? 3/12 - Freckles-PMPS 15.1- dose advice please-ready to increase? - a few more questions

[Judy and Freckles]

Yesterday's condo

Freckles continues to stay relatively flat in the yellows and today is Day 3 of following TR. If I'm reading the TR protocol correctly, Freckles' nadirs (nadirs haven't really been well established due to a flat cycle) is between 200-300, so we should increase her dose by .25u correct?

Second question... I spoke to another vet today by phone and she suggested that a fructosamine test may be in order. After reading a bit on what the test will show, I'm not entirely sure what the benefit would be of doing this test?

Third question... this vet also said that 3u of Lantus was high and that I should be thinking of changing insulin - she suggested Prozinc may be appropriate.

I would appreciate people's thoughts on these questions. Typical.. the more you learn, the more questions you have!

 

[tiffmaxee]

Freckles has been on lantus less than three months. I’d give TR a chance to see what it can do. You just haven’t hit the magic dose yet. I’d increase by .25. Hang in there. It’s a marathon for most.

 

[Wendy&Neko]

Yes, I would increase to 3.25 units tomorrow morning, unless you see blue tonight.

IMHO, doing a fructosamine helps the vets pocketbook and is good for caregivers that don't test. It gives an average over the last couple of weeks, but doesn't tell you if that's highs and lows or flat. Your testing tells us it's flat. Save your $$ for test strips.

this vet also said that 3u of Lantus was high and that I should be thinking of changing insulin - she suggested Prozinc may be appropriate

3.0 units is not a high dose. Prozinc will not be better. People generally switch from Prozinc to the L insulins, not the other way around. The depot helps keep numbers flatter. I'm not saying Prozinc isn't a good insulin for cats, just that you won't see any improvement going there. I can show you spreadsheets of what I think is a high dose, ie. over 30, and even double or triple that. A cat needs however much insulin they need. Changing insulins doesn't change that.

For now, keep following the protocol with increases. You WILL find a dose that moves Freckles. And honestly, the size of dose doesn't really matter. The numbers that matter are the blood sugar values. The dose is just the mechanism to get you where you want to be.

 

[Judy and Freckles]

You just haven’t hit the magic dose yet

Thanks! Looking for that "magic wand' for sure! lol

 

[Judy and Freckles]

Yes, I would increase to 3.25 units tomorrow morning, unless you see blue tonight.

Will do. Thanks Wendy!

It gives an average over the last couple of weeks

That's exactly what I read but thought I may have missed something or misinterpreted.

3.0 units is not a high dose.

This is what I thought too since most cats start out @ .25u/kg or .5u/kg depending on their presenting numbers right?

The dose is just the mechanism to get you where you want to be.

Excellent quote to keep in mind Wendy! Thanks.

I was basically doing a phone 'interview' with this vet. Her credentials on the website state that she specializes in internal medicine. When she told me that some cats do really well with 'loose regulation' (i.e. testing once/month even when first diagnosed) major red flags went up, but I wanted to check with experienced FD folk!

You guys are rockin' it!

p.s. the sticky on "interviewing the vet" was very helpful!

 

[Wendy&Neko]

You guys are rockin' it!

And so are you.