2/10 Buzzy AMPS 335; 1U; +4 337; +8 327; PMPS 410; 1U FS? Bounce?

I’m sooo glad you’re going to 1u. Been worried for you and Buzzy. When you tell the vet the numbers you got over the weekend I hope they agree with your decision. Because reality is, the vets aren’t available (working) at the times we need to give insulin. You are about to find out a lot about your vet.
 
Thanks! I'm feeling better/safer too.
I've decided they don't have to agree with my decision lol. I mean you can't really argue with "my cat's blood sugar literally just kept dropping....and dropping."
But, truly, she did actually encourage me to home test -- so I think she will be understanding. She doesn't seem AS out of touch as some other vets even if her dosing was way off, which ... I just don't understand ... she seemed to have a lot of diabetic cat experience...
But, she's also a new-to-us vet; we just moved here in June. So, if I feel uncomfortable, we'll switch vets again even though this practice is well-reviewed.
 
I'm glad you're starting over! This is a much safer dose to begin with. Let's hope we see some better numbers as a result today - steady as she goes.

I understand you'd like to have a good relationship with your vet - I enjoy having a good relationship with my vets too (I have one in Michigan and one in Florida)...however I have to add, as I believe others said yesterday; we don't discuss her diabetes except for me to tell them that she IS diabetic and that I'm managing her diabetes - whatever else they have to say I respond with 'ok, thanks' and let it go. I do not engage in lengthy discussions about treating her diabetes. If they ask me a direct question like what kind of insulin she's on, etc. I will happily provide an answer - but I'm not there for diabetes treatment - I'm there for Luci's broken toe currently OR a dental evaluation OR wellness check, etc....but not for her diabetes. Many of us here understand that our vets simply do not have the knowledge/training to treat feline diabetes - so although you may want to call your vet and give her an update please don't expect to get much back in the way of advice, etc. I'll even send my vet Luc's SS if he wants to see it and typically he says, 'great job you're doing managing Luci's diabetes - wish we had more pet-parents like that'...

I'm just saying set your expectations for your vet to perhaps object to what you're doing and at best say how wonderful it is that you're trying to learn what to do and that you're taking on Buzzy's diabetic management to this extent.

Keep reading the information here - it's valuable and keep posting so we can help you along the way!

Have a wonderful day!
 
Sue - doesn't your vet have to prescribe the insulin though? I mean, I imagine if she didn't agree w/ my management, she could refuse to prescribe the insulin, and I'd be sorry out-of-luck...

Yeah I won't be looking for advice when I call her today. I'm going to tell her what I'm doing & ask to change this Friday's appointment to ONLY do the urine culture for this UTI. Then tell her I'd like to only do appointments to treat the UTI for now since I'm so closely monitoring the diabetes at home & see no point in her weekly fructosamine & spot bgc checks. But will, of course, keep her informed of dosage changes if she wants (the paperwork she gave me about adjusting dosage at home does ask to be kept updated).

I want a good-enough relationship w/ them bc whenever I adopt again, I'll need a vet reference lol.
 
toomanycats said:
Thanks! I'm feeling better/safer too.
I've decided they don't have to agree with my decision lol. I mean you can't really argue with "my cat's blood sugar literally just kept dropping....and dropping."
But, truly, she did actually encourage me to home test -- so I think she will be understanding. She doesn't seem AS out of touch as some other vets even if her dosing was way off, which ... I just don't understand ... she seemed to have a lot of diabetic cat experience...
But, she's also a new-to-us vet; we just moved here in June. So, if I feel uncomfortable, we'll switch vets again even though this practice is well-reviewed.
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She encouraged you to test !! That’s huge !
 
toomanycats said:
Sue - doesn't your vet have to prescribe the insulin though? I mean, I imagine if she didn't agree w/ my management, she could refuse to prescribe the insulin, and I'd be sorry out-of-luck...

Yeah I won't be looking for advice when I call her today. I'm going to tell her what I'm doing & ask to change this Friday's appointment to ONLY do the urine culture for this UTI. Then tell her I'd like to only do appointments to treat the UTI for now since I'm so closely monitoring the diabetes at home & see no point in her weekly fructosamine & spot bgc checks. But will, of course, keep her informed of dosage changes if she wants (the paperwork she gave me about adjusting dosage at home does ask to be kept updated).

I want a good-enough relationship w/ them bc whenever I adopt again, I'll need a vet reference lol.
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My vet did give me a prescription for insulin - the first vet gave me an Rx for Novalin - a quick acting insulin - never used that. 2nd vet gave me a prescription for Lantus which I had filled. Now I get my insulin from the Supply Closet as the insulin at all of the pharmacies, even Costco is exorbitantly expensive!

There is absolutely no reason for you to be paying for fructosamine tests or spot bgc checks at your vet since you're doing all that now at home with your testing...Neither of those tests will give you any information that you can't get yourself.

I hope your vet continues to be supportive and encouraging :)
 
I think we got lucky in that our pharmacy is willing to sell us a single Lantus pen at a time AND they applied a coupon/discount for uninsured patients....it was only $70 for the 3mL pen, which seems a good price to me?
In any case, I am hopeful that she'll just keep prescribing it and trust my testing! Will keep everyone updated :)
 
toomanycats said:
I think we got lucky in that our pharmacy is willing to sell us a single Lantus pen at a time AND they applied a coupon/discount for uninsured patients....it was only $70 for the 3mL pen, which seems a good price to me?
In any case, I am hopeful that she'll just keep prescribing it and trust my testing! Will keep everyone updated :)
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You may want to check the Supply Closet here on the FDMB for better prices for Lantus. I think that's terribly expensive myself. That's $350 for a box of 5 - I typically pay $150 for a box of 5...just sayin'...
 
