Jack 5/11 day 4

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Darlene & Jack

Darlene & Jack

Member Since 2011
So today is day 4 on Levemir. The first 2 days got a little messed up with the late PM dose on day 1. Todays numbers seem much better. No one home during the day to check readings until my son got home from school.

371 @ AMPS fed
390 @ +1
216 @ +9
224 @ PMPS
321 @ +2

I will check +4 and hopefully +6 as well. Please let me know if there is any dosing advice, or do I hold with this dose for the first 5-7 days? Thanks!
 
Darlene & Jack said:
So today is day 4 on Levemir. The first 2 days got a little messed up with the late PM dose on day 1. Todays numbers seem much better. No one home during the day to check readings until my son got home from school.

371 @ AMPS fed
390 @ +1
216 @ +9
224 @ PMPS
321 @ +2

I will check +4 and hopefully +6 as well. Please let me know if there is any dosing advice, or do I hold with this dose for the first 5-7 days? Thanks!
Click to expand...

I think you would be fine with increasing the dose slightly to one unit. I don't see any bouncing going on here as yet.

Looking good. :) (still need to look into that dental though).
 
I would like to see if he can hold these lower patterns for a couple more days because his BGs are appearing to stabilize. That's what you want to see in the beginning, not necessarily blue or green numbers right away. I'm not seeing any indication of rebound except after that 145 the other night. I would rather see only 200s and 300s than those kinds of numbers with double digits like he was having before on PZI (prozinc?)

The 321 and 325 he had at +2 and +4 tonight are typical, a rise after the shot, but they are steady and then he's come down already by +6. I hope he can maintain another yellow number in the morning.

He's doing really well! And so are you!
 
Just saw Pamela's post. While I agree 1U would be the next step up, I think he should be allowed to stabilize a little longer at this dose before increasing. His numbers aren't so high anymore that they call for an immediate increase. Increasing too soon could set him up for the same patterns he was having on the PZI.
 
Thanks for the responses, ladies. My inclination was to just stay with the same dose for now too since he seems to be coming down gradually. I want to avoid the bouncing as much as possible! As colorful as Jack likes to be, I prefer not hitting all 5 colors on the spreadsheet in one day!
 
So Jack is having a more colorful day today.

317 @ AMPS shot .8 un
494 @ +9
447 @ PMPS shot .8 un
348 @ +2
147 @ +4

He didn't seem to eat too much during the day today but ate well tonight. I don't believe this morning was a fur shot, and I have been pretty consistent with the dose. I had practiced my drops from the "drop dosing" stickie on here until I got 10 per unit. I started that on maybe day 3 of Levemir. So now instead of trying to eyeball the dose, I just draw up 1 unit then let off 2 drops. It's much easier!

Will stay up to get a +6 reading to make sure he is not dropping too low.
 
Darlene & Jack said:
So Jack is having a more colorful day today.

317 @ AMPS shot .8 un
494 @ +9
447 @ PMPS shot .8 un
348 @ +2
147 @ +4

He didn't seem to eat too much during the day today but ate well tonight. I don't believe this morning was a fur shot, and I have been pretty consistent with the dose. I had practiced my drops from the "drop dosing" stickie on here until I got 10 per unit. I started that on maybe day 3 of Levemir. So now instead of trying to eyeball the dose, I just draw up 1 unit then let off 2 drops. It's much easier!

Will stay up to get a +6 reading to make sure he is not dropping too low.
Click to expand...

Well, he has definitely settled now so in my opinion Jack is ready for an increase to one unit. Especially now too since it is the weekend and you will be able to check mid-cycle.

Wondering also when his nadir is yet. It looks like it is 'around' +5 but more spot checks will be able to tell more easily.

Also when eating habits are inconsistent because of health reasons, or if other cats are stealing the food, then to me it is hard to establish a pattern of sorts. Try to keep things as consistent as possible if you can. I know with multiple cat households, or with work demands, that isn't always possible so do the best you can.
 
Not sure if anyone will be up now on a Saturday morning...

Jack went down to 58 last night at +7. This morning he is 243. Should I give his usual dosage this morning? Pamela, I would have increased to 1un before these low numbers, but now I am not sure what to do.
 
Darlene & Jack said:
Not sure if anyone will be up now on a Saturday morning...

Jack went down to 58 last night at +7. This morning he is 243. Should I give his usual dosage this morning? Pamela, I would have increased to 1un before these low numbers, but now I am not sure what to do.
Click to expand...

My first question when you see an unusual drop like that is did he eat enough? Then I saw you noted in your spreadsheet that he was off his food yesterday and didn't eat much so then the drop down to 58.

I still think he is due for a slight increase, but let this dose ride longer especially if he is not eating well for whatever reason. Hopefully, he won't bounce too much from the low last night. Looking good so far today. :) How is he acting otherwise? Is he eating better today?
 
