3/26 Mim: Dose Advice Please

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Andrew and Mim

Andrew and Mim

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I'm wondering if AM shot & PM shot have to be the same dose - for example, if PMPS tends to be higher than AMPS, can a higher dose be administered in the mornings? (eg. 0.8IU AM & 0.7IU PM). I do think Mim needs an increase overall, but I've noted the AMPS & PMPS numbers can, at times, be quite different.

The latest suggestion from the specialist re Mim's leg problem is a consultation with an orthopedic surgeon. Following this, further x-rays and MRI maybe required. Depending on the results, more testing maybe necessary including spinal tap, blood tests etc. I'm not sure what to do, although I think the consultation would be worthwhile. Apart from the costs (up to $3000) of all the potential investigation, there is no guarantee of a solid diagnosis. If a cause is found, then there is the cost of whatever treatment is necessary. All of this would obviously cause Mim stress and, given he seems to be coping and is pretty happy atm, I'm unsure if I want to put him through it all :? It's so hard seeing him struggle with walking etc. but I somehow need to try to distinguish my discomfort from his!
 
Re: 3/26 Mim: General Dosing Question / Legs Update

I know others have asked about different doses for am and pm and I believe the simple answer is no - not a good idea - remember Lantus likes consistency and if you change doses for each cycle, you aren't being consistent. also doses aren't based off the am pm ps - rather it's based off the nadir (lowest point ) in the cycle.

If an increase is needed, then that is what you need to do, don't toy with the different doses/cycles.

I hear you about the procedures for Mim. I think a consult is a good idea, xray and even mri - as those are non-invasive procedures. spinal tap and other invasive and painful procedures, personally I would question - what is it going to tell me? will it fix the problem or create new ones or more questions and no answers?

I'll tell you my Buster story that may help - around age 3 she started to have epilipitec seizures. Took her to the vet and a specialist - they wanted to spinal tap, cut into her brain and all kinds of other things -

why I ask - to see what's going on and if she has a brain tumor or not.
And if she does - well, he says, it all depends, surgery, chemo or nothing could be done

so, you want to open my cat's brain and look around to see if she has a tumor and if she does then her time is limited and what dangers are there by doing this? - well, she could die on the table, she could seize and not come out of it, she could well.....and they stopped.

So, I told them no thanks, I'll take my cat home and deal with this. I couldn't imagine doing that to my cat, putting her through that, without any guarantees or solving the problem.

She continues to have intermittent seizures, but when it's done, she come out of it and is fine.

the question to you - becomes quality of life and what's in Mim's best interest. personally, I'd get the consult, the mri if it will lead to answers and then go from there.
 
Re: 3/26 Mim: General Dosing Question / Legs Update

My Bailey get about 2.5 units Lantus AM and 3.5 PM. He dose better on the different doses than when he had the same doses.

fixed typo 2.5 AM an 3.5 PM
 
Re: 3/26 Mim: General Dosing Question / Legs Update

Larry and Kitties said:
My Bailey get about 2.5 units Lantus AM and 2.5 PM. He dose better on the different doses than when he had the same doses.
Click to expand...
Sorry? I don't see a difference between 2.5 and 2.5... typo, maybe? :-D
 
Re: 3/26 Mim: General Dosing Question / Legs Update

Hillary & Maui said:
I know others have asked about different doses for am and pm and I believe the simple answer is no - not a good idea - remember Lantus likes consistency and if you change doses for each cycle, you aren't being consistent. also doses aren't based off the am pm ps - rather it's based off the nadir (lowest point ) in the cycle.

Oh yeah, I did actually know that......brain fade :mrgreen:

I hear you about the procedures for Mim. I think a consult is a good idea, xray and even mri - as those are non-invasive procedures. spinal tap and other invasive and painful procedures, personally I would question - what is it going to tell me? will it fix the problem or create new ones or more questions and no answers?I'm thinking along the same lines - even wondering about the x-rays/mri as it would require general anesthetic.

