12/29 Walter AMPS 593 PMPS 527

I'm hoping some of the experts will stop by and advise you but from what I see it sounds like your vet is recommending that you change doses based on the current number? Or a preshot number?

I presume you know by now that we do not shoot based on pre-shot numbers but on the nadirs. Since you're following SLGS the recommendation is that you increase every 14 cycles - which in my estimation is too slow - however since you do not know what dose will be effective and you're following the slower method it's going to take you longer to increase to the numbers he's suggesting. If you want to switch to TR (no dry food, and a curve every 7 days) it would be more aggressive and you'd get him to higher doses with higher impact sooner.

The decision is yours as to which protocol you're following - the worry that I have is that he has a history of ketoacidosis and with these numbers I'd be working on the TR protocol as the danger exists of a repeat episode of DKA. Please re-review the stickie for TR and think about going in that direction. http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/
 
Sue and Luci said:
I'm hoping some of the experts will stop by and advise you but from what I see it sounds like your vet is recommending that you change doses based on the current number? Or a preshot number?

I presume you know by now that we do not shoot based on pre-shot numbers but on the nadirs. Since you're following SLGS the recommendation is that you increase every 14 cycles - which in my estimation is too slow - however since you do not know what dose will be effective and you're following the slower method it's going to take you longer to increase to the numbers he's suggesting. If you want to switch to TR (no dry food, and a curve every 7 days) it would be more aggressive and you'd get him to higher doses with higher impact sooner.

The decision is yours as to which protocol you're following - the worry that I have is that he has a history of ketoacidosis and with these numbers I'd be working on the TR protocol as the danger exists of a repeat episode of DKA. Please re-review the stickie for TR and think about going in that direction. http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/
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Hi Sue— his recommendation is based on the pre-shot number and we change each time based on the number. I agree about switching to TR— I don’t want a repeat of DKA. The good news is that Walter’s put on a little weight and all of his vitals are good.
Thanks for your advice.
 
carfurby said:
You don't want to make dose changes based on the pre-shot numbers. A lot of vets do that because they don't understand how Lantus works. Was yesterday Walter's vet visit? How did it go?
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Overall— the visit went well. He’s gained weight and seems to be fine except for the diabetes.
 
I'm glad the vet visit went well and he's gained some weight. It sounds like you just haven't found a good dose for Walter yet.
 
Zelda, I'm really glad to hear Walter's vet visit went well. I also agree with Sue and Carla, unfortunately your vet doesn't understand depot insulin.
Wishing you both a good day!
 
I moved to Tight Regulation protocol at the beginning of December because Freckles continued to stay in higher numbers, the insulin didn't seem to be having much affect on her numbers (but she has gained her weight back, and now no dandruff - so I know the insulin is affecting her positively, just not so much with her numbers yet.) SLGS meant that she stayed at these higher numbers longer, which wasn't helping her pancreas any. With TR we are able to increase her insulin at a quicker pace and thus find "her" dose more quickly. We are still looking to hit the 'right' dose, and we have confidence in the many members on this board and their experience to help guide us on her journey. I'm glad I switched to TR.
 
Judy and Freckles said:
I moved to Tight Regulation protocol at the beginning of December because Freckles continued to stay in higher numbers, the insulin didn't seem to be having much affect on her numbers (but she has gained her weight back, and now no dandruff - so I know the insulin is affecting her positively, just not so much with her numbers yet.) SLGS meant that she stayed at these higher numbers longer, which wasn't helping her pancreas any. With TR we are able to increase her insulin at a quicker pace and thus find "her" dose more quickly. We are still looking to hit the 'right' dose, and we have confidence in the many members on this board and their experience to help guide us on her journey. I'm glad I switched to TR.
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Thank you! I’m going to start TR tonight. I’m optimistic.
 
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