Effy, PMPS=407, looking for opinions please.

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Randi & Effy

Randi & Effy

Member Since 2017
Hey All! I've been MIA the past few months because things have been pretty stagnant my way. Effy's been on Lantus since last December. It seemed to be working well for the first few weeks but then stopped. I just updated my SS today. You'll notice I'm missing a few numbers here and there but still shot, I chose to still shoot because his numbers are usually always in the same realm, I have never had a low enough number with him that I would need to withhold a shot. Anyway, there was a period of mornings where he absolutely was not having the ear prick. We got pretty low with our vile so I did one last curve on 5/1 and took him to the vet on the 8th to talk numbers and possibly trying a different insulin. Much to my dismay, I got a vet that isn't our usual vet that day and she was not very helpful. She pretty much looked at my ss, and decided to keep him on Lantus but increase his dose from 2.5 to 3.5. I told her about a few weeks ago I started giving him 3.5, then lowered it to 3, and the numbers were still the same. That didn't phase her much and she was pretty adamant on staying with Lantus and trying the higher dose, doing another curve in a week and going from there. I didn't want to spend the $300 for another 10mL vile of an insulin that isn't doing much for him but I needed more ASAP, and it was my only choice because she literally would not give me levemir. So, here we are. I'm wondering if this sort of thing has happened with anyone else, and if increasing the dose did any good. I almost feel like he's starting to build up some sort of insulin resistance. He seems normal and happy even with his high numbers, but he's starting to look really unkept, is peeing a lot, and his eyes are starting to get a little cloudy like he's slowly losing vision. These things still didn't bother the vet, so I don't know. I wish I would have gotten the lady we normally get, to be honest I've never seen another vet at our usual place so I wasn't ready to talk to someone who wasn't familiar with us, nor did I know there was even any other vets there lol. Anyway, just looking for any sort of insight. I have the latest curve up, give or take a few missing hours but you can still see that his numbers stay pretty high.... Hoping someone on here has ANYTHING to say lol
 
Hi. I’ve never been on one of your condos. Here’s the problem as I see it. Lantus is dosed on the nadir which is usually between +4 and +7. You don’t have many tests at that time. If you work I know it’s sometimes impossible. In that case a weekly curve is important to do. I only see a few. If there is no movement then glucose toxicity could be setting in since you’ve kept the dose the same for so long. Have you read the information on SLGS and TR? Im assuming you would do SLGS with so few tests. A before bed test would help as well. It doesn’t look like you are following any protocol.
 
No, i'm not following either of those, I don't think my vet is even familiar with either of those either so I honestly can't tell you which one I should be doing! From my curves that I have done it seems the lowest numbers happen between +4 and +7, but yeah, admittedly I am bad at testing inbetween shots, he's not the biggest fan of testing but i'll try and start getting some inbetween numbers to see what's going on. When we first got on here I read between the two protocols but it was still a tad unclear, I'll go through both tonight and see whats up
 
tiffmaxee said:
Hi. I’ve never been on one of your condos. Here’s the problem as I see it. Lantus is dosed on the nadir which is usually between +4 and +7. You don’t have many tests at that time. If you work I know it’s sometimes impossible. In that case a weekly curve is important to do. I only see a few. If there is no movement then glucose toxicity could be setting in since you’ve kept the dose the same for so long. Have you read the information on SLGS and TR? Im assuming you would do SLGS with so few tests. A before bed test would help as well. It doesn’t look like you are following any protocol.
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Alrighty, so after reading these over again...... I feel like i'm definitely not following either one completely but I know for sure i'm not on TR. It seems like I was technically started on SLGS but not at the dosing recommendations given on here. We started out on 2.5u, did a curve a week later and whatnot but it was never adjusted by the results of the curve..... so I guess what i'm asking now is how do i start this off with the new vile the correct way? Just test him around every 3 hours this week until we do a 12 hour curve, go back to the vet and adjust according to the nadirs? Is it too late for this!? I'm worried now! lol
 
@Stacy & Asia needs to focus on Asia right now. My thoughts, I agree with Elise @tiffmaxee, there are a lot of missing pieces. I see you are using the AT2, and you are jumping around in doses, and the dose changes are 1/2u, usually we change doses by .25u..with Lantus, you want to be as consistent as possible, and only adjust based on assessment of low points (nadirs). Right now, it's difficult to see, because there isn't any mid cycle data. Also, kitties like to go lower at night, so a before bed test if you can do it will help to see how the insulin is working.

