12/12/18 Ginger, PMP 107 ?

Hi. I’m don’t know how you are dosing. From looking at your spreadsheet you aren’t following either protocol we use here. You test a lot so I suggest you read TR and consider following it. You are jumping around in dosing and lantus does best with consistency. We increase and decrease in .25 increments based upon nadir rather than preshot numbers. Preshot numbers let us know whether it’s safe to shoot. I suspect Ginger’s numbers are bouncing around because you keep changing the dose. As long as you can monitor most willshoot anything over 50 and definitely 100. Next time that happens list and there’s usually someoyaround tostick with you and help guide you after you shoot a lower number than you are comfortable shooting. Keep in mind normal bg is 50-120 on a human meter.
 
Hi. I’m don’t know how you are dosing. From looking at your spreadsheet you aren’t following either protocol we use here. You test a lot so I suggest you read TR and consider following it. You are jumping around in dosing and lantus does best with consistency. We increase and decrease in .25 increments based upon nadir rather than preshot numbers. Preshot numbers let us know whether it’s safe to shoot. I suspect Ginger’s numbers are bouncing around because you keep changing the dose. As long as you can monitor most willshoot anything over 50 and definitely 100. Next time that happens list and there’s usually someoyaround tostick with you and help guide you after you shoot a lower number than you are comfortable shooting. Keep in mind normal bg is 50-120 on a human meter.

I have been on a feline diabetes group on FB and apparently they advise differently than they do here. When Ginger was switched to Lantus, our vet started her at 3 units twice daily, as she was on on that dose of NPH and her numbers were high. The FB group believed her dose was too high and told me to lower it to one unit twice daily for 6 shots, and then raise it to 2 for 6 shots and then add a half unit every six shots until her numbers improved. At 3.5 they thought it was too high and told me to reduce to 3.25 which I did. However, when her numbers were lower, they recommended a " token dose" like 1 .5 or .5, so she didn't go too low. Meanwhile my vet thinks I should raise her to 4 units.

Just yesterday one of the advisors on the FB board said I should put her back to 1.5 and leave her there. At this point I'm so confused and I'm thinking I should have stayed with my vet's advise. As for testing, I test before each shot, and do spot checks as well as curves on occasion. Also, if her numbers are low I check them to make sure she doesn't go too low. I've been told on the FB group how great Lantus is, but so far I'm not impressed. It stings her when I inject her. They told me NPH was horrible, but the truth is she did much better on that - even went into remission at one point. I'm thinking of asking the vet about switching her to Levemir. At least that shouldn't hurt her when I give her shot.

Thanks for answering me. To be honest, I don't find this board easy to participate in, so it was nice having someone answer me. Haven't had many people respond to my posts here.
 
I'm sorry you haven't had the feedback here that you were seeking. It's a large, busy forum and because of that posters are asked to start a new thread daily with a particular format (AMPS followed by other BGs during the cycle as the thread title - have a look at the thread titles here) so that you don't get lost in the sea of posts. It takes a little time to get used to this but will be worth it in getting attention from experienced Lantus users.

We on FDMB know that there are other groups who dose Lantus differently and are successful doing it. However, here on FDMB consistency rules and the clear guidelines in SLGS and TR have helped many people to get their kitty into good control if not remission. In my opinion it's best to stick to one methodology and try it out as it's intended to be used for a long enough time to clearly see the effect. I think you'll be very confused and won't have the best outcome if you compare FDMB "ways" with the FB group and others and/or try to mix different approaches.

I hope this helps. :)
 
Hi there. Sorry the responses are not what you thought they would be. I have checked out the FB group as well. I found the FDMB more to my way of doing this.

Kris is right, the FB group does things differently but I think the intent is the same. Those missed shots were advised for the safety of your kitty as you gather data and understand how Ginger does. We would of advised the same here.

I think you are getting some good movement on that 3.25u and that she is looking for another reduction soon down to 3.00u. I would not raise it to 4u. She is bouncing today from those blues you recorded yesterday and that needs time to clear. The protocols here help you decide if and when you go up in dose and when a reduction is earned - all guided by the BG's test results that Ginger has. Like the FB group but a little more detailed. Have you checked out the yellow sticky threads on the top of the forum yet? Don't want to beat you with information you may have already read.

Lantus can sting some kitties and I have heard that Levimar is better in that regard.
 
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I'm sorry you haven't had the feedback here that you were seeking. It's a large, busy forum and because of that posters are asked to start a new thread daily with a particular format (AMPS followed by other BGs during the cycle as the thread title - have a look at the thread titles here) so that you don't get lost in the sea of posts. It takes a little time to get used to this but will be worth it in getting attention from experienced Lantus users.



We on FDMB know that there are other groups who dose Lantus differently and are successful doing it. However, here on FDMB consistency rules and the clear guidelines in SLGS and TR have helped many people to get their kitty into good control if not remission. In my opinion it's best to stick to one methodology and try it out as it's intended to be used for a long enough time to clearly see the effect. I think you'll be very confused and won't have the best outcome if you compare FDMB "ways" with the FB group and others and/or try to mix different approaches.

I hope this helps. :)

Thank you. On this board what is the view on following our vet's advise? I was told on the FB group that my vet was "crazy and dangerous" . That bothered me a lot as he has been so good with our animals for years. It's hard to choose between the advice of your vet and people you don't know online. I think they despise vets on the other board.
 
