Jetta- we're making the switch- a few ?s

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Jacspets

Jacspets

Member Since 2011
Hello Levemir group!

I'm Jaclyn and my sugarcat is Jetta. We've been on Lantus since Jetta's FD dx in August 2011. Jetta is a world class diver and bouncer on Lantus. She has a super early onset (+1.5 usually) and her nadir has usually come (and gone) by +4. Her SS is in my signature if you're interested in the full picture, but basically we're switching to Levemir to try to flatten out her curve. She cannot maintain consistently good numbers on Lantus. I got a script for the Flex Pens, and that's new to us too. I've used the vial with Lantus. But I'm sure we can manage that OK. I am Jetta's primary caretaker and I work from my home when I'm not travelling. DH and my mom DM manage Jetta when I'm gone which sometimes is a few weeks a month.

A few quick questions. I have read the stickies and DH and I are sure we're ready for this new journey. But, is there any anecdotal evidence to suggest early Lantus onsetters like Jetta continue to be early onsetters on Levemir? How about Nadir? Typically Levemir is later than Lantus, +8ish right? Should I expect an earlier nadir for her like she had on Lantus? Or should I not expect anything and just see what happens? :lol:

And, can you see anything in my speadshhet I should do differently as we switch as far as testing times and patterns? Most days I'm really flexible with testing so if I need to start thinking in terms of dfiffernt + #s to get, let me know.

Jetta did have a vet visit today and full blood tests were run so I'll have those results Tuesday. I plan to fill her script Tuesday and start Wednesday AM, unless the bloodwork tells us anything that causes me to rethink a switch. I think I'm just most nervous about the unknown. With Lantus I know what to expexct from Jetta and this is a whole new ball of yarn. I appreciate Ny insight this group has to offer.

-Jaclyn-
 
Hello Jaclyn and Jetta :smile: and welcome to levemir !!

Callie just started Levemir on april 11th prior to this she was on prozinc for 10 months we got the same swings with prozinc, and then she just stayed flat cat_pet_icon what I can tell you thus far is usually callies onset is +3 to +5 and her nadir is usually + 7 or + 8 but sometimes its at +12 ????? I thinks she has to settle more ;-) have a look at callies ss, she is not getting the high and low as she was on prozinc, which is so much better for her little body ! now we just have to get her to the right dose !! I hope this helps some what ;-) again callie and I welcome you to levemir and we look forward to getting to know you and Jetta !! :YMHUG: dancing_cat \M/
 
Hi Jaclyn

I can only tell you what I have found with Musette, Musette like your Jetta was erratic at best on Lantus, we struggled with Lantus for 7 long cruelling months of highs, lows, early onset, early nadirs bounces sky-high that lasted for days etc. I never knew if I could leave her alone because never knew if she was going to dive from the basement or be on the roof, her numbers just plain made no sense.

So out of desperation, since my mom is also diabetic I borrowed a couple of her left over pens and started Musette on Lev..the difference was day and night for her and not in just the terms of her numbers. Her personality shifted as well, she went from being the Queen of the tortietude to my cuddle bug, she relaxed, she stopped growling and trying to bite me at shot time. She came running when she heard the meter turn on and started looking for me if I was running late on her shots. Then her curves became smooth, the diving and bouncing stopped, and if she did bounce she cleared them virtually by the next shot.

After months and months of going up and down the dosing scale with Musette trying to find anything that would make Lantus work for her, she is now walking down the dosing scale and for the first time since I adopted her as a diabetic last June I have high hopes that she will go OTJ finally. The switch to Levemir was absolutely the best thing I could have done for her. her onset is somewhere between +3 to +4 but her nadir is usually about +8ish but I have seen it as late as +10

I will most of your dosing questions to the more experienced users but I think you and Jetta will be very happy that you are making the switch. I know Musette and I are, it is the best thing we have been for smoothing her out and helping her fully blossom.

Mel, Maxwell, Musette & The Fur Gang
 
Hi Jaclyn,

Congratulations on taking the plunge with Levemir. Thank you for the recap of what's going on with her. I have not read her profile yet, but I did look over her spreadsheet.

