Linus threw me a loop today

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Dragonfly229

Dragonfly229

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AMPS was very usual, 320's. I was home and so grabbed a test at about +7 . . . 87???? What the heck? 2nd test was a 99. About 2 hours later he was at 147, and at 715 tonight he was back above 300. I told Pierre and Alec to go with a lower dose tonight, 1u instead of the 1.2u we have been giving.

I came home off night shift this morning and gave him his shot. I really don't think I screwed up the amount, but what else could explain this? He had food, and had eaten about a half can from AMPS to +7. He slept a lot of that time (as did I). This seems like a pretty steep curve to be usual, most of the time the best I see is high 200's.

I'm hoping for no huge bounce, and good numbers tomorrow. I have levemir in hand, and will be starting it this weekend when I can try to monitor a little closer. I was wondering if I should give him a break from insulin completely tomorrow to allow the ProZinc to clear?
 
If you were switching the other way - from Lev to PZI, you might skip a shot to allow the Lev to clear some. But going from PZI, to Lev, you don't have to. You will want to reduce the dose when you switch, however. I'll be back later to explain....I am getting ready for work:-)
Carl
 
If you were switching the other way - from Lev to PZI, you might skip a shot to allow the Lev to clear some. But going from PZI, to Lev, you don't have to. You will want to reduce the dose when you switch, however. I'll be back later to explain....I am getting ready for work:-)
Carl
 
Thanks, Carl. I knew the ProZinc should wear off and be out of his system, but Linus has sometimes been the exception to every rule.

I have to laugh at my mixed metaphors - either Linus threw me a curve or he threw me FOR a loop, but somehow I've combined the two.
 
Well, my theory is that he heard you were switching insulins and decided to make sure you were paying attention! Seriously, you would be surprised how many cats have odd numbers when the bean decides to up the dose or switch insulins. I think they understand everything that we say and stay up nights figuring out what they want to do about it.....l :mrgreen:

Goof luck with the Lev. Hope it works great.
 
Hi Sue,
Seeing as how Linus seems to enjoy dancing to the beat of his own drummer, if you want to skip a shot before switching, that would be okay too.

On starting dose - it depends who you ask. It looks like you've been shooting 1.2u and 1.4u most of the time lately. If you ask in the TR forum, they usually recommend a dose that is 70% of the current Prozinc dosage. So you'd be going with either .75u or 1.0u. If you ask in the Lev forum, from what I have seen, they are usually more conservative and would probably say .5u or .75u to start.

I'm not sure where you plan to post once you switch. I can tell you that there's lots of Lev users who post in Lantus TR, and some Lantus cats that post in Lev. It's just a matter of where you feel more comfortable. Sometimes it's a matter of how fast you need a reply to a question. TR is just a lot busier. Whether you use one or the other, or follow tight regulation or not, you can post in either place.

There are some differences in the two insulins. They work different ways in the cat's body. The primary difference I've seen is that Lev can have a somewhat later nadir (like +8 instead of +6) but every cat responds differently, and nadirs aren't set in stone. Just like PZI cats!

Both insulin types are less "flexible" in terms of timing, and keeping as close to 12 hours apart with your shots seems to give the best results.

Although it happens on occasion, don't expect immediate results from the change. Because they are both "depot" insulins, it can take a few days for the depot to be established. Most people are advised to stick with the starting dose for at least 3-5 days before any adjustments are made to dose (unless you do see a quick response and get a low nadir, in which case you decrease immediately).

Differences in the L's vs. Prozinc -

You've been using U100s and the conversion chart, right? You'll still use the U100 syringes of course, but no more conversion charts. Do you have the ones with 1/2 unit markings?

Dose adjustments are made in .25u increments, so you might need to practice drawing up .25, .5, or .75u doses.

Dose adjustments are based on the nadir number, and the preshot numbers are not as important.

While you might see smiley shaped curves at first, eventually you'll see flatter curves. This is a good thing, because the insulin is designed to work more evenly over the course of a cycle. Seeing a kitty hang out in blue or green numbers all day isn't uncommon.

The hardest thing to deal with, (I think, from having used PZI), is that shooting what you would consider to be a "no shoot" PS number is pretty common. When somebody tells you that shooting a regular dose into a 130 is okay to do, that sort of makes you take a step back and say "huh???". :o It's a hard concept to wrap your head around, but try to keep in mind that doses are based on the lowest numbers you see, not the highest ones.

Hope that helps some. Make sure and post in one of the L forums and ask for advice before switching, and read the stickies. There's a lot of them, and they contain tons of info, so don't try to soak it all in at once.

Carl
 
Oops,
I see you've already posted an "intro" on Lev! And I was right in guessing a starting dose of .5u would be the likely recommendation. :-D

Carl
 
Carl & Bob said:
The hardest thing to deal with, (I think, from having used PZI), is that shooting what you would consider to be a "no shoot" PS number is pretty common. When somebody tells you that shooting a regular dose into a 130 is okay to do, that sort of makes you take a step back and say "huh???". :o It's a hard concept to wrap your head around, but try to keep in mind that doses are based on the lowest numbers you see, not the highest ones.
Carl
Click to expand...

Carl hit the nail on the head - the panic I've had, after 10 months - of shooting low numbers... it feels like I'm starting all over again! As I've looked at patterns, however, I've found that when I omitted the R and shot a reduced dose, we ended up with a setback that took several days/weeks to recover from. If I delete the R, it's not so bad. And if I do an ever-so-slight reduction, I'm usually okay; I still get drops, but not so much. And when I panicked and cut the dose in half; then in half again... thinking it was the SRT kicking in... that was a mistake. So now I shoot the low numbers. Still a little hesitantly, sometimes with just a teeny-tiny reduction, but it's been okay. And he's gotten into a nice rhythm... and I'm sleeping a little bit more and stressing a lot less.

I think I told you - I started at 50% when I changed. But Grayson is a high-doser... so it took a LONG time to get where I needed to be. With Linus, it won't take you long to find the right dose if you start at 50%. Hoping the transition goes well.

As for skipping a dose, if you're starting higher than 50% I WOULD skip - because Linus likes to throw you a curve. If you're going with 50% however, you can probably go either way safely.

Lu-Ann
 
I won't be a stranger - you guys are my bookmark! I have to come here to get there :-D

Day 3 on Levemir, Linus seems ok, but not quite himself. This morning he seemed pretty "off", and even threw up, then he went outside, I saw him running back up the stairs on the deck, came in all talkative and nibbled on some treats. He finally ate some food several hours later. BG seems within his normal range, I did get a ketone check yesterday which was negative, so I'm chalking it up to the weather and possibly just feeling weird from the new insulin.

All you micro-dosers, how the heck do you do it? I can't get a .5u dose without an air bubble, and even when I go more and try to push it out, it stays and the insulin goes. Do they make tiny syringes? I guess if they did, we would all know about it.
 
Hi SUe
Glad to hear you are switching to Lev,
I wish you much luck with this insulin.
Shakes has been doing wonderful on it, and after 2 years, no longer has neuropathy!
Good luck, I am praying for you both
 
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