantus cycles. The curve shape can be similar, just the timing changes. Lev typical onset is +4 and typical nadir +8 but there is some variation by cat. Theodore's onset looks more like +3 on Lev, not uncommon. Neko was later on both. It wasn't uncommon for Neko to have her Lev nadir around +12. The good news, I was always home for those +12 nadirs. :). But you do have to get used to shooting lower numbers. With Neko's onset of +5, I had plenty of time for her to eat before the next cycle insulin action started.

What are you giving Theodore regularly for nausea? Are you giving him probiotics to help with the antibiotics killing the good flora too? Give the AB and probiotics a couple hours apart.

Maybe update your signature, sounds like the foods are completely different now. Dry food means following SLGS, which means staying with doses that get nadirs in the 90-149 range.

Have you tested ketones lately?
 
Levemir's typical onset and nadir both tend to be later than that of Lantus cycles. The curve shape can be similar, just the timing changes. Lev typical onset is +4 and typical nadir +8 but there is some variation by cat. Theodore's onset looks more like +3 on Lev, not uncommon. Neko was later on both. It wasn't uncommon for Neko to have her Lev nadir around +12. The good news, I was always home for those +12 nadirs. :). But you do have to get used to shooting lower numbers. With Neko's onset of +5, I had plenty of time for her to eat before the next cycle insulin action started.

What are you giving Theodore regularly for nausea? Are you giving him probiotics to help with the antibiotics killing the good flora too? Give the AB and probiotics a couple hours apart.

Maybe update your signature, sounds like the foods are completely different now. Dry food means following SLGS, which means staying with doses that get nadirs in the 90-149 range.

Have you tested ketones lately?

I haven't tested recently for ketones to be honest. Last time was a week ago...Should I ask for Cerenia to give him regularly? I just worry about all this medication with his cardiologist appointment coming up. The pulsating neck vein is really scaring me.

I am trying to put probiotics on his food but it's hit or miss if he takes it. The antibiotics will be done shortly. I actually got him eating something called SquarePet ( I will update my signature that is diabetic friendly )!!!! I didn't want to update because him eating something was only lasting a day or two but this one seems to be sticking :smuggrin:

https://globalwanless.globalpetfood...h298MmMI5zvuIwViZg_aem_OEjnGrerWMdpKukyS5FKEQ
 
We had one other member (Canadian too) using the SquarePet.

Does Cerenia help his nausea? I find it better to control vomiting, and use ondansetron for nausea.
 
We had one other member (Canadian too) using the SquarePet.

Does Cerenia help his nausea? I find it better to control vomiting, and use ondansetron for nausea.
I haven't used Cerenia to be honest lately, I have tried the appetite stimulant which I believe is supposed to help nausea. Is ondansetron safe heart issues? I will double check with the vet about it
 
Just shot at 131. Hoping no bounces.

***EDIT*** Is it strange that I just checked his glucose and FSL shows 15.8 :arghh: Is it normal for it to double so quickly
 
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Absolutely, Neko had heart issues when on it.

As for that +1 number, he could be bouncing, in combination with some New Dose Wonkiness.
Do you mind me what the process looked like with the heart issues? I'm really nervous about his cardiologist appointment. I am not sure what to expect. They will be doing an echocardiogram Tuesday. How did you find out Neko had heart related issues? With Theodore it's just this odd pulsation in neck, high blood pressure (165) and his heart murmur
 
How did you find out Neko had heart related issues?
Neko had acromegaly, which very often causes heart issues. She was also part Maine Coon, and they often have heart issues. So heart issues were not a surprise. The regular vet heard a murmur, so we had it checked out with an echocardiogram. Her heart was a little bigger than normal, not much, but enough to be classified as HCM (hypertrophic cardiomyopathy), but the cardio vet said her murmur was from age related changed to her heart, not the HCM. She needed no medications at the time, just some regular monitoring and the cardio vet suggested that the regular vet check her heart each time she saw Neko, and to note when the murmur changed location or level, and then get into the cardio vet if that happened.

That's not not how I found out her heart had gotten worse. I had her scheduled for a second radiation therapy for her acromegaly. A precondition to that (requires anaesthesia), was an echo, which she did and got the all clear. Three weeks later, during the anaesthesia for CT scan, she had a heart block and they had a hard time reviving her. When we got back home, the cardio vet said she still didn't need meds, but could no longer have anaesthesia. 6 months later her appetite fell off suddenly. She went into the internal medicine vet to get checked out and also saw the cardio vet. She was diagnosed with CHF (congestive heart failure) and small cell lymphoma. This was the point where she started on medications for the heart (and SCL). SCL by itself would have been enough to reduce her appetite. From the cardio vet, I learned to test RR or resting respiration rate and used that to track how her heart was doing.
 
Neko had acromegaly, which very often causes heart issues. She was also part Maine Coon, and they often have heart issues. So heart issues were not a surprise. The regular vet heard a murmur, so we had it checked out with an echocardiogram. Her heart was a little bigger than normal, not much, but enough to be classified as HCM (hypertrophic cardiomyopathy), but the cardio vet said her murmur was from age related changed to her heart, not the HCM. She needed no medications at the time, just some regular monitoring and the cardio vet suggested that the regular vet check her heart each time she saw Neko, and to note when the murmur changed location or level, and then get into the cardio vet if that happened.

That's not not how I found out her heart had gotten worse. I had her scheduled for a second radiation therapy for her acromegaly. A precondition to that (requires anaesthesia), was an echo, which she did and got the all clear. Three weeks later, during the anaesthesia for CT scan, she had a heart block and they had a hard time reviving her. When we got back home, the cardio vet said she still didn't need meds, but could no longer have anaesthesia. 6 months later her appetite fell off suddenly. She went into the internal medicine vet to get checked out and also saw the cardio vet. She was diagnosed with CHF (congestive heart failure) and small cell lymphoma. This was the point where she started on medications for the heart (and SCL). SCL by itself would have been enough to reduce her appetite. From the cardio vet, I learned to test RR or resting respiration rate and used that to track how her heart was doing.
I'm sorry she went through so much :(
 
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