First day on Levemir

Tucker's Mama CS

Tucker's Mama CS

Member Since 2019
Hi all,

This is Tucker's first day on Levemir. I am not too excited about the numbers, lol. How long until we see the depot build up and a reduction in his BG's?

0647 - BG 559
0649 - given 1 unit of Levemir (per vet's instructions for starting)
1050 - BG 428
1257 - BG 479
1408 - BG 525
1652 - BG too high for the meter to read (>600)
1825 - BG too high for the meter to read (>600)
1825 - given 1 unit of Levemir

Also, do you guys keep your pen in the fridge? The pen says to store at room temperature after first use. Do you shake it? I am used to shaking his Vetsulin.

Thanks for all of your help and advice!
 
Do NOT shake Lev. Unlike many other types of insulin, both Lantus and Lev are solutions. Many of the other kinds of insulin are suspensions and you have to shake them to get everything evenly distributed. Your Lev should alway look clear. If there's anything floating around in it, the insulin may no longer be good. (This doesn't happen very often.)

It takes roughly 5 - 7 days for the depot to become fully established. You may gradually see better numbers as the week progresses. Have you started a spreadsheet? If you look at our signature lines, we all have spreadsheets attached to our signatures. This means you don't have to keep typing out Tucker's readings and, the big benefits you can observe his progress and we can, as well. The link to setting up the spreadsheet is here. In the New to the Group sticky, there's information on how to understand the headings on the spreadsheet.
 
Hi over here. Here is your post on health for some background. http://www.felinediabetes.com/FDMB/threads/vetsulin-no-longer-working.209094/

What was the Vetsulin dose you were giving? For a cat with recent DKA, I would be reluctant to start on too low a dose. Getting that spreadsheet going will help us help you and Tucker.

Keep Lev in the fridge. People using pens keep it out of the fridge, but hopefully you are using U-100 syringes to give the insulin.
 
Sienne and Gabby (GA) said:
Do NOT shake Lev. Unlike many other types of insulin, both Lantus and Lev are solutions. Many of the other kinds of insulin are suspensions and you have to shake them to get everything evenly distributed. Your Lev should alway look clear. If there's anything floating around in it, the insulin may no longer be good. (This doesn't happen very often.)

It takes roughly 5 - 7 days for the depot to become fully established. You may gradually see better numbers as the week progresses. Have you started a spreadsheet? If you look at our signature lines, we all have spreadsheets attached to our signatures. This means you don't have to keep typing out Tucker's readings and, the big benefits you can observe his progress and we can, as well. The link to setting up the spreadsheet is here. In the New to the Group sticky, there's information on how to understand the headings on the spreadsheet.
Click to expand...
Thank you! I did a lot of reading in the message board this morning, and did some printing of important information. I am planning to set up the spreadsheet this week as I am on break from school and only have work to worry with. Thanks again!
 
Wendy&Neko said:
Hi over here. Here is your post on health for some background. http://www.felinediabetes.com/FDMB/threads/vetsulin-no-longer-working.209094/

What was the Vetsulin dose you were giving? For a cat with recent DKA, I would be reluctant to start on too low a dose. Getting that spreadsheet going will help us help you and Tucker.

Keep Lev in the fridge. People using pens keep it out of the fridge, but hopefully you are using U-100 syringes to give the insulin.
Click to expand...
Thank you! Spreadsheet is planned for tonight or tomorrow hopefully (break from school and supposed to be off work tomorrow). I am feeling really bad about how high his numbers are! He was on 5 units of Vetsulin BID, and even then his lowest numbers were in the 200's.
 
Are you testing every day for ketones? I started on Caninsulin (same thing as Vetsulin), got up to 5 units of it with just upper blues, switched to 1 unit of Lantus, and ended up at more than 5 units but wasted months of time. With recent DKA, you need to test for ketones daily and we may get you to bump up the dose much faster. Typically we will start people on close to the dose of their previous insulin when they switch.
 
Wendy&Neko said:
Are you testing every day for ketones? I started on Caninsulin (same thing as Vetsulin), got up to 5 units of it with just upper blues, switched to 1 unit of Lantus, and ended up at more than 5 units but wasted months of time. With recent DKA, you need to test for ketones daily and we may get you to bump up the dose much faster. Typically we will start people on close to the dose of their previous insulin when they switch.
Click to expand...
I have never tested for ketones at home. :-/ Do you think urine would be acceptable? Or blood? Do you have a preferred meter or recommend where I can get one in a hurry?
 
