Yoshi 9/18 amps 394 +8 443 dosing advice for tonight just talked to vet

Good morning Jennifer and Yoshi! Good job on that increase.
Do keep in mind that you are doing well, and don't let those numbers tell you otherwise.
There will be a "breakthrough" dose coming up, if this isn't it.
Have a good day and pet Yoshi for me;)
 
Yeah on the increase! Yes, just keep doing what you're doing - great job! Walk him up to where he starts to get into the lagoon - that'll be the 'magic' dose...it just takes a little time to get there :)
 
Hi everyone,

I feel so bad for bothering you...

But alas,

I put a call into the vet a couple of days ago regarding the increase and she just called me back.

1. She doesn’t advise increasing until I talk to her. He can go low and that could be very bad etc... I get it, but I’m watching him as best I can.

2. She recommends him staying on 2u for 3 wks because Lantus is a nice slow insulin and we can increase/decrease from there after running fructosomine (which I said he didn’t need, she seems fine with that because of my testing).

3. But she doesn’t like the 400’s 500’s. Double edged sword.

4. She said that if over the course of 3 wks that he “normalizes” at 300 or so with a few dips, that’s fine. That 2u may be the dose for him. That 200 is normal. This may be fine if I want him on insulin the rest of his life, but my goal is to try to get him back in remission.

In my gut this goes against a lot of what I’ve researched heavily on this board for 3 years. The problem is that I do respect her as a vet and she really is great in that she calls after hours and talks forever and I really think has good intentions.

I guess I’m just looking for some reassurance in what I’m doing. I’m also scared that if I go against what she’s saying, a big “I told you so” is on the horizon.

He’s still on antibiotics for uti and his teeth need a cleaning.

I will test at whatever time and do whatever I need to do to get him better. She said she gets spreadsheets of people testing their cat hourly and that it’s too much stress for the cat. I should test 1-3 times a day. Yoshi I’m thinking in a sick way likes his tests. His ears bleed after warming and he sits and waits patiently for the beep.

I’m wondering if I should stick to 2.5 or go back down to 2.

Thank you guys so much
 
Also his +8 test was an hour after feeding at +4 and +6 (roughly) on the timer. He had Ff turkey pate, but I don’t think that would make his numbers rise
 
Stressedcatmom said:
Thank GOD I don’t have human children.
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Haha I think this all the time about myself!! My younger sibling has juvenile diabetes and unfortunately didn't get good balanced care as a kid... I remember my parents fighting with the doctors and doing all their own research just like we do for our cats. I understand my parents better now.

As for your vet... all I can say is, it can be very difficult to marry traditional vet advice to our methods on the board. When I was in a similar spot to you, trying to decide what to do, I came across something on the board to this effect: as caregivers we need to decide what our goals are, and consider what our limitations are. Some are okay with following their vet's instructions. I decided that wasn't what I wanted, but it's a personal choice we all have to make.

I started with a vet who clearly had no clue about Lantus and told me to dose once a day so I could "go out at night if I wanted to" :eek: I am still offended by that, especially because I trusted her advice and I believe I missed an important window of opportunity early on because of her approach.

With my current vet I made clear I wanted to partner with her, and that I wanted to follow a protocol but would be glad for her input. Mostly she advises on other things and not the diabetes so much. I believe she respects that I educate myself and clearly care about my cat. At some point she said "it wouldn't be wrong to put him at 2 units and not test for 10 days, to give you both a break" and I said thank you, I would think about it. Then proceeded as normal :rolleyes:She's great with other things and we have a good relationship.

At the end of the day, it's your cat, your decision. If anyone says "told ya so" about something so personal and important as your beloved pet, I wouldn't give them the time of day!
 
Figaro's Liz said:
Haha I think this all the time about myself!! My younger sibling has juvenile diabetes and unfortunately didn't get good balanced care as a kid... I remember my parents fighting with the doctors and doing all their own research just like we do for our cats. I understand my parents better now.

As for your vet... all I can say is, it can be very difficult to marry traditional vet advice to our methods on the board. When I was in a similar spot to you, trying to decide what to do, I came across something on the board to this effect: as caregivers we need to decide what our goals are, and consider what our limitations are. Some are okay with following their vet's instructions. I decided that wasn't what I wanted, but it's a personal choice we all have to make.

I started with a vet who clearly had no clue about Lantus and told me to dose once a day so I could "go out at night if I wanted to" :eek: I am still offended by that, especially because I trusted her advice and I believe I missed an important window of opportunity early on because of her approach.

With my current vet I made clear I wanted to partner with her, and that I wanted to follow a protocol but would be glad for her input. Mostly she advises on other things and not the diabetes so much. I believe she respects that I educate myself and clearly care about my cat. At some point she said "it wouldn't be wrong to put him at 2 units and not test for 10 days, to give you both a break" and I said thank you, I would think about it. Then proceeded as normal :rolleyes:She's great with other things and we have a good relationship.

