12/1 Chloe 168 @ 7 am

Roberta and Chloe said:
My vet knows what she is doing. I'm giving the other .5 at her regular time at 7:00 and I will test her at least twice tonight before bed. I am very suspicious that her morning dose contained no insulin in the syringe. I don't know why the pens do this and as soon as Covid ends, I'm putting her back on the vial.
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As you may recall, I live in Tucson and I know of your vet. She does not know what she’s doing with insulin. I hope you will stop and think that we’ve been dealing with FD 24/7 for decades.....Sienne and I, alone, have over 20 years experience with Lantus and helping hundreds of members here get their cats regulated and into remission. We are strongly urging you to not shoot that extra 0.5u of insulin.
 
As for dose tomorrow, we have given you our recommendations to reduce. Even the most experienced members who test a lot (more than you do) would take a full 0.25u reduction. 35s are nothing to mess around with, frankly speaking. I can only share what I have learned being here over the time that I have, and am genuinely trying to help.[/QUOTE] I'm confused now. One of you said to give .75 tomorrow am and the other is saying to increase.
 
Marje and Gracie said:
I know of your vet
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I didn't know you lived in Tucson. What vet would you recommend? The vet who diagnosed her at PAWS (1/2017) suggested that I euthanize her. Another 2 (Dove Mountain and Twin Peaks) wouldn't trust me to do my own testing and curves and said I should give her 2 units. I'm not sure if I went to anyone else until I found my current vet. Even the vets I saw at the Animal Hospital on La Canada for Chloe's DKA's were constantly leaving.
 
tiffmaxee said:
I don’t think anyone said to increase. A drop under 40 is an automatic .25/reduction. The dose will be .75. I hope you do reduce.[/QU

I was told that I should wait for her numbers to come up to shoot. I thought it would be safe when she hit 163 to give her regular dose of 1 unit. Are you saying that I should have given .75?
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No. You should not have shot a second dose. All the mods said not to give a second shot. Shoot a reduced dose 12 hours after the .50.

I thought you were asking about tomorrow morning. If I had a fur shot or shot a reduced dose I would still wait 12 hours for the next shot.
 
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tiffmaxee said:
No. You should not have shot a second dose. All the mods said not to give a second shot. Shoot a reduced dose 12 hours after the .50.

I thought you were asking about tomorrow morning. If I had a fur shot or shot a reduced dose I would still wait 12 hours for the next shot.
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So tomorrow morning at 6:30 am I should shoot .75?
 
Roberta and Chloe said:
So tomorrow morning at 6:30 am I should shoot .75?
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The New dose should be 0.75u.

We reduce the dose when we see a drop below 50. That 35 signals a dose reduction.

HOWEVER I would NOT shoot at 7.
You need to shoot 12 hours after that second 0.5u dose. Otherwise you will be shooting early again and that is like increasing the dose because the 0.5u will not be out of her system and the overlap between the two shots could very well land you in deep water.


I'm not sure what is going on, when I looked at your ss when I just got on line it showed a 0.5u shot at +4, but now it is not showing that??



tiffmaxee said:
Did you shoot an extra .5 of insulin?
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I saw 0.5u on the ss when I first looked this morning at +4, now it's not there??? Hopefully @Roberta and Chloe will confirm for us.
 
The condo on main says you shot .5 at 3:20 p.m. I don’t understand. Did you shoot again at 7? I’m going to sleep.
 
She's back to normal this morning and woke me up at the right time, not by peeing on the bed, but just sitting and staring at me. I think that the syringe doesnt fill and probably her bouncing is from fur shots. This morning it happened again, but I was careful and checked. The first time I pulled, nothing came out. I got it with the 2nd pull and checked that there was some insulin in the syringe. Why does this happen with the pens and not the vials?
 
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Roberta and Chloe said:
I think that the syringe doesnt fill
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Just get into the habit of checking. I would always overfill, so I would have to squirt a bit out to get the right dose.

Roberta and Chloe said:
I think that the syringe doesnt fill and probably her bouncing is from fur shots.
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Not all high numbers are bounces. You do not get a bounce from a fur shot.

But what we do know is that she was 35 at pmps the other day, she was screaming for food before her shot time, in all likelihood she may have been lower than 35, dropping that low and if she did it fast could well result in one heck of a crazy bounce, the numbers of which may have been compounded by the fur shot, but the furshot did not cause the bounce, it was the drop to 35 (or lower) that caused the bounce.
We can never really know for sure if we gave a fur shot or not, so it is extremely risky to assume that and shoot again or shoot early. It turned out OK yesterday, but it might not if you react to a high number like that again.
Shooting early midcycle because you see a high number can prove disastrous. With a kitty in a hypo situation that can be difficult to recover from.

