1/20 Ming PMPS = 419 / AMPS = 310 weaning off pred in Feb?

http://www.felinediabetes.com/FDMB/threads/1-19-pmps-356-ming-amps-275-5-110.209635/

AMPS = 310

I plan to either start Levemir on January 31's PM cycle or February 1. I have 4.5 days off and that sounds like the perfect time to hole myself in at home and change Ming's insulin

I do have some non-urgent questions:
1. I read on another thread that it's recommended cats stay on a type of insulin for at least 6 months. Ming's been on Lantus for about 3 months. I feel like we've been seeing some good things in the past month so am I not giving Lantus a long enough chance if I change next month?
2. If Bolus insulin is needed, how is that calculated and how does it work? I assume we'd need data on Levemir before attempting bolus but I'm just curious. Ming got Humulin in hospital but it hardly did anything to him - the IM specialist thought the dose was probably too low. I remember drawing up 0.07 ml of bolus but I have no idea how it's calculated or made up.
3. Is my math correct? 70% of Ming's (current) Lantus dose (6.75 u) would be 4.75 u?

Edit: This AM cycle is the 6th cycle of Ming on 6.75 units. I'd LIKE to change to 7 units tonight (Ming, ya hear me? I'm threatening a dose change! ) but I have work tomorrow so ideally, he'll have to stay on 6.75 units until tomorrow's PM cycle and mom can't monitor AM cycle from +2 to +6 again.

 

Crista, I really can't say if someone should be on a particular insulin for any lengthy of time. My belief with Smokey was to give insulin at least 6 months to see how it's working. BUT, ECID.

HOWEVER, there are other things to consider. I had a previous FD kitty so the dance wasn't new to me, I was home full time, Olive was getting aggressive and already on 8 units lantus in less than 2 months. We did not follow protocol, had very experienced people here guiding us every step of the way. I knew how to treat lows, how to syringe feed if needed. I knew before any tests were done that Ollie had more than FD going on. She was only diagnosed diabetic 18 days before I got her, insulin was only started 8 days before she arrived to me and dosing wasn't consistent.

But it was clear early on she would be high dose, still not knowing the issues yet, so I switched to levemir after 6-7 weeks of lantus.

Take everything into consideration. If Ming has late nadir (Ollie does not) are you comfortable shooting low numbers and being there to monitor. Or like Ollie had early drops for a while so I needed to be home +3 to catch and boost if needed. There were times she came with me if I had to be out. But that has settled down now.

I love levemir for her, she reacted right away to it and it did level her out some, she still bounces, just not so high now. Just consider everything, including your way of life and your schedule.

 

Thanks @Olive & Paula for the insight.

I think I'll need to discuss with my mom how she feels about everything as well. But I'm fortunate to be able to bring him to work if needed too.

I spoke to my vet today (the one that dealt with Ming when he was hospitalized), and asked her how she felt about weaning Ming off pred. She said we could try. She'd like to run a blood test to make sure his liver is doing okay and also a specFPL to get a base line. Then start weaning him off pred. Then do another specFPL in 3 weeks to see how he's doing. She said once he starts to come off of pred, I'll need to monitor him closely.

So now I might change my plan... maybe instead of switching to Levemir this February, I focus on taking him off pred and see what it does to his numbers and his dose. Give Lantus a longer shot.

Tonight's PMPS = 419. I decided to increase to 7 units tonight. If he gets low tomorrow, my mom can come home and/or feed him HC.

 

That sounds like a plan.

 

There are reasons to switch to Levemir earlier, such as higher doses or a kitty that is visibly reacting to the Lantus sting. That includes smaller dose cats too. When/if you switch, wait until you are closer to switch time before figuring out the new dose. A lot could happen between now and end if the month.

Let’s cross the bolus bridge when we get there. Yes you need to understand onset, nadir and duration of the basal insulin first. Then you start small and work your way up in dose, with guidance from an experienced R user. It’s as important to know when not to use it.

Good luck with the new dose and plan to phase out the pred. Curious to see what that does for Ming.