Will be switching Pumbaa to Levemir soon...

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Sheila, my pre-shot time is 7 pm Arizona time, which is 9 pm Chicago time (right now, anyway, until you all change time at the end of October). So don't hurry on our account.

Thank you so much...there's so much I didn't consider. I just wanted that Lantus out of his little body.
 
From where he has been this afternoon, I would give him 1u.

The lantus will be gone soon enough. You just don't want to take too many risks in the next 48 hours.

At 9pm, I will probably be just getting back from my neighbor's who's cat I am watching this weekend. I'll check, but I might miss your shot time. But I doubt there will be any huge changes that would make me suggest other than 1u.
 
Thank you, Sheila.

At least Pumbaa was consistent...he was still at 355 for him PMPS so I gave him 1.0U. And, no flinching from Pumbaa when the dose was 1.0U. If Pumbaa goes above the mid-300s at his AMPS, I will probably raise him to 1.50U. But, hopefully, that won't be the case.

It will be interesting to see what he does tonight, and if we can tell how quickly he reacts to a dose change like this. At least with the Lantus. He may react totally differently on the Levemir.

In all seriousness, while I did expect his numbers to flatten out once he stopped the bouncing and diving, I really didn't expect him to settle into mid-300 numbers, especially since the insulin stored in the shed should still be distributing itself. :YMSIGH:

Dealing with Pumbaa these last 5 months has been the one area in my life (other than dealing with my mom *LOL*) that defies all of my logic and common sense.

I need to make time tomorrow to go back to the beginning and read up on FD, Levemir, Roomp/Rand, SLGS, and prep myself for Monday night. Since I have been on auto-pilot with Pumbaa for the last month due to the excruciating deadlines I have been working under, I feel like I have forgotten a lot, or maybe I just never grasped it from the start, or maybe all of the new things I've had to learn for my business in the last month has crowded out everything about FD. Maybe it's just the stress and total exhaustion taking its toll. In any case, my brain is fuzzy these days on anything not concerning the projects I've been working on.

The good news is that I really don't have to worry about Pumbaa taking a dangerous dive tonight, so maybe I can go to bed early, and get a glorious 7 hours of sleep! (Shhhhh...clients haven't sent me any new corrections tonight...so my slate is actually clean. I need to log off of email to make sure I don't see anything coming in. *LOL*)

Suze

ps: if something I typed above didn't make sense...blame it on my very foggy brain. :(
 
I am not surprised that he is in the 300s. You have suddenly removed a component that was active in keeping him where he was - even that was going form 400 to 40 and back. But I also think he was rebounding from those 40s and that means his body was exerting a force against the action of the insulin (by releasing hormones and stored glucose). Think of two forces pushing on each other and then suddenly remove one of them. What happens? The other one flies forward by its own force because resistance was removed. Make sense?

Also, the lantus is not hanging around somewhere slowing being used up. It was being used at a rate that was replenished every 12 hours - meaning since he went 24 hours between shots the "old" stuff is all gone already.

Those two things equal really high numbers, but they probably will come down at least a little over the next 36 hours.

I would plan on staying at 1u and let the rebound hormones clear so that the lev has a "clean slate" to work from.

You are testing for ketones right?
 
Sheila:

First and foremost, just checked for ketones and they are still negative, thankfully!

I truly appreciate the rest of your informative post, and hope and pray that you will guide me during Pumbaa's switch to Levemir.

(((HUGS)))
 
Sheila, and I'm interested in having his blood tests done again to compare to 5 months ago. :)
 
Can you believe that Pumbaa went down to 206 on 1.0U???? Now, if only he doesn't bounce because of this!
 
Cool! I think those rebound hormones are starting to clear. Keeping paws crossed that he doesn't bounce back into the 300s. Remember, with a smaller dose and rebound response fading, he may just stay steady in the 200s - similar to where he was at diagnosis. Then again, he might sag into the 100s now that he doesn't have to fight a too big dose.
 
Sheila & Beau & Jeddie (GA) said:
Then again, he might sag into the 100s now that he doesn't have to fight a too big dose.
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Wouldn't that just be fricking awesome????????
 
I absolutely love this new vet!

First of all, Pumbaa didn't bite anyone, and only hissed once, at it wasn't even when they stuck the thermometer in his butt! *LOL*

The vet did an overall exam (even his teeth), and said that clinically, Pumbaa is in excellent shape! He went over Pumbaa's last blood work results (taken when he was being diagnosed) and said that, unless I wanted to throw my money away, he saw no reason to repeat the blood work as the numbers he saw were all indicative of Pumbaa's FD, and there were no clinical signs that Pumbaa was having any problems.

The vet (a big, boisterous guy, probably in his early 50's), said that:
• They normally prescribe Lantus as the initial insulin of choice for cats;
• They see a lot of diabetic cats;
• Very few of their patients home test their cats;
• While he has read up on, and knows that dry food is bad for cats, he hasn't switched his cats over to a wet diet yet. (I told him about using parmesan or FortiFlora and he was amazed.) But...this vet admits that dry food (for cats and dogs) is "a convenience for the owners and not the best thing for the pets";
• He's looking forward to seeing how Pumbaa does on the Levemir.

