Dosing advice part 2

Breanna H

Breanna H

Member Since 2019
Link to previous thread

Started a new thread since my other one was past 50 posts.

Just wanted to clarify before I went up to 6u..
I was looking over Tigger's spread sheet and is it possible he was doing better at a lower dose like .75u? I almost feel like he was getting the same amount of a drop or even more at .75u than he is at the 5.5u. So is it even worth it to keep going up when he was getting literally the same numbers at a lower dose?
Just considering all my options.
 
Hi Breanna!

I looked back at your previous thread where Deb threw out the possibility of a high-dose condition for Tigger. If that is the case, going back to .75u isn't going to help him anymore. Sometimes those old doses were what was needed at the time but a cat's needs change incredibly often. He may simply benefit from switching to a depot insulin as well.
 
You were varying the dose quite a bit, skipping shots because you did not have test data to support shooting <200 mg/dL (11.1 mmol/L).
Tigger has never stayed down below the yellows at the 0.75U dose. He doesn't get down to the low blues much either. Hardly ever in fact. His BG levels are still too high.

You increase the dose, until you see Tigger dropping lower at mid-cycle. Down into the low blues (> 100 < 150 mg/dL; >5.5 < 8.3 mmol/L) and into the greens (<99 mg/dL; < 5.5 mmol/L)

It's possible that Tigger has a high dose condition. You need to test for that possibility. When a cat reaches 6 units per cycle is often the point at which we suggest you get your cat tested for IAA (Insulin Auto Antibodies) and Acromegaly.

Not all cats do well on a particular insulin. You may want to consider Lantus (Basaglar is a biosimilar). Sometimes cats do better on the depot type insulins, because the duration is longer in many cases.
 
158 this AM! Currently stalling. So we will see. I will be home all day but am still a little nervous to give a full dose (unless he comes up, of course).
 
@Chris & China (GA)
@Deb & Wink

150 at retest. I know I shot at 178 the other day and gave the full dose and he was fine. But he went up after the shot (on 4/23 PM). So I was thinking of giving a reduced dose.

I over think everything. And I really just wasn't sure so I went with 5.5u. I will retest in 2 hours. Not sure yet if I made the right decision.

Do I start over with dosing now or can I return back to my 6.75u tonight if Tigger is high enough?
 
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Breanna H said:
@Chris & China (GA)
@Deb & Wink

150 at retest. I know I shot at 178 the other day and gave the full dose and he was fine. But he went up after the shot (on 4/23 PM). So I was thinking of giving a reduced dose.

I over think everything. And I really just wasn't sure so I went with 5.5u. I will retest in 2 hours. Not sure yet if I made the right decision.

Do I start over with dosing now or can I return back to my 6.75u tonight if Tigger is high enough?
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I think us two Pennsylvanians are made from the same mold...lol...You and I sound so much alike with our questions, thank goodness we have this group of people.....Im probably worse than you though, age helps you become more worrisome....
 
Irish Pat said:
I think us two Pennsylvanians are made from the same mold...lol...You and I sound so much alike with our questions, thank goodness we have this group of people.....Im probably worse than you though, age helps you become more worrisome....
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I'm not sure about the age thing, I worry about everything. Tigger looks at me funny now and I think there is something wrong with him, haha. I drive my husband crazy. All I talk about is my cat :p:cat:
I really don't know what I would do without them. I try to make decisions for myself but then I second guess everything and love having the other opinions and advice.


We were 141 at +2. I'm thinking I could have perhaps went with a full dose, but I am learning.
 
Breanna H said:
I'm not sure about the age thing, I worry about everything. Tigger looks at me funny now and I think there is something wrong with him, haha. I drive my husband crazy. All I talk about is my cat :p:cat:
I really don't know what I would do without them. I try to make decisions for myself but then I second guess everything and love having the other opinions and advice.


We were 141 at +2. I'm thinking I could have perhaps went with a full dose, but I am learning.
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I hear ya, my wife and I are trying so hard, and we are the same way...everything he does now, its like...why did he do that.....This insulin is just a tricky thing...One day it seems to help and you get good numbers...the next day it changes....ugggghhh…..As far as dosing...wish I could help, maybe someday I will get it but not yet, lol.....I used to play softball up that way back in the day, Turbotville, down the road from you a bit....Used to be a nice bar we visited when we were up there towards you...KC's I think was the name...but anyways....Hopefully we get this for the sake of our kitty's.....
 