May I ask what you are feeding, as well as your feeding schedule? That will help others see if something needs to be addressed.
 
Christie & Maverick said:
@Stacy & Asia needs to focus on Asia right now. My thoughts, I agree with Elise @tiffmaxee, there are a lot of missing pieces. I see you are using the AT2, and you are jumping around in doses, and the dose changes are 1/2u, usually we change doses by .25u..with Lantus, you want to be as consistent as possible, and only adjust based on assessment of low points (nadirs). Right now, it's difficult to see, because there isn't any mid cycle data. Also, kitties like to go lower at night, so a before bed test if you can do it will help to see how the insulin is working.

May I ask what you are feeding, as well as your feeding schedule? That will help others see if something needs to be addressed.
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Thanks for the input! I really appreciate it. I definitely agree with you on needing more mid cycle data, I'll be sure to start doing that asap. I'll test him in a little bit to get some bed time numbers as well. His diet right now is FF classics pate, with some water mixed in to make it soupy, he likes the soupy consistency more than just the straight up pate. He gets fed about every 4-5 hours, starting at 5am, his last can of food of the day is given to him around midnight ish.
 
I guess my main question is, since I didn't start on a strict protocol, is it possible to restart the SLGS all the way over and go from there, even if he's on the same insulin he's been on the past five months? I almost feel like we started on too high of a dose and his numbers are acting as if it's not enough insulin because it's too much insulin, if that's possible? The vet upped him to 3.5u but I think we need to go lower, I'm just scared of starting the SLGS from the beginning and have his numbers shoot higher than they are now.
 
Randi & Effy said:
Hey All! I've been MIA the past few months because things have been pretty stagnant my way. Effy's been on Lantus since last December. It seemed to be working well for the first few weeks but then stopped. I just updated my SS today. You'll notice I'm missing a few numbers here and there but still shot, I chose to still shoot because his numbers are usually always in the same realm, I have never had a low enough number with him that I would need to withhold a shot. Anyway, there was a period of mornings where he absolutely was not having the ear prick. We got pretty low with our vile so I did one last curve on 5/1 and took him to the vet on the 8th to talk numbers and possibly trying a different insulin. Much to my dismay, I got a vet that isn't our usual vet that day and she was not very helpful. She pretty much looked at my ss, and decided to keep him on Lantus but increase his dose from 2.5 to 3.5. I told her about a few weeks ago I started giving him 3.5, then lowered it to 3, and the numbers were still the same. That didn't phase her much and she was pretty adamant on staying with Lantus and trying the higher dose, doing another curve in a week and going from there. I didn't want to spend the $300 for another 10mL vile of an insulin that isn't doing much for him but I needed more ASAP, and it was my only choice because she literally would not give me levemir. So, here we are. I'm wondering if this sort of thing has happened with anyone else, and if increasing the dose did any good. I almost feel like he's starting to build up some sort of insulin resistance. He seems normal and happy even with his high numbers, but he's starting to look really unkept, is peeing a lot, and his eyes are starting to get a little cloudy like he's slowly losing vision. These things still didn't bother the vet, so I don't know. I wish I would have gotten the lady we normally get, to be honest I've never seen another vet at our usual place so I wasn't ready to talk to someone who wasn't familiar with us, nor did I know there was even any other vets there lol. Anyway, just looking for any sort of insight. I have the latest curve up, give or take a few missing hours but you can still see that his numbers stay pretty high.... Hoping someone on here has ANYTHING to say lol
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What is he eating? This sounds VERY similar to my vet. I believe she was unknowingly having me OD him. Look at my 2017-2018 SS to see the difference. I just changed his diet 9 days ago. I'm still new here, so I don't feel comfortable yet giving dosing or any insulin advice. But I'm 100% a believer in diet!! No dry. Wet only, high protein/low carb.
 
JennRoss86 said:
What is he eating? This sounds VERY similar to my vet. I believe she was unknowingly having me OD him. Look at my 2017-2018 SS to see the difference. I just changed his diet 9 days ago. I'm still new here, so I don't feel comfortable yet giving dosing or any insulin advice. But I'm 100% a believer in diet!! No dry. Wet only, high protein/low carb.
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I 100% think he might be getting too much insulin at this point! He's strictly on wetfood, since the day of diagnosis he was switched to wet and taken off the dry! He only eats FF classics pate right now, so his diet isn't what's affecting it i don't think. He was on the wetfood diet for two months and his numbers were in the high 200's after the diet change, so we started him on lantus when he started hitting the 300's again.
 
