Yoyo at 0.75 units

Night BG Tests: I did a PM +6 last night. I woke up to go to the bathroom and did a BG as well.

Dehydrated Chicken Picked some up from Petsmart and was quite suprised -- he likes it. A lot. I have been giving him that for a treat for BG testing.

Quotes out of Context: Don't know what the problem is but, for clarity, I will do as I did in this post.

Lana

 

I know you feel you need to give this lower dose a try. And I hope it works out for you. At least you will know for sure then one way or another.

Glad you found the treats!

 

My cat love those freeze dried chicken treats. Did you get the "dog" ones? I will also crumble some on their food if they are not liking that flavor that day (they are never consistent).

 

Lana, I checked out your SS to see how Yoyo was doing on the .75. I think you mentioned you might hold this dose for a week? I wonder if just holding it for three days might be a better idea = 6 cycles. Remember the guidelines.....

http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

"General" Guidelines:

* Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

* Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

* Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


Increasing the dose...

* Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

* After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

* After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit."

Also, try to keep him at more or less the same amount and type of food each day. Try not to let him eat two hours before shot time so that you are not shooting a food spike number. Maybe even three hours before. Just a small piece of the dried chicken treats is fine though.

 

My cat loves those freeze dried chicken treats. Did you get the "dog" ones? I got the Beefeaters brand Chicken Beast Freeze Dried Cat Treats at Petsmart. I did not have to search. It was in the cat treat section along with Temptations.

At my neighborhood natural pet food store today, I picked up up a bag of Stella & Chewy's Carnivore Crunch Freeze-Dried Chicken Recipe Treat for dogs (made with raw chicken) and was given a free sample of Bellyrubs Organic All Natural Freeze-Dried Chicken Liver Dog Treats.

I also picked up a can of Nature's Variety chicken, a can of duck, & a can of rabbit. Hope Yoyo does not have a problem with carrots, pumpkin, cabbage, etc.


I notice on the Petsmart website that they have a dry food, Blue Buffalo Wilderness Food for Cats, which they advertise as "Inspired by the raw diets of the lynx, high-protein, low-carb Wilderness all natural cat food is the perfect choice for any cat with a high activity level." Wonder what "high activity level" has to do with anything? That's not Yoyo --- he is the very definition of the Law of Conservation of Energy. I use EVO dry, but it would be nice to have some options for variety. I have been mixing 2/3 EVO with 1/3 reg dry for the benefit of my other cat. I now put out the mixture after I have fed Yoyo his wet food and replace it a few hours later with straight EVO for the portion of the day when Yoyo might be snack-prone. Has anyone seen a carb percent for this product? I don't see it on the dry food list.

Lana

 

I wonder if just holding it for three days might be a better idea. Recommendations are to stay at a dose for 3 days then evaluate for an increase or decrease --- Pamela : The recommendations, as I read them, are the exact opposite of what I have done, so I am playing it by ear. I need to see how today goes.

I am juggling some questions in my mind regarding

1) Should I follow the protocol
2) Why was BG lower initially when I first started Levemir?
3) What about the formal dosage recommendations for going from Lantus to Levemir


a) BG could have been lower because Yoyo still had Lantus in his system which had a positive effect on his BG. Maybe Lantus is a better choice and works better for Yoyo for some reason. Maybe Yoyo would respond to alternating Levemir and lantus every 12 hrs.

b) Dosing at the beginning was problematic. I was using the needle that came with the Levemir Flexpen and how much insulin I got into Yoyo is questionable. The needle on those pens is very, very short. We all know when we have done a fur shot because the coat is wet, but a shot into the dermis is equally ineffective and offers us no feedback whatsoever, other than BGs (assuming we know what to expect from our dose) over the next 12 hrs. So, for all I really know, Yoyo could have been getting anywhere from nothing to a few drops to one unit in the beginning. I have now stumbled across a FAQ on how to inject using a flexpen needle -- Wish I had found it in the beginning

c) I have a paper, "Management of Feline Diabetes Mellitus," that the Vet gave me that says, "Detemir results in similar remission rates and time to remission as glargine, but the median maximum dose used (1.75 IU/cat BID) is about 30% less than with glargine (2.5 IU/cat BID). According to this, Yoyo should be at 1.4 units since he was on 2 units of Lantus.

Lana

 

I didn't know you were feeding dry food of any type. What is the "regular dry" food that you are feeding? Even a small amount will raise bg levels. Even the Evo dry food can raise bg levels. I have heard a number of times that owners felt it contributed. I think I remember the carb content as being 8% calories from carbs which isn't high, but Dr. Lisa says it is high in fat and phosphorus: Here from her website in her transitioning to wet food section:

"There are three grain-free/low carbohydrate dry foods currently on the market. Natura/Innova's EVO, Wellness CORE, and Nature's Variety Instinct.

The low-carb dry foods are very high in fat and therefore are very calorie dense. These foods must be portion-controlled otherwise, your cat may end up gaining weight. Note that dry Innova EVO has 612 calories per cup according to the information on the bag. One quarter of a cup contains 153 calories so be very careful to pay attention to how much of these high calorie dry foods you feed.

The caloric needs of an average cat can range between 150 - 250 calories/day depending on their lean body weight and activity level.

The low-carb dry foods are also very high in phosphorus. This is especially detrimental for cats with compromised kidney function.

And, of course, these low-carb dry foods are water-depleted just like all dry foods are and are cooked at very high temperatures in order to dry them out.

I do not recommend these dry foods for long-term feeding for all of the reasons stated above. Please use them only as transition diets.

When you are trying to find the right dose it really is a good idea to try and stick to as few food varieties as possible. That way you are eliminating more variables that might be interfering. When you find the right dose then you experiment with adding other foods in.

 

That Blue Buffalo is a "good" dry food (if there is such a thing) - it has a decent protein and is grain free, but it is about 22% carbs by my calculations (with I make with no guarantees), so, IMO, too high in carbs for a diabetic. But possibly better that the "reg dry" you have been feeding. FYI, I would consider the food Pamela listed to be the best dry foods, but I would not feed dry if I could avoid it at all. I do give mine about 8-12 kibbles of low carb dry a day as treats.

I think a lot of cats react to the first few shots of Lev as it is new to them. I know Beau did and there have been several other cats here that have, and then they go on to need more insulin. (although Beau did not).

I wouldn't get hung up on trying to figure out why or calculating how much lev he should get compared to lantus. Those percentages are averages over many cats and make good guidelines, but they are not a hard and fast rule.