3/20/18 Olive AMPS 400; +6.5=375; PMPS 354; +3=253; +6=153 NOT CUSHINGS

Discussion in 'Lantus / Levemir / Biosimilars' started by Olive & Paula, Mar 20, 2018.

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  1. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Yesterday

    I thought I updated yesterday's thread. It is now. Not bad had yellows in both cycles. She didn't eat +6 or +9 last night. Tux had me up +10 so grabbed a pokie, not bad then she saw the feeder open so she ate her +9. Food spike for this morning I guess???????

    What does everyone think about leaving out the dehydrated freeze dried raw nibblets out for the PMPS +9 instead of regular food?

    2 vials of Lev is arriving tomorrow. I've read what I could find here, but nothing says when going from Lantus to lev what dose to start with. I remember reading in the past start with 70% of current dose is the correct?
     
  2. CassAndGordy(GA)

    CassAndGordy(GA) Well-Known Member

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    Sep 23, 2016
    That's what I was told - 70% current dose.

    Good luck!
     
  3. Judy and Boomer

    Judy and Boomer Well-Known Member

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    May 23, 2014
    Nice to see those yellows!
     
  4. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Feb 19, 2012
    I hope you see more yellow today.
    I don't think it can hurt to try and see if she eats it and how it affects her BG.
     
  5. Stacy & Asia

    Stacy & Asia Well-Known Member

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    Oct 2, 2017
    70% is what I did as well when I switched. Good luck with the freeze dried treats, I tried them exactly once for my overnight +9. Civvie Toki (who normally entirely ignores Asia's autofeeder) could smell them in there and went mad trying to pry, chew and otherwise finagle the autofeeder open! :rolleyes:
     
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  6. Doodles & Karen

    Doodles & Karen Well-Known Member

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    While a 70% reduction is the guideline when switching from Lantus to Levemir you also want to take consideration of the numbers they are seeing on Lantus. A few things I'm thinking with Olive
    • She's pretty stuck on the higher floors with some yellow trickling in
    • Very new to starting her insulin treatment
    • Has some dx with health issues which might be contributing to a degree of insulin resistance and/or possible Acro/IAA which is TBD
    70% of 7u would take her down to a starting dose of 5u Levemir. IMHO that may be a bit too much of a reduction considering the above factors. When Doodles switched to Lev he was also stuck on the high floors at 12u Lantus along with R. It was believed that 70% would've been too much and therefore we went with just less then 85% of the 12u Lantus dose.

    If it were me I'd lean toward a starting dose around 80-85% which would be 5.5u-6u of Levemir unless she surprises you with a blue before starting. Of course you can start with the 70% and fast track if needed. Just my 2 cents and would also see what @Wendy&Neko thinks.
     
  7. Olive & Paula

    Olive & Paula Well-Known Member

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    UCCR is 4. Reference is <13 Cushing is highly unlikely. Another thing we know she doesn't have which is good, still doesn't answer what is going on.

    Will keep plugging along. Eventually something will point us in the right direction.
     
  8. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    The lev will arrive tomorrow she will be 7.5 units tomorrow. I won't start the lev until Thursday AMPS. So dose will be between 5.25-6 units lev. The lev shed will need to fill, correct? So her readings could be higher for a few days right? Just want to know so I don't panic.
     
  9. Amy&TrixieCat

    Amy&TrixieCat Well-Known Member

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    Feb 14, 2011
    Not Cushings is a good thing. Hopefully you will eventually find the answer for sweet little Olive - she is so lucky to have you fighting for her!
     
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  10. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

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    Good news on no Cushings! I've no experience with the switch from Lantus to Lev, since it occurred before we adopted Rusty. However, I seem to recall that there is a period of adjustment when the Lantus depot is fading and the Lev depot is establishing itself. Wishing Olive a smooth transition!

    :bighug::bighug:
     
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  11. Doodles & Karen

    Doodles & Karen Well-Known Member

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    Some kitties have a marked response to an insulin change and some don't. I wouldn't assume anything and be prepared to test every 3 hours or so for the first 24/48 hrs. (of course the frequency might need to be more or less depending on what Olive does).

    Doodles did have a marked response on the first cycle. He saw blue on the first cycle and green on the 6th cycle which was the first time since Jan. 2016 and we switched to Lev on April 16, 2016. Of course we knew he had IAA and recently started heart meds so who the heck knows for sure. Before that I was dosing 12u Lantus and R multiple times a day.

