? 11/14 Mačka AMPS 378, +4 258, +6 270, PMPS 348, +4 155 Dosing advice, changing to Levemir

Hi everybody,

I just came back from France. I brought with me Levemir pens. The Lantus vial is about to be empty, so I'm considering changing to Levemir this week-end, before any dental, as opposed to what we said before.

Of course, Macka threw a bounce break the evening I came back from the airport, while my husband had an emergency, and I had to deal with everything, so I ended up skipping a shot for the first time I think he's back on track now, kind of.

Macka's dose is at 4 units on Lantus right now. I am aware it should be increased because there aren't any greens yet. I have so many questions:

• What would be a good starting dose with Levemir? 3u?
• How risky is it to switch and start low? Ketones?
• What if the starting dose is too strong?
• How fast can I increase the dose to reach better numbers? Do I follow the TR protocol or can I increase faster?

All advice welcome
Thank you all and I hope that all the kitties of this forum have been good and happy!

 

Welcome back! I hope you had a great time.

We normally suggest Levemir be started at 70% of the Lantus dose that is working. You are doing SLGS and I’m seeing “some” blue (a little with the tests you have) at 4u. While 70% of 4u is 2.8u and you could do 2.5u or 3u, because he’s not seen any green at 4u, I would start at 3u as long as you can test. If you can’t, I’d start at 2.5u and we can fast track him up (which we can do anyway if the 3u doesn’t get and keep him in blue).

It’s important that the day you start him on Levemir, you can test and it would be best to perhaps do a curve that day; we’ve had some cats that reacted with a very active cycle on the first cycle of Levemir. You would shoot Lantus one cycle and levemir the next. I’d also recommend you start on a day cycle so you aren’t potentially up all night.

We can’t really foresee who will respond quickly and who won’t. My Gracie did not and I had to fast track her back up to and above her working Lantus dose but it’s better to be safe.

Let us know if you have any questions. Good luck!

 

Thank you! When you say "fast track back up", are we talking about TR fast track or even faster? Do I wait 3 days? I am considering going back to TR anyway, if work becomes slower. I really want him in better numbers.

 

I switched from Lantus to Levimer on 7/12/19. I started very conservatively and you can take a look at Luci's SS to see how she did. The first day/night she hit some low numbers...but then languished...so we had to keep increasing...and now we're sliding down the dosing ladder it seems...very slowly...but moving down.

Hope that her SS is helpful.

 

Thank you. I can see that you started with a 1/3 of a dose, scary! Are you happy with the results? Do you think Levemir helped with lowering the dose or could it just be a coincidence?

 

I'm not sure it helped with lowering the dose...but it did help her not to be so bouncie....if you look at her SS before Lev she hit a lot of pinks...it seems to me that her days have flattened out a bit and she rarely hits a pink - hardly never, but less than she used to.

 

I mean after two cycles, if he’s in all red, we can increase the dose, give it 4 cycles, and then increase again if need be. This fast-tracking has nothing to do with SLGS or TR.

As an example, when I switched Gracie to Levemir, her Lantus dose was 0.75u bid and Jill suggested we start at 0.5u bid. After two cycles, she was solid pink when she had been even going low on the 0.75u of Lantus. Therefore, after two cycles, I increased her dose to 0.75u of Levemir. Still mostly pink so after four cycles, Jill suggested I raise her Levemir dose to 1u bid. She saw a little blue on that dose so I held it for six cycles and then raised her to 1.25u bid and that’s when she started seeing green.

It’s important to note that when you switch between Lantus and Levemir, it can really take a few months to see progress in terms of better numbers overall, lower dose, potentially less bouncing. Just be aware and don’t think it’s a failure if you aren’t seeing much better patterns fast. I’d say it easily took Gracie a few months before she started looking alot better and seeing lots more green and less bouncing although she, generally, did not totally quit bouncing.

 

Welcome back Penelope! I hope your trip to France was amazing! you'll have to fill us in about the best parts

 

Thanks! The best parts are always baguettes, croissants, and cheese

 

Macka is having a fast drop tonight. +4 155, +4.5 123.
I gave him some MD to slow the drop. He's acting a little weird/nervous. No sleep for me tonight :/

 

Welcome back!!