Thank you. On this board what is the view on following our vet's advise? I was told on the FB group that my vet was "crazy and dangerous" . That bothered me a lot as he has been so good with our animals for years. It's hard to choose between the advice of your vet and people you don't know online. I think they despise vets on the other board.
I personally would never disparage vets. Like the rest of us they can differ in personality, conscientiousness and "people skills". Most do the absolute best they can do but are often limited in their experience with diabetic cats and as a result can have different views around feeding, dosing and monitoring than we have here. Some of those views, if followed, can lead a kitty into dangerous territory (no testing, doses that are too high or increases in whole unit increments, for example). It's a struggle for almost everyone who comes to FDMB to deviate from a trusted vet's advice. I was certainly one of those people. I spent 8 months at the beginning following my excellent vet's advice but got nowhere with Teasel and had no comprehension of why he was so very difficult to figure out. When I finally bit the bullet and came here, the magic combination of regular testing, keeping the spreadsheet and getting advice from experienced members opened the door wide for me. I'm very lucky in that my vet is willing to learn from me about managing diabetes in a complicated kitty. The rest, as they say, is history ... :)
 
I love my vet and was very reluctant to listen to advice here at first. My vet is very experienced and for the most part agreed with advice here. Maxwas complicated. My vetwas very impressed with what I learned here and eventually I controlled diabetes and my vet controlled most everything else. He even showed my spreadsheets to his students who spent a week shadowing him. I sent him the ss every couple of weeks. I became so impressed with this forum and the dedicated people here that I still help out even though Max has been gone for two years. Many others do the same. In your shoes I read all the yellow stickies and listened to my vet and the people here and did what I felt was best. Max was tightly controlled. JMHO.
 
On this board what is the view on following our vet's advise?

I found that due to all of Jones' issues, that it was a tough balancing act. She was surprised at the dedication I put into learning about not only his FD but his IBD as well. I did follow her instructions at first in regards to dose etc. but then came here. After following the advice and testing more, I found I saw a bigger picture and was able to daily monitor his situation with the experienced people here. My vet now works with me on this and says I know more than she does and the proof is in the pudding! He has been classed as tightly controlled/in remission since coming here (I still allowed her to run her tests to prove it). She is also very impressed with my spreadsheet. I love her and she has done great with my pets on so many hard medical concerns...I just found this board a little more versed in FD as they live it and breath it every day.

I don't think you just discount a vet's advice as diabetes can affect the system as a whole, that said, if there is a better approach for you to take and you feel good with that...than that is a your decision to make.

Just a final note...Jones' Internal Medicine vet once told me that medicine is not an exact science and sometimes, it is all guesswork. That was an eye opening statement for me. If they are a good vet...then they should be open to new approaches.
 
I personally would never disparage vets. Like the rest of us they can differ in personality, conscientiousness and "people skills". Most do the absolute best they can do but are often limited in their experience with diabetic cats and as a result can have different views around feeding, dosing and monitoring than we have here. Some of those views, if followed, can lead a kitty into dangerous territory (no testing, doses that are too high or increases in whole unit increments, for example). It's a struggle for almost everyone who comes to FDMB to deviate from a trusted vet's advice. I was certainly one of those people. I spent 8 months at the beginning following my excellent vet's advice but got nowhere with Teasel and had no comprehension of why he was so very difficult to figure out. When I finally bit the bullet and came here, the magic combination of regular testing, keeping the spreadsheet and getting advice from experienced members opened the door wide for me. I'm very lucky in that my vet is willing to learn from me about managing diabetes in a complicated kitty. The rest, as they say, is history ... :)
It is hard when you have a vet who has been exceptional and then you come online and people advise you not to listen to them! I'm sure you know how that feels. :) . Our vet was very open to my home testing Ginger as soon as I told him I am diabetic myself and wanted to do it. I got the impression that most people he encounters don't want to do the testing at home and are extremely reluctant to do the insulin shots. He seemed very happy that I was willing to test her at home. He even told me my meter might be better than the one they use. They gave me their info on doing curves and recommended I do them at home, as her numbers will be higher if they do them due to the stress of her being at the vet office. We think the world of our vet and would never cut him out of Ginger's treatment decisions.
 
It is hard when you have a vet who has been exceptional and then you come online and people advise you not to listen to them! I'm sure you know how that feels. :) . Our vet was very open to my home testing Ginger as soon as I told him I am diabetic myself and wanted to do it. I got the impression that most people he encounters don't want to do the testing at home and are extremely reluctant to do the insulin shots. He seemed very happy that I was willing to test her at home. He even told me my meter might be better than the one they use. They gave me their info on doing curves and recommended I do them at home, as her numbers will be higher if they do them due to the stress of her being at the vet office. We think the world of our vet and would never cut him out of Ginger's treatment decisions.
I totally understand this. My vet is great and has seen me through many kitty health issues over many years. When I had one of Teasel's siblings in a few months ago for an annual checkup my vet had a new vet to the practice shadowing her. Her comment to that new vet was that if she (new vet) wanted to know anything about feline diabetes I was the person to ask. :smuggrin:

My vet likes to work collaboratively with her clients and to the extent that they're willing and able let them participate in treatment decisions. She has said that many clients can't or won't do this but she recognizes that I'm very motivated, have made it a priority to learn a lot about FD and have a good understanding of everything involved. Periodically I give her an update on how Teasel's FD treatment is going. I handle his diabetes and she would be the go to person for anything else. It's a good balance. :)
 
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