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  #1  
Old 11-18-2017, 08:05 PM
moccasgrampa moccasgrampa is offline
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Default Help with Mocca's levemir dose

First post piggy-backing on this thread since it is about Levemir. NOTE: Administrator seems to have segregated my posts into their own thread now - thanks

I need some very quick advice. Dog sitting (Nov 13 to 22 or 23) my daughters 9 year old female mixed breed, 72 pound dog that has been diagnosed for a couple of years I believe. The dog is on Levemir and we were told to administer 20 units !!! twice daily after feeding. She is also on antibiotic for a bladder infection ?

The dog crashed Wed evening Nov 15, so we took her to emerg vet. I have to convert readings from mmole/L to mg/dL with 0.0556 conversion ratio for you guys. Emerg vet said she was at 1.7 / 31, kept overnight on IV and discharged Thurs evening at 23.4 / 420. Taken to her reg vet Friday morn at 33 / 583. Vet gave her 20 units Levemir and we were told to give her another 20 units at dinner.

Picked up our daughters AlphaTrak2 blood glucose meter on the way home (she's out of town). Started to take readings:
5:49PM BG around 8 / 143
7:30PM given dinner
7:43PM gave a reduced shot (our decision) of 11 units
8:20PM BG 8.8 / 158
10:50PM BG 14.5 / 261
.......................................
Sat Nov 18
7:25AM 3.6 / 65 so gave breakfast
7:40AM gave 10 units
10:31AM BG was 9.1 / 164
1:33PM BG was 8.7 / 156
6:50PM BG was down to 2.8 / 50 so gave dinner but no shot
8:44PM gave 1/4 more of a normal meal

will recheck BG before bed and decide on any shot for overnight

we need some advice from any vet on here that can interpret this sequence of readings/feedings and make suggestions

thanks

update: 10:23PM Bg was 25.3 / 455 so gave 4 units

Last edited by moccasgrampa; 11-22-2017 at 06:28 AM. Reason: update
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  #2  
Old 11-18-2017, 08:09 PM
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stylynjm stylynjm is offline
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Question Re: Levemir?

Wow, just popped in.not on much

How much does pup weigh...20 units levemir is a lot
..!!!!
My 12 lb pup was on 1 to 2 units levemir ...
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Sissy 13 yr old Bichon, born 4/17/03, 12 lbs. Diagnoised 7/20/12. Passed away 12/29/16 in my arms. My life will never be the same again. She will always be with me. Run free my babygirl 3 ozs I/D 4 x's day. 1.75 units levemir 2 times a day. .1 mg thyroid pill, tramadol for leg pain, morning & night,Use Alphatrak 2 and Relion Confirm meters.
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Old 11-18-2017, 08:21 PM
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jesse girl jesse girl is offline
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Default Re: Levemir?

levemir is 4 times more potent than NPH and vetsulin as far as dosing so that would compare to 80 units of insulin for a 72 pound dog that is an extreme amount as compared to those other insulin's

how long has the dog been on 20 units ? i tend to agree with your decision to drop down to 10 units at a maximum especially since you have already have seen a hypo event
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Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .

Last edited by jesse girl; 11-18-2017 at 10:17 PM.
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Old 11-18-2017, 08:58 PM
moccasgrampa moccasgrampa is offline
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Default Re: Levemir?

dog is 72 pounds and yes I think this vet is out to lunch

we are new to all this, having it dropped in our laps knowing nothing about treating diabetes. There's a big hole in our wallet though from that emerg vet stay!!!!!!

emergency internet searches about Levemir indicated a starting dose would be 0.1 units/kg twice a day, so that would only be 3.2 units each shot!

compounding our confusion was the meter was set at code 36 as obtained and used for our first couple of tests before I read the literature and found that the vial of test strips said code 6 for dogs. Changing the code and retesting showed a result about half the original value. I'll have to check with my daughter when she gets back as to why it was set at code 36

Last edited by moccasgrampa; 11-18-2017 at 09:07 PM.
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Old 11-18-2017, 09:12 PM
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stylynjm stylynjm is offline
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Default Re: Levemir?

It's a process...I would definitely cut levemir back..I'm not good at conversions, but 100 to mid 200's is a good. Goal.. just give each insulin change time to settle....5 to 7 days, unless you get to low... keep karo syrup handy,lol...
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Sissy 13 yr old Bichon, born 4/17/03, 12 lbs. Diagnoised 7/20/12. Passed away 12/29/16 in my arms. My life will never be the same again. She will always be with me. Run free my babygirl 3 ozs I/D 4 x's day. 1.75 units levemir 2 times a day. .1 mg thyroid pill, tramadol for leg pain, morning & night,Use Alphatrak 2 and Relion Confirm meters.
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  #6  
Old 11-18-2017, 09:17 PM
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stylynjm stylynjm is offline
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Default Re: Levemir?

