Jack switching to Levemir 5/8

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Darlene & Jack

Darlene & Jack

Member Since 2011
Hi everyone,

Just wanted to introduce myself. My 9 yr old cat Jack was diagnosed on 4/1/11 in DKA. Had lost some weight and seemed to be eating and drinking a lot, but then got very lethargic and stopped eating and drinking. Brought him to the vet and he was diagnosed with diabetes and was in DKA. he was sent home the next day on Pro Zinc 2 units, but there were issues with incorrect syringes and I'm really sure what dosage he got at the vet. I started home monitoring the first night, and his numbers have pretty much been all over the place. He does get steep drops then possibly some rebounding. I did change vets and now have found a great one. A few people mentioned that maybe Levemir would be gentler and a better fit for him. So I read up on it and talked to the vet. Picked it up from the pharmacy and will start it Sunday morning for the first dose.

He has been on all wet food since the diagnosis, Fancy Feast Classic, and he free feeds. He seems to be feeling pretty well and acting normal. He is an indoor cat and weighs about 14 pounds. I also have 2 other non-diabetic cats.

Soooo...just wanted to say hello and hope this roller coaster will smooth out a little bit!!
 
Welcome Darlene! Levemir has proven to be a wonder insulin for some many of us. Hope you get the attention here you will benefit from. So happy you are on board.
Lori
 
Darlene & Jack said:
Hi everyone,

Just wanted to introduce myself. My 9 yr old cat Jack was diagnosed on 4/1/11 in DKA. Had lost some weight and seemed to be eating and drinking a lot, but then got very lethargic and stopped eating and drinking. Brought him to the vet and he was diagnosed with diabetes and was in DKA. he was sent home the next day on Pro Zinc 2 units, but there were issues with incorrect syringes and I'm really sure what dosage he got at the vet. I started home monitoring the first night, and his numbers have pretty much been all over the place. He does get steep drops then possibly some rebounding. I did change vets and now have found a great one. A few people mentioned that maybe Levemir would be gentler and a better fit for him. So I read up on it and talked to the vet. Picked it up from the pharmacy and will start it Sunday morning for the first dose.

He has been on all wet food since the diagnosis, Fancy Feast Classic, and he free feeds. He seems to be feeling pretty well and acting normal. He is an indoor cat and weighs about 14 pounds. I also have 2 other non-diabetic cats.

Soooo...just wanted to say hello and hope this roller coaster will smooth out a little bit!!
Click to expand...

Darlene, welcome to the Levemir forum!

I was trying to go back through your posts and gather some history on Jack and yourself, but there are too many posts! LOL

Can you do us a favor and write up a profile. The instructions are here. You just add it to your signature like you did with your spreadsheet:

profile instructions

I am not sure how the Prozinc insulin works these days since when Tigger was on PZI we used the BCP PZI which was a U100 insulin dilution. We never used the PZI VET either which was a U40 insulin dilution as well like Prozinc. We just treated the kitties the same on either one back on the TR forum.

But anyway, the first thing you have to remember with Levemir is that it does not work like any of the PZI's. I had a lot of trouble with that at first and still do at times. ;) A lot of people do.

I think you said you have read the Stickies here. Have you also read the Stickies on the Lantus forum? Good info there too.

What was the infection that he had that prompted his going into DKA before his diabetes diagnosis?

I think you will see that .5 units will be the recommended starting dosage from most here. Hold for three to five days, always checking for ketones and then we will go from there.

Others will weigh in. I hope Levemir turns out to be the insulin for your Jack.
 
Hi Darlene,
I will second the .5U starting dose, especially because he had some drop in BG on even .5U of ProZinc. The key to determining a good dose of Levemir is starting low enough that you have room to increase because Lev works best using a step-up approach. Start with .5U and give it at least 5 days then look at curve results to see how well it's working.

You can and should do intermediate BG testing, just like you've been doing, but we do not make dose adjustments on a daily basis, nor do we adjust dose on preshot values. Dose is adjusted based on nadir (the lowest BG in a cycle) or on the whole cycle (did they rebound?). In the beginning a preshot lower than 150 probably needs a slight dose reduction, but only because owner does not have enough data to know the overall effectiveness of the current Lev dose. Once a good dose is determined, it is usual and desirable for preshots to be lower than 120 even.

The goal is to even out the BGs in a cycle. Please see the graph in the Lev 101 sticky above. A good cycle is what Gandalf achieved on Day 16 of using Lev. ECID is different though and it takes some longer to determine the dose which will produce that result.

Hope that gives you the basic idea of using Levemir. Hopefully it will get Jack out of the reds soon!
 
Fortunatley Darlene you I hope were not on Pro Zinc long enuf to be as hard headed as I was for this poor group to work with. The difference in treatment protocol breaks about every pz rule we go by. It is a hard change for some. I believe you will find it easier.
It took my a while to trust this insulin...more, these folks words. I could not be happier they did not give up on me and I am now completely regulated after a long bout of amps in the 600's. Levemir and the ways to use it...are miraculous.
 
Thanks ladies,
I didn't have time today to work on the profile or to practice drawing up my drops. I started with the 0.8 dose that was recommended by my vet (had already given it this morning before I read the responses to my orignial post). Will see what happens with this. Today he stayed fairly high all day, but I know that I might expect that for several days when switching insulins. Will try to re-read the stickies and Levemir info tomorrow. I will be patient and give it time to work, and hopefully see some good results!