You could go back up to 6.75U, but that 85 at +4 today tells us that Tigger is ready for a dose reduction.
Not strictly according to the MPM protocol, but I would suggest no more than 6.25U for the PM dose.

Higher doses get bigger reductions, so a 0.5U reduction is in line for Tigger.
If he doesn't maintain the reduction, you can always increase the dose again.

But you need to wait until Tigger clears the bounce. In fact, I think Tigger was clearing the bounce, and that is why you got that nice low blue 150 range this morning and then the nice low green 85 at +4.

p.s. Believe it or not, your post and Tigger's SS was next on my to do list. :)
 
Deb & Wink said:
I would suggest no more than 6.25U for the PM dose
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6.25u given! Thank you!

Deb & Wink said:
But you need to wait until Tigger clears the bounce. In fact, I think Tigger was clearing the bounce, and that is why you got that nice low blue 150 range this morning and then the nice low green 85 at +4.
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I will hold the 6.25u for a few days and see how he does. I will check in with you before I change it at all again.

Deb & Wink said:
p.s. Believe it or not, your post and Tigger's SS was next on my to do list. :)
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Thank you for thinking of us and always checking in. Also sorry for potentially driving you crazy! :oops::oops:
 
Tigger just had his 6.25u this PM. He seems to not be dropping at all now after the dose reduction. Today was a challenge with Tigger, he was being a naughty cat.
I caught him trying to steal some dog food that was left behind in the bowl. I took it away before he got any though.:banghead::banghead: He also spent the afternoon trying to bite my ankles, to remind me he was out of food.
I cleaned out the pantry today (where I keep his food) and had to lock him in the basement because he kept trying to carry off and shred all of his treat bags. He succeeded with one of those, haha. He snuck it away while I turned my back. Usually he always acts hungry, but I guess he was extra bored today. Maybe it was all the rain we are getting here.
Also, his litter box is back to being filled. I was seeing a decrease in urine at the 6.75u.

Do you think I should increase back up in the AM? Or is it still too soon?
 
Breanna H said:
Do you think I should increase back up in the AM? Or is it still too soon?
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Breanna, I think we can call this a "failed reduction" in dose.:(:(

So go back to the 6.75u at the next cycle.

p.s. Wink chewed through the tough bag of the Hill's W/d dry food that I had left in the hallway. That was some tough heavy duty plastic bag to chew through, but he did it in < 2 minutes while I was getting some other food out of storage, to take out to the trash. It was a horrible food for any diabetic cat to eat, so I was getting rid of that high carb junk food, 37% carbs!
 
Deb & Wink said:
So go back to the 6.75u at the next cycle
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Sounds like a plan!

Deb & Wink said:
p.s. Wink chewed through the tough bag of the Hill's W/d dry food that I had left in the hallway. That was some tough heavy duty plastic bag to chew through, but he did it in < 2 minutes while I was getting some other food out of storage, to take out to the trash. It was a horrible food for any diabetic cat to eat, so I was getting rid of that high carb junk food, 37% carbs!
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He tries to chew into every form of food he can get his mouth on. I threw out everything high carb that's dry. I do have some in the freezer, just in case. But nothing he can get to.
Thankfully his treats are the purebites, so low carb.

Thanks for the updated advice! :)
 
Tigger is now showing no improvement on the 6.75u. Do I raise again? 7 or 7.25? I was so hopeful that we were getting somewhere. I know he needs to get to the vet. I will call tomorrow to see if I can hopefully get him in with someone new.
 
I do think you will need to increase Tigger's dose again. At least by 0.25U. Your choice to increase by the 0.5U. You'll want to be able to monitor more if you do that larger increase.

Do please try to get Tigger into the vet soon.

This higher and higher insulin dose needed looks like it could be insulin resistance.
So have the vet see if running a IAA (Insulin Auto Antibodies) blood test and a test for agromegaly is something that needs to be done.

Agromegaly is more common than once thought, with as many as one in four diabetic cats having that pituitary tumor.
See this vet article on the prevalence of acromegaly in cats. Acromegaly in Cats WSAVA 2014
 
So I spent all morning calling vet offices in my area and not one knew what acromegaly was (or said it was so rare that it was highly unlikely:banghead:) nor did they agree with the switch to levemir. (Most suggested switching to vetsulin:banghead:).
I chatted with a woman who lives in my area and she said she had the same problem so she used a traveling vet who came to her home and gave her the prescription for Levemir. She did do a test for acro, but she said the vet was hard to get a ahold of and not the most reliable so she never got her results back, but she at least got her prescription.
At this point, that seems like my only option. Unless I can find a vet who specializes in feline diabetes who is willing to do a Skype appointment and then just have blood work done at a local vet. Do you happen to know of a vet who would be willing to do this? I thought about posting to the Facebook group and asking if anyone had a vet they thought might be willing to work with me.
Why does this have to be so difficult! It's very frustrating.
 
