03/22 Furball, AMPS-253, PMPS=248

[carfurby (GA)]

Yesterday - viewtopic.php?f=9&t=66837

Help. I am getting frustrated with my vet right now. I just got off the phone with her and she didn't remember leaving a message on my answering machine this past Saturday telling me she thought we should lower Furball's insulin from 2 units to 1 unit. She told me today she wants to keep her on 2 units. I tried to explain about the storage shed, but she insisted with her recent numbers she wants her on 2 units. I think with today's reading, her glucose may finally be starting to come down.

Can you please give me your opinion on this? I don't want to give her too much and not be at home because I have to go to work and then she become hypoglycemic. Am I worrying too much? Thank for your advice.

 

[Sienne and Gabby (GA)]

Re: 03/22 Furball, AMPS-253

Personally, I'm in a quandary. It would really help if you could get some spot checks at night. Ideally, it is important to get at least one test during both the AM and PM cycle. Since you're not home during the day, it's doubly important to get tests in the PM and on the days you're not working. Lantus dosing is based on the lowest point in the cycle (nadir) not on your pre-shot value. If your vet is basing her input on the numbers you're giving her, I agree with you -- I would wait before increasing until you have some spot checks. In addition, we change doses in 0.25u increments. It's very easy to miss what would be a good dose by increasing/decreasing by a full unit.

You may want to share this article that was published in a leading veterinary journal with your vet:

 

[PeterDevonMocha]

Re: 03/22 Furball, AMPS-253

Hi guys .. I can't remember if I've ever posted in furball's condo or not, so welcome from us! I have to say Sienne gave you some good advice .. spot checks are so important, I really hope you can squeeze in a few .. have a great day!

 

[julie & punkin (ga)]

Re: 03/22 Furball, AMPS-253

:YMHUG: sienne's given you great advice!

seeing the nadir tells what needs to happen with the dose. lantus is different from other older insulins in that way. the decision on their doses was based upon the preshot number. so it's a different way of thinking.

 

[carfurby (GA)]

Furball's PMPS is 248. I really think my vet is crazy to up the dose, even based on these numbers. They are starting to come down. I will try to get another reading later this evening. I plan to try and get some in between readings on Saturday, including the +6. Is the nadir the +6 reading, the halfway point? Thanks for the help.

 

[Jill & Alex (GA)]

Furball's PMPS is 248. I really think my vet is crazy to up the dose, even based on these numbers. They are starting to come down. I will try to get another reading later this evening. I plan to try and get some in between readings on Saturday, including the +6. Is the nadir the +6 reading, the halfway point? Thanks for the help.

we won't know when furball nadirs until you can get some mid-cycle spot checks. some kitties reach their lowest point early, some mid-cycle, and others experience a late nadir. i'm glad you'll be able to begin to fill in the blanks this weekend. think of spot checks as pieces to a puzzle. the more pieces you have, the easier it is to see the whole picture. :mrgreen:

from the STICKY: LANTUS & LEVEMIR - NEW TO THE GROUP? PLEASE READ...

Learn how YOUR kitty is responding to insulin:
Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
Peak/Nadir - the lowest point in the cycle
Duration - the length of time insulin continues to lower blood glucose
How to do a Curve

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.


you might want to take a look at that sticky. there's lots of good info containing many clickable links.
hope this helps!