Jack is eating better today, and he ate well last night, it was just during the day yesterday that none of the cats seemed to eat as much. I have 2 other cats, and they usually eat a good amount first thing in the morning, but none of them did. Kind of weird! I have an auto feeder that I fill and set to go off a few times during the day, and they barely ate from that either. Not sure what was up yesterday, but today they are eating well. The feeder is set to go off once during the night too, and I try to be consistent with the times, etc. But like you said, it's hard to control who gets what when there are 3 of them.

Jack is acting fine, playing and happy, usual naps. I'm very happy with today's numbers so far!

Now at +8 he is 150, and due for his shot in 2 hours. If he is still under 200, what do I do then? Give the usual dose? Give a smaller dose? I'm reading the protocol and it looks like I would hold the same dosage? I'm just afraid of low numbers again tonight...but I am still not used to how Levemir works.

SORRY...meant to say the 150 was at +10
 
Darlene & Jack said:
Jack is eating better today, and he ate well last night, it was just during the day yesterday that none of the cats seemed to eat as much. I have 2 other cats, and they usually eat a good amount first thing in the morning, but none of them did. Kind of weird! I have an auto feeder that I fill and set to go off a few times during the day, and they barely ate from that either. Not sure what was up yesterday, but today they are eating well. The feeder is set to go off once during the night too, and I try to be consistent with the times, etc. But like you said, it's hard to control who gets what when there are 3 of them.

Jack is acting fine, playing and happy, usual naps. I'm very happy with today's numbers so far!

Now at +8 he is 150, and due for his shot in 2 hours. If he is still under 200, what do I do then? Give the usual dose? Give a smaller dose? I'm reading the protocol and it looks like I would hold the same dosage? I'm just afraid of low numbers again tonight...but I am still not used to how Levemir works.
Click to expand...

I am confused. You said he is 150 at +8 and you are to give the shot in two hours? That would only be +10.

Try to get a couple more spot checks in at +10 and specifically at +11 so that you can see whether or not he is still dropping when you test him at +12.

While waiting, read (and print) through this primer on how to deal with low preshots:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=39309

ETA - Since you said he ate enough last night, now I am re-thinking whether or not to increase the dose since he went that low even with food on board. I know Vicky had suggested to you to start off at .5. See what others think.
 
For what it is worth - shooting the full dose (.8u) tonight was the right thing to do and would have been the right thing to do even if he was in the upper 100s. The lower numbers last night are perfectly safe numbers. He just barely dropped below 60. Most cats are fine and perfectly safe down to 40, but you don't want to aim for 40 and getting there would make you think about if the dose needs a tiny reduction.

I would not increase his dose now, but hold this for a while and see if he continues to settle on it.

Lev will work by bring all the numbers down to a flatter curve with lows in the 60-100 range and highs in the mid-upper 100s or low 200s. Eventually you will find yourself faced with a low PS and what to shoot on it. I'd say that if you are going to be home to monitor/test, then shoot the full dose above 100. It's really about data gathering to see what Jack's normal cycle is (when does he start to drop and for how long and when does he start to rise and for how long. A lot of times the PS is lower, but the data shows a rise will continue until +3 or something so it is safe to shoot.
 
I am wondering if Gandalf's profile when he was first on Lev would help. He also came from PZI, but had been on it for over 2 years.

Yes, I increased fairly quickly and should not have. I also suffered horribly from "PZI thinking," note the late shots and skipped shots.


Day 1-9.26.07
7:30 AM +12.5 375 1U
+2 352
+4 292
+5 310
+6 265 Ate regular meal
+7 209
+8 234
+9 220
+11 259
+12 263 1U

Day 2 9.27.07
+6 280 (night of full moon)
8 AM +12.5 385 went up to 1.5U
+3 387
+6 234 Ate regular meal
+7 249
+8 203
+11.5 193 no shot ate half can FF
+14 234 1.5U

Day 3 9.28.07
+10.5 170 no shot
+12 172 skinny 1.5U ate
+2 172!!
+7 214
+11 281 1.5U ate (earlier had ate a few pieces of dry kibble & cooked chicken)

Day 4 9.29.07
9:30AM +12 only 141, fed, no shot
+13 173 skinny 1.5U
+12 10:30 pm 269 1.5U ate

Day 5 9.30.07
8:30 AM +10 257 1.5U ate 1/2 can FF
7 pm +10.5 56 fed as normal, no shot
Stormed about 9 pm, hiding. No further BG checks. Previously acted normal, ate good.

Day 6 10.1.07
3:30 AM +19 337 fat 1U
7AM lethargic. No test. Would not come for food.
6:16 PM 432 fur shot, gave fat 1U
+2 397

Day 7 10.2.07
7 am +12.75 398 Let him off food schedule last night. Gave 1.5U
6:45 pm +11.75 220 1.5U Acting much better, also not as hungry. Still at 0 and +6 for feedings, considering changing either back to 0, +2, +6 or 0, +3, +7.