If you're using alphatrak strips,it needs to be set for code on strip vial... some people use another strip (forgotten what kind) in the alphatrak meter, then code is different..
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Sissy 13 yr old Bichon, born 4/17/03, 12 lbs. Diagnoised 7/20/12. Passed away 12/29/16 in my arms. My life will never be the same again. She will always be with me. Run free my babygirl 3 ozs I/D 4 x's day. 1.75 units levemir 2 times a day. .1 mg thyroid pill, tramadol for leg pain, morning & night,Use Alphatrak 2 and Relion Confirm meters.
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  #7  
Old 11-20-2017, 09:28 AM
moccasgrampa moccasgrampa is offline
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Default Re: Levemir?

Thanks folks for all the replies and apologies to this threads OP for somewhat highjacking the thread but I tried to start a thread of my own at first and was denied so had to piggyback on an existing thread in my haste to get info. NOTE: Administrator seems to have segregated posts related to Mocca into their own thread after original postings

We're not too interested in dog sitting again for any extended period but can't help but think if our daughter had a neighbor dog sit her following the instructions given that Mocca would not be here now. We'll be having a discussion with the daughter and family when she gets back.

Last edited by moccasgrampa; 11-22-2017 at 06:37 AM.
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  #8  
Old 11-20-2017, 12:35 PM
moccasgrampa moccasgrampa is offline
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Default Re: Levemir?

Mocca BG at 2 PM was 20.9 / 376, again, not too bad but still high, will check again before dinner feeding & injection I think, then again before bed.

When I said one last question in post 15 I lied! Mocca is given small Milkbone biscuits at home (how many per day I don't know) and 1/2 a biscuit as a treat here after getting perforated for a blood sample or getting an injection. I just looked at the ingredients list & breakdown on the box. What are opinions on these for diabetic dogs? Obviously anything in moderation is a general rule, but what about this particular biscuit specifically?

edit: my concern about the milkbone biscuits related to 18 kcal rating per biscuit, which I have now clarifed with respect to Calorie, whew.

Last edited by moccasgrampa; 11-20-2017 at 12:58 PM.
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Old 11-20-2017, 07:17 PM
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Raysaint Raysaint is offline
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Default Re: Levemir?

most biscuit type treats are high in carbs, so they'll raise blood sugar. Biscuit type treats are usually made from wheat or grains or potatoes as a main ingredient.
I only give biscuits if he is getting low as he approaches nadir time.

Lots of good treats out there that are low or no carb.
__________________
Riley, 8 yr. old maltipoo, 25 lbs., diagnosed Feb 2017, taking thyroid meds, had pancreatitis and DKA mid March, eating Wellness Senior formula can food. NPH dosage now at 9.0 units Humulin N. Adding either pumpkin, spinach, blueberries, yams, or green beans to his food. Also omega-3 oil.
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Old 11-22-2017, 07:12 AM
moccasgrampa moccasgrampa is offline
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Default Re: Help with Mocca's levemir dose

One last post for continuity sake, mostly for others reading this thread searching for helpful info like we did when first coming here in a somewhat desperate frenzied search.

Tuesday morning BG was 27.2 / 489, too high for comfort (I think we gave her 7 units at dinner time last night). She was given 9 units Levemir one hour ahead of breakfast. BG at 2PM was 23.2 / 417 and at 7PM was 15.3 / 275, nice! She was then given 7 units and dinner.

We handed Mocca back Tuesday night and discussed her situation with the following 'highlights':

- Mocca was tried on a canine insulin at first but has been on Levemir for quite a while
- daughter says hubby gives Mocca too many 'treats' necessitating a higher insulin dose so his knuckles need to be whacked
- resetting the BG meter code setting when changing insulin was overlooked so she was basing dosage on falsely high readings but that has now been corrected
- dosage in the 7-9 units seems to be a sweet spot (he says hopefully, lol)

My blood pressure hasn't come down yet from this rollercoaster ride, but I sincerely thank all responders for their comments. I'm sure you all recall your initial anxiety when starting to deal with this.

Last edited by moccasgrampa; 11-22-2017 at 07:16 AM.
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