Starting Levemir Friday AM - New Newbie needing help

Hello Lev users!
I am reaching out today to prepare a bit for Friay.

My baby girl was dx a bit over 4 yrs ago. Used PZI and remission was reached quickly.

We are back and started in May w/ the same insulin type.

I have received Lev... full box to start my girl on.

She had a UTI in May, a tooth pulled on 7/22 and a urine culture w/ AB for 3 weeks. We will be returning for another test to see if the bacteria is completely gone next week as the AB will be gone by Thursday. We are adding in some ffeast w/ our diet of home made raw and friskies. Trying to lower those carbs even more.

I know NOTHING about depot insulin. I have done my reading and stayed active w/ facebook and a small amount of posting here for these 4 yrs. I am not sure what a 'condo' is, but I do have the spreadsheet that is quiet colorful and hoping to change that.

I will need help! lol and hope you all can assist. I am wishing for eyes to see her sheet, some advice as I know that fbook will not allow that there. As you will be able to see, she is all over the place. I know that the insulin I am using know can be adjusted and that lev. really needs to be constant for 3 cycles.

I plan on starting at .50 and will be home from Friday to Tuesday until about 9am. Our shot times right now are 430/4-430. Thinking I will see something by Saturday? Sunday?

Thanks! and looking forward to all the assistance I can get. Should I also post on health?

 

Welcome back -- well not really since it would obviously be better if your kitty decided to stay in remission.

There are decidedly differences between Prozinc and Lev. First, make sure you are using U100 syringes.

The 2 shifts in your thinking that you'll need to make is that dosing is based on the nadir, not on the pre-shot value and that we don't use a sliding scale to dose. I'd suggest reading through the stickies on the Tight Regulation Protocol and the Start Low Go Slow approach a couple of times so you have a feel for how dosing is done and then pick a method to try.

The biggest aspect of a depot insulin is that it's like trying to steer an ocean liner. You turn the wheel and eventually you see a response. Because it takes the depot a while to fill/drain, there is a "wait" for the depot to catch up. It's also what gives Lantus and Lev their long duration and flattened cycles. You'll also need to keep in mind that the nadir with Lev is typically later than mid-cycle. However, this varies and follows the rule of "every cat is different." (ECID)

Please let us know if you have questions. We'll do our best to help.

 

Thanks Ms. Sienne!

start low go slow approach best fits me. If she nadirs later than +5, I will miss that 2 - 3 days a week. As my last time to test her would be the +5. And even looking at what she is doing now, she does hit a nadir at +7.
I hope that by grabbing a +5 that that will be enough on those days?

I have read through them and some of it sticks and some not... Guess it will work better, the more I am actually using it. And the more I post for questions.

I have been using U100 and doing conversion chart from the beginning. I will be nice to just use the right insulin w/ the syringe...one less thing to have to think about.

 

Hi Shellie! Any time your post starts to slip down the forum, comment on it and it'll bring it back to the top!! Just say something like "bump" and it'll bring your post to the top.

Also, if you'll add the ? prefix when you have a question, it can help get the attention of the people looking for questions first. When you make your title line, where it says "No prefix" there is a drop down arrow that will give you the choice of the ?

Now when you first start Levemir, you'll want to hold the dose for 5-7 days (no matter which protocol you use) It takes 10-14 cycles to establish the depot and get the full effect of that starting dose. Of course if he drops below 50 (on a human meter) he'd earn a reduction even during that time!!

Getting a +5 most days is great!! You can fill in some of the other "blanks" on days you are able to!! You should also read the "Is Tight Regulation possible with a full time job" Sticky while considering your options. Even if you start one protocol, you can always switch to the other!

Sorry you have to be back, but if you post daily, people will start to get re-acquainted with you and will be watching for updates from you and your "extra sweet" kitty!!

 

Thanks Chris... this helps allot as I shoot so early and if I am in a omg, dont know what to do state, I really would like to be able to get someone to answer. I believe her nadir is a bit later than +5 and sure want to get that nadir test.
she was 408 pmps and +3 is at 283...not bad but will be getting up w/ alarm for a +6-7 ~ sometimes I sleep thru it and get so mad at myself

If she drops to 50, I just know I will panick! lol

I you see, my title did say needing help but did not do the ? - will try that next time.

Again, thanks!

