3/20 Blackie AMPS 548, +3 510, +6 476, +9 486, PMPS 457

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Ele & Blackie (GA)

Ele & Blackie (GA)

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We started Lantus last night 1 unit on a pmps of 338. +3 was 381. Blackie has only had numbers in the 500's twice before - I'm trying not to panic. We gave 1 unit this am.

WCR: Blackie was hungry for breakfast and is acting his normal self.

Our first post: viewtopic.php?f=9&t=9636
 
Re: 3/20 Blackie +7 456, AMPS 548

Hi Ele, Don't panic! The dosing experts will be along soon to give advice. Keep in mind that Lantus takes a few days to "build the shed" (the insulin-storage depot under the skin) and that until this storage shed is built, the insulin you are giving now is largely being used to build it. It may well be that your dose is too low, but the experienced people will be able to tell you that. Just to be safe, you should test for ketones, since the amount of insulin you are giving now is not as much as previously on PZI Vet. As long as Blackie is acting normally, however, he should be fine.
You and Blackie have a good day.
Ella & Stu
 
Re: 3/20 Blackie +7 456, AMPS 548

Hi Ele! Welcome to you and Blackie! :YMHUG:
I know its hard to be patient, but give it a few more cycles and hopefully you will see the numbers go down a little bit - then adjust the dose from there.

Hang in there!
 
Re: 3/20 Blackie +7 456, AMPS 548

No cause for panic. Ella is correct on all counts. I've asked a couple of people to stop by so we can think about dose. I believe you said yesterday that you were hoping your starting dose would be higher. While I've got to say that your vet is good from the standpoint that we often see kitties who are on whopping amounts of insulin and we have to then drop doses because the increases were too aggressive, your vet is being conservative. It's a balancing act because you don't want to start too high or increase so aggressively that an ideal dose is missed. That said, it may be that a little more insulin may be needed. We'll get a few more experienced people coming by and get a consensus.
 
Re: 3/20 Blackie +7 456, AMPS 548, +3 510

No need to panic! Lantus takes a few days to settle into the system.... consider this 'frustration day 1". :lol: Just keep an eye on the invited party guests (ketones) to make sure they don't show up and crash the place. All is good.
 
Re: 3/20 Blackie +7 456, AMPS 548, +3 510, +6 476

Do I really need to do checks every 3 hours when he is so high? I'm home and can do them, I just don't know what they're telling me on day 1.
 
Re: 3/20 Blackie +7 456, AMPS 548, +3 510, +6 476

It will likely tell you nothing on day 1. IMO no need for a poke fest.
 
Re: 3/20 Blackie +7 456, AMPS 548, +3 510, +6 476

I wouldn't worry about testing too much while he's this high. It's just going to worry you.

If Blackie stays this high, then let's not leave him at this dose long. 2-3 days tops, ok?

Here's what the protocol says (in the starting dose section):

"Cats that have a tendency to get ketones and/or who are getting relatively high flat curves after the switch should have their dose raised earlier (after 24-48 hours)."

Essentially this would mean that we set Blackie's starting dose too low, so we can adjust sooner than usual. Let's see where he goes today, but I don't want him in the 500's for more than a day or two. Keep checking for ketones.
 
Re: 3/20 Blackie +7 456, AMPS 548, +3 510, +6 476

Thanks, Libby. That makes me feel better. I haven't been able to catch him peeing, but I'm sure I will sometime today. If increase tomorrow morning, do I go up .5 to 1.5 units or all the way to 2 units. I don't want to miss his dose, but I don't want him so high for very long.

Thank you to all of you for your advice and support.
 
Re: 3/20 Blackie +7 456, AMPS 548, +3 510, +6 476

I would go up by 0.5 units, but then do it again in another 2 days if needed. Keep posting every day, we'll help. :smile:
 
Re: 3/20 Blackie +7 456, AMPS 548, +3 510, +6 476

Hi Ele! Just wanted to say I know how worrisome it can be when Blackie is in higher numbers than you are used to seeing. Just as the others have said, it's a waiting game. His numbers WILL come down, and you will get a good dose figured out. I remember well how frustrating it is, but I know you can hang in there and wait it out. :)
 
Re: 3/20 Blackie +7 456, AMPS 548, +3 510, +6 476

See, told you that you would receive excellent advice, especially about the dose.

As Libby and Sienne pointed out - when changing insulins starting dose can be different from the protocol of a new cat getting insulin for the first time. Personally, I'm not up on the protocol (switching insulin) so I didn't want to suggest a starting dose yesterday.

While you hate seeing him this high, just give him time to get the lantus built up in him and hopefully you will see these numbers drop and stay at a much lower range.

Remember Lantus is a human insulin and a lot of what you may (the label) and hear is based on how a human would it, not a cat. While technically it doesn't need to be fridged, in order to get the longer shelf life out of it, we recommend fridge. Also, my mom uses lantus and keeps it in fridge too.

Again, welcome and I'll be popping in now and again just to see how Blackie's doing.
 
Re: 3/20 Blackie +7 456, AMPS 548, +3 510, +6 476, +9 486

I just checked ketones - negative. (sigh of relief) He seems to feel fine so we'll stick to the 1 unit for tonight and see how he does. I can't thank you all enough for being here.
 
Pmps was better, but I might have done a fur shot. I'm not sure - I didn't feel wet or stinky fur after, but it felt like the plunger was already down when I pushed it. I am definately climbing the learning curve.
 
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