? 4/21/18/Ravan/355+2/287 +7/pmps307/+2 342/+7 318

Discussion in 'Lantus / Levemir / Biosimilars' started by JoyBee&Ravan, Apr 21, 2018.

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  1. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    http://www.felinediabetes.com/FDMB/...2-349-8-277-pmps345-3-276-6-199-9-317.194404/

    Ravan not interested in food this morning. (He's been eating every few hrs for the last week ) I finally got him to eat,after his shot, some cat food with fish.

    I let him outside & he was acting strange. Looked like he was frightened. Crouched down looking around. I walked toward him & he look terrified,ran back into the house.

    The other 2 cats were near him & they acted normal. I've never seen Ravan act like that.

    He's normally very friendly,greets people that come over. Not afraid at all?

    I wonder what caused this? It took a while before he calmed down.
     
    Last edited: Apr 21, 2018
    Reason for edit: add
  2. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    @Sharon14
    Ordering Lantus from Canada, how long does it take to get & is it necessary to be kept cold during shipping?

    One pen will last me over 3 months (so far) That would be over a year with 5 pens. Will they keep that long in the fridge?

    Is it better to pay with check or Credit card?

    I wish I knew this before i bought here!
     
  3. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    I’ve never ordered from Canada, so I can answer your question. If you call the pharmacy you can talk to them. https://rxcanada4less.com/search.php
    Glad Ravan settled down. Has he still been getting agitated?
     
  4. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    @Sharon14
    It's just 5 days since I increased the dose. SLGS says don't rush it.

    It's still confusing. People have different opinions .

    The bounce is because his body isn't used to the lower #'s & his liver is releasing sugar & hormones that bring the bg up. Can take 6 cycles.

    It's been over 8 cycles & he's still in the 300's?

    Waiting longer should get his body used to the Lower # but if you wait & his body gets used to the lower #'s that will cause the bounce when you increase the dose

    People have said the bounce is caused because the insulin is TOO HIGH (Insulin Toxicity) (Rebound Hyperglycemia)

    Why were there more yellows & even a few blues when he was at a lower dose? When i increased he went to 581.

    Yesterday PM yellow Blue then pink. I thought Yellows today! So far high pink.

    It's take a step forward & then go 2 steps back.
     
  5. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    @Sharon14

    I thought I read in a post that you were buying from canada. My mistake.

    Did you read my 1st post about how strange ravan was acting this morning?
     
  6. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    I probably posted that many here get their insulin from Canada. I get mine from the supply closet from someone that lives not far away so I get it within a couple of days of ordering.
    Yes, I saw how he was acting, that’s why I asked if he was still getting agitated. It is rare, but there have been a few cats that had reactions to Lantus even on a low dose. I’m not saying that is what’s going on with Ravan, but you may want to read this thread. http://www.felinediabetes.com/FDMB/threads/attention-lantus-to-levemir-users.122941/
    As much as you are testing, I don’t think he’s getting too much insulin. In fact the high numbers may be what’s causing the agitation, he just doesn’t feel right and is showing it maybe. I started with SLGS, but like you, I didn’t like all the high numbers, so switched to TR fairly quickly. Sometimes you have to go up a bit in dose until you hit the right one to break through any resistance then the dose will start to come down. You haven’t been at this that long really, and sometimes it just takes time and patience (difficult, I know, when our babies aren’t feeling well!)
     
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  7. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    @Sharon14
    Thanks sometimes I need to hear the reassuring words again.

    I'm worried the dose will keep going up & up!

    ( it feels like I've been doing this for at least a year!)
     
  8. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Ravan is still on a small dose on Lantus. He is not getting too much insulin. I have been following your posts for a while, and I don't think I have seen anyone say he needs to go down in dose. He barely touches blue. He spends the vast majority of his time above renal threshold which is hard on his kidneys. The goal with SLGS is to get nadirs between 90 and 150. The longer Ravan spends above this range, the harder it will be to get him into range.

    The reason people have been suggesting faster increases is twofold. One, his numbers are too high and hard on his system. Two, you do a great job testing and could follow TR. Regardless or not if you follow TR or SLGS, there are no gaps in the data and we know it's safe to increase. One reason SLGS calls for slower increases is that some people work 12 hours a day, and cannot gather the data sooner to say if it's safe to increase. And one more thing, call it point number three, the sooner you can get a cat regulated and in better numbers, the greater the chance of remission, should that be a goal you have. If not, and you just want regulation, the sooner you get to good numbers, the easier it will be.

    I "wasted" time and gave Neko Caninsulin for two months and the vet didn't want her any lower than mid/high blues. She got used to higher numbers. It was a battle fighting that glucose toxicity. It took over a year before she stopped bouncing to red. Sure she had other issues, but if I had been firmer on getting her onto Lantus and not been timid in my increases, she might have gotten regulated sooner. So, been there, done that.
     
  9. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    Echo everything Wendy said. :)

    It might help if you focus less on the bouncing and more on increases and getting numbers down, safely. Bouncing is just a thing, it happens, and it’s frustrating to see, sure, but it is not a thing to focus on because it’s a symptom of a problem rather than the problem itself. The numbers are all over the place because Ravan is unregulated, the only solution to that is finding the dose that brings him in to the range you need him to be. For right now, the way to do that is to increase the insulin safely and consistently until you get there.