I'll tell you my Buster story that may help - around age 3 she started to have epilipitec seizures. Took her to the vet and a specialist - they wanted to spinal tap, cut into her brain and all kinds of other things -

why I ask - to see what's going on and if she has a brain tumor or not.
And if she does - well, he says, it all depends, surgery, chemo or nothing could be done

so, you want to open my cat's brain and look around to see if she has a tumor and if she does then her time is limited and what dangers are there by doing this? - well, she could die on the table, she could seize and not come out of it, she could well.....and they stopped.

So, I told them no thanks, I'll take my cat home and deal with this. I couldn't imagine doing that to my cat, putting her through that, without any guarantees or solving the problem.

She continues to have intermittent seizures, but when it's done, she come out of it and is fine. I hear you loud & clear! I think sometimes the "solution" can be worse than the problem. I had a Dobie who started having seizures late in life - SO hard to watch! And again,the challenge is differentiating between our pain & suffering and the animal's.

the question to you - becomes quality of life and what's in Mim's best interest. personally, I'd get the consult, the mri if it will lead to answers and then go from there.
Click to expand...
 
Re: 3/26 Mim AMPS 277,+2~254,+4~94,+6~79

Todays' numbers look weird to me! I know my spot checks have been a bit sparse, but could this be rebound? I was thinking of an increase but now I'm hesitant.
 
Just looked at the ss. It's interesting that you are getting action at this dose and last night (morning)? shows that. What are you thinking of increasing to?

Since you aren't getting morning or is that evening checks in, it's hard to know what's going on during those cycles. Now that the weekend is upon can you get some of those checks in and let's see what's happening.

I would say (and remember, I'm not an expert here), if you wanted to fatten the dose just a wee bit (that's a technical term) that might force more greens your way and keep him out of the yellow.

However, without knowing what the 2nd daily cycle is doing, he may be going green on his own and doesn't really need an increase, even if it's slight.

But, who's to say if you find it hard to see through that magnifying glass and give that wee bit more I mentioned.

Didn't realize the MRI required anesthesia - we haven't had MRI's done here, so I didn't know...that is something else to think about - because anesthesia brings on it's own set of concerns and you need to know what they are going to use, etc. one brand of anesthesia was recently recalled.

go for the consult - talking with someone who hopefully has more specialization/expertise in this area may be beneficial and then you can decide what to do or not do after that.

Hey, love the new Mim pic!
 
Just wanted to chime in with my opinion on differing the AM and PM dose. As consistent as possible is what I like. In reality, there can be minor differences in the dose no matter what you do since the barrels of the syringes can vary but not much we can do about that.

That is a fantastic photo of Mim. What a beautiful cat.

I'm sorry you are up against such an intense health situation with Mim. We will be sending snowflakes/vibes/prayers that the answers you need come to you.
I'm wondering if JoJo might be a good person to ask about this situation.

I'm curious to see Larry and Kitties spreadsheet is there a link to it?
 
Hellow there Andrew. I glad they are continuing to try and come up with the true cause of Mim's leg issue.

As far as the dose......it looks like with the most spot checks over the last couple of days you could be seeing a little rebound. However he is clearing is fast. Would it be possible for you to get a before bed check in the PM cycle (like a +5 or +6)? From 3/23 - 3/25 you only got AMPS and PMPS and he might have had some green then which is what could lead to the yellow PMPS numbers. I am no expert here but I would hold off on increasing his dose right now. You got some very good green surfing during todays cycle. Increasing could cause him to drop too low or cause more reboud (remember even a drop can make a difference).

Call me crazy but I would maybe even decrease by one drop to see if he doesn't bounce to much. Yes call me crazy ok? :lol: :lol: But again, I am not an expert by any means. I would wait to see if the other more experienced peeps could come along. :mrgreen:
 
My 2 cents:

I suspect there are some people who give different doses at AM and PM. The conventional wisdom is that the dose should be as consistent as possible. From a theoretical standpoint, I can see how constantly shifting AM and PM amounts would have an effect on the shed. I've never seen a SS though where the dosing has fluctuated. If you're considering different doses at AM and PM based on the 3 yellows at PM recently, I'd say wait. Those are 3 days out of many. Further, and I know you know this, Lantus dosing is not based on the pre-shot number. You would need considerably more mid-cycle tests to build an argument as to why the doses need to be different.
 
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