Now I need to call around and get prices so I can get this prescription filled this afternoon!

Yeehaw!!!!!! :RAHCAT

What a relief. And I will be switching Beck to the same vet!

Suze
 
Fabulous! Glad it all went ok. That vet sounds like he is "practical" about what people are able and willing to do as well as what is necessary and not. I do hope you can get him on board with recommending wet food for cats - and switching his own. He may not know that you can free feed wet food and leave it down all day. Maybe direct him to Dr. Lisa's site? (catinfo.org).

Just have to say that the logic of convenience over proper nutrition is lost on me. Would it be ok for parents to hand their kids a bag of chips and a soda for every meal because it is convenient? Or even give them a fast food cheeseburger, fries and soda for the same reason? It would sure be "easier" at least until the kids started having severe health issues that no one could figure out the cause of because they would never look at diet... geeze. Come on, people!

And don't forget to mention to the old vet why you switched. That it had nothing to do with skill or personality and only with the unwillingness to Rx a drug that many cats are already on ......
 
Thank you, all! (((HUGS)))

Yes, this new vet is very open and honest. Not just for telling me I didn't need to pay for a new blood panel, as Pumbaa didn't clinically exhibit any symptoms of any of his high/low results from his April FD diagnosis blood panel, but also for admitting that he knows he should get his cats off of the dry food, except that they are resistant to the wet food (which is why he got excited when I told him to try parmesan or FortiFlora). He can even take a joke, because when I told him my advice on this was free and I wouldn't charge him, he pointed to his credentials on the prescription form, winked, and said "but I have these letters after my name...DVM". :)

I really, really like this guy! He was pleased/excited when I told him that the link to Pumbaa's SS was kept current every day. And my mom has been taking her cats to these vets for years now. Again, the only reason that I didn't switch my animals to this vet's office about 4 years ago when I was changing vets was because, at that time, I worked outside of the home, and they didn't have Saturday hours.

I loved my previous vet as well. But she was about 10 minutes further away, and more expensive, and she wasn't willing to take the risk to prescribe Levemir for the first time to a cat, even based on my history of testing/caring and knowing that Levimir is more potent so you start them at a much lower dose. So now, she has lost my business for Pumbaa and for Beck. How sad. (Yes, Sheila, I will be telling her exactly why I am moving both of my animals. I don't need the headache of different vets for different pets, and, since she was unwilling to prescribe Levemir for Pumbaa, they have now lost all of my business.)

Pumbaa got his first dose of Levemir tonight! 0.50U.

I am very exited about this!

As for prices:

WalMart was the highest at $236.32. Walgreens was next at $235.00. Costco had the best price @$222.64, and said that they would honor the $25 off coupon, but then didn't when they said that the coupon prescription had to be from a VET/MD in some national network. But, still, I only paid $193.60 due to my Costco membership and some forms I had filled out when I got Pumbaa's Lantus there five months ago. I would have paid $160.00 plus shipping charges had I ordered the cartridges from Canada. Also, when I called the pharmacies today for pricing, I also asked about the country of origin for the Levmir, and how it was shipped and handled. Costo couldn't tell me country of origin (Walgreen's said Denmark), but did verify that the Levemir was shipped refrigerated and was then stored, refrigerated, ever since.

$196.30 isn't too bad when I know this insulin has been cared for correctly. And when I'm too impatient to start Pumbaa on this new insulin to order from Canada. :)

Suze
 
hmjohnston said:
Yay for the new vet!!!!

Sounds like he is willing to learn and is not such a stuck in the mud.
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Isn't it awesome when we find vets like this???? :)
 
Sheila & Beau & Jeddie (GA) said:
Did you discuss starting dose with him? I'm just wondering what his thoughts were, if any, on that.
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New vet started quoting percentages of current Lantus dose, and I stopped him and said that a very wise person who has been through this many times (that would be you) suggested starting low and slow at .5U, and seeing how Pumbaa reacts to this more potent insulin, and he was fine with that! (((HUGS))) to you, and also (((HUGS))) to the new vet for realizing that he would be following my lead on all of this, based on what I learn here and what I do due to frequent home testing, since he has never prescribed Levemir before.

:)

Suze
 
I figured it would be Costco. But I can't believe they wouldn't take the coupon. :oops:

When Walmart pulled that one on me after waiting around more than an hour, I stormed out of there demanding the script back. That was after he twice told me I wouldn't be getting the script back. Actually he processed the coupon but the final coupon price was higher than the everyday low price. Then he tried to claim the everyday low price was the manufacturers list price, after I'd already called before hand.

They must assume most people will just pay whatever they ask.

But now the fun begins, get some tests just to keep track of what happens the first few cycles. :cool:
 
Dale: Using the coupon would have been nice, but going back to Costco for the insulin alone saved me $42.72 over what I would have paid had I gone to Walgreen's, so I'm not unhappy over the price I paid. It only hurt for a minute. Hahaha!

I'm really looking forward to testing Pumbaa again these days...while praying for some Levemir magic. <-- insert anti-jinx. nailbite_smile

Suze
 
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