4/26 - Pagan - AMPS 429, Dosing advice?

[Liadh & Pagan]

Happy Monday, LL!

I just spoke with my vet, and she'd like to keep Pagan on 2u BID for another month or so. I wanted to see what our resident experts would recommend, given his weekend numbers. My concern is that he's probably dropping into the green on a regular basis, when I can't be around due to work.

Here's his Saturday Condo and Sunday Condo. His spreadsheet is up-to-date as well.

Thanks in advance!

 

[Sienne and Gabby (GA)]

As a general comment, we don't usually have a kitty on the same dose for that long a period of time unless the cat is very tightly regulated. I do suspect that you are correct, that Pagan is seeing some green numbers at mid-cycle. It may not be an every day occurrence since it also looks like Pagan is bouncing.

With a newly diagnosed cat, there are often dose adjustments that need to be made on a relatively frequent basis. Did your vet happen to explain what her rationale was for holding the dose this long? Many vets are not used to having people take a very active role in their cat's diabetes management. Likewise, they aren't used to having people who home test the way we do or that we can measure the kinds of micro-doses that we routinely measure. Perhaps her recommendation is based on her experience with people who do not home test. One thing you may want to consider is printing out the protocol that we use and bring it to your vet or e-mail it.

 

[Liadh & Pagan]

Hi Sienne,

Thanks for the thoughts.

The vet said that his Saturday numbers made her think we might want to drop him down to 1.5u, but that his Sunday numbers showed he was still pretty all over the place and we should try and stabilize him some more. I will definitely show her the protocol and discuss it with her. She is excited that I am willing and able to do curves at home, because I can get more numbers and more accurate numbers (she mentioned higher numbers at the vet due to stress). I'm not sure if she's all that used to it, however, or how many other patients are being hometested.

 

[Libby and Lucy]

that reminds me of a conversation I had with my vet while Lucy was on insulin. I was there for a different reason, but gave the vet Lucy's spreadsheet for her file. The vet looked at the spreadsheet and said "hmm, from these numbers I can't tell whether Lucy needs more insulin, or less." I replied "that's because the dose is just right for now." Then she wanted to do a fructosamine to find out if the dose was ok or not. I told her that I would be more than happy to do a fructosamine, if it would make her feel better, but since SHE was the one who needed the test to prove that the dose was ok, then she could pay for it. I didn't need to pay for it, because I didn't need the test. We didn't do the fructosamine. :lol: The vet did come to respect me and the work we do here, but it took a while.

Most vets are trying to keep the cats in the 200's pretty much 24/7. That's the safest place for them to be if the owner isn't testing. It's also about the lowest number some vets will ever see because they are always testing under vet stress.

I agree that 2 units is a good dose for Pagan for now, but I wouldn't even try to say for how long.