Kiki, Levemir, numbers are wonky

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tuckers mom

tuckers mom

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Wonky is a medical term, right?

She went too low on Friday, gave her a full can of gravy FF, I believe she was high for a while because of the gravy food. Today we started high and now at +10 she's at 86.

I'm not sure if I should continue trying to stick with 0.5U BID or not. She is eating FF classic flavors most of the time, she also gets table scraps from Ron, today's treat was bacon.

Her spreadsheet is attached, any comments are welcome.

Thank you in advance.
 
86 is in the normal range for using Levemir. I would hold the dose. Begin testing now every half hour though to see if she is going to rise on her own and do not feed at the present time.
 
I posted in Lantus for advice over here.

Posting from PM:

Sent: Sun Dec 19, 2010 8:04 pm
by tuckers mom
She's at 132 now, but there's food spike, when she went low on Thursday she responded to food within 20 minutes.

This is shot time, normally I'd wait a half hour, test, then test again if we weren't high enough but I'm gun shy after Thursday.

I was told at the shelter she had two hypo incidents.

None of my other FDs have had hypos (knock wood), I'm not sure if Kiki is simply a cat that really is not diabetic just stress induced/diet induced, or if she's going to end up being a really small dose kitty. Although Thursday there were no clinical signs of hypo, she was acting fine, or at least the same way she's been acting since she moved here on Saturday of last week.

Sorry, I'm going on and on :) Thank you for the advice.

* Quote Blue

Re: Kiki, Levemir, numbers are wonky

Sent: Sun Dec 19, 2010 7:54 pm
by Blue
What a sweet bean you are. They often come around to really enjoy the high life.

If she has just eaten ...try and get a test ASAP. Otherwise we'll have to deal with a foodspike too.

It is important in these situations to not feed as we want to see exactly when the insulin starts to wear off.

Beth

* Quote tuckers mom

Re: Kiki, Levemir, numbers are wonky

Sent: Sun Dec 19, 2010 7:51 pm
by tuckers mom
Thank you very much. I might try the Lantus forum soon. I don't always have the ability to post each day so I can't do the daily condos, therefore I tend to stick to the main board. But you're right, I'll give LL a try soon if I can't get better numbers very soon.

I saw your post that I should not feed her, but she had just conned me into food. Not really conned so much as bullied :roll: She was from an impound lot and had two litters of kittens from what DCIN found out. I think she's one of the toughest kitties I've had the pleasure of getting to know. I hope she likes the soft warm bed kind of life :)
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Blue said:
I posted in Lantus for advice over here.
Click to expand...


Thank you very much.

We're up to 194 at +12.5

I think I can go ahead and shoot 0.5U, but going forward, I fear she is going to continue with difficult numbers as she gets used to our home, her new brothers and sisters and of course her new mom and dad beans.
 
I agree I think you can shoot. You know DCIN is known for presenting defective diabetic kitties right? I mean at least that is what I have heard. Supposed be diabetic...and their not? :lol:


You might go ahead and grab a plus one reading too.
 
Blue said:
I agree I think you can shoot. You know DCIN is known for presenting defective diabetic kitties right? I mean at least that is what I have heard. Supposed be diabetic...and their not? :lol:
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LOL!!! Yep, I got two broken FDs already, Bean and Mr. Darcy(GA), if Kiki ends up broken I may not trust DCIN anymore :lol:

Thank you so much for your help, I really appreciate it.
 
A couple of questions...

When you got the 21 on Friday, were you shooting 12/12? Your SS indicates that you shot late the evening before. Did you shoot early the next day to get back on schedule or are you currently shifting the times in order to get back to your usual shot time?

I like that 86. It's a very pretty number!! I agree with what Beth posted -- stick with this dose. My guess is Kiki is working up to wanting a dose reduction. You might want to think about shaving the doses. A full 0.25u decrease at the current dose is a BIG decrease especially in light of the pink AMPS numbers.
 
Sienne and Gabby said:
When you got the 21 on Friday, were you shooting 12/12? Your SS indicates that you shot late the evening before. Did you shoot early the next day to get back on schedule or are you currently shifting the times in order to get back to your usual shot time?

I like that 86. It's a very pretty number!! I agree with what Beth posted -- stick with this dose. My guess is Kiki is working up to wanting a dose reduction. You might want to think about shaving the doses. A full 0.25u decrease at the current dose is a BIG decrease especially in light of the pink AMPS numbers.
Click to expand...


Shot late Thursday because the firm's holiday party lasted longer than expected, Friday's AM shot was +11, I couldn't do later as I had to get to work.

Friday night shot a little under +12, working our way back down to 7:30 AM/PM dosing. Tonight's dose at 8:30, shot time tomorrow will need to be at 8AM and will try to work back down to 7:30 again.

Thank you.

Kiki is still being wonky, up to 281 at +2 tonight. Before coming here she was on 3U of Lantus AM and 2U PM. The bottle may not have been very potent, but that was her dose down in West Virginia. She's new to Lev.
 
Kiki is still giving me funky numbers, if anyone wants to peak at her spreadsheet, I'd appreciate any advice.

Her coat is getting softer, she's not as hungry as she was, she's still madly in love with Ron but I'll get over that :roll:

Thank you.
 
Yes, the swing is wide between peak and nadir; drives me nuts too. If you look at other, relatively new cats on Lantus, you may similar wide swings. (Not Spitzer - we're working out the last time we had to delay a shot due to low numbers!)