Your vet got away with giving you some bad advice, Lantus shouldn't be used in the way she suggested, it was reasonable advice if you were still on a short acting insulin, but not, with a long acting insulin like Lantus.

I'm glad you reduced to 0.75u.
With all the craziness of the last 48 hours I would strongly advise you to get a +2, and if she is dropping at +2 you need to think about monitoring this cycle very closely.
It looks like the bounce is clearing and shooting when clearing a bounce (which is OK to do) can often lead to a very active cycle. By that I mean that you might see her drop significantly today so you should be on your toes.
 
I’m glad to see this is all figured out. I hope it’s smooth sailing from now on. I do know if once a cat is in very low numbers sometimes they are more sensitive to insulin. Another reason why those extra spot checks are important.
 
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tiffmaxee said:
I’m glad to see this is all figured out. I hope it’s smooth sailing from now on. I do t know if it was met but once a cat is in very low numbers sometimes they are more sensitive to insulin. Another reason why those extra spot checks are important.
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But I waited until she reached 168 before I shot. I don't understand. I would NEVER give her insulin if she was below 80.
 
Roberta and Chloe said:
I didn't know you lived in Tucson. What vet would you recommend? The vet who diagnosed her at PAWS (1/2017) suggested that I euthanize her. Another 2 (Dove Mountain and Twin Peaks) wouldn't trust me to do my own testing and curves and said I should give her 2 units. I'm not sure if I went to anyone else until I found my current vet. Even the vets I saw at the Animal Hospital on La Canada for Chloe's DKA's were constantly leaving.
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Yes, we discussed that I was in Tucson and that she was at Veterinary Specialty for DKA in this thread when you were here in 2017.

Unfortunately, my vet has moved to TX but I’m still using the same clinic. I currently see Dr. Weintraub at Sunrise Pet Clinic which is a distance for you. When Gracie was alive, I saw Dr. Weintraub on occasion and found her to be fairly knowledgeable about Lantus and FD; she was supportive of what we were doing but she also recognized and respected that I wasn’t asking for help with FD because of the incredible experience on this board.

Quite honestly, before I found the vet at Sunrise, I spoke with many, many vets around Tucson regarding FD and I found a general lack of knowledge of dealing with FD. I asked my vet about it and she said that vets don’t see a lot of diabetic cats but also that they are not available to help clients to the extent that we do here so they are often overly cautious. There are also vets who have neglected to stay up on the longer lasting insulins and so try to dose them as they did the older ones (which is what it sounds like your vet was doing by suggesting you give her an extra 0.5u at a time Chloe shouldn’t have it). Lantus is never, ever used as a bolus insulin to bring high numbers down. It just can’t do it.
 
Marje and Gracie said:
Yes, we discussed that I was in Tucson and that she was at Veterinary Specialty for DKA in this thread when you were here in 2017.

Unfortunately, my vet has moved to TX but I’m still using the same clinic. I currently see Dr. Weintraub at Sunrise Pet Clinic which is a distance for you. When Gracie was alive, I saw Dr. Weintraub on occasion and found her to be fairly knowledgeable about Lantus and FD; she was supportive of what we were doing but she also recognized and respected that I wasn’t asking for help with FD because of the incredible experience on this board.

Quite honestly, before I found the vet at Sunrise, I spoke with many, many vets around Tucson regarding FD and I found a general lack of knowledge of dealing with FD. I asked my vet about it and she said that vets don’t see a lot of diabetic cats but also that they are not available to help clients to the extent that we do here so they are often overly cautious. There are also vets who have neglected to stay up on the longer lasting insulins and so try to dose them as they did the older ones (which is what it sounds like your vet was doing by suggesting you give her an extra 0.5u at a time Chloe shouldn’t have it). Lantus is never, ever used as a bolus insulin to bring high numbers down. It just can’t do it.
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Thank you. Veterinary Specialty is the one I've used for Chloe's DKAs and every time I went there, the previous vet I had seen and liked was gone. I like Dr. Upchurch because she answers my emails and phone calls promptly. She wants me to send her a copy of Chloe's chart for November which I will send now that I fixed it. I will also check out Dr. Weintraub. I also like Dr. Upchurch because she always has cats and kittens in the lobby that she adopts out.
 
+7 looks good though.

I imagine it's been stressful and tiring.