When Jack was diagnosed he had a UTI as well, in answer to that question.

Happy Mother's Day to all of the mommies of furries out there who take such good care of these kitties!
 
Hi Darlene!

I just tried to open your spreadsheet and the link is broken now for some reason. I know I looked at it before so not sure what happened.

Go to this link on the Tech Forum, scroll down to the instructions Under B, Number 6, or use the instructions on Number 7 if you want it to show up that way. Hope that makes sense. Otherwise you can ask on Tech for help.
 
Hi Pamela...can you check the SS again now? I think it got messed up when I updated my signature to include the change to Levemir. I think it should be ok now.

So I know the Lev works differently than the PZ did, but the numbers seemed so strange today! I am off today and tomorrow so I figured I would get as many tests as I could these 2 days. I was surprised by the low number this morning, then it just kept rising all day long. I know it will take a few days for him to get used to it. Not really sure what to expect at this point.

So I hope the link is working now.
 
hmmmmmm.....i know it takes a few days to see what's going on. But, this is strange. Perhaps the .5u would be better. I now remember I cut tom's dose in half when i switched from pz to levemir.
my first few days...weeks even...were not great...but they did make sense to me.
hope others have a clue to this mysterious kitty Jack.
FWIW other folks...Jack had some pretty strange trends on pz as well.
 
My shot time was off last night, so I'm not sure if that had any effect either. Usually i shoot at 6a & 6p. Was out and on Sunday he didn't get his PM shot until 7:30p. This was his first day on Levemir. So this morning I gave him his AM shot at 6:45am. Not sure if I did the right thing or not with the times.

Tonight at +2 at least I got a lower number. He seems to be following the same trend we had the last several days on PZ where he didn't drop in the mornings and then dropped in the evenings. Jack is quite mysterious...
 
Darlene one of the few down sides of levemir is that it is much more dependant on consistancy of shot time. pz offered a wider berth with no consequence of import. With lev if you shoot late you shall consider that to be a reduced dose. Likewise if you shoot early this would be equivalent to a dose increase.
The 12/12 has been a pain for me and I now test 10/10 to make it more doable.
Lev builds up in the body as it's important to keep that steady flow going.
Of course life does happen... :?
 
I don't see anything strange. I see the second dose of Lev doing what it does and producing a 171 at +11. That is evidence that it's definitely working.

So the 145 you got tonight at +4 concerns me. .8U concerns me, when he had green numbers on less PZI.

If you can get a couple later checks tonight, +7 or sooner, that might be good. If you see a green number overnight, the dose is probably a bit too much.

Nice progress for 2 days in though.
 
Vicky I guess I thought the 60 point rise at +8 or 9 into the reds today strange...and then I believe he went back down...
It did'nt look like a familiar trend...but I'll keep watching until I get it.
Makes me wanna go back and look at toms earliest days on the lev.
 
Unfortunately I didn't get anymore checks after the +4. Went to bed and meant to set the alarm to do a check but didn't. :-(

Today is day 3, and I am off again so i will try to collect as much data as I can today.

Just as an FYI for myself...I am usually able to stay on target with the 12 hour dose times, but if I do run into a problem and have to give the pm dose late as I did the 1st night, do you actually give a reduced dose? Or just give the same amount and then try to get back on schedule in the morning?
 
Darlene & Jack said:
Unfortunately I didn't get anymore checks after the +4. Went to bed and meant to set the alarm to do a check but didn't. :-(

Today is day 3, and I am off again so i will try to collect as much data as I can today.

Just as an FYI for myself...I am usually able to stay on target with the 12 hour dose times, but if I do run into a problem and have to give the pm dose late as I did the 1st night, do you actually give a reduced dose? Or just give the same amount and then try to get back on schedule in the morning?
Click to expand...

It depends on how much later and if you need to keep the same schedule the next day, in other words, you don't get home till 7PM, give shot, then need to have shot be at 6AM the next morning. You could reduce just a .1U, especially if you are using less than 1U. And you would actually want to lower the dose on the next day's shot, the +11 shot, not at the PM one. You're already at +13, why mess them up further with a reduction?

It does make a difference and may prevent him from being too low for you to feel comfortable shooting the next morning. It's not so much that if you gave the regular dose at 7PM and then 6AM the next morning, you would cause a hypo of anything, it's just about keeping them from going lower than you would feel comfortable shooting.

If it's going to be 2 hours late, that would need a reduction if you needed to do 6AM the next morning, because that would be +10. It's not a good idea to give doses that close together without a reduction.
 
Hi Darlene, glad you got the ss working. When you can try to get some +1 and +2 tests in. Assuming he is eating most of his meal at shot time, except for a couple of exceptions it doesn't appear that Jack has much of a food spike, even when on the PZI.

Also, I know some of these questions will be answered when you set up his profile, but meanwhile has he ever had a dental?
 
Thanks for the info on late dosing, etc. I'm sure if it comes up I'll be posting for more advice though!

Jack does free feed and eats at shot time, but he did seem to eat a lot throughout the morning today. I will try to get +1 and +2 readings when I can, but those will be easier on the weekend. And no, Jack has never had a dental but from reading other posts in the past month it looks like I should get that done.
 
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