Randi & Effy said:
I 100% think he might be getting too much insulin at this point! He's strictly on wetfood, since the day of diagnosis he was switched to wet and taken off the dry! He only eats FF classics pate right now, so his diet isn't what's affecting it i don't think. He was on the wetfood diet for two months and his numbers were in the high 200's after the diet change, so we started him on lantus when he started hitting the 300's again.
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Well that's good!! I'm having great luck with Merrick Limited Ingredient Diet. I honestly believe upping his dose is not the right thing to do. I didn't have luck with that, and then there's glucose toxicity. Grey's numbers got better once I started again with 0.5U BID.

PLEASE let other people give you advice. I'm not saying change his dose now, I'm just saying that from my experience, a higher dose makes the body react and the levels go higher. It's really weird. I've spent the last few days reading and reading and reading. So I'm still over here 10 months post Dx trying to make sense of all of this.

I just wanted to give you my support, and I hope that you can get your baby's numbers down!!
 
Randi & Effy said:
Thanks for the input! I really appreciate it. I definitely agree with you on needing more mid cycle data, I'll be sure to start doing that asap. I'll test him in a little bit to get some bed time numbers as well. His diet right now is FF classics pate, with some water mixed in to make it soupy, he likes the soupy consistency more than just the straight up pate. He gets fed about every 4-5 hours, starting at 5am, his last can of food of the day is given to him around midnight ish.
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That's excellent, so he's on a low carb diet. I'd keep with your dose, if you can get some mid cycle tests, that will definitely help. Just saw your post as I was typing, without seeing how low the dose is taking Effy, we can't be certain it's too much or too little insulin. It's not too late to start applying a method, and working to get the right results, there are a lot of great people here, willing to try and help, you'll get there.
 
JennRoss86 said:
Well that's good!! I'm having great luck with Merrick Limited Ingredient Diet. I honestly believe upping his dose is not the right thing to do. I didn't have luck with that, and then there's glucose toxicity. Grey's numbers got better once I started again with 0.5U BID.

PLEASE let other people give you advice. I'm not saying change his dose now, I'm just saying that from my experience, a higher dose makes the body react and the levels go higher. It's really weird. I've spent the last few days reading and reading and reading. So I'm still over here 10 months post Dx trying to make sense of all of this.

I just wanted to give you my support, and I hope that you can get your baby's numbers down!!
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Thanks so much! This is exactly what I'm feeling like I should do at this point. When we first started and I first found this site, I was so scared and frantic that literally none of it made any sense to me. Now that i'm 5 months in and rereading all this information it's making sense to me now and i'm realizing what i've been doing. Looking back on it now, I remember constantly being told by other users on here that they thought my starting dose was way too high, and at the time, I thought "well his numbers are in the 400's and my vet is telling me to give him 2.5u and that sounds like it's going to change things" but now looking back on it i'm realizing that it was absolutely too high of a starting dose, and now i'm worried that i've just been giving him way too much! lol. Mostly, I just am wondering if it's even going to make a difference at lowering the dose back to 0.5ubid, on the same insulin he's been getting too much of for the past 5 months. But from what i'm reading I feel like he may benefit from lowering it significantly. I'm just gunna keep asking around on all my other sites and get a few more opinions on here and the others before I decide what to do right now.... I'm just feeling worried that I messed this all up from the get go and now there's no fixing it. But from what i'm gathering lots of people have restarted things on multiple different occasions and with different insulins and have found what works for them, so that's definitely taking some weight off my shoulders! lol I just think my vet means well, but she equates lowering numbers with upping the doses and I just don't think that's what he needs. But i'm no vet so i'm scared to stray too far away from what she's saying too! ahhhh! so much to think about!
 
