? 2/21 Alphyne 195 PMPS - partial dose when shooting under 200?

[bobjoh]

Hello!

My girl, Alphyne, has had some weird numbers lately. She's typically in the 300s, but spiked to 400+ yesterday PMPS, and then tonight PMPS was at 195. My vet said not to shoot under 200, but per some other advice I received from this group, that may not be the best course of action. I shot tonight, but I lowered the dose to 1.5U (she's normally at 2.25U).

I'm hoping that was ok, and I will monitor her throughout the evening.

I asked my vet about when to shoot and not to shoot for both of my girls, and she sent me a 21-page veterinary paper outlining the protocol she's following, but never did really answer me as to when to shoot or not. She's been pretty adamant not to shoot under 200 any other time I've contacted her.

Based on the curves we've done, and the nadirs, my vet did not increase any dosing recently. We've been on Lantus for almost a month for both cats.

In any case, what are the thoughts on shooting under 200? I know I need to get over my fear of it, and I felt better giving a partial dose, but I'm hoping I did not mess anything up? I'm not really getting the clarity I need from the vet, so looking for advice from the experts here, which have given me wonderful advice so far!

Thank you!

 

[bobjoh]

Note: +3, and she's at 383; chances are good she wont have a hypo. I did test the 195 twice, so it was a valid number.

 

[Wendy&Neko]

Awesome preshot number!

A partial dose is one strategy when you get a preshot below 200. Another technique that might have worked today is to wait 15-30 minutes without feeding (called a stall), then test again to see if they've come up. At least tonight she would have been over 200. And eventually, as you gather data on your girl, you can lower your preshot number where you feel comfortable shooting full dose. The no shot under 200 is for new people.

With SLGS, you hold a dose for a week, then do a curve, and if you aren't seeing nadirs between 90 and 149, you increase. Looks like she's due for an increase to 2.5 units.

 

[bobjoh]

That's what I tried to tell my vet, about the increase, but she's fighting me on everything. She even fought me on doing the latest curve; told me I only needed to do one every 2 months. I have no idea why. (The 21-page paper she sent me even says 7-14 days.) She doesn't want to do anything until we do their fructosamine again, on March 4. I know I can do the increase without the vet approval, but I feel like if something goes south, I'm going to be guilted into feeling terrible. (Which is odd, because I love my vet!) She hasn't suggested a dose change for Gryphen, either, and based on her numbers that may also be due.

I'll keep pushing her.

Thank you SO MUCH for responding!!

 

[Wendy&Neko]

Whether you decide to listen to your vet on dosing, or learn how to do it yourself with our help, is a personal decision. I was lucky that a locum vet pointed me here and said "follow what they say", once we switched to Lantus. Though he did start me on too low a dose. I started out double checking with my vet, but either she was too busy to get back to me or answers weren't timely, so I decided to go my own. I gave her a copy of the dosing method I was following and gave weekly updates of the spreadsheet, for a while and she was happy with that.

Frankly, I don't know why vets say not to test. Especially if the client is willing to do so. The number of emergencies we get from new people landing here when their cat is hypoing is reason enough to test.

 

[bobjoh]

She told me she didn't have much experience with Lantus which is why I'm always checking here. Unfortunately, she also works only part time. I can contact her outside of working hours, and she normally responds, but not always. Dosing isn't really something that can 'wait', and me interpreting veterinary documents is iffy at best.