 

If it's a medical emergency, there's also a 911 prefix you can use...gets everybody's attention as they grab their chests and have a small heart attack, but it works!...LOL

I don't use Levemir, but from reading lots of other condos, the one thing that seems to run fairly true is that it's nadir is usually later than Lantus or ProZinc

I know @Wendy&Neko use it, so I've tagged her...hopefully she'll be able to answer some of your concerns

 

Chris, we did 911 when we were first dx and I did not test before shot...tried and was not successful.... +2, she was 26! That was my first test of many to follow on the same night.

Yes, that was 911 and did not realize how 911 it was.... I really do now and just in shock at how calm I was and how NOT calm I am now.

 

If you are planning on using the SLGS (Start Low Go Slow) Method, could you put something like that in your signature. It helps us help you best as reduction points and length of time to hold doses differ. You do test enough for TR, but your circumstances best dictate what dosing method you use.

If kitty is on all wet food and you are using SLGS, the starting dose is 0.5 units. As for nadirs, as usual it's ECID. The typical Lev onset is +4 and nadir +8, but that varies, some earlier/some later. By +5 you should have a good idea what the cycle is going to look like (unless your kitty is named Neko). Best of luck, I was happy I made the switch to Lev.

 

@ohbell Might I also suggest while you are updating your signature line indicating the method that you are going to use, that you change the insulin type you are using as well as it still shows prozinc......

 

Just wanted to say Welcome to L&L Land. I know very little about Lev, but I'm happy to provide any moral support needed. You will find lots of that here, along with tons of great advice and guidance. Sorry you're here, but nice to meet you!

 

Everyone, thanks so much for the welcome and the suggestions.
Tomorrow is the big day and da mamma is a bit nervous.
Have heard I could see changes in 24 hours and up to 5 days?
I have 4 days to adjust and hope to see results.
I will be changing signature tomorrow and posting more.
What is the condo? Is that something I start tomorrow?

 

A condo is just what we call our daily posts here (I've heard it stands for "condition report" as well as just the little houses our kitties live in...lol)

Each day you start a new condo...You put the date/name and AMPS number in the title and as the day goes on, go back and "edit" the line to add any other tests you get in so that the people scanning the forum can quickly see how each kitty is doing and watch for numbers that might need to be addressed

So an example for a condo for Bean today would have the title line : 8/6 Bean AMPS 349,+2.5 288....with additional tests added as the day went on.

Then in the body of the post, first put the link to the prior day's condo so it's easy for people to quickly go back and look at what's been going on with Bean in the past few days

Then give your "whole cat report"....How is Bean is doing? .....any questions you have, anything you feel will help us get to know your sweet kitty better, etc. If you read through some of the other posts when you have a little time, you'll get a pretty good idea of what to do tomorrow when you start your condo

 

In some cases, there's an initial response to Lantus. More typically, it takes several days to see any response. Because this is a depot insulin, it can take a while. Lantus is gentle so it doesn't "squish" numbers down. The trade off is that it can take a while to see a response. We talk a lot about having "patience pants".

"Condo" is actually a reference to a cat condo. You know, one of these things:


The idea being that we visit each other's "condos." It doesn't seem to make quite the same sense if you visit someone's thread. (Way back when I first started here, there was a person who was an amazing resource on insulin and health issues -- she was a vet tech. She also had a unique way of referring to things. I suspect the term "condo" was her doing. I'd need to ask someone who pre-dates me if that's the case, though.)

 

Chris, I will try to read up on the other condos and copy that.

Sienna, she will start out with levemir, assuming it is pretty much the same with depot build up.
Really wanting to see what is going to happen in 4 1/2 days. Lets hope something.
Thanks!

 

With Levemir, most of the time, it takes a bit longer before you start seeing the full effect. With Mikey, it takes at least a week when I change his dose. My neighbor's cat was just recently diagnosed and I started her on Levemir on Saturday. It wasn't until yesterday that we saw any noticeable difference in her numbers. Even though her numbers are still high, I won't be increasing the dose yet because I expect her numbers will continue trending down over the next few days.

You might also be interested in reading this post about users who have switched to Levemir (not just Lantus users) that might give you some more ideas.

 

Another term you'll see a lot here is ECID - each cat is different. When kitty first starts a depot insulin, whether it be Lantus of Levemir, it can take 5-7 days to build the depot. Neko had a really nice flat blue surf her second cycle after I switched - I was thrilled. I've also seen some cats, as Sienne says, really react quickly with low numbers. For dose changes, I can usually tell within 6 cycles whether the dose is going to work for Neko. If she's getting normal numbers, I'll it longer - which is what the Tight Regulation protocol says. But with SLGS, you'll hold each dose one week then evaluate it.