Raffy 23U Levemir .50U Humalin R

http://www.felinediabetes.com/FDMB/threads/using-both-levemir-and-humalin-r.189101/#post-2104008

Good morning/afternoon all;
PMPS 398 +1 444
Last 2 days we have seen some yellows.
@Wendy&Neko , @Gill & George ,@Sandy and Black Kitty ...
We r ready for your support

 

Good luck Gurkan and Raffy! Let's get those numbers down .

 

Thx Ed....
+2 430

 

Can’t wait to see your +3, I hope the current dose with the R does the trick.

 

I’m on the road but will check in periodically.

Please keep your spreadsheet updated to the minute - it makes it easier for us to quickly assess what’s going on

Good luck!

 

+3 488, but how
He ate a big peace of cauliflower with yogurt....

 

+4 480

 

Can you update your SS so we can follow along that way too?

 

SS is update now.
Right now we have one more problem;
Yesterday i ordered LEVEMIR from pharmacy, but he just made a phone call and told me that , LEV is out of stock.
As a result of this , i ll switch to LANTUS.
So, should i keep same dose with Lantus?

 

Can you try another pharmacy? It would be better if you can stick with Lev.

ETA: Sorry I didn't respond earlier, but I'm asleep at your PMPS.

 

, Good morning Wendy, it is quite normal , time diffirence is 11 hours .
I asked for LEV to 3 more pharmacy, one of them said , there is a problem with the local
main distributor
So , if i can not find ??

 

I'd keep calling around a bit more, maybe someone has it it stock?

 

What do u think about R dosing?
Initially should i go up to 1U if PS values are higher than 300?

 

If you have to switch to Lantus, I would stop the R experiment until you understand how Lantus works in Raffy. You would need to learn the Lantus onset and nadir to start. Once that is done, we can figure out the best times to add on R. If you get more Levemir, I would stick do a 0.5 unit experiment one more time. The cauliflower/yogurt eating messed with the experiment. I'm sure it was yummy, I loved the yogurt salads in Turkey. But probably had some carbs in it.

When do you run out of Levemir? If you can't get any more, what day would you have to start Lantus? And would you be home or would it be your wife? The amount of monitoring possible would help me decide on a Lantus dose if you have to do that. Some cats react strongly (ie. lower numbers) to a change in insulin. Especially if he has antibodies which we can't test for.

 

This AM shot,i ll start Lantus. We were on 23U Lev, so am i going to keep same dose?
I will give AM shot at 04:30Am and both my wife and me will be at home until 10:00am, that means first 5,5 hours we ll be with him.

Now it’s time to give some good news.
I found a new Vet (he seems to be very well informed); i explained him Raffy’s situation, and IAA and IGF-1 tests as well, and he said he is able to sent blood samples to RVC or any where else. Tomarrow afternoon we ll meet with him.Let’s see what happen with a new Vet and new insulin

Note:cauliflower/yogurt with garlic was perfect. Boiled cauliflower home made yogurt with garlic and on the top pour melted butter and some spices.

 

Great news on the new vet! RVC does not test for IAA - only Michigan State University in the US does that. But it would be good to know if acromegaly is involved and RVC can do that.

When we switch L insulins, we typically start at around 70% of the dose of the previous insulin. For Raffy's current dose of 23U Levemir, that would be 16U of Lantus. If we find he stays high and flat, we can fast track or increase faster after about 4 cycles of Lantus. Do try to do frequent testing, in case he's one of those cats that has a strong reaction. The onset and nadir will be earlier. I would get a +3 to start. If he hasn't dropped much, you can wait until +5.5 for the next test. If he drops quite a bit at +3, post here if you are wondering when to test next.

I hope you'll eventually be able to go back to Levemir. Larger doses of Lantus can sting, so you Raffy might show some discomfort with the Lantus shot.

Garlic isn't good for cats Raffy!

 

I gave 16U Lantus, AMPS 472 / +3 462.

 

The Levemir depot will still be working for the first few cycles of Lantus. But hopefully we'll get a picture soon of whether we'll need to increase faster.

 

+5.15/460 .
So steady.