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Tucker's Mama CS said:
I have never tested for ketones at home. :-/ Do you think urine would be acceptable? Or blood? Do you have a preferred meter or recommend where I can get one in a hurry?
Click to expand...
You can do either or! You can buy urine ketone strips at any human pharmacy or Walmart, although some people have issues either catching their kitty in the litterbox or their kitty is shy. Check out the Ketones and DKA article on our FAQ thread HERE. It also includes a link with tips for collecting urine samples. My buddy Lou isn't shy in his LB (I used a large cooking spoon and just caught some while he's going), but I never could catch him going pee. So I got a Nova Max blood ketone meter. The strips are a bit spendy, but the blood test is more accurate and ketones show up in the blood prior to urine. Unfortunately, I don't know of any place that you can buy the meter locally, but you can order a kit/strips from ADWDiabetes.com. I took advantage of their free meter deal located HERE.

Best of luck on the Levemir!
 
Amanda and a Loudogg said:
You can do either or! You can buy urine ketone strips at any human pharmacy or Walmart, although some people have issues either catching their kitty in the litterbox or their kitty is shy. Check out the Ketones and DKA article on our FAQ thread HERE. It also includes a link with tips for collecting urine samples. My buddy Lou isn't shy in his LB (I used a large cooking spoon and just caught some while he's going), but I never could catch him going pee. So I got a Nova Max blood ketone meter. The strips are a bit spendy, but the blood test is more accurate and ketones show up in the blood prior to urine. Unfortunately, I don't know of any place that you can buy the meter locally, but you can order a kit/strips from ADWDiabetes.com. I took advantage of their free meter deal located HERE.

Best of luck on the Levemir!
Click to expand...
Thank you very much!! Do the blood ketone meter strips require a lot of blood? My new glucometer requires more blood than the previous/discontinued glucometer I had and Tucker does not always bleed well for me.
 
The FAQ link Amanda posted has a link to a document with urine testing tips. I would start testing for ketones ASAP. My girl wasn’t shy at all, I could stick the test strip in her urine stream once she’d started.
 
Tucker's Mama CS said:
Thank you very much!! Do the blood ketone meter strips require a lot of blood? My new glucometer requires more blood than the previous/discontinued glucometer I had and Tucker does not always bleed well for me.
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I think the Nova Max does need about 0.5uL or so of blood, so it is more than the confirm or micro meters needed, which was 0.3uL I think. Hopefully Tucker starts to bleed better soon. It took awhile for my buddy Lou in the beginning as well.
 
Awesome news! Keep testing daily while his numbers are high. If they start creeping up, we will have to do something about the insulin dose sooner.
 
Just noticed you have the spreadsheet going too. That’s great. Do you have any Vetsulin data? If you had a week of that before the switch,that would be really helpful.
 
Wendy&Neko said:
Just noticed you have the spreadsheet going too. That’s great. Do you have any Vetsulin data? If you had a week of that before the switch,that would be really helpful.
Click to expand...
I do, but I posted in the tech forum because I have no idea how to use this Google sheets :-/ I am lucky to have figured out how to enter what I have lol. I don't know how to add more info/columns/rows, change colors, etc. and I am afraid to mess something up. Brand new to spreadsheets!
 
Wendy&Neko said:
We have some people here who can help. Tagging @Marje and Gracie to see if she’s around.
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Yep I am! ;)
Tucker's Mama CS said:
I do, but I posted in the tech forum because I have no idea how to use this Google sheets :-/ I am lucky to have figured out how to enter what I have lol. I don't know how to add more info/columns/rows, change colors, etc. and I am afraid to mess something up. Brand new to spreadsheets!
Click to expand...
I’ll send you a private message so you can set me up with editing rights and I can add some less nes, etc for you to put in the Vetsulin data. Check your inbox, upper right corner of this page in a few minutes.

IMHO, the Lev should have been started at a much higher dose as Wendy indicated. Because there’s also been DKA in the picture, as soon as we have a little more data, we will likely have you increase the dose sooner than usual. Please try and always get a preshot test and as close to midcycle as possible. The more data you have, the sooner we can increase, if necessary.
 
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