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Breanna H said:
So I spent all morning calling vet offices in my area and not one knew what acromegaly was (or said it was so rare that it was highly unlikely:banghead:) nor did they agree with the switch to levemir. (Most suggested switching to vetsulin:banghead:).
I chatted with a woman who lives in my area and she said she had the same problem so she used a traveling vet who came to her home and gave her the prescription for Levemir. She did do a test for acro, but she said the vet was hard to get a ahold of and not the most reliable so she never got her results back, but she at least got her prescription.
At this point, that seems like my only option. Unless I can find a vet who specializes in feline diabetes who is willing to do a Skype appointment and then just have blood work done at a local vet. Do you happen to know of a vet who would be willing to do this? I thought about posting to the Facebook group and asking if anyone had a vet they thought might be willing to work with me.
Why does this have to be so difficult! It's very frustrating.
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There aren't any vets in your area seeing animals...Down our way, my vet is still open and taking animals, just cant go in with them, they come out and get Brady and take him for his exam. That is terrible you cant find anyone
 
Irish Pat said:
There aren't any vets in your area seeing animals
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They are seeing animals for emergencies, my current vet just doesn't agree with switching Tigger to levemir. She said she's "never had a cat on that and it doesn't work well in animals". But Tigger is up to 7u/2x a day of his Prozinc so clearly something is wrong, so I'm searching for a new vet because I'm hoping to try something different with him. I wanted to call and discuss options with them before I spent money actually taking Tigger in and them suggesting something that won't really help him. I want him tested for insulin resistance and acro as well, but vets around here don't seem to even know what those things are in cats. So I'm at a stand still at the moment. :(
He seems happy so I wouldn't be so inclined to bother switching or testing him (for acro), but the amount he is still peeing and his constant begging for food is clearly not right. I'm spending about 120 for food a month (or more, it's hard to keep track sometimes) and about 60 on litter, plus his insulin. Not that I can't do that because I would do anything for Tigger, it's just starting to get a little expensive and I want him healthy.
 
Breanna H said:
They are seeing animals for emergencies, my current vet just doesn't agree with switching Tigger to levemir. She said she's "never had a cat on that and it doesn't work well in animals". But Tigger is up to 7u/2x a day of his Prozinc so clearly something is wrong, so I'm searching for a new vet because I'm hoping to try something different with him. I wanted to call and discuss options with them before I spent money actually taking Tigger in and them suggesting something that won't really help him. I want him tested for insulin resistance and acro as well, but vets around here don't seem to even know what those things are in cats. So I'm at a stand still at the moment. :(
He seems happy so I wouldn't be so inclined to bother switching or testing him (for acro), but the amount he is still peeing and his constant begging for food is clearly not right. I'm spending about 120 for food a month (or more, it's hard to keep track sometimes) and about 60 on litter, plus his insulin. Not that I can't do that because I would do anything for Tigger, it's just starting to get a little expensive and I want him healthy.
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How far are you willing to travel, I was doing some research on vets locally here and there seems to be a pretty good one in Mechanicsburg, actually seems to be well educated in diabetes, I may look into them as well, just holding off for right now. Here is the link if you are interested.... https://vcahospitals.com/gettysburg-road/services/canine-and-feline-diabetes
 
Breanna H said:
They are seeing animals for emergencies, my current vet just doesn't agree with switching Tigger to levemir. She said she's "never had a cat on that and it doesn't work well in animals". But Tigger is up to 7u/2x a day of his Prozinc so clearly something is wrong, so I'm searching for a new vet because I'm hoping to try something different with him. I wanted to call and discuss options with them before I spent money actually taking Tigger in and them suggesting something that won't really help him. I want him tested for insulin resistance and acro as well, but vets around here don't seem to even know what those things are in cats. So I'm at a stand still at the moment. :(
He seems happy so I wouldn't be so inclined to bother switching or testing him (for acro), but the amount he is still peeing and his constant begging for food is clearly not right. I'm spending about 120 for food a month (or more, it's hard to keep track sometimes) and about 60 on litter, plus his insulin. Not that I can't do that because I would do anything for Tigger, it's just starting to get a little expensive and I want him healthy.
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This is an expensive dedicated disease that's for sure...Brady doesn't pee often, just when he goes its a good bit, may have a large bladder, some days he drinks a bit of water, not many days though.....He bugs and bugs and bugs for food but honestly I think its because im here working from home. I know 7U is a lot especially with prozinc, do you order the prozinc online, Chewy has free delivery?
 
