2/28 Charlie AMPS 252, +2 166, +4 189, +6 194, +8 214, +10 269, PMPS 291

Charlie'sMom22

Charlie'sMom22

Active Member
Previous post

Does anyone have any advice on how to politely tell my vet I'm using the SLGS protocol and I'm not going with her recommendations? Should I do a longer post in the main forum about this?
 
This is the best place to talk about Lantus dosing.

We call SLGS a dosing method, not a protocol. SLGS is not a protocol, as it's not a published peer reviewed dosing method like TR is. However, it has been around here for decades and there is lots of experience here with it.

Does your vet have access to your spreadsheet or expect to see copies of it periodically?
 
Wendy&Neko said:
This is the best place to talk about Lantus dosing.

We call SLGS a dosing method, not a protocol. SLGS is not a protocol, as it's not a published peer reviewed dosing method like TR is. However, it has been around here for decades and there is lots of experience here with it.

Does your vet have access to your spreadsheet or expect to see copies of it periodically?
Click to expand...


Ah, okay gotcha. Thanks! Yes, she has access to my spreadsheet--I sent it to her the other day and she recommended a dose increase of 1u BID, which I thought was too much (you may remember my thread about that). She also wants to put a libre on in a week which I don't think I want to do either--Charlie is terrified of the vet and he has some trauma with being shaved. Last time we were there we had to rush out because he started hyperventilating. I'm hoping to push back on her suggestions without offending her.
 
I do remember your previous thread.

You know your cat best, you are with him all the time. You are also doing a great job with manual BG testing, so I'm not sure a Libre would give you a lot more data. Except in the wee hours of the night. But as long as you are getting that before bed test, you can tell if he's diving over night. As you can see today, if the +2 is quite a bit lower than the preshot, then it's a good indicator of quite an active cycle that should get more testing. Regarding what to say about the Libre, I'd ask that vet how doing that would change what you do. I used that technique a lot with my vet - how would doing procedure X change what I was doing already?

I think the Libre is great for people who cannot do BG tests (fractious cats, mobility issue as examples) or for petsitters. But even then BG tests are strongly recommended in lower numbers.

As far as not increasing by a unit, you can tell the vet you felt uncomfortable increasing by that much, and want to take a slower approach to increases to start out. At this point, Charlie's body is getting adjusted to the injected insulin, and you are still getting used to how Charlie uses the insulin and his responses to food. Lots to learn in the beginning. You don't need to add managing lower numbers into the mix right away. Of course we will help you should the numbers go low.
 
Wendy&Neko said:
I do remember your previous thread.

You know your cat best, you are with him all the time. You are also doing a great job with manual BG testing, so I'm not sure a Libre would give you a lot more data. Except in the wee hours of the night. But as long as you are getting that before bed test, you can tell if he's diving over night. As you can see today, if the +2 is quite a bit lower than the preshot, then it's a good indicator of quite an active cycle that should get more testing. Regarding what to say about the Libre, I'd ask that vet how doing that would change what you do. I used that technique a lot with my vet - how would doing procedure X change what I was doing already?

I think the Libre is great for people who cannot do BG tests (fractious cats, mobility issue as examples) or for petsitters. But even then BG tests are strongly recommended in lower numbers.

As far as not increasing by a unit, you can tell the vet you felt uncomfortable increasing by that much, and want to take a slower approach to increases to start out. At this point, Charlie's body is getting adjusted to the injected insulin, and you are still getting used to how Charlie uses the insulin and his responses to food. Lots to learn in the beginning. You don't need to add managing lower numbers into the mix right away. Of course we will help you should the numbers go low.
Click to expand...


Thank you so much Wendy, this is incredibly helpful. I would be so lost without all of you amazing people here. :bighug::bighug::bighug:
 
Oh wow Charlie is such a beautiful, fluffy boy!! You are doing an awesome job with all the testing!

