Nelson AMPS 361, +1 325, +7 251 PMPS 247

yesterday's condo: viewtopic.php?f=9&t=3323

Should I suspect that the Lantus is losing potency? It seems that it is an issue when looking at the human diabetes forums. It still looks ok, BGs are dropping after he gets his shot but not by much, and average BGs have been climbing over the last several days.

Poor Nelson was doing better on w/d but I find it VERY hard to believe that he was doing better because of w/d but despite w/d. I was only feeding him that for maybe 2- 2.5 days? He was also doing much better later last week and through the early part of the weekend when he was eating just low carb wet. Still eating low carb wet along with those I have successfully transitioned over. Some of the cats are still transitioning and still getting a small amount of dry but I don't leave any dry out after feeding time whatsoever.

Ideas, anyone? Nelson has been doing so much better but I don't want to reverse the progress he's made in the last week and a half because he looks and acts so much better. Hunger markedly increased this morning. Last night when we came home from church he was a bit sluggish compared to what he had been. Very alert, but not as active. Tested him and BG still below 300 then but well up into the pinks today. :?

Yesterday someone suggested that I do a dosecrease... should I discuss with vet first? I was under very strict orders not to increase without approval.

 

Re: Nelson AMPS 361, +1 335, av BGs slowly climbing, eyes?

hi

ur SS says 325 for +1, double check ok?

+1 sometimes is similar to the preshot number, plus u also have some food in there too for spike.

let's see what others suggest, but don't panic k?

 

Re: Nelson AMPS 361, +1 325, av BGs slowly climbing, eyes?

Oops, sorry. SS is correct. I revised the thread.

I'm not so much concerned about the spike but overall trend over last few days... he was in blues and low yellows, and now more mid to high yellows and now pinks.

 

Re: Nelson AMPS 361, +1 325, av BGs slowly climbing, eyes?

01/19/10, u commented in SS that u dropped the vial, I've added this here for others too just in case.

are u around for a couple more checks this morning?
wait for feedback about your concerns alright, and we see how it goes.

hang in there!

 

Re: Nelson AMPS 361, +1 325, av BGs slowly climbing, eyes?

Yep, that's my concern. Vial obviously didn't break but I know that Lantus doesn't like movement. I was also rolling the vial per vet's instructions until I learned otherwise, and had it in the refrigerator door until I learned otherwise.

I'd hate to think I wasted $100 on a vial that may have already lost it's potency in less than 2 weeks but I'll ask next time for a pen or cartridge (I'll have to go back to stickies to see what is recommended).

I am at work so can't do a whole lot of spotchecking (that's why I did a +1) but I can go home for lunch and get a +6.

 

Re: Nelson AMPS 361, +1 325, +7 251 av BGs slowly climbing

I checked him on my lunch hour and while it was down into the yellows from pink this morning, so the Lantus is probably still working, I still suspect it may not be as potent as it was before I dropped the vial. Made a call to my vet to see if rx could be changed to pen or cartridge. They said no, probably not, but that they would call in a refill for me. I'll talk to pharmacist about getting cartridge refills instead, but if not I'll take what I can get. I'll give it until the morning and if BGs still high will start using new Lantus. Worst case is that I'm wrong, it's not the Lantus, and we'll take it from there. It's not like I have $100 bills to go throwing around but we'll make it work.

 

Re: Nelson AMPS 361, +1 325, +7 251 av BGs slowly climbing

Hey may just need more insulin. I would bump the dose up to 1.25u and spot test as often as you can. Doses do not remain static - we constantly have to adjust as the body's needs go up and down.

 

Re: Nelson AMPS 361, +1 325, +7 251 av BGs slowly climbing

One of the other points you noted is that you switched meters. The True2 Go meter does not get rave reviews and does seem to give lower readings. The Relion meter that I believe you are currently using is very popular. I think with the change in meters, you are comparing apples and oranges, especially if the True2 Go was giving you consistently lower readings which were likely to be falsely reassuring.

Personally, I don't see the advantage of using a daily average. Unless you are getting data that is consistent with respect to the number of times per day that you test and the time of day, your numbers are going to be unduly influenced by uncontrolled measurement error. If you have AMPS and PMPS only on some days, you are missing the lower points in the cycle. Comparing those averages to the days when you have mid-cycle checks may give you very different averages. In order to make comparisons, you probably need a mean and standard deviation as well as statistical analyses to know whether the differences are significant or not.

 

Re: Nelson AMPS 361, +1 325, +7 251 av BGs slowly climbing

I first started Lantus with one of those big vials; Shadoe's numbers were slowly going up, but we had been using that vial for a bit longer than 28 days and when I got a box of smaller cartridges, then opened one, Shadoe's numbers improved on the very first shot from the newly opened cartridge.

I know that some people use their containers of Lantus past that 28day mark, I can say that the vial I had did seem to lose its punch around that 28day mark. I never dropped or rolled the vial, so I can't say much about your Lantus.

The meters are a pretty big deal though. If you had a lousy meter, then switched to a better one, it's not really fair to compare the numbers from the old meter to the numbers on the new meter.

I don't think an average is of any use; I can't see how it could be applied unless you consistently tested at identical times each and every single day. As was said, a day with 2 test numbers can't be compared with a day that has many more test numbers.

Could it be that you just need to increase the dose a bit? I don't know and can't say one way or another, but it looks like you have been on that same dose for quite awhile. Have you spoken to your vet at all about the dose?

Anyways, getting back to the vials and the cartridges. The cartridges have a long life, not clock starts counting with they are unopened. If the shelf life on an opened container is close to a month, and your dose is remaining small, you will frequently be wasting most of that vial. It's better value for your money if you get the 5-cartridge box that each have 3ml instead of cracking open the big vial of 10ml. The insulin and strips are expensive enough without having to be wasting on each vial. Don't ask if you can have the cartridges, just state that you want the rx for cartridges and there will be no discussion. It's your money and your cat, so you should be able to decide on the size of the containers. :smile:

 

Re: Nelson AMPS 361, +1 325, +7 251 av BGs slowly climbing

My regular vet wasn't in. I will see if I can talk with her tomorrow or Monday. The vet who owns the clinic (who I'm not very impressed with) said no, can't have cartridges, in fact they don't even exist. They would only call in an rx for a vial. I talked to the pharmacist and he said that there was more insulin in the cartridges than in the vial, but I explained that I'm only going to open them one at a time. He looked at me as if I had two heads.

Tomorrow makes two weeks since Nelson has been on the same dose. Unfortunately, I don't have a vet who is really keen on this protocol and I may have to wait until he goes for his blood curve to get an *approved* dosecrease. I could try but I will be on my own as far as vet support. There aren't a huge number of vets here--I probably go to one of the best if not the best in town since our local cats-only vet went out of state--and I might have to go to a city 60 miles away to find one who specializes in cats and/or is open to the nutritional approaches we discuss here.

I did get a new meter on Saturday but I'm just comparing numbers since I started testing with that meter Saturday, mainly because of posts here that indicated that the True meters tended to test low.

He did drop down to yellows this afternoon which is good.