I will definitely look - so, I want to make sure I understand expiration and such right - the pens are good until expiration as long as you haven't started using them? But then their life is shortened after you start drawing from them, right?
 
toomanycats said:
I will definitely look - so, I want to make sure I understand expiration and such right - the pens are good until expiration as long as you haven't started using them? But then their life is shortened after you start drawing from them, right?
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I have used a vial of Lantus for a full year - after I started using it. Kept in the refrigerator the entire time. (not in the door)...never frozen and never left out. It was effective to the last drop.

Since we're using it in smaller increments than humans, we don't use the manufacturers guidelines for exp dates, etc. I have used Lantus and Lev passed exp dates - as long as it's refrigerated I don't get too worked up about it. Often people say, 'well, my Lantus, etc. must be too old as my kitties numbers aren't what I'd hoped'..and just as often, I believe it's the kitties' numbers and not the insulin to blame - a little increase or patience and that insulin works just as good at the end of the vial/pen as it did in the beginning. I understand the only absolutes about insulin is that if it's frozen or heated (like left in a hot car)...which will basically negate the therapeutic value of the insulin - in either case it would have to be discarded.
 
When you go back to vet, before you say anything, get a written script for the insulin you are using IN your hand. Then send or hold onto it for a short time, then send to Marks in Canada. You won't ever need another script again (unless laws change). This way you will always have a place to purchase from.
 
Vet and I just spoke, and she's totally fine with me doing this on my own at home and just sending them pictures of his chart to keep them updated. She said if I even wanted to back him down to half a unit, that was fine (I don't; I think the 1 unit is a good starting point), but just recommended we stay at this dose for a number of days (oh I will) and collect data before adjusting. She agreed no need for fructosamine/spot checks or bringing him in for anything other than the UTI, so he'll go in for that urine culture Friday, but then we will save lots of $$$ not doing the weekly fructosamine/spot check thing, so that's a relief!
 
About to cry.
I'm afraid that I missed somehow both this AM and this PM...
I had to push a teeny bit of insulin out before injecting this PM & am not sure if that's the teeny bit of wetness I felt after shot or not... he moved when I was injecting, so that's why I'm suddenly not sure.
I really thought I got it in this AM, but he's just risen all day???
Really discouraged & afraid...and now need to figure out some way to capture urine and make sure it's his and not my other cat's...they are impossible to catch peeing
 
Marie&Leonard said:
Lantus smells terrible ! If you gave a fur shot i’m pretty sure you would know it.
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Well, I did smell a little bit of it, but the thing is, I pushed out literally one drop onto the needle before injecting, so not sure if I smelled that or if I gave a FS. I guess it kinda is what it is... like, can't redo it regardless.

Reading about bounces I'm wondering if that might be it, but, if so, how do you know? And, am I supposed to reduce further or just stay at 1U? Do I wait another day before determining if it's a bounce?
 
Might be part bounce, but more likely you are seeing the high numbers because of the skip last night. Lantus dose not last 24 hours in the cat. And bounces can last up to six cycles. Time to strap on some patience pants!

Stay the course at 1.0 unit. Might be a bit low - I saw Sandy's recommendation for 1.5 units on your previous post, but OK to start as long as you are testing daily for ketones while numbers are high.
 
I'd decided to do SLGS but starting at 1 instead of the 0.5 (I know, breaking rules already), which is why the 1 and not 1.5 (I won't be able to test during the day Tues, Wed, Thurs, so was afraid 1.5 would still be too high & I wouldn't catch it or even be here). If he stays high tomorrow (will only be able to test pre-shots though), I guess I'll be back asking if I should adjust dose...ugh. I feel like I'm totally destabilizing him :(

I'm trying to catch urine to test for ketones -- my mom suggested putting some seran wrap in his favorite pee corner of the box...but of course I need him to actually pee for this to work.
I'm so scared of ketoacidosis, bc we will not be able to pay to have him treated; we will basically have no choice but to let him go... and it will be my fault for lowering his dose too much and not trusting my vet and and and... there I go spinning...
 
It takes more than a couple days to build the depot, bounces take up to six cycles to resolve. So, time learn patience and hold the dose, unless you see ketones. Short term high numbers by the themselves are not dangerous. SLGS says to hold the dose for 7 days.

Hopefully he's eating well and hydrated.
 
He's definitely eating. And alert. Acting normal. And hopefully hydrated (I'll add a little extra water to his last wet food here in a bit to be sure). I'll hold the dose. It's not so much a patience problem as just fear of hurting him by doing the wrong thing & anxiety bc I feel like I don't know what I'm doing...of having already hurt him...of doing everything wrong & losing him & it being my fault :(
 
Been there done that, spun down the anxiety whirlpool several times.

Deep breaths, you are actively trying to help your cat with the best info you can gather, you are ahead of the game.

Keep him hydrated, keep him fed, and continue to love on him. A few extra days a little high well you figure things out is OK.
 
Astexcat said:
Been there done that, spun down the anxiety whirlpool several times.

Deep breaths, you are actively trying to help your cat with the best info you can gather, you are ahead of the game.

Keep him hydrated, keep him fed, and continue to love on him. A few extra days a little high well you figure things out is OK.
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Thank you.
This whole situation reeeeally activates my OCD.
I keep telling myself that I'm doing the best I can, and that's really all I can do. Buzzy's been with my my entire adult life -- since sophomore year of college! ...through every boyfriend, graduation, 7 moves, marriage, my daughter's birth, and soon my son's... it's a lot to think of something bad happening to him because of me making a mistake.
 
My anxiety feeds my OCD which sometimes triggers my anxiety, all of which is amplified by stress. I understand completely!
 
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