Wendy’s advice is spot on. I have seen with my Bell and many other cats here that a 0.25 unit increase can be night and day in terms of their BG levels. A 1 unit increase carries the risk that one of those “in-between” doses is Charlie’s breakthrough point and you sail right past it.

I had a lot of stress early on with my vet where I wasn’t comfortable with what she was recommending. I didn’t want to just ignore the advice without addressing it, so I would write my thoughts and concerns to my vet through their portal (not sure if you have something like that with your vet). That allowed me time to collect my thoughts and send over some scientific research that backed my point of view. I was extremely careful not to come across as knowing more than the vet, but I was pretty forceful in areas I felt I needed to protect Bell.

I was fortunate in that my vet took the time to listen to these concerns and eventually understood that I had Bell’s safety in mind. I don’t think many vets are used to folks being proactive about feline diabetes. They struggle to even get caretakers to commit to giving insulin shots.

I really hope the vet stress resolves for you soon, you don’t need any additional stress right now :bighug:. You’re doing great! Give Charlie a good fur ruffle for me :D
 
bluesunshine said:
Oh wow Charlie is such a beautiful, fluffy boy!! You are doing an awesome job with all the testing!

Wendy’s advice is spot on. I have seen with my Bell and many other cats here that a 0.25 unit increase can be night and day in terms of their BG levels. A 1 unit increase carries the risk that one of those “in-between” doses is Charlie’s breakthrough point and you sail right past it.

I had a lot of stress early on with my vet where I wasn’t comfortable with what she was recommending. I didn’t want to just ignore the advice without addressing it, so I would write my thoughts and concerns to my vet through their portal (not sure if you have something like that with your vet). That allowed me time to collect my thoughts and send over some scientific research that backed my point of view. I was extremely careful not to come across as knowing more than the vet, but I was pretty forceful in areas I felt I needed to protect Bell.

I was fortunate in that my vet took the time to listen to these concerns and eventually understood that I had Bell’s safety in mind. I don’t think many vets are used to folks being proactive about feline diabetes. They struggle to even get caretakers to commit to giving insulin shots.

I really hope the vet stress resolves for you soon, you don’t need any additional stress right now :bighug:. You’re doing great! Give Charlie a good fur ruffle for me :D
Click to expand...


Thank you so much, this is really helpful too. I'm planning to sit down and write out an email this weekend. They don't have a portal but I can email her vet tech and they'll show it to her. Did your relationship with your vet improve over time? Or at least get less stressful? Right now this is such a cloud over my head--I have a super stressful job that requires a lot of diplomacy and walking on eggshells with sensitive stakeholders--It'd be nice to have a break from that in my personal life!! :facepalm:

I'll give him TWO fur ruffles for you:cat:
 
Yeah it is a lot better! Some of the stress might have been in my head, but not knowing how my vet would react to my differing opinions combined with the stress of being new to feline diabetes was a lot.

My vet now basically lets me do my thing with Bell’s insulin. Bell recently tested positive for IAA and my vet said that if anyone had to deal with IAA, she was glad it was me. I’ll take that as a compliment :p

I hope your vet considers your concerns and your point of view. I do think most vets are just happy to have a caretaker who is proactive about FD, there just needs to be some trust built up at the beginning. :bighug::bighug:
 
bluesunshine said:
Yeah it is a lot better! Some of the stress might have been in my head, but not knowing how my vet would react to my differing opinions combined with the stress of being new to feline diabetes was a lot.

My vet now basically lets me do my thing with Bell’s insulin. Bell recently tested positive for IAA and my vet said that if anyone had to deal with IAA, she was glad it was me. I’ll take that as a compliment :p

I hope your vet considers your concerns and your point of view. I do think most vets are just happy to have a caretaker who is proactive about FD, there just needs to be some trust built up at the beginning. :bighug::bighug:
Click to expand...

I'm sorry to hear about her diagnosis :bighug: I'm glad your vet has learned to trust you though! I hope I can get there too. Thank you for the encouragement :cat:
 
You must log in or register to reply here.
Back
Top