Irish Pat said:
How far are you willing to travel
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It's an hour and 30 minutes from me, and Tigger has traveled for an hour and 15 before (he's actually doing that this weekend as we've been quarantining ourselves and are going to visit family at the end of our two weeks and I have no choice but to take him with me). He hates the car but does okay with the feliway calming spray, so one trip to the vet and back that far wouldn't be out of the question if they are actually knowledgeable and willing to help us. I will look into them though, and maybe even give them a call, thanks for the info!

Irish Pat said:
I know 7U is a lot especially with prozinc, do you order the prozinc online, Chewy has free delivery?
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I do currently use Chewy. They seem to have the best pricing. But at 7u 2x a day, I am going to barely get 2 months out of a vial, so roughly another 50 a month. He's lucky I love him, haha.
 
Breanna H said:
It's an hour and 30 minutes from me, and Tigger has traveled for an hour and 15 before (he's actually doing that this weekend as we've been quarantining ourselves and are going to visit family at the end of our two weeks and I have no choice but to take him with me). He hates the car but does okay with the feliway calming spray, so one trip to the vet and back that far wouldn't be out of the question if they are actually knowledgeable and willing to help us. I will look into them though, and maybe even give them a call, thanks for the info!


I do currently use Chewy. They seem to have the best pricing. But at 7u 2x a day, I am going to barely get 2 months out of a vial, so roughly another 50 a month. He's lucky I love him, haha.
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Yes give them a call and see what they say, let me know how you make out, hopefully someone can help you...Wish you the best.....

I know when I saw how much prozinc you were giving it had to be tough.....that stuff is not cheap.....We love our animals and I hope you can continue to hang in there....Im in the same boat, it is quite costly, I really got hit hard when he was diagnosed, three days in the hospital was a killer on the pocket...Hopefully we got this!!
 
Breanna H said:
Unless I can find a vet who specializes in feline diabetes who is willing to do a Skype appointment and then just have blood work done at a local vet. Do you happen to know of a vet who would be willing to do this? I thought about posting to the Facebook group and asking if anyone had a vet they thought might be willing to work with me.
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Yes, that is a question for the facebook group. I have no idea of any vets in your area. Pat and Breanna, you're both in PA which at least is the same state.

Tell your vet to come here and check things out.
Plenty of members use Lantus, fewer but still some that use levemir.

It shouldn't be THAT hard to get a vet to write you a prescription for levemir.
Once you do, order it from Marks Marine Pharmacy in Canada. Ordering Lantus, Basaglar, or Levemir from Canadian pharmacies

Acromegaly was once thought to be rare. But I linked you that study, that shows 1 in 4 diabetic cats has it. From 6 YEARS ago. Send the article to your current vet practice, so they can read it, and get up to date on the prevalence of acromegaly in cats.

@Jacque- Tiger & Jazz Man just switched her high dose kitty Tiger to Levemir only 4 days ago, and he's already doing better. He was up to 6.25U on Prozinc, even more, 7U on Vetsulin and the duration just wasn't there for him.
 
Deb & Wink said:
Yes, that is a question for the facebook group. I have no idea of any vets in your area. Pat and Breanna, you're both in PA which at least is the same state.

Tell your vet to come here and check things out.
Plenty of members use Lantus, fewer but still some that use levemir.

It shouldn't be THAT hard to get a vet to write you a prescription for levemir.
Once you do, order it from Marks Marine Pharmacy in Canada. Ordering Lantus, Basaglar, or Levemir from Canadian pharmacies

Acromegaly was once thought to be rare. But I linked you that study, that shows 1 in 4 diabetic cats has it. From 6 YEARS ago. Send the article to your current vet practice, so they can read it, and get up to date on the prevalence of acromegaly in cats.

