7/4 Figaro AMPS 402, +5 404 PMPS 408, +4 327, +8 372 (AT2 #s) -- Bad dosage advice from vet??

[Figaro's Liz]

I just posted a detailed intro here http://www.felinediabetes.com/FDMB/threads/introducing-figaro-3-weeks-after-diagnosis.216408/

Fig had a BG curve done at the vet who said the numbers were good, and that I should go to once-a-day dosing (0.5U lantus). I was hesitant but followed her advice. Well now I wish I had trusted myself with 400s. I'm going back to the 0.5 BID and will be testing more myself for better regulated dosing.

I'm not following either SLGS or TR - have been following vet's advice. But they are closed for the 4th.

I think I need a different vet, too, this seems really wrong, like she doesn't understand how lantus works...

 

[Perry & Jenn]

I have seen some threads in here that explained how Lantus works best for cats if they're on a twice a day schedule...though I'm not finding it now. I'm hoping someone more experienced will chime in here about that.

Since you're testing at home, you're empowered to make good decisions for your sweet little Fig. But I'm also wondering if you might have given a fur shot today (which I have done myself, sending my boy sky high, then castigating myself for it) since you had a sudden jump.

 

[Sue and Luci]

I just posted a detailed intro here http://www.felinediabetes.com/FDMB/threads/introducing-figaro-3-weeks-after-diagnosis.216408/

Fig had a BG curve done at the vet who said the numbers were good, and that I should go to once-a-day dosing (0.5U lantus). I was hesitant but followed her advice. Well now I wish I had trusted myself with 400s. I'm going back to the 0.5 BID and will be testing more myself for better regulated dosing.

I'm not following either SLGS or TR - have been following vet's advice. But they are closed for the 4th.

I think I need a different vet, too, this seems really wrong, like she doesn't understand how lantus works...

Well you've figured out the issue with your vet - and most vets - simply put they don't understand much about feline diabetes - much less any experience with Lantus or any insulin for that matter.

Please go to the stickies at the top of this forum and read, read, read. There is a wealth of information there - lifesaving information. Don't waste your time/money on another vet (unless Fig has other health issues, then of course you'll have to seek another vet)...but as far as I'm concerned, I wish we never had to discuss diabetes with another vet again - I don't withhold the information - but I also take what they have to say with a grain of salt. Since joining this forum I've learned 100 times more than I would have if I'd listened to my vet - the one who diagnosed Luci said 'if it were his cat, he'd put her down' - cats are too hard to regulate, blah, blah, blah...Luci is still alive and well nearly two years later - yes, it's a fair amount of work but we'd do that for any member of the family - and she's been a member of our family for almost 11 years - not ready to just do what he said yet...grrr...made me so upset to receive THAT advice.

Your vet is incorrect saying that you should give Lantus once a day - glad you've gone back to twice a day dosing. Forget your vet - read the stickies, ask questions here. Yes, there's a lot to learn about FD - and this is the place to learn it. Your vet doesn't have time to learn all of this ...he/she is busy treating lots of animals for a lot of conditions so the in-depth knowledge needed to treat this particular disease is not going to be found at any vet's office.

I'll be looking for your future posts - have a wonderful day!

 

[Sienne and Gabby (GA)]

Welcome to the group! This is likely the best place you never wanted to be!!

From the post you linked, it sounds like you just started to home test. FYI -- the AlphaTrack strips are crazy expensive. Many of the members here use a human meter as the strips are a fraction of the cost.

I'm guessing the vet didn't provide you with the results of the curve he did. Looking at the data that's on your spreadsheet, I don't see what your vet is seeing. However, you don't have a great deal of data yet. I'll come back to that point. As Jenn noted, Lantus does not perform well with once a day dosing. A cat's metabolism is faster than a human's, and the manufacturer notes that Lantus can be dosed once daily in humans. Frankly, there are plenty of humans whose doctors have them on a twice a day schedule! In other words, your vet did not give you the best advice. If you dose once a day, you lose all of the duration that Lantus can give your cat. You'll see high numbers before shot time and they will drop by nadir (lowest point in the cycle -- somewhere around +6) and then continue to rise over the next 18 hours. In addition, with once a day dosing, you lose the purpose of using a depot type of insulin. The depot needs to be kept at a steady level and that only happens with twice a day dosing.