Hold steady (you're at 8 cycles on the new dose of .5 and some cats need a bit longer to settle) and continue to watch for a mid-cycle dip below 50.
 
What, you haven't broken her yet?

The problem I see, Jenn, is that she is bouncing.

But she's not bouncing badly. 12/20 is so much better than 12/17. I would keep her on the .5U for another week or so. She needs to work her body into an understanding of the insulin. And you say her coat and appetite is better, so that is telling you that thing are improving with her. (Nobody can compete with Ron and filet.)

BJM, Kiki is on Levemir, not Lantus.
 
I still don't feel comfortable with her numbers. I can't get many spot checks since I work, but today we were high for AMPS and +7 is 67. I had to rush back to work so I gave her extra low carb canned. I don't know if she was low before and on her way back up or still going lower.

I don't like these 300s then down to double digits and I imagine that Kiki must not like them either. Feels like the old days when we were on PZI.
 
Hi Jennifer,
Bouncing from 300s to double digits is not normal for Levemir. The reaction is consistent almost every day which concerns me for her. Even with that, Levemir works its magic and makes them feel better and look better.
Please consider a dose reduction sooner than later. A week on this dose is not necessary with these swings.
A desirable and effective "curve" on Levemir is steady numbers, not a rollercoaster.
I see nothing wrong with dropping to .25U or even lower, so that you have room to work up. Yes, dropping to .25U is a 50% reduction but you are getting too much action from that half unit when .25U might produce a flatter curve.
Look at the whole cycle with Levemir, not simply nadir.
And since you don't post every day, consider popping over to the Lev ISG.
 
Since you asked for people to look at the ss, I did.
I would think maybe decreasing the dose may stop the bouncing, and then once Kiki's got flatter numbers, then you can think of moving up, that is if Kiki needs to increase.

Another thing I thought of was what about mini meals in an auto feeder? maybe if you spread out the food up front, a couple tbsp every hour, maybe it will slow the drop and with a gentler drop, you could get steadier numbers.

I know what it's like to work and be unable to get all the tests we want, so just try to get numbers at different times, if possible not all at +6, and for sure the before-bed test.
You can always leave curves for your days off.

The biggest thing is that in the few weeks that Kiki's been there, you are already seeing those improvements like the coat changes and the appetite reduction, so you know that something's working, despite the bouncing.

I'd think a decrease will help to get some flatter numbers, and with up front frequent mini-meals, you could break the nose dive from pink to green.

Good luck and I am glad to hear that Kiki is settling so nicely.
 
Jenn,

I was going to suggest a dose drop as well. I think she is very sensitive to the Levemir. Like Gayle says, drop her a full quarter to .25 and see if she levels out.

I have a new one, Tabitha, giving me Amps in the 200s and 60s nadirs on .5 for two weeks. I stopped insulin for 4 days and she gave me AMPS in 160-180 and nadirs at 70-80. Then she gave me a 190 AMPS, so I shot .25 and she bounced up to 220. I took her off and she settled back down again.

This morning the AMPS was 149. On the way to being a broken diabetic, I think. I will test lots over the holiday time when I'm home.

Also, agree that mini meals helps. With the numbers you and I have, that would be real tough when we are working. For an example of spread out meals and Levemir, take a look at Rusty's spreadsheet in LL with Ella. Amazing the numbers she is getting with him, even though he is fractious about testing. He was with me on Lantus for 18 months and I never got close to where he is now.

Best of luck with Kiki and happy holidays,

Claudia
 
Hey, Jenn, can I throw in my 0.25U too? :)

I am so bad that I don't keep Moochie's SS up but I did initially when I switched her from PZI to Lev. Just thinking like others that having started out a bit too high she got rolling in a funky cycle and a fresh start might just be the answer.

When I started Moochie it was at 0.5U BID (remember she's a dry food monster :lol: ) and she dropped beautifully. I did end up increasing her to 1U BID and I do apologize for the old SS but she did nicely. I recently actually dropped her back to the 0.5U and she's doing great - nice and steady.

I'm trying to re-link my old SS. A lot has happened since then but if you can see the August 2009 portion you can see what I mean

https://spreadsheets.google.com/ccc?key ... l=en#gid=0
 
HI JENN!!​

Had to stop in and see your latest beauty, and she sure is giving you some nice response.. how could she not though, in your amazing home :)

Time to reduce chica, she's headed down down down the dosing scale :cool: Great job!

Scritches to all the babies, and extra snugglies to The T Man!
 
Thank you everyone :)

I had dosed her before reading the board, but I did go down slightly, the smaller side of the 1/2 mark, a 0.45 is what I would call it.

Her day today was:

AMPS: 342 .5U
+6 67
+10 144
PMPS: 239 .45U

I do feel better about dropping her dose. I'd like to give her a chance to see what she can do with the insulin, so I'll cut down to .25U tomorrow and see how she handles that for a while. As mentioned, clinical signs are great, I think even the PU/PD is better. She drinks rarely and the litterbox is not as filled as it was.

I do a +6 each day because that's my lunch hour, I could probably get a +5.5, but I'm not sure that would be much help. I'll get more night time numbers, I'll get some different checks on the weekends. She eats 4 meals per day now, I could try a timed feeder but with 5 others who would be able to access a feeder, I can't promise someone else won't eat it.

Thank you again, I really appreciate the help. Tucker says thanks too :mrgreen:
 
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