12/8 Loudogg AMPS 399 +3 276 +6 213 +9 97 PMPS 45/84/96 +4 74

December 7, 2018 Condo - Last day on Basaglar

Good morning all,
Today is Day 1 of Levemir, and in true Lou fashion, he is bouncing pretty spectacularly. An almost red AMPS is pretty over the top, even for him. He likely went lower yesterday, but Caleb was out during his +8 testing. Also, I forgot to post that day, but the 6th marked 1 month post dental. He's doing as well as can be expected. The only question going forward will be what was the status of his remaining teeth and when should another dental be performed? Since he had root absorption, I'm guessing they'll all need to be pulled eventually. I don't want to wait too long like we did for his first dental.

As I've said a ridiculous number of times, I'm really excited for Lou to be on Levemir. I really do have a good feeling about this switch. With that being said, I need some assistance on some day-to-day Levemir basics. Apparently the onset is usually around +4, with the nadirs generally being +8 to +10. When do you Lev users generally test? I've held a basic testing schedule of +3, +6, and +8/+9. How should I adjust it for Levemir? +4, +7, +10? The only downside with that is not being able to feed after the +10. It also just occurred to me that I may need to adjust his feeding schedule, which is the same as the spot checks. I'd appreciate any basic insights you can give me.

I hope you all have a wonderful day and your kitties stay safe out there. Sending vines to all those kitties and beans in need, but sending some extra to Mr. Jones (@Tracey&Jones).

 

So glad you got Lou started on the Levemir. I hope it works well for him, and that you find a good feeding/testing schedule.

 

Glad Lou started lev and hope wonderful things happen.

I can't answer about testing/feeding schedule as Ollie has early to mid day nadirs (+4-6). Only thing I can say is once you get some testing in you will see.

 

Thank you! Interesting though. Lou's generally had later nadirs, even when he was on Vetsulin (which peaked at +4 to +6), he would regularly nadir around +8. Things have been in flux a bit more on the Basaglar, but lately his nadirs are generally later again. But in the end, you're absolutely right. I'll just have to test regularly and see how he's reacting to the change.

 

Good luck wother the Lev! Hope it works great for Lou!

 

Neko’s Lev onset was around +5 and nadirs generally in the +9-12 range, though of course earlier or later occasionally to keep me on my toes. IAA kitties are often a little slow getting things going. I didn’t adjust feeding schedule much -Neko was a traditionalist when it came to feeding, but I did change quantity or carbs.

As Paula said, ECID. Don’t be surprised if you feel like a newbie all over again for a couple weeks. I did as I tried to figure out the new normal.

 

Rusty's onset was between +4 and +5, but his nadir came rather soon after onset, usually around +6. I liked Lev. because if Rusty was low at AMPS, I knew I had at least 4 hours for him to come up. Therefore I never even thought about stalling.
ECID indeed! You will soon figure out what works best for Lou. Best of luck with Lev. I hope it produces the desired results.

 

Gosh that makes SO much sense, haha! I've always wondered why it seems he rarely follows "normal" rules with his insulins, but seriously that would explain a lot!

Lou's finally gotten used to the feeding schedule, and I doubt he'd really allow me to change too much with it. I think I'll just keep the status quo and see what tweaks might be needed as they come up. I think it may be a hard learning process, but at least today I find myself much more prepared than I did when switching from Vetsulin to Basaglar. We'll see if that continues (not likely, haha), but I'll bask in the excitement while I can.

I think that's going to be my favorite part about the switch! When I work, Caleb usually wakes up around +6, so it would be great if he didn't have to worry quite so much prior to that time. We'll see how it goes.

Thank you so much everyone for your help and well wishes! Lou's having a rocking good day so far! I'm impressed!

 

Could still be the Lantus depot talking, but we’ll take it.

 

Good luck with the Lev. I hope it works for Lou.

 

Help please! His PMPS is 45! Do I technically skip, or give a reduced dose of 1.75U? Shot due within 15 minutes.

ETA - I think I lost my head a bit there. I know you're supposed to skip with a PS that low, but I don't want to screw up progress (specifically with the new insulin).

 

Best of luck with the switch to Lev. I'll be watching Lou's progress closely as that was suggested to us a while back. I'd already invested in Lantus so it was too late to switch at that point...but we'll be watching Lou...tell him he's the 'poster cat' now for Lev...and that he needs to behave and go on to OTJ...k? Lou? Listening???

 

No, stall and see if he comes up first. No food.

 

I agree with Wendy. Since you don't yet know when he onsets, it is best to stall. The dose may need to be adjusted, but it is too early to tell.

 

Well crap. I know better, but I gave him food... and I gave him a bit of HC. I think I panicked a bit there.

 

OK, got that out first. Neko did this quite often, usually in the morning when I was groggy. Let’s see if Lou comes up enough after a stall so you can shoot. Ugh, just read you fed. And yes in the reduction, like some kitties, a strong reaction to the switch.

How late can you delay the shot and still get back on time when you need to be? There is a section on the Sticky Notes on shooting low that you should really get to know when using Lev. Test in 20-30 minutes after that HC. If you can shoot later, you still might be able to get a shot in.

 

I can probably give him his insulin up to an hour later, in about 45 minutes, and still get him back on track by Monday. It's been almost 30 minutes post food now, so I'll test him in 5 minutes or so. Jeez, what a mess I made. You'd think I'd be better prepared, but he's only been so low at PS once before I think. And apparently it makes me panic.

 

On the upside, nadiring at preshot means someone is always home then.

 

A fantastic point! He's at 84 right now, 30 minutes post food (LC & HC).

 

OK, let’s see where his is in another 30. If he has continued up on his own with no additional food, you are OK to shoot.

 

Okay, he's at 96 1 hour post food. I'm going to shoot 1.75u.

 

Thank you so much for your help tonight! I hope I'll keep my head on better next time!

 

Welcome to the wonderful world of Lev, the crash course version.

BTW. what you are seeing today was a combo of the Basaglar depot, plus initial strong reaction to an insulin switch. The reaction may not last. When the B depot wears off, you may find yourself increasing again. Or not. Cat in charge.