The Caninsulin Years - 2003 to 2006
Aztec was initially difficult to regulate, due in large part to his finicky eating habits. Food intake was very inconsistent in both type and amount, although this has gradually improved. He was eating 3 tablespoons of Innova EVO dry per day, alongside one 5.5oz can of low-carb wet food. Being a life-long free-feeder seemed to complicate the regulation process, until we managed to work out a system where he would eat *most* of his meal within the first 2-3 hours of his insulin shot. This really helped to extend the duration of Caninsulin and brought his preshots down from the mid 20s to mid teens. His highest dose was 4.4u bid, which he only remained at for a couple of months, followed by a gradual reduction to 2.8u bid. He was at this dose the longest. BG numbers weren't bad, usually under 17mmol/L for preshots with a peak of 6-8mmol/L at anywhere from 5 to 8 hours post-shot. What made me eventually want to change insulins was increasing unpredictability and a much wider variation of numbers, no matter what the dose.
I must mention that Aztec is absolutely fabulous about home blood-glucose testing (ear-pricks with a lancet and human glucometer). Purrs the entire time. This is from a cat that used to hate being held or picked up, and was never a "lap-cat" (in case anyone thinks home-testing and insulin shots will make their cat hate them - it's often quite the opposite). Now he jumps on my lap whenever I sit in his Testing Spot on the couch, expecting some ear rubs and his favorite freeze-dried chicken treats.
Switched to Levemir in April 2006.
After being on Caninsulin for 3 years, we started having some difficulties with it in early 2006 (high preshots, little duration), possibly due in part to Aztec preferring a free-feeding lifestyle. The gentler, smoother, and longer action of Levemir seemed like a better fit, so he was started on 1.5u bid (after consulting with his vet and ruling out any other issues). Results have been great. His water consumption dropped from an average of 125ml/day on Caninsulin in March, to 75ml/day on Levemir in April (2006). Fine-tuning of the dose to 2.0u bid, along with the occasional booster of fast-acting Humulin R insulin to combat food-spikes, has resulted in fairly tight blood glucose control (3.0-14.0mmo/L). Water intake has decreased even further, to an average of 40ml/day. As well, the amount of dry Innova EVO was decreased slightly to 1 tbsp per meal (and keeping with the half of a 5.5oz can of wet food).
Issues in the past have been 2 DKA episodes; the first right when he was diagnosed in February 2003 (also required a PEG feeding tube for 3 months afterwards due to inappetence), and another one in November 2003 after more appetite issues. He had severe neuropathy for many months in the summer of 2004, which has since completely reversed itself. Aztec has never had a UTI or other infection, and is now quite healthy, despite being diabetic.
Update: 3+ Years of Levemir
After some settling, an ideal dose of 1.25 units of Levemir has been the most effective. Aztec now eats balanced raw food as a large part of his diet and loves it! He very rarely drinks any water at all. Boosters of R insulin are still occasionally required, but probably only once or twice a week, and only the teensiest amount (1/4 to 1/3 of a unit).