Questions for Lev users

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Kris & Jane (GA)

Kris & Jane (GA)

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Jane's on Lantus again after a five-year honeymoon. We're seeing huge drops and, as a result, bounce.

Does Lev act the same?

What made you choose Lev over the other options?

Many thanks,
 
Hi, Kris. Sorry to see that Jane needs insulin again. I've been through this with both of my cats.

Beau was OTJ about 3 months and got into some dinner rolls that sent his sky-high. He couldn't seem to get himself back down so I shot micro doses for 9 days. As needed - pretty irratic shooting shedule, but came to about 1 shot per 24 hrs of .05u - yes you read that right. It was the dose he had been on before/while going OTJ. He has been doing well, and OTJ, since then.

Jeddie came to me on vetsulin, but with only a few tests he seemed to only need a diet change. But he has been back on insulin for several months now after about 4 mos OTJ.

I decided on Lev over Lantus for several reasons some of which had to do with it's neutral ph and longevity. I have been very happy with it. I do think, from all that I have observed here, that the two insulins are very similar, but not exactly the same and one might work better than the other for certain kitties.

I know you didn't ask for dosing suggestions, but to me, it looks like even .25u may be too much to give consistently - and consistency is key to these insulins. I had a rocky start on lev with Beau because he didn't "follow the rules" of the Tilly Protocol. What I had to discover was that he was very subtly rebounding on .5u (Jane's numbers are not at all subtle - she is clearly rebounding). What worked for Beau was lower doses - in the .2u, .1u and .05u range. You might try that with Lantus before switching insulins - unless you are needing to buy new insulin right now and want to change.

Let me know if you want tips on drawing those micro-doses.
 
Oh, and did you get her checked out - dental, UTI, etc. to rule out something causing a BG spike?

I see you were shooting .1u for a few days. I wonder if that could have been held a bit longer as the first few days might have still been buncing from the higher dose before. But it could be that somewhere between .1u and .25u is the right dose. I know, it will drive you mad getting those tiny dose differences.
 
Hi Kris - It's nice to meet you.

I'm sorry to hear that Jane requires insulin again - she is one lucky kitty to have you looking out for her.

Here is a link to the Tilly protocal:
http://www.tillydiabetes.net/en_6_protocol2.htm

I chose Levemir for Molly (we were previously using PZI but for her, it wasn't the best insulin) after doing all the research. From what i read, it appeared that Lev was a bit more forgiving and sounded like the more appropriate choice given the amount of time Molly was/is diabetic and the fact that she had gone off insulin in the past. I feel both Lantus and Lev are excellent insulins that work very similarly. I agree with Sheila though that before switching insulins, rule out anything else medical and consistency.

Good luck, keep us updated.
 
Hi, we recently started using Lev after 1 year of Vetsulin. Since Vetsulin was recalled and taken off the market we decided to try Levemir. I chose this product because of successes I have seen here and the hope of a smoother curve for Simba. We are still in the early dose adjusting stages, so, I am not certain of our overall results yet. I do like the product, except for the price, but we use less and the needles are cheaper so it evens out. So far, I am pleased with Levemir and like the results we are getting. Our numbers are still a little high but no big swings. We are getting there though.
 
Please read the link that Michele posted for the details of Tilly, but basically if gives the guidelines for how/when to decide to raise or lower the dose based on the numbers you are getting. And the dose changes are in either .25u or .5u - also depending on the numbers you are getting.

It is a very good starting point. And I know I will get flack from that comment by some people on the Lantus ISG, BUT the reason I say that is because it doesn't work for all cats. I think it is the place to start, but as you are seeing, Kris, the quarter dose changes are not working for Jane. Something less is needed as it was with Beau, and, I believe, Jeddie.

My experience with Beau has colored my treatment of Jeddie and I could probably be moving him along faster. I just didn't want to believe he was going to need insulin again for more than a few weeks. Sigh.

Anyway, it might be helpful to think of dose changes in percentages of current dose. In other words, a change from .5u to .6u is a 20% increase. A 20% increase is probably fine so if you are giving .5u it is .1u more, but if you are giving 1.25u it is .25u more. To me, that makes more sense than set increments of a quarter or half unit regardless of current dose. Make sense?

I'm guessing that you figured out how to do the small dose measurements. I practiced with used syringes and expired insulin (actually my old vetsulin) by drawing up 1u and twisting the plunger until a bead of insulin formed on the tip of the needle. I practiced getting 10 beads from 1u and 5 beads from a half unit. THEN, I practiced getting beads HALF that size for the .05 amounts. Good lighting and powerful reading glasses are helpful! To me, the .1u beads were about the size of the head of a straight pin.

What insulin were you using before?
 
Hi Kris,

I agree 100% with Sheila about microdoses and Tilly being a good starting point but that some cats can't play by those rules. Sheila has excellent experience with microdoses, has a great method how to do them and understands how they work. I really like her observation about shoot as needed. Jane may need a 24 hour cycle or custom schedule rather than a 12 hour one. Others headed for the Falls have had success with custom plans, such as no shot unless BG is headed over 150.

Sheila, please add your input on that. Isn't that what you did - set a BG level at which you shot?

I read on Health that Jane has blood work done today. Hopefully that will give you some clue as to any changes she's experiencing. Hope it went well.

If you were to change to Lev, you'd probably see the same thing - very miniscule need for insulin and easily rebounding otherwise.
 

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I did/do set a BG level. It is trial and error to find the one that works for your cat.

Beau ended up being 130, I think. I found that, contrary to what *should* be happening, I could not shoot even .05u on anything lower or he would dive to the lower 30s. You'd think that itty, bitty amount of insulin would not make any difference, but without it he would start to climb and with it, on a too low, PS, he would nose-dive - hence 24 hour cycles, etc.

Jeddie appears to be shootable to a lower number, but I haven't found it yet - and I am gun-shy after seeing Beau's response.
 
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