Day 8 (yea! It's been 1 week)
7 AM +12 193 1.5U
6:30 PM +11.5 345 1.5U (I think he ate Tigget's extra food at least a half 5.5 oz can more than normal.) Acting very good though, wanted outside, very alert and vocal. Except at nap time ;-)

Day 9 10.4.07 (
Puked brown bile at 6 am, sign of hairballs
+13 8 am 141, only licked at food. Gave 1/4 tsp. Laxatone and only 1U
He went outside (ate grass I bet), then came in and ate off & on till gone, like normal, little dickens.
+4.5 241 must be the laxatone. Gave .5U booster. No more food yet.
+6 213 Ate 1/2 can FF
+8 237 ATe 1/2 can FF
+10.5 285 Gave 1.5U fed 9Lives 1/3rd can

Day 10 10.5.07
Woke me up at 4:30 am, had only licked at +6 food. Gave him 3/4can of FF and he ate some and came back to bed.
8:30 AM +14 173! Gave 1.5U
Ate some, went outside.
+2 261, still has food left.
+14 142 1.5U

Day 11 10.6.07
7 AM ate some sardine (in water type)
8 AM +10 242 gave 1.5U left side, nibbled more sardine.
Wanted outside finally, had been lying around.
10 PM +14 222 right side.

Day 12 10.7.07 (weird day)
Outside between 7:30-8:30am
8:30 AM + 10.5 279 1.5U left side
Probably had some of Tigget's dry Wellness Core overnight. Ate maybe third of food. Wondering if less appetite is from lower #'s.
+6 292 (unable to get earlier BG, don't know if we had any drop)
+7 346
+8 415 WTF?
5 PM +8.5 shot 1.5U, ate plain sardines
+ 2 467
+3.5 266, fed 1/3 can 9 Lives
+4.5 158, gave about 1 tablespoon of Wellness Core dry
+5 131
+5.5 110, put out rest of 9 Lives can as per feeding schedule.
+6 119

Day 13 10.8.07

Puked up hairball in AM
6 AM +13 377 left side 1.5U
6 PM +12 209 right side 1.5U
Caught a mouse and ate it all!

Day 14 10.9.07

6:30 AM +12.5 227 right side 1.5U
6:20 PM +12 152 don't remember which side 1.5U

Day 15 10.10.07

6 AM +11.5 195 right side 1.5U
Had to be gone all day
9:45 +15.75 387 left side 1.5U

Day 16 10.11.07

8 AM +10 159 left side 1.5U
+2 146 ate more
+4.75 97
Went outside, ate food
+6 121
+7.5 103
+9.5 98
Went outside
+12.5 123 1.5U

10.12.07
9 AM +12.5 100 1.25U
+2 150
+13 270 1.5U left side

10.13.07
+12 171 1.5U right side
+12.25 303 1.5U left side

10.14.07
+11 9 AM 187 1.5U left side
+11 8 pm 105 right side
Drinking more & peed a lot about 10 Pm

10.15.07
+12 8 AM 137 1.5U right side
+11 Got very mad about going in bathroom
instead of outside like he wanted.
BG 519, where was it a half hour before?
1.5U, ate good, acting good. Noted some drinking.

That was a sure sign of rebound because 1.5U was too much.

What I wanted you to notice is that it took over 2 weeks to finally get a true rebound number. They do a lot of bouncing before that, which is when you'll get 100s and then it zooms back up to 300s. I consider those soft rebounds and the 500+ is hard rebound result. He even told me because he got mad before his shot! He knew something was not right.

On day 16 I was fooled in to thinking 1.5U was a good dose because he had such good numbers because he was coming off an almost +16 from the previous night's shot, so the shed was emptied.

Knowing what I know now, it is clear to me by day 6 even that 1.5U was too much. Jack has not had greens until now and perhaps because he was lacking on calories for the day.

For now, the .8U looks good, especially from today's numbers, when I assume he ate better. I don't agree that he has settled nor that his dose should be increased. What would have happened last night had he been given more insulin?? Also, please note that although he had greens for an extended period last night, he did not bounce hard today, he lowered eventually at a good even pace.

Hope that helps ease your mind on .8U dose.
 
Sorry for the confusion Pam! I had the numbers right on my ss, but posted wrong in my message. The 150 reading was at +10. Thank you for the article on shooting low preshot numbers. I will be sure to print it out.

Vicky, thank you for the info on your switch to Levemir. I was very surprised that there was no rebound today. I really expected that from his low numbers last night and he actually had a pretty good day!

And Sheila...I had found your photos and info on drop dosing and that helped me immensely on figuring out these tiny doses. And thanks for the Levemir info and how it works. I know it will take a while to figure it all out!
 
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