    I very much remember being new and thinking the way you are, is it ever going to stop, how much insulin will it take, is this normal? Yes, however much it takes and yes. ;) Trust a bit in the process and know that hundreds if not thousands of kitties were here before you and went through the same thing and come out better on the other side. Vent all you want to, that can help too, it’s frustrating. But focus on getting his numbers down so he can start to feel better. :bighug:
     
  10. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Great advice from Wendy and Stacy. I agree 100%. :)
     
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  11. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    @Stacy & Asia

    I just read your post about switching from Lantus to levemir. I have questions. Is there a reason you waited 5 months to switch to levemir?

    Now I'm worried that the same thing can happen to ravan. If he keeps going up in dose I don't know what i'll do about the cost. Since this started 11 weeks ago everything is on my credit card.

    How long do I wait till I know Lantus is not going to work for him?

    I see some people micro dosing. I thought you're supposed to adjust doses by .25 units?

    Some people are using only 1.5 units & getting nearly all green #'s except for the amps in the 300's What causes that?

    I see people changing doses from 4.5 to 2.5 & changing every few days up or down. That's OK?

    The more I read,the more information ,the more confusing this all is!

    So if i increase Ravan's dose to 2 units tonight it just feels I'll keep increasing with no results. I thought each increase would drop him to lower #'s but it looks like he is just staying in the 300's for so long.

    I have this picture that a month from now i'll be at 5 units with no better results! This is so frustrating. No end in sight. Very discouraging.
     
  12. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
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  13. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    I didn’t wait 5 months, I just didn’t have any reason to switch until around the time that I did. Lantus was working well enough for Asia, as time went on and I saw some her patterns that might work better if she were on Levemir and realized it was stinging her (which isn’t the case for many cats, by the way), I decided it couldn’t hurt to try it out and so I did.

    Ordering insulin from Canada or on the supply forum should be less of an impact to your wallet, but no doubt, diabetes is an expensive disease to manage the way that we do. With any luck, you can get Ravan in a good range and he may go into remission. :bighug:

    Lantus and Levemir work very well for most cats. They each have their benefits and drawbacks. If you are considering switching I would say wait at least until you find a breakthrough dose and then see how he does for a bit from there and reassess. Switching can be a bit like starting over, and I’m sure you don’t want to prolong the waiting to get there phase by switching soon. ;)

    We reduce by .25 units in most cases, but some cats .25 is too much and literally a drop of insulin will regulate them. We also recommend tapering off insulin slowly to increase odds of a strong remission, that’s why there are 2-3 levels of microdosing under .25. Alternatively, some long term diabetic cats can maintain on a drop dose or a hair more to stay well regulated, yet they can’t do on their own without insulin just yet.

    You are seeing frustration in action! There are many reasons for higher preshots while mid values stay in the desired range: dawn phenomenon, dusk phenomenon, lack of duration (numbers rise rapidly near the next preshot, insulin poops out a bit for a variety of reasons), as well as bouncing from a steep drop or too low a number and finally, sometimes the preshots are higher because of a postprandial response, the higher carb food or sugar given to steer the cycle can take hours to clear the system and show up in this way some hours after being eaten. There may be more reasons, that’s all I can think of at the moment, but it’s challenging for sure. I very much have this problem with Asia. Not everybody encounters it to any degree of concern.

    It’s okay in that you hold the syringe and it’s your cat. If you’re asking if it’s in line with what is spelled out in either of the dosing strategies we use (SLGS or TR) it is not.

    I empathize! I cried a lot in the first few months, I was overwhelmed and exhausted and didn’t think there were enough hours in the day to learn all I felt I needed to understand. It’s so much to take it, but is awesome that you are so interested to learn, it will serve you and Ravan well. I’m still learning every day. It does get easier after you get over the initial learning curve hump, I promise you that. :)

    It just feels like you’re going to increase forever with no results, that’s not reality. Many SSs look like little difference has been made with each increase until...the magic dose is reached and then you start seeing blues and greens! Sometimes it’s more gradual than that, but sometimes it’s just like a light switch got flipped on. When that happens for Ravan you will be doing the happy dance, and I will be doing it with you! :cat:

    I know it’s discouraging, and there is an end in sight, we just can’t predict when it will happen and at what amount of insulin it will take to get you there. The only consolation I can offer is, get there as soon as you can by increasing when it’s safe to do so; you will get there. :)
     
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  14. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    @Stacy & Asia

    I am grateful that you took the time to read my questions & answer them! It means a world of difference!

    "I will be doing it with you" Thank You!

    I haven't done the "Happy Dance" for a LONG time. I look forward to it!
     
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  15. Sandy and Black Kitty

    Sandy and Black Kitty Well-Known Member

    Joined:
    Dec 31, 2009
    Try not to be discouraged.
    One of the many important lessons to learn is that getting to regulation is a marathon not a sprint.

    I experienced the same frustration with my BK ... up and up his dose went yet always a sea of red and pink.
    It was over 6 months before he saw green- at that time his combined dose (we used a fast acting insulin along with Lantus) was around 14u

    turns out his body was making antibodies to insulin resulting in extreme insulin resistance.
    We persevered and after 21 months on insulin the last cat that anyone, myself included, imagined would go into remission did just that.

    He enjoyed that remission for 6.5 years - which was the rest of his life.
     
  16. JoyBee&Ravan

    JoyBee&Ravan Well-Known Member

    Joined:
    Feb 17, 2018
    @Sandy and Black Kitty

    Thanks , but I don't know how I would afford it if Ravan's insulin keeps going up!

    How old was Black kitty?
     
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