Have you been given any idea as what dose to start out with? I would really like to see you use only .25u, for 2 reasons. One, she appears to be having some difficulty with her appetite lately. That makes me cautious for you to start out any higher than .5u for sure. She definitely goes low when she doesn't eat!
And the second reason is that bouncing on either Lantus or Levemir can indicate simply too much insulin. We firmly believe in microdosing here and I see you've done as low as .25u. Some cats may not even need that much! It can be very difficult to get your head around the fact that since insulin is a hormone sometimes teeny tiny amounts can be all it takes to cause a big reaction. We have seen cats drop to 30s on their 3rd day using Levemir when the dose was too high. That cat, Sheila's Beau went in to remission within 3 months after 2 years as a diabetic because she recognized the signs that he was getting too much insulin, even at .3u.

Sheila will probably be by later tonight and see this. We are a small group ourselves, but we give big welcomes and we want you to feel comfortable with this wonderful insulin. I think you should probably play it by ear and not have expectations, other than some good results for Jetta. You obviously know the drill about frequent testing. You probably don't need to go overboard on the first day, but a +3, +6, +9 would be helpful and would keep her safe. We don't see much reaction the first couple days as they get the shed built up. You don't have to do anything different, just give the first Lev dose at the normal shot time, but you might want to start in the AM, when you can be there to monitor. It's fine to give Lantus the night before and start fresh with the Lev the next morning. The +3, +6 and +9 are good to get, but in her case you may also want to get +1 or +2 to see how fast she drops, especially after the first 3 days. Even +10 or +11 is helpful to see how steep the rise is before preshot.

If any other questions occur, please ask.
 
Hello Jaclyn and Jetta! I hope you, and more importantly, Jetta, will learn to love lev as much as we do.

I agree with what Vicky said about starting at .25u. What I noticed was that you have been up and down the dosing scale a couple of times. I think this may be because you "missed" the many doses between .25u and .5u! I dose my boys in .1u increments, sometimes in .05u increments (.3u, .15u, .55u, etc). Generally, I think that changes of .1u are fine, but sometime you need to fine tune by just a hair. FYI, it does take practice. There are links to photos and instructions for getting .1u increments (I call it the drop methods).

Also, when you think of dose changes in percentages, those smaller changes on doses below 1u make sense. Going from .25u to .5u is a 100% increase. Going from .25u to .3u is a 20% increase.

I see that Jetta has had some decent numbers at .25u but didn't seem to hold on to them, so starting there and then increasing to .3 or .35u might work. It will depend on how she responds to lev.

Early onset can be from too much insulin, but could also just be an ECID thing. We've seen it all in terms of response times. My guys both tend(ed) to nadir at or just after +6.

Good luck!
 
Welcome Jaclyn and Jetta!

Sneakers and I are new converts from ProZince, so I won't be giving out dosing advice- just tagging on to say welcome!

One thing, Sneakers had been all over the place on PZI and has now stabilized into a nice curve with not so much roller-coaster action on Lev so I do like it. And the pens are easy to get used to.
 
Hi Jaclyn! I"m not sure if you remember me....but you and I spent one long eventful evening with Jetta in Lantusland when she was having a severe IBD and AP attack last fall (post here). I'm so glad to hear she's been doing well.

I switched Boo Radley to Levemir a couple of weeks ago. We switched for so many of the same reasons you notated in your intro and although it hasn't been long enough to quite settled in yet, I have noticed a few things:
Boo used to hit nadir somewhere around 4.....now it seems to be more like 6
We are using less Levemir than Lantus to get some "normal numbers"
His bounces only seem to last 1 day instead of 3
When he used to have a lower number on Lantus, he'd be CRAZY...now he just kicks back and enjoys
And lastly....Sheila was right....Micro-dosing does take practice :roll: :roll:

Welcome and Good Luck!!!
 
Jaclyn,

I finally got a chance to look at Jetta's spreadsheet ....Man, she looks so much like Musette on Lantus, I'm going to echo what Sheila and Vicky have already said, when you switch her over to Levemir, start super low dose like .25u, Musette got up to 1.5u on Lantus with still no good control, I started her too high on Lev and we had lots of reductions in the early days, now she is a different kitty on a mere .4u of Lev, and if she keeps up her tends so far I can see up going down again shortly.

If you want to see a real clear difference between a kitty on Lantus and the same kitty on Levemir look at Musette's spreadsheet...its as different as night and day.

Mel, Maxwell, Musette (Who is forever grateful her mom wised up) & The Fur Gang
 
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