@Jacque- Tiger & Jazz Man just switched her high dose kitty Tiger to Levemir only 4 days ago, and he's already doing better. He was up to 6.25U on Prozinc, even more, 7U on Vetsulin and the duration just wasn't there for him.
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Yep even tried him 3x a day on Vetsulin
..back to Prozinc and then it was clear that we had to switch. We have had to lower the Levemir dose, on 3.25 now and been steady YELLOW to BLUE
 
Now Breanna, you just have to convince your current vet that Acromegaly and IAA are more common than they know, and to write you a prescription for Levemir.
 
Don’t you just hate that….anxiously awaiting that +2 test…nervous what you’ll see but still hoping for the best then disappointed when you see the bounce.

This disease is an absolute roller coaster of emotions!
 
Shelley & Jess said:
Don’t you just hate that….anxiously awaiting that +2 test…nervous what you’ll see but still hoping for the best then disappointed when you see the bounce.

This disease is an absolute roller coaster of emotions!
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I know! I figured he would bounce but it still makes me nervous shooting a full dose. I get hopeful then I get shot right down, haha.
 
Is Tigger still acting ok on the large dose of insulin?
Some cats may get a "stinging" effect from a large dose, is why I'm asking.

Yes, that 200 may have been nerve wracking, but you are using the MPM protocol and should be able to shoot at 150 with no problems. Then later, you should be able to shoot at 50 mg/dL or above with more test data.

Darn vet. I really think that Tigger needs to try the Levemir, and get the Acro and IAA blood tests done.
 
Deb & Wink said:
Is Tigger still acting ok on the large dose of insulin?
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I think he is, haha. He can be kind of restless and "annoying" at times, like getting into things, roaming around the house randomly
meowing, constantly wanting food and chewing on random things..but that is something he's always sort of done. So not sure if he's a whole lot different than he's always been. He still will snuggle here and there and play. Handles his checks and shots just fine usually as well.
How do cats usually act with "stinging?"

Deb & Wink said:
Darn vet. I really think that Tigger needs to try the Levemir, and get the Acro and IAA blood tests done.
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I know. I'm really hoping it would help him. I did find a vet someone recommended on Facebook a little over an hour from my house. So I need to call and discuss a potential plan to make sure he is on board and try to get an appointment. I am back to work on Monday so I am going to have to try to work around my schedule but I need to get in as soon as I can. I already need to order a new bottle of Prozinc since I'm over half way done with the vial.
 
Deb & Wink said:
They can flinch from the shot. Sometimes, they become very aggressive when they are given the shot, biting and scratching you.
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Ah got it. He does flinch a little, but I usually give it to him towards the end of his PM meal, so he's usually busy chowing down still and it distracts him.
 
Hello! Just checking in for an update.
Tigger is still doing the same. Saw a brief improvement in his numbers, which quickly seems to be going away.

I have a telemed appointment Tuesday afternoon with a vet who is about an hour away from us. He was recommended to me by one of the group members on Facebook. She said he is very knowledgeable with feline diabetes and her own diabetic cat goes there. So we will see, fingers crossed for us that he has a different plan than the track we are on now. I'm so glad he was willing to do a telemed appointment before I had to drag him all the way there.
So many places aren't even willing to talk to you without you bringing your pet in! I even offered to pay the visit fee! They seemed offended I didn't want to bring my pet to them. I don't want to put Tigger through the trauma just to have them tell me they've never heard of acro testing or a cat being on levemir.

Anyway, hope everyone is staying safe and healthy. Will update again after our phone call on Tuesday! Wish us luck!!
 
Wonderful that you were able to get a telemedicine appointment with a vet!

Hope they have heard of acromegaly and how to test for it and have heard of using Levemir in a cat with diabetes.

We have quite a few members here with acro cats. There is even a separate ISG forum for them. Maybe go do a bit of reading there, so you know what to discuss in the telemedicine visit with this new vet.

No, radiation therapy is NOT the only treatment for acromegaly. There are medications such as cabergoline that people use with their acro cats too.

Remember to point them to that Acromegaly in Cats WSAVA 2014 link about acromegaly in cats.
 
So, the appointment went pretty well.
He acknowledged the fact that acro testing would be a good idea but rather than making me drive all the way there with Tigger, we would try a switch in insulin first. He also mentioned testing for Cushings disease. I'm glad he acknowledged that it was a possibility he could have acro. He planned on looking into the exact testing process so he would be better prepared.
I mentioned how I thought levemir might be a good option. He said he has heard of it being used, mostly in dogs. He said he was willing to try it but would like to research it some more first. He recommended trying lantus for 6 weeks and if Tigger showed no improvement, we would go to levemir.
I agreed with this, as I don't have many other options or a vet willing to work with me. I also liked the fact that he was willing to do research.
He did encourage the prescription wet food, but I just said I would look into it. Why do they push this so much? How do they think the prescription wet food is any different than the cheaper stuff? I'll stick to my friskies and FF. That costs me enough already, haha.

