Sneakers- changing from Prozinc to Levemir- dosage?

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hmjohnston

hmjohnston

Member Since 2011
New to Levemir but not FD- Sneakers was diagnosed Thanksgiving of 2011. First Humalin, then Prozinc, but her numbers haven't gone down with a high dose. Gayle suggested Levemir and my vet was willing to prescribe (I printed off the 101 info and took it with me :-D ).

So I bought some Levemir pens in the 100u and currently dose with the 40u in PZI. I am, however, using the 100u syringes. The vet read the article and suggested to start with the .5 dose BID as suggested so I am just making sure I understand the dosage- 100u pens, 100u syringe- .5 dose is the first hash-mark on the syringe with half unit measurements. Right? (Currently I do 9 units of the 100u to make 3 units of the 40u PZI.)

I DO have ketone sticks and about 5 test strips left for the meter and know to keep an eye on those as the insulin levels drop while changing.

I will change over on Friday night as I will be home later in the morning and then home earlier in the afternoon. I can do a semi-curve both weekend days but I know that it will take her a few days to settle into the new stuff.

Thanks!
 
It takes 2.5u in a u100 syringe to equal 1u of u40 insulin (someone correct me if I am wrong - its been a while), so by giving 9u on the u100 syringe you are actually giving 3.6u of u40 PZI. Maybe that is what you meant to wrote because you have 3.6u on her SS. When you get to using the lev, it is u100 so a unit is a unit is a unit - and yes, the first short line on a u100 syringe with half unit marking is .5u. My u100s have long lines on the right (needle facing up) for whole units and short lines on the left for half units. I think most are that way.

As for the starting dose I'm not sure about starting at .5u with a cat on 3.6u of PZI that is having trace ketones now and then. You might want to start at 1u.

I was trying to figure out what food you are feeding her. Is it FF classics (pate) or other ones with gravy in them? The gravy ones have higher carbs.
 
The problem with ProZinc for some cats is its lack of duration. That's what I'm seeing for most of the doses on Prozinc, but she's not getting much response now.

Has your vet suggested having her tested for acromegaly or IAA antibodies?

Levemir can be a powerful insulin, but only in its ability to maintain blood glucose more level. It can have a hard time bringing down high numbers until the shed has been built. ;-) Have you heard that term "shed" on the board before? It refers to the depot or reserve which Levemir establishes and is necessary to help hold BG steady.

I also think you'd be more successful and perfectly safe for Sneakers to start with 1U. Ketones are nothing to mess with and lack of insulin is one of the factors in their development. How is her weight and has she recently had an infection or is there possibility of infection such as from poor dental hygiene or UTI?

Have you familiarized yourself with the Tilly Protocol? It is very methodical, which is an excellent approach to help determine the best dose of Levemir. We can discuss.

Sorry, not much time this AM for further info. Others will be by if you have more questions before tonight.
 
Heather,
From what some others have done when switching, I think Marcy and Claudia along with others, is to go with a 50% dose of Lev, so from your 3.6u now you may think of somewhere around 1.75u Lev.
That would be a safe starting switch dose, but that's with no ketones in the picture, so in Sneaker's case, it may be safer for you to switch at 75% Lev, or somewhere around 2.25u Lev and just be sure to be around to test and have a few cans of HI carb handy.

As has been said, you will likely not see much of a reaction until the Lev shed is built up, so you can expect to see some highish numbers for a day or two.
Lantus & Levemir – Insulin Depot –AKA- Storage Shed

The two insulins are quite different in how you base your dosing; you won't place as much importance on your ps numbers as you do on the lowest part of a curve. Where PZI ps may determine dose with a scale, Levemir will use your nadirs and type of curve as your dosing deciders.
 
Yes, reading the posts and getting some PM's and doing my own thinking... starting at .5u for Sneakers doesn't seem to be that great since she does have ketones in her past and I really DON'T want to go there again. I would feel comfortable starting her out at a higher number- Gayle suggested starting at 2.25u because of ketones- so that would be 2 full u (right side lines) plus half way between the little half hash mark on the other side :-D . I was starting to think that isn't half of what i was giving her but I am forgetting I am going from 40u to 100u so the dose would be less as I am initially giving her more.

Yes, her current PZI dose is 3.6. I have a little number dyslexia sometimes and am always careful to double check everything I write :-D .

Have heard about the shed but as PZI didn't have it I am very vague about it. I know it is a slow build-up and a slow drop-off because it is a longer lasting insulin. I've printed off a lot of stuff for me to read through this week before starting. I read through Tilly's protocol but have not printed it out yet so I will do that as well.

Testing... the new vet at least knew what i was talking about with the acro... but, as I just spent $400 in one day on her I couldn't do more testing at the time. I have to sew a lot more stuff first (side job over a side job- all extra money made goes to Sneakers 'habit' costs- strips, syringes, insulin). He did draw blood to check for anything else going on but I haven't noticed that she has been sick or 'off'. He said her teeth were great and the only thing is she just pees a lot- in the box. Doesn't look like any pain from that. I do give her mirilax each day as she has been constipated for a while. When I was in Chicago I froze the FF into 1 oz cubes and sprinkled mirilax in those so my sitter wouldn't have to do it.

Feeding... I do Dr L's raw diet, frozen in ice cube trays to make 1oz cubes. That is fed 1/2 and 1/2 with Fancy Feast- currently she has been getting the Chopped grill feast at 2% (I was feeding her between 0-5% and her numbers were all over the place because she is carb conscious out the wazoo so now I stay within a % to keep her on the same carb level. Once I did that she leveled out and didn't jump so high- but didn't dip too low, either) . If I write 2oz mixed that means 1oz of each at one time.

I think I answered all the particulars :lol: . If I left something out just let me know.
 
Yes, reading the posts and getting some PM's and doing my own thinking... starting at .5u for Sneakers doesn't seem to be that great since she does have ketones in her past and I really DON'T want to go there again. I would feel comfortable starting her out at a higher number- Gayle suggested starting at 2.25u because of ketones- so that would be 2 full u (right side lines) plus half way between the little half hash mark on the other side . I was starting to think that isn't half of what i was giving her but I am forgetting I am going from 40u to 100u so the dose would be less as I am initially giving her more.
Click to expand...

I have no experience with PZI or ProZinc, so all of the dosing suggestions I offered were from actual people who have switched... Sure you can go with half the dose in the numbers, if 3u PZI then 1.5u Lev, but you don't want to have to worry about ketones and with a bit of ketones in Sneaker's past, you may want to go with a higher %... whatever you figure is 75% in the numbers, that would be good. I think you need to put aside the U40 and U100 thinking, even if you were using U100 syringes and giving 3.6u of the U40 insulin in the U100 syringes... just focus on the numbers.

The 50% is very safe and you would most likely need to increase the dose, but it's just the starting point.

The short of the shed is this..... you need a spare tank of gas before you are going to get to your destination.
if you give 2.25u the first shot, most of that dose is going to the shed and very little goes to the cat.
With each progressive shot, less goes to the shed and more goes to the cat.
It is for that reason you will not see decent numbers until maybe 3 shots or more.

When any cat first starts on Lantus or Lev, the protocol suggests you hold the first dose for 5-7 days, so that shed can get filled....think of it like a glass of water and if you don't give it a chance to fill, you won't have much to quench yr thirst. hold the glass under the tap till you have it filled to the amount you want and then you can have a good drink.
 
Yes... I watched the video and red the sticky on it.

I might start with 2u then. that is halfway between 50% and 75%. And keep an eye out for her to take a bathroom break :lol: .
 
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