We encourage members to test before every shot and to get at least one test during both the AM and PM cycles. The pre-shot test lets you know that it's safe to give a shot. However, Lantus dosing is based on the lowest number in the cycle which is around +6 (give or take) for most cats. We can be of greater help if you are able to collect more test data.

What kind of food are you giving Figaro?

I'd encourage you to read through the sticky notes at the top of the Board. Please let us know if you have questions. The members here are very generous with their knowledge and time.

 

[Figaro's Liz]

Thanks all! I should have mentioned in my first message, I have definitely read the stickies, which has helped me understand better how lantus works on a 12-hour cycle...and which is why I felt weird about the once a day change. If I hadn't read through a TON of info and previous posts on this forum, I would have been completely in the dark still. It is frustrating to not be able to trust your medical professional, and the resources here are helping me educate myself for sure. I feel like every spare moment is spent reading up on FD!

After realizing the misdirection of my vet's advice I have decided to take matters into my own hands (more so, at least!). Thus, the beginning of better data collection, which will be collected moving forward

From the post you linked, it sounds like you just started to home test. FYI -- the AlphaTrack strips are crazy expensive. Many of the members here use a human meter as the strips are a fraction of the cost.

I'm guessing the vet didn't provide you with the results of the curve he did. Looking at the data that's on your spreadsheet, I don't see what your vet is seeing. However, you don't have a great deal of data yet. I'll come back to that point. As Jenn noted, Lantus does not perform well with once a day dosing. A cat's metabolism is faster than a human's, and the manufacturer notes that Lantus can be dosed once daily in humans. Frankly, there are plenty of humans whose doctors have them on a twice a day schedule! In other words, your vet did not give you the best advice. If you dose once a day, you lose all of the duration that Lantus can give your cat. You'll see high numbers before shot time and they will drop by nadir (lowest point in the cycle -- somewhere around +6) and then continue to rise over the next 18 hours. In addition, with once a day dosing, you lose the purpose of using a depot type of insulin. The depot needs to be kept at a steady level and that only happens with twice a day dosing.

We encourage members to test before every shot and to get at least one test during both the AM and PM cycles. The pre-shot test lets you know that it's safe to give a shot. However, Lantus dosing is based on the lowest number in the cycle which is around +6 (give or take) for most cats. We can be of greater help if you are able to collect more test data.

What kind of food are you giving Figaro?

You are correct, I don't have the vet's numbers (requested, but haven't recieved yet...). I will of course add them once I have them. Honestly, I was hoping the vet was right. Today's numbers suggest not.

Figaro gets Wellness complete health canned, and on occasion Tiki cat grill flavors.

I have read about the BG meters, and I understand the cost difference. I may switch to a human meter in the future but for now I've chosen the AT.

 

[Figaro's Liz]

I have seen some threads in here that explained how Lantus works best for cats if they're on a twice a day schedule...though I'm not finding it now. I'm hoping someone more experienced will chime in here about that.

Since you're testing at home, you're empowered to make good decisions for your sweet little Fig. But I'm also wondering if you might have given a fur shot today (which I have done myself, sending my boy sky high, then castigating myself for it) since you had a sudden jump.

I did go for two days with the once per day shots, and I suspect that's where these highs are coming from. It is possible I got a fur shot this morning... I don't think I did, but it certainly may have happened. But I am also wondering if perhaps his depot was depleted (by what essentially was two skipped shots over two days), thus causing no drop between. AMPS and +5?

Will definitely be getting a PMPS number.

 

[Wendy&Neko]

For what it’s worth, my vet started us on Caninsulin, and did not understand how Lantus worked. Fortunately I had the resources here, and my vet also liked to learn. She was also well versed on other things cat, so I handled the diabetes, and she did everything else.

Welcome aboard!

 

[Figaro's Liz]

For what it’s worth, my vet started us on Caninsulin, and did not understand how Lantus worked. Fortunately I had the resources here, and my vet also liked to learn. She was also well versed on other things cat, so I handled the diabetes, and she did everything else.

Welcome aboard!

Thanks, Wendy! That is an interesting model and does give me hope that I too can establish a good partnership with my vet. Thanks for sharing.