5/9 Annie PMPS 319, +2-281 - talked to vet finally

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RockStar033

RockStar033

Member Since 2012
Those must be her favourite colours. :YMSIGH:
I talked to my vet last night, he's like "well we will do some tweaking on the dose, my lesson is to not jump too fast since the body can take time to equilibrate" :lol: if only he knew i've already started that road. Thanks to everyone here. I go in at 5 today to meet with him.



Yesterdays Condo viewtopic.php?f=9&t=70554
 
Re: 5/9 Annie AMPS 356

Just a question.... how do you know she is in a bounce when her numbers are consistantly in the yellow/purple. last time we upped the dose her numbers were in that range as well. so it's possible for her to bounce more then once being on one dose? when we first upped the dose to 1.25u she bounced, but then she bounced again?

sorry, i've been staring at her spreadsheet trying to make sense of it and her numbers are just the majority of the time stuck in the yellow/purples with a couple blues.

What if she just keeps bouncing on this dose?
 
Re: 5/9 Annie AMPS 356, +2-335, +4-358

Just talked to my vet. Here's the story.

he wants me to change her dose to 2u am, and 1u pm because her amps is always so high and he thinks the 1u at night will help her amps be a bit lower. Now i know from this board that the BID doses should be the same but is it ok to have a different am and pm dose?

he also said i can reduce her prednisolone to 1.25mg... which is what i've been doing.

He also said her numbers may be staying high because she does need dental work.... and he said as soon as her dental is taken care of, her numbers will look better... but i can no way afford the dental right now :cry: i just can't. i'm tapped out.
And also, he said that he knows Prednilosone raises BG levels, at higher doses... he said the dose i'm giving her is too minimal to affect her BG's. but he said if i'm more comfortable reducing it, then to go ahead.

he also wants to do another PLI test to see how her pancreas is doing, and he wants to do a scope to check her stomach eventually because he wants to rule out stomach cancer(because she's been puking, and he has seen alot of cats come in with pancreatitis but along with that there was cancer present, so i guess from his experience), and he said once her numbers come lower, then her pancreatitis will reside, but on the flip side, once her pancreatitis is gone, her numbers will come down.

Wow!!

bye bye wedding :sad: :sad:

so for the dosing, should i do the 2u am and 1u pm? or just like 1.5 am and pm?
I really think she's ready for an increase, and i feel like for once... i should listen to him....... i'm so confused.
 
Re: 5/9 Annie AMPS 356, +2-335, +4-358 - talked to vet final

I know others will chime in soon but I would not do the two different doses. Lantus needs consistency.

Predisonal does raise the BG at any dose. Tarragon is on it every other day