    This post Switching from Lantus to Levemir _ Doodles advice Post is found in the Where Can I Find section under High Dose Kitties. Post #25 has several high dose kitties SS's that made the switch so you can peak and see how they responded.

    As for the dose unless she does something between now and the switch you can decide on the 70% of the current dose or as I mentioned above something closer to 80%. Sure Wendy will chime in too.

    Great news for no Cushings! :bighug::bighug::bighug::bighug:
     
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  12. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    What great news about no Cushings! What a relief. Good luck with the lev switch.
     
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  13. Squalliesmom

    Squalliesmom Well-Known Member

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    Jun 26, 2015
    Glad to hear no Cushings! Hope the changeover to Lev helps!:bighug::bighug:
     
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  14. carfurby (GA)

    carfurby (GA) Well-Known Member

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    Yay for no Cushings! :):):)
     
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  15. Pamela & Amethyst

    Pamela & Amethyst Well-Known Member

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  16. Judy and Boomer

    Judy and Boomer Well-Known Member

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  17. Olive & Paula

    Olive & Paula Well-Known Member

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    Promising PMPS
     
  18. Chubba (GA)

    Chubba (GA) Well-Known Member

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    Good luck with th switch to Lev! Gizmo really seems to be doing well on it.
     
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  19. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    No Cushings is good news indeed.:)

    As the Levemir depot fills, the Lantus depot empties. The first couple of days are likely not going to be indicative of how Olive will respond to Lev. You will still be seeing some action from the Lantus depot.

    As Karen said, some cats have a marked response to the insulin switch. Wes's Jack went from a see of red/pink on Prozinc, to the same dose on Lev and saw the 70's on the first cycle. See May 2016. Turns out he had IAA and acromegaly. I would do "some" reduction and be ready for action. You are an experienced caregiver who has seen low numbers before, so maybe don't have to be quite as conservative as 70% if you can monitor. No harm in going to 70% if that is what you are comfortable with. We can always go back into fast track mode.
     
  20. Olive & Paula

    Olive & Paula Well-Known Member

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    Thanks Wendy. I will do some reduction. I think I'm going to finish up my open Lantus pen. Not much in it so might as well.
     
  21. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    It's not a typo. 153:cool::cool::cool:. That is one beautiful color.

    Do I hold dose in morning or raise by 0.25? I don't want to over do it. Sure she will bounce for a day or 2. Got to get her use to blue before we go for green.
     
  22. Tricia Cinco(GA) & Harvey

    Tricia Cinco(GA) & Harvey Well-Known Member

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    Jul 18, 2011
    If I'm reading your SS correctly, this is only the 4th cycle on this dose, so you'd need to hold at least one more full day. Maybe Olive will give you more blue tomorrow and further confuse the issue!

    YAY for no Cushings!!!
     
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  23. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Woohoo, she's blue! :cool::cool:
    wonder what she'll do tomorrow on this dose.
     
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  24. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    That blue is just like a cat -- you're mentally preparing for an insulin switch and Olive tosses you a (good) surprise!

    I like Wendy's suggestion. Karen gave a good summary of the points you need to consider. The only other thought I might add is whether you'll be home to keep an eye on Olive if you don't reduce her dose a bit. We can always consider fast tracking her dose back up if her numbers aren't all that pretty if you were to take the 30% reduction.
     
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  25. Chubba (GA)

    Chubba (GA) Well-Known Member

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    How exciting ... a blue for Olive! :cool:
     
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  26. Judy and Boomer

    Judy and Boomer Well-Known Member

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    When I saw your thread title I was really hoping that wasn't a typo!!! YAY for blue! :cool::cool::cool::cool:
    I would definitely hold the dose for at least another day!
     
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  27. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    I will be home to monitor. I will take a some reduction, will wait to see where she's at.
     
  28. Olive & Paula

    Olive & Paula Well-Known Member

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    @Tricia Cinco(GA) & Harvey not quite following TR right now. Have been increasing every 4 cycles x2 then a 6 cycle for shed to adjust.
     
  29. Doodles & Karen

    Doodles & Karen Well-Known Member

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    Jun 2, 2015
    Hold the dose! Beautiful blue :cool::cool::cool: When they are new to blue you hold the dose 6-10 cycles. Save smaller increases for when you're seeing mostly green & blue (if over 5u). How exciting :)
     
  30. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Ok. Exciting color for her.
     
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