1 October - Sam - AMPS 115, +3 87, + 7 99

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Djamila

Djamila

Member Since 2015
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Well, with more data, Sam's patterns do seem to be more or less the same as always, with an earlier nadir, however for the most part, he's looking flat since most of the tests are within meter variation of each other.

I'm thinking he needs a dose increase, but the last time he was at one unit he seemed so sick. Lethargic and didn't want to eat, play, or even get up really. When I lowered his dose (around 8/21), he had an immediate improvement in mood and energy. When I moved him to 0.75 about a week ago, he again went into a big energy slump, which is why I've held the dose this long, hoping he would improve. He seems like he's adjusted and is feeling better, but just in the past two days.

We talk a lot here about how our kitties are more than a number. So what do we do when the numbers could be better, but it makes the kitty feel worse? On Prozinc, he always seemed to feel his best in lower numbers (60's), so I'd really like to get him down lower, but worry that the increase in insulin will just make it worse.

So I guess I'm just nervous to do the increase because I don't want to make him feel bad again. :(
 
Normally I would guess that it was simply because the cat was not used to the lower BG numbers but I don't think that applies to Sam. He was in the same-ish numbers at .5U. Would it be so bad to hold this does a little longer? If he just started feeling better two days ago maybe give him a little more time to adjust? Then if you increase and give it a week and he still feels crappy then I would decrease. If he had an immediate improvement (on 8/21) that is a good thing so if you reduce again he should feel good quickly.

What about trying Lev? Could it simply be the insulin itself that is not agreeing with Sam? That might be a bigger undertaking than you would want to do because you would definitely have to monitor for any big changes and new patterns. At least in the beginning.

@Bobbie And Bubba , @Doodles & Karen , @Wendy&Neko , @Tuxedo Mom - Have some kitties just done better on different insulin's with regards to the way they feel? Not a numbers thing. I'm not sure with Sam as he's spent plenty of time in greens.
 
I would increase his dose. He looks good but his green numbers are in the high greens and he could look better. I forget, are you using calipers? The reason I ask, is to take consistency off the table. How is he other wise? All 5 P's in place? I think if it were me, I would take him up to a skinny 1 unit, just above the 1 unit line and see what that does.

Let's see what others think.

ETA: about the Lev..... I think I would increase first and see what happens. He is nadiring earlier and then going higher....... maybe Lev could flatten that out???? @Wendy&Neko and @Doodles & Karen could be more helpful with Lev.
 
Yes to the calipers. Yesterday and today all 5 P's are in place, but they haven't been. He pees and poops, but lost the playing, purring, and preening when I raised to 0.75u. It's taken about a week to get it back, and he's still only half-hearted in the playing. He was also hiding a lot the past week. That's why I haven't wanted to do the increase.

I have definitely though about Levemir. And also thought about going back to Prozinc. He's seemed a little off ever since the switch to Lantus, and even on a low dose, he always bites at the injection site which he never did on Prozinc. I've wanted to give it time to see if he just needs to adjust to a new insulin. But I think like anything, some things work for some cats, some things don't.

Going back would be the easiest choice because I know that insulin, and I know how he responds to it. But I've thought about Levemir too because the reason we switched from Prozinc was that I wanted a flatter cycle than I was getting. He's definitely flat on Lantus, but he's too high. So maybe third time's the charm on insulin, and we should give Lev a chance. Who knows?!?!
 
Djamila said:
Yes to the calipers. Yesterday and today all 5 P's are in place, but they haven't been. He pees and poops, but lost the playing, purring, and preening when I raised to 0.75u. It's taken about a week to get it back, and he's still only half-hearted in the playing. He was also hiding a lot the past week. That's why I haven't wanted to do the increase.

I have definitely though about Levemir. And also thought about going back to Prozinc. He's seemed a little off ever since the switch to Lantus, and even on a low dose, he always bites at the injection site which he never did on Prozinc. I've wanted to give it time to see if he just needs to adjust to a new insulin. But I think like anything, some things work for some cats, some things don't.

Going back would be the easiest choice because I know that insulin, and I know how he responds to it. But I've thought about Levemir too because the reason we switched from Prozinc was that I wanted a flatter cycle than I was getting. He's definitely flat on Lantus, but he's too high. So maybe third time's the charm on insulin, and we should give Lev a chance. Who knows?!?!
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I understand your reasoning. I don't know about the hiding and not engaging in the 5's P's when you raised the dose to .75. I will tell you this, when Bubba first started in all green numbers, he did not seem himself. Almost like normal numbers were too foreign to him. You need to be comfortable with your choice and if you switch insulin. But, that said, I would try a fattened dose first before you go on to another insulin.

And all that said, I am trusting that every thing else is fine with him, LB and eating?
 
Djamila said:
He's seemed a little off ever since the switch to Lantus, and even on a low dose, he always bites at the injection site which he never did on Prozinc.
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I've read Lantus is acidic. Not felt by kitties until high doses and some never notice. But if we revert back to ECID maybe Sam is sensitive to the acidity of Lantus, even at a low dose. Just thinking out loud but that tid-bit of info makes me feel even more strongly that Lev might be worth a try down the road.
 
Some kitties feel. The Lantus sting at smaller doses. Somewhere on the Think Tank forum is a post from people who switched from Lantus to Lev, and some cats did a personality change. Biting at the injection site is a concern.

Rather than increase the dose, I would do a bit more testing at odd times. There is no guarantee cats will nadir at the same time every day. 70's are not a bad place for a nadir, but I would want to make sure that's as low as this dose is taking him before increasing.
 
Thank you all for your thoughts on this. @Wendy&Neko, I just went and found the thread in Think Tank, and it made me cry to read it. I thought I must be crazy to think that he was reacting to Lantus, since it seems like so many people love it. But the posts there describe exactly what is going with Sam since the switch. I think reading that thread really answers my bigger question. It's not my imagination - this really isn't a good insulin for him.

I was thinking I would give it a bit longer before considering a switch, but I think I'll move up that timeline and put a call into the vet tomorrow.
 
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