Randi & Effy said:
Thanks so much! This is exactly what I'm feeling like I should do at this point. When we first started and I first found this site, I was so scared and frantic that literally none of it made any sense to me. Now that i'm 5 months in and rereading all this information it's making sense to me now and i'm realizing what i've been doing. Looking back on it now, I remember constantly being told by other users on here that they thought my starting dose was way too high, and at the time, I thought "well his numbers are in the 400's and my vet is telling me to give him 2.5u and that sounds like it's going to change things" but now looking back on it i'm realizing that it was absolutely too high of a starting dose, and now i'm worried that i've just been giving him way too much! lol. Mostly, I just am wondering if it's even going to make a difference at lowering the dose back to 0.5ubid, on the same insulin he's been getting too much of for the past 5 months. But from what i'm reading I feel like he may benefit from lowering it significantly. I'm just gunna keep asking around on all my other sites and get a few more opinions on here and the others before I decide what to do right now.... I'm just feeling worried that I messed this all up from the get go and now there's no fixing it. But from what i'm gathering lots of people have restarted things on multiple different occasions and with different insulins and have found what works for them, so that's definitely taking some weight off my shoulders! lol I just think my vet means well, but she equates lowering numbers with upping the doses and I just don't think that's what he needs. But i'm no vet so i'm scared to stray too far away from what she's saying too! ahhhh! so much to think about!
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You and Effy will be fine! Grey was Dx 10 months ago. I've been "ODing" him since then. So if I can do it after 10 months, you can do it too. He's been on Lantus (was switched from Vetsulin) since January. You've got this! I can't wait to see your progress. #following <3
 
JennRoss86 said:
You and Effy will be fine! Grey was Dx 10 months ago. I've been "ODing" him since then. So if I can do it after 10 months, you can do it too. He's been on Lantus (was switched from Vetsulin) since January. You've got this! I can't wait to see your progress. #following <3
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Thanks lady! That made me feel a whole lot better. I was freakin out for a little bit here! lol :bighug:
 
Randi & Effy said:
Thanks lady! That made me feel a whole lot better. I was freakin out for a little bit here! lol :bighug:
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I feel you, it's hard not to. But since I've found this forum and catinfo.org it's like a bomb of knowledge exploded in my face! I talk about my freaking cat ALL. THE. TIME. and people don't get it. And I don't expect them to, but man, what a relief to know people out there GET IT. And everyone here has been an angel to me and my Grey. This forum alone may have saved him!! Don't always trust your vet either. I'm constantly wondering if she just doesn't know any better, or wants to make $$$ - I hate saying that... but I feel strange going into my vet's office and educating them on diabetes. I'll keep spreading the word though!
 
Christie & Maverick said:
Going back to 0.5u wouldn't be recommended from what I have seen here. You need to see how low this current dose is taking him, and right now, there isn't enough data to tell you.

Here is your last post, for continuity, we link our last posts so others can quickly see the history...
http://www.felinediabetes.com/FDMB/threads/effy-amps-134-do-i-dose-or-no.189295/#post-2105882
the same comments apply.
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Agreed! That's why I was saying don't change his dose yet. I want all you experts to help her and I'll be over here for moral support!! xoxo
 
Yes. It's never too late to be more consistent.

Keep the dose and try to get some random tests ( maybe a curve too) over the weekend. It would be especially helpful to have some pm cycle data. the preshot test, a +2 is really helpful.... and then depending on what the +2 is, we can tell you how many hours to get another test to give us that data. This will mean setting an alarm most likely ....
It's always possible that numbers are lower than what you are seeing in that big absence of pm cycle. The data will prove it and we should see signs of whether it's time to increase or not. ( It probably will be time but you did have a yellow a week ago so that 's really good data to have)
 
Christie & Maverick said:
Going back to 0.5u wouldn't be recommended from what I have seen here. You need to see how low this current dose is taking him, and right now, there isn't enough data to tell you.

Here is your last post, for continuity, we link our last posts so others can quickly see the history...
http://www.felinediabetes.com/FDMB/threads/effy-amps-134-do-i-dose-or-no.189295/#post-2105882
the same comments apply.
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Yeah that's what i'm thinking too, I think I may keep him on this dose for a week and gather some midcycle tests and see whats going on throughout the day and decide from there. I was originally freaking out thinking I had a time limit on redoing and fixing everything but it seems like I don't, which makes me worry a lot less! Whew, thank the heavens for this forum, honestly!
 
rhiannon and shadow (GA) said:
Yes. It's never too late to be more consistent.

Keep the dose and try to get some random tests ( maybe a curve too) over the weekend. It would be especially helpful to have some pm cycle data. the preshot test, a +2 is really helpful.... and then depending on what the +2 is, we can tell you how many hours to get another test to give us that data. This will mean setting an alarm most likely ....
It's always possible that numbers are lower than what you are seeing in that big absence of pm cycle. The data will prove it and we should see signs of whether it's time to increase or not. ( It probably will be time but you did have a yellow a week ago so that 's really good data to have)
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Yeah, my thing is every time I get a yellow number and test immediately after, I get a red number immediately, so I take the yellow numbers with a grain of salt. I just didn't get a second test after that one yellow number the other week because sometimes he won't let me prick him a second time lol. He's a big dude, and is really good at escaping the pricks or shaking his head immediately after and I lose the drop :( When I updated his SS today, there were multiple times I got a yellow number and then retested a minute later and got a red number, so I just put the red numbers on the SS test, and left out the original yellows.
 