It's almost bedtime for me here.

I would suggest a +10, it will give you heads up if she gets up to shenanigans at the end of the cycle, giving you time take some action.
 
Critter Mom said:
LBL board slang for a daily thread.


Mogs
.
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Thanks, but not sure what LBL stands for. I absolutely abhorr acronyms from my 20 years as a special education teacher. My brain can't stand any more acronyms. Anyway, I felt a bit dizzy when I got up from sitting just now and I hadn't taken my blood pressure for almost a month because it had been in the normal range without meds, for quite awhile. Once I changed the batteries, it was rather high, which might explain why I've been feeling 'off' the past couple days. Well, I have to go out and get more test strips. I was going to do this yesterday, but Chloe got sick.
 
@Roberta and Chloe On Saturday when you accidentally used a u-40 syringe (https://www.felinediabetes.com/FDMB/threads/where-is-the-u40-u100-conversion-chart.239256/ ), what line did you draw to on that u-40 syringe?

You said that you “eyeballed” the dose but were asking for the conversion chart (after dosing?), which makes me wonder how much insulin you actually gave. I’m also questioning whether that had anything to do with the low numbers and craziness that happened yesterday.

I sincerely hope you put those u-40 syringes high up in the back of a cupboard so that never happens again.

Please listen to the others here regarding dosing. They really do have the knowledge and experience to guide you and Chloe.

Also, I assume you’re still using Start Low Go Slow (SLGS), which is important for everyone advising you to know.

Best wishes to you and Chloe.
 
JL and Chip said:
@Roberta and Chloe On Saturday when you accidentally used a u-40 syringe (https://www.felinediabetes.com/FDMB/threads/where-is-the-u40-u100-conversion-chart.239256/ ), what line did you draw to on that u-40 syringe?

You said that you “eyeballed” the dose but were asking for the conversion chart (after dosing?), which makes me wonder how much insulin you actually gave. I’m also questioning whether that had anything to do with the low numbers and craziness that happened yesterday.

I sincerely hope you put those u-40 syringes high up in the back of a cupboard so that never happens again.

Please listen to the others here regarding dosing. They really do have the knowledge and experience to guide you and Chloe.

Also, I assume you’re still using Start Low Go Slow (SLGS), which is important for everyone advising you to know.

Best wishes to you and Chloe.
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I'd forgotten all about that. I think it was very close to what her dose was supposed to be. I looked at the conversion chart first. Anyway, now I've just gotten back from Walmart where I bought 2 boxes (100) of test strips and some lancets. They didn't have the blue ones, so I got the beige ones. Maybe they won't hurt as much. I'll put the u-40 in the supply thread.
 
Roberta and Chloe said:
Thank you. Veterinary Specialty is the one I've used for Chloe's DKAs and every time I went there, the previous vet I had seen and liked was gone. I like Dr. Upchurch because she answers my emails and phone calls promptly. She wants me to send her a copy of Chloe's chart for November which I will send now that I fixed it. I will also check out Dr. Weintraub. I also like Dr. Upchurch because she always has cats and kittens in the lobby that she adopts out.
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I’m not saying she’s not a good vet. I’m just saying, like many vets, her knowledge of FD seems limited. My philosophy is to get a great vet that you like and is open to you using FDMB for dosing advice. If it were me, and I really liked her as you seem to, I wouldn’t switch vets. I’d just let her know you are using FDMB for dosing advice. She can join here if she wishes to. We’ve had many vets over the years.
 
Marje and Gracie said:
I’m not saying she’s not a good vet. I’m just saying, like many vets, her knowledge of FD seems limited. My philosophy is to get a great vet that you like and is open to you using FDMB for dosing advice. If it were me, and I really liked her as you seem to, I wouldn’t switch vets. I’d just let her know you are using FDMB for dosing advice. She can join here if she wishes to. We’ve had many vets over the years.
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I don't want to mention FDMB, because last time I told her about this site, she said that you had caused Chloe's DKAs. I will however ask her if she ever had a diabetic cat. I vaguely recall that she had told me this once, but I'm not sure. I've been emailing her copies of Chloe's spreadsheets and she said that Chloe just isn't a cat who can ever be regulated. She's known Chloe for over 2 years now and I worry about taking her to a new vet at this point. I will just discreetly try to find out how much experience she's had with diabetic cats. I do remember that when I first took Chloe to her, Chloe had been on Prozinc and Dr. Upchurch changed her to Lantus. She also has very good ratings on Yelp.
Also, when it came down to it, her advice yesterday worked.
 
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