At the end of the day, it's your cat, your decision. If anyone says "told ya so" about something so personal and important as your beloved pet, I wouldn't give them the time of day!
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Thank you for this. She does care about my lively hood and stress level, and I think that’s what a lot of vets do. I appreciate it, but I’d rather work hard on the front end to get him better than be complacent
 
Stressedcatmom said:
She said she gets spreadsheets of people testing their cat hourly and that it’s too much stress for the cat. I should test 1-3 times a day.
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I've heard this before. When Ming was first diagnosed, my initial vet was 100% against testing, even when I asked about it multiple times. Ming would go on to have pancreatitis episodes and probably DKA every month. I'm amazed he isn't dead.

Ever since I took control of Ming's diabetes, Ming hasn't had to be hospitalized since. It's almost been a year since his last one! Still not regulated but he's not having pancreatitis every month! It's due to many things, not just me taking control of diabetes. I found vets that will work with me and I learned a lot on this board. I don't say much about his diabetes to my vets unless they ask and even when they give me their opinion, I just see it as an opinion.

I've only been working as a vet assistant for a year and been on this board for about a year, but a few coworkers and even the vets look to me about some things related to FD. I definitely don't feel comfortable giving advice but things like: when is Lantus' onset, what syringe does this insulin use, how often should you feed and test, are questions I'm okay with answering.

The way I see it is, the people who care for their diabetic cats here live and breathe feline diabetes. Vets don't often get that chance for a variety of reasons. They don't get enough training or they're used to a certain type of client and patient that doesn't test and only have frutosamine tests as their only tool. It's very clear to me that diabetes is not a one size fits all. But it might not be so clear to them. It's also really nice that most of us only have to focus on one patient at a time: our own cat :) This allows us to tailor their diabetes treatment to what our cats need and deal with issues in REAL time, rather than waiting for a vet. Diabetes sometimes isn't a disease that can wait a day or even sometimes half an hour to treat.

I agree with @Figaro's Liz. You have to decide what your goals are and what you want to do. I have had my vet tell me that Ming is looking very good and he was in yellows. I don't think that's good for him. I've overheard vets tell clients to stop insulin after one low number on 1 unit when I know there are doses smaller than 1. I've had vets make a scared face when a diabetic patient would come in with a number like 100, while I nodded in glee. A cat tested at 30 and was sent home to go have a meal.

I don't think you should feel like you need to follow anyone's advice just to avoid a "I told you so" moment. instead, you should make the decision based on what you think will benefit Yoshi the most and what is most safe and doable for you.
 
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You are the pet parent, you live with Yoshi and know best what is good for him. Listen to all what people have to say, decide what makes the most sense for you and Yoshi. My $0.02 is stick with 2.5 tonight, the higher number is new dose Wonkiness.

As for vets, mine had been a long time vet for me. She also donated pet exams at the shelter I was at, so I greatly respected her. She just didn’t know about felines diabetes or acromegaly. Frankly, a lot of clients don’t treat their diabetics, she was thrilled I was going to. Neko and I were the first clients to use Lantus (courtesy of locum vet), first to home test, first to have tests done for acromegaly and insulin auto antibodies, first to be diagnosed positive for both, first to have stereotactic radiation therapy. Yup, we butted heads (gently) a number of times. Getting the high dose tests took a lot of convincing. I flooded her with data, published vet articles and the spreadsheet. Kind of funny to see how thick Neko’s file was.:p Anyway, when I was proven right, she admitted it. She liked to learn new things, the relationship worked well. She was great at other conditions. But if I hadn’t listened to the folks here, Neko would have passed a lot sooner and not had the quality time she did have. FDMB saved her. That’s just my story.
 
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I agree with Wendy. This is your cat and the vet doesn't.

I don't mean for this to be snarky but what is your vet basing her decision making on? TR is based on published research in a top veterinary journal. SLGS is based on a lot more cats than your vet has likely ever to seen in her practice.

When I moved to Columbus, I interviewed vets. I didn't really care if the vet agreed with my being a bit of a pain in the butt. The bottom line for me was whether the vet was familiar with the Roomp & Rand version of Tight Regulation and would support my treatment of Gabby's FD. I like the vet I chose -- a lot. At the time I needed to schedule an appointment, she had left the practice she was with and opened her own clinic. The clinic wasn't quite ready for kitties (it'a a cat only practice) so she was making housecalls. I opened up my laptop to show her Gabby's spreadsheet and she pretty much told me to keep doing what I was doing and to let her know if I had any questions. She supported home testing, feeding a non-prescription low carb diet, she could see Gabby's progress, and didn't give me a hard time because I could make a decision about raising or lowering a dose. Frankly, this is exactly what MDs do with their patients.

I know I am lucky to have the vet that I use. I trust her and she trusts that I will do what is best for my cat. She treats me like an adult with a brain. You should expect no less.
 
Many vets think that having kitty run at BG levels around 200 is just fine figuring that is low enough to limit the damage of uncontrolled diabetes and kitty might be just fine for years to come. A lot of pet parents aren't going to test daily and I think a lot of vets try to make things as easy as possible and don't really explore a more aggressive goal of remission.

You have to decide what you want for Yoshi and you. If your goal is to try to get Yoshi back into remission then I'd stick with the 2.5u dose.
 
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