it's possible that the yellows are causing him to bounce to red. When they've gone a long time, their body gets used to the higher numbers then when it hits something lower than the "new normal", the liver dumps counterregulatory hormones and they go up. We'll be able to see this better after you get us those random tests.
 
rhiannon and shadow (GA) said:
it's possible that the yellows are causing him to bounce to red. When they've gone a long time, their body gets used to the higher numbers then when it hits something lower than the "new normal", the liver dumps counterregulatory hormones and they go up. We'll be able to see this better after you get us those random tests.
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THIS. I was just reading about this today. So crazy!
 
rhiannon and shadow (GA) said:
it makes sense after a while..... but FD is such a steep learning curve. There's so much that you have to start doing from the beginning all at once. That's why it's useful to go back and read things again . Those sticky's at the top are there so you can refresh constantly.
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I totally agree. A few things I've already read 4 times over. It does start to sink and, especially after talking to so many people who have much more experience dosing than I do. If present me could go back in time, I'd slap past me so hard! haha
 
JennRoss86 said:
I totally agree. A few things I've already read 4 times over. It does start to sink and, especially after talking to so many people who have much more experience dosing than I do. If present me could go back in time, I'd slap past me so hard! haha
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Oh my god I said the same thing earlier on the phone with my mom, I keep thinking back to old me reading those stickies and not understanding it all and i wanna slap myself for being so crazy, lol. I reread everything now and it all makes so much sense that I can't believe it went so far over my head the first time! lol
 
rhiannon and shadow (GA) said:
it makes sense after a while..... but FD is such a steep learning curve. There's so much that you have to start doing from the beginning all at once. That's why it's useful to go back and read things again . Those sticky's at the top are there so you can refresh constantly.
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Yes I agree! It was so helpful to come back and reread everything now! I wish I had done it a little bit sooner! I have to admit after my first few months of being on here obsessively, all day and night just reading and reading and freaking myself out more and more, I kind of just stayed away to give my mind a break. Now that i'm back i'm kicking myself for scaring myself off. Then again I can't blame old me, being newly diagnosed was absolutely terrifying to me so I can understand my past thought process but man... wish I would have worked up the guts to come back sooner lol
 
Randi & Effy said:
Yes I agree! It was so helpful to come back and reread everything now! I wish I had done it a little bit sooner! I have to admit after my first few months of being on here obsessively, all day and night just reading and reading and freaking myself out more and more, I kind of just stayed away to give my mind a break. Now that i'm back i'm kicking myself for scaring myself off. Then again I can't blame old me, being newly diagnosed was absolutely terrifying to me so I can understand my past thought process but man... wish I would have worked up the guts to come back sooner lol
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I hate that we all have or have had furbabies with this disease, but like, there's animal people, and then there's US. You know?! We are in the company of some amazing human beings on here. I am FURever grateful!
 
China went OTJ after 4 years, 8 months on Lantus

Where there's life, there's always hope!!

Unfortunately, she didn't stay OTJ, but I really never thought she'd do it in the first place after all that time!!! We're now working towards OTJ #2!!
 
Chris & China said:
China went OTJ after 4 years, 8 months on Lantus

Where there's life, there's always hope!!

Unfortunately, she didn't stay OTJ, but I really never thought she'd do it in the first place after all that time!!! We're now working towards OTJ #2!!
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Honestly, I don't see him ever reaching OTJ but it's still a goal of ours! I'd just be happy to have him regulated honestly. I can tell the high numbers aren't treating him well, I'd be happy if he was just down to lower numbers even if he never went OTJ!! I think i'm just playing it safe by not getting my hopes up but still working towards it with some hope! lol
 
I also agree that if you can start getting at least a mid-cycle and a "before bed" test on the PM cycle, it'll help tell us a lot.

I have a feeling you're probably giving too much, but the numbers will tell the tale
 
Chris & China said:
I also agree that if you can start getting at least a mid-cycle and a "before bed" test on the PM cycle, it'll help tell us a lot.

I have a feeling you're probably giving too much, but the numbers will tell the tale
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How long do you think I should stay on his current dose and gather numbers, i'm thinking another week? Gather a bunch of midcycles and pm cycles and one last curve and go from there?
 
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