Levemir 1st dose

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heatherj932

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Hello All,

I just gave Cyrus his first dose of insulin (1 unit). I test his bg and it was at 290 pre shot. I looked at the FAQ's for newbies, but did not find an answer to my question. My question is: How soon will the insulin start working? Should I test him in 2 hours to see if his #'s went down? Last night when I tested at 9 p.m., Cyrus was at 198!!!! I got my hopes to high in the air thinking that maybe his #'s were going to start getting lower. I should know better and just need a dose of patience.

Thank you!!

Heather & Cyrus
 
Re: Just gave 1st dose of insulin.....

What insulin are you using? Each insulin works differently. You should see a drop in 2 hours, but the lowest point (Nadir) might be at 4 or 6 or 8 hours. Doing random tests will help you learn exactly how your insulin is working with your cat. Start a spreadsheet to chart what's going on. The more information you gather, the better you will be able to treat your cat.
 
Re: Just gave 1st dose of insulin.....

Cyrus is on Levimir.

Thank you~ I will transfer all of my number from my notebook to a spreadsheet :mrgreen:
 
Re: Just gave 1st dose of insulin.....

Heather can you change your original subject title to Levemer 1st dose...just to get the right peeps looking in on you.
 
Re: Just gave 1st dose of insulin.....

His numbers will probably be lower as his diet is changed. makes a huge difference. nice numbe anyway and definitly cause for happiness.
 
Hi Heather,

Have you tested anymore? I am concerned that 1U may be a rather high beginning dose if you have yet to change diet and given that his preshot BG was only 290. Levemir may be a slower acting insulin, but it is powerful.

With that said, it may take a few cycles for you to see significant response. Levemir can peak or nadir anywhere from 7 to 10 hours after the shot. Some cats on Lev experience nadir even at time of next shot.

For tonight, it might be a good idea if you set your alarm and tested around 7 to 9 hours after the shot. This is a 24 hour message board, so someone would answer you if you get a number below 50, which bares watching. Don't mean to scare you, but I am concerned that with a beginning BG of only 290 he will not need 1U.

What type cat foods did you feed tonight and what cat foods do you have on hand?
 
I agree with Vicky that the 1u may be too high for a starting dose. Also agree that it could be tonight or tomorrow night before you see a real response. My Jeddie went from 200 to 80 on his first shot (.5u) in 9 hours and last night from 295 to 108 in 4 hrs on .6u. My Beau dropped from 318 to 95 on his first shot (.5u) in 8 hours and was down to 37 at 4 hours after his 3rd .5u shot - so.... some kitties get an immediate response and other take longer. I was told that it takes several days for the insulin to build up in their system so I was quite surprised by the 37 Beau got on his 3rd shot - basically 28 hrs after his first shot.

Please be testing - 4, 6 and 8 hours after the shot would be good even if you have to set your alarm - and probably it would be good to feed him before you go to bed (and test then too). 50 is a safe number, but not one you want to ignore. You would want to feed him a snack of low carb canned food and test in 30 mins. If he drops lower feed a little higher carb food. This is why Vcky asked what you feed and what foods you have on hand. I keep some higher carb Fancy Feast (with gravy) on hand just in case.

The 198 last night at 9pm, was that after vetsulin or no insulin? If after no insulin he may have a little pancreas action going on - just not enough to bring him down to good numbers and keep him there.
 

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Jock's typical curve on Levemir appears to be pretty typical.

Blood sugar tends to continue going up for the first 2 hours after shot.

By about 3-4 hours it's down past preshot.

By about 7 hours it's having some serious effect, which tends to gradually descend to a nadir around 10-12 hours.

Somewhere between +11 and +14, just after peak, blood sugar starts rising again, and rises very fast.

This may help with your own observations.

But note: Levemir's action is sensitive to two things:
1) Dosage. If you're giving a bit less than optimal, peak time will be shortened. Too much, and peak time will be later.
2) Previous doses. Levemir leaves a "storage shed" of previous doses which keep blood sugar lower, so if previous doses were inadequate, current dose will be less effective.

All this means you'll need to be a bit patient and not fiddle with doses more often than every 3 days, and expect your nadir dose to happen just before the next shot.
 
P.S.

Something no vet will tell you, but it's important: with Levemir, tiny variations of dose really matter. 1.2 units is MUCH different from 1.0, and 0.8 much different again.

So please don't overreact to dosage errors -- keep your adjustments teeny-tiny.
 
Hello,

Thank you to all who replied. Cyrus had been on a diet change for 3 wks now. He is on Hills' M/D and FF Classic. When I tested him on Tuesday his BG was at 198 at 9 pm, that was after no insulin and after he ate. I had not even started the insulin till yesterday. After I gave him 1 u last night, I tested 3 hours later and his bg was low 300's. Can you belive that my vet said to start Cyrus out at 2 u 2 times daily????????? I even thought that was a lot. Yes, Cyrus is 15 lbs, but I took my sheet in that had 10 days of testing and his #'s never went above 290. Since my husband is diabetic, I know how powerful even 5 u can be, so I thought that starting at 2 u seemed too high. I hope that I answered all of the questions. I also learned that I should have high carb FF on hand-will pick some up tonight.

I really hope that I can get a handle on this sooner than later!!

Any other advice is much appreciated.

Heather & Cyrus
 
Heather, please take Cyrus off the Hill's M/D - it is too high in carbs for a diabetic, even though yes, the vets will sell it to you as "prescription" diabetic food. No one can "prescribe" food - frankly, it's a marketing ploy and the vets mostly all buy in to it and try to sell it to us, the hapless pet owner who believes the vets. They are taught feline nutrition in vet school BY the food companies!!

But if you remove the M/D food, please please drop the Levemir dose to no more than .5U! There is a website which has pictures of how to give micro doses: Micro dose pictures

I can see Cyrus being able to be diet controlled if he's given only low carb food. Have you looked at Dr. Lisa's website yet? http://www.catinfo.org She explains what types of foods cats need and which ones they should not be fed. Most foods that are appropriate for cats are low carb anyway, as they should not have grains which are the main source of carbs in pet food. Feral cats eat birds and mice, not ears of corn!

Steve is too modest to tell you that he and his cat Jocularity were the first feline users of Levemir in the world! If anyone knows Levemir, it's Steve!
 
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