Using Both Levemir and Humalin R

http://www.felinediabetes.com/FDMB/threads/is-raffy-overdosed.188617/
Right now Raffy is on 22U Levemir, however his BG is still around 300s and very few blues.
As a result of this we ve decided to use both insulin together.
Is there anyone who has an experience using both Lev and R at the same time,

 

You might want to ask @Marje and Gracie about this. Good luck!

 

Hi Gurkan - we have a number of experienced R users here. I did, Marje, Paul (@Bronx's dad ), @Dyana all used R with Lev. As did Wes with his Jack, now passed. We also have people who used R with Lantus. There isn't much difference in how you use R between the two, other than the timing of when you give it because Lantus has an earlier onset and nadir. Both Lantus and Lev users start with using it at preshot.

 

Hello there

I don’t believe we have met. As you can see in Black Kittys ss, I am quite familiar with using R along with Lantus. Don’t hesitate to tag me if needed.
I hope it helps your kitty.

 

Gurkan - post here when you get the AMPS number. You can shoot the Levemir, but wait for our response before shooting the R, in case it's not a good time to do so.

 

Good morning/afternoon to all 04:46 AM at Istanbul.
Mr. RAFFY is 426.
My opinion; he is ready for R operation....

 

Yes, time for the first R experiment. Give 0.25 U R. Test and report back here in an hour. See you then.

 

Good luck with the R experiment!!!! You are in great hands.

 

Now is a good time to mention the importance of to documenting your use of R on the ss, so those able and willing to help you can best do so.

Attached are examples of what worked for us back in 2008/2009...
for both PS time shots as well as shots given other times

 

Hi Gurkan,

You are in good hands with Wendy & Sandy. They "coached" me with R and have been using it over a year now with Levemir. As Sandy said, make sure you notate when you use it and how much. If you have a minute, check out Bronx's SS for 2017 to give you an idea how R worked for Bronx. It was the reason we finally got into lower numbers. Start low, as Wendy said, with 0.25u and go from there. Good luck!

 

Thank you very much to all.
AMPS 426, +1 440....

 

Nothing yet, maybe next hour. See you at +2.

 

Do we have a +2 yet?

 

I am so sorry, but my phone was out of battery so i missed the wake up call.
+4,5 430.....

 

Looks like he was flat. Sometimes R can help keep numbers flat instead of going up. That still allows the Levemir to work with a lower number than it might have been.

You will have to try the same experiment again, when you will be awake to gather the hourly data. What day/time will work for you?

 

It is going to be much more easier at pm cycle. But right now between 9:00-17:00 i am Home Standby which is my company can call me for a flight, but if they don’ t , next PM cycle i ll create a BG curve.
The next PMshot will be .25U or more?

 

Try 0.25 units again, as long as he is still high and not breaking a bounce. We need to gather data on the R onset, nadir and duration first. Gill @Gill & George or Sandy @Sandy and Black Kitty might be awake and able to check in for your PMPS.

 

I’ll be looking for you

 

I'm about too.

 

PMPS 380, i gave .25U and 22U levemir....
Nice 2 see experts here

 

Hi Gurkan,
remember to get that +1.
will be watching for you. I am sure Sandy and BK will too.

 

Let the data collecting begin!

 

Good morning/evening Gurkan, Titan and I are watching with crossed paws for you and Raffy . Remember what my dad used to yell at us kids many years ago ( he was a pilot for Eastern Airlines) , when the phone rang and he was on Standby alert " if that's crew scheduling I'm NOT home ! "

 

Last 11 minutes Ed but i am still standby for Raffy

 

+1 375 , so flat...

 

see you at +2

 

See you at +2
Work the R Raffy!

 

+2 360 going down....

 

Next stop +3

 

heading in the right direction
see you at +3

 

+3,15 375

 

See you at +4.

 

+4.10 370

 

+7 345.....

 

Looks like the R just kept Raffy flat today. Which is not a bad thing, normally he might have been rising from preshot to onset so R prevented that rise, and gave the Lev a lower number to work with. It'll be interesting to see what he gives you for PMPS.

Could you put the +2 and +3 data in the spreadsheet? It makes us easier for us to look at the data that way. Thanks.

 

I ve updated SS, AMPS , which is 5 hours later, should i give the same doses for both?
Also , until sunday afternoon i won’t be at home, that is why my wife will make the shots; and she won’t be able to make each hour tests.
Is it better to stay with these doses?

 

So you won't be around tomorrow morning after shot?

 

I ll give the shot at 04:30AM, and my flight is at
6AM . Till sunday AMPS my wife will be at controls. Two cats (one of them is so sweet) one
dog and a 4 years old kid is a very high dose for her, so i think she won’t be able to make each hour tests

 

That's a lot on her plate. We have 3 indoor cats, 3 outdoor cats, 2 dogs and 5 hens, I can relate.

I'm not sure about shooting R if you/your wife is not able to monitor, as it's early days with R so you haven't got much data yet.
It just seemed to keep him flat today, but that may influence the up coming cycles as LEV now has a lower number to try and get hold of.
In some instances (eg if it looked like he was clearing a bounce) it might not be safe to shoot the R, and that would be a call your wife would have to make, not sure that would be very fair to her, with the limited testing she is able to do.

I'd wait and see what Wendy thinks, she's used R and had a high dose kitty too, so I will defer to her.

 

I agree with Gill. I think I would have your wife skip doing the R until you are back. We don't have enough data yet to shoot it and not monitor. Sunday's not far away, Raffy will be fine without R. If you wanted, you could probably increase his Lev dose tonight.

 

I too agree with Gill-more data needs to be gathered so that you develop a feel for which size doses of R work under which circumstances. It takes time and close attention until you ‘know thy cat’ with R in the picture.

 

Good morning/evening.
AMPS 340; i only gave 22U Lev...
See you on sunday, have a nice weekend.

 

PMPS 473.?
He has started the cycle at 340.
I think, it is time to make all blood , urine etc. tests and a dental check as well.
Dose and BG are going up together.