in the interest of sharing and learning...
i apologize for bumping up an old thread, but this might be a good place to add a comment or two. my comments are based on the assumption kitty's spreadsheet has been studied by members who are experienced
and knowledgeable in analyzing spreadsheets and are extremely familiar with the basics as well as the exceptions in the action of the insulin(s) under discussion.
since 2007, we've had more lev kitties come through the TR group than have participated here or in the Lev group itself. we've found (through tons of trial and error and accumulated experience) when kitties have switched from one of the P insulins to Levemir they can *usually* start with a levemir dose which is similar or even the same as their last good "P" dose. since it took 5 units of BCP PZI to pull toby down into double digits, in toby's case that would mean suggesting a dose of about 4 units (for safety's sake we'd suggest a little lower than 5 units, but not too far off 5u because he's ketone prone). iirc, toby's vet also suggested a 4u starting dose of lev.
as already mentioned, when kitty switches from lantus to lev we usually suggest an initial lev starting dose of 70% of the last lantus dose.
addressing the urgency found in toby's case (actively throwing ketones):
ketones can rapidly turn into a dangerous and potentially fatal condition known as DKA (diabetic ketoacidosis).
the recipe for developing ketones = an insufficient supply of insulin + inappetance + infection OR certain other systemic stresses.
- when kitty is prone to developing ketones and more importantly when kitty is actively throwing ketones... one must get more insulin into the cat without allowing the cat to bottom out. in other words, get the insulin into the cat even if one finds it necessary to feed high carb foods to prevent kitty from dropping too low. starting lev at 1u when kitty was up to 5u BCP PZI before seeing any known double digits is leaving the door wide open for ketones to develop... and sure enough --- that's exactly what happened here. ketones walked right in that open door!
- getting plenty of food and water into kitty becomes very important. if kitty won't eat talk to your vet about what you can give kitty to stimulate their appetite and/or assist-feeding or a feeding tube if necessary.
- discuss and address any infection or other problems kitty is having with your vet. also talk to your vet about administering fluids.
keeping ketones at bay can be a lot of work, but oh so worth it!
you're doing an awesome job, peg!
i'll be cheering you and toby on from the sidelines. good luck!
