Sticky Using Lantus/Levemir With an Acrocat

Discussion in 'Acromegaly / IAA / Cushings Cats' started by Carolynn FletcherGA & RobbieGA, Dec 30, 2009.

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  1. Carolynn FletcherGA & RobbieGA

    Carolynn FletcherGA & RobbieGA Member

    Dec 28, 2009
    Posted by: Carolynn and Fletcher (IP Logged)
    Date: December 14, 2008 01:46PM

    **With gratitude to Jojo for simplifying it**

    First dose of lev you are suppose to hold for 5-7 days, but acros don't have to: 3 days if numbers too high. If they aren't that bad then try to stick it out the 5 days. After that you can pick up the pace to every 3 days (6 cycle) increases.

    Raise dose in increments of how far off numbers are. Really far, I've raised by 1 unit in acros when numbers way off (like nadir's in 300's or higher) , 0.5 units (like nadirs in 200's), or close (like nadirs in 100's) use 0.25 dose increases.

    Just remember with Lev/Lantus your nadir is pushed back. Nadir'ing in second half of cycle is common, so bolus at PS if needed is best-- don't bolus the +6 until you know the Lev/Lantus nadir AND the R nadir because the dreaded double nadir can really drop out any cat. Lev/Lantus is very gentle stuff, but it is powerful and what we love about it, the long hang, can be a PIA if your cat is hanging in the 30's.

    Make sure you do have high carb (HC) canned (FF grilled with gravy's are 18% carbs and work) in-house should you ever need it (Carolynn's note: an acrocat may not respond to regular low carb carb (LC) food since their pancreases generally work--so regular low carb food can actually push the bg down. Your best bet is to go straight to HC to slow a drop or bring up numbers).

    Remember, what you shoot with Lev/Lantus is not so much about what will happen now, but what will happen tomorrow. This insulin is all about the overlap (or as called on Lantus: the storage shed, same principle).
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