So not quite the direction I wanted but we are at least heading in new one, so that's good.

Now I have to learn all about lantus and figure out how to get my prescription to Marks Pharmacy. :banghead: There's always something.

Thank you, as always, for listening and helping.
 
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Breanna H said:
So, the appointment went pretty well.
He acknowledged the fact that acro testing would be a good idea but rather than making me drive all the way there with Tigger, we would try a switch in insulin first. He also mentioned testing for Cushings disease. I'm glad he acknowledged that it was a possibility he could have acro. He planned on looking into the exact testing process so he would be better prepared.
I mentioned how I thought levemir might be a good option. He said he has heard of it being used, mostly in dogs. He said he was willing to try it but would like to research it some more first. He recommended trying lantus for 6 weeks and if Tigger showed no improvement, we would go to levemir.
I agreed with this, as I don't have many other options or a vet willing to work with me. I also liked the fact that he was willing to do research.
He did encourage the prescription wet food, but I just said I would look into it. I'll stick to my friskies and FF. That costs me enough already, haha.

So not quite the direction I wanted but we are at least heading in new one, so that's good.

Now I have to learn all about lantus and figure out how to get my prescription to Marks Pharmacy. :banghead: There's always something.

Thank you, as always, for listening and helping.
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Im happy this worked out for you and extremely happy the vet is working with you...Is this Vet up your way or more towards Harrisburg?
 
Irish Pat said:
Im happy this worked out for you and extremely happy the vet is working with you...Is this Vet up your way or more towards Harrisburg?
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They are in Kingston, which is right outside of Wilkes Barre, so about an hour north of me.
Overall I liked him, at least he liked the fact that I do home testing. I can live with a switch to lantus. At least he was willing to switch me to something other than vetsulin and would consider levemir in the future. So we will see.
 
Have your vet give you a prescription. Either emailed or hardcopy or fax or whatever.
Then send it yourself to Marks Marine Pharmacy.
Make sure the vet writes the prescription for the lantus pens and not the vials.
The vials often can't be used up, before the insulin loses potency, and you are wasting half the vial.
The pens act just like a mini-vial and can usually be used to the last drop. Easy to use with an insulin syringe. There is a video on how to do that drawing from the insulin pen in the Health Links Index sticky. See if you can find it yourself. Hint: look at the end.
Sticky INDEX: Health Links/FAQs

Health Links / FAQs about Feline Diabetes Index Sticky has the thread link for ordering from Marks.
It's this one. Ordering Lantus, Basaglar, or Levemir from Canadian pharmacies

Testing for Acro has to be sent out to the University of Michigan. Only place in the US that does it. RVC in London does too, for those folks in Europe.

Send this thread, from our Acromegaly ISG forum to that new vet. It explains how to request the IGF1 test from U of M.
http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/
 
Deb & Wink said:
Make sure the vet writes the prescription for the lantus pens and not the vials.
The vials often can't be used up, before the insulin loses potency, and you are wasting half the vial.
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Do you know if the vet wrote for the vial if the pharmacy can switch it to pens? I didn't specify as I didn't realize you had to :( he mailed it out today so I'm not sure which I'm going to get.

Deb & Wink said:
There is a video on how to do that drawing from the insulin pen in the Health Links Index sticky.
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I was actually wondering how to do this. The video was very helpful, thank you!

Not looking forward to this new learning process. Just when I thought I was kind of figuring prozinc out. Nervous also for Tigger and how he will do.
 
Breanna H said:
They are in Kingston, which is right outside of Wilkes Barre, so about an hour north of me.
Overall I liked him, at least he liked the fact that I do home testing. I can live with a switch to lantus. At least he was willing to switch me to something other than vetsulin and would consider levemir in the future. So we will see.
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I hope it works out for you, a switch may be good. Brady had a pretty good apt yesterday, vet was happy..so we will see.....
 
Call up Marks Marine Pharmacy and ask if they can do the insulin pens instead of the vial.

Go to the Lantus ISG and read the stickies at the top. Start with the New to the Group one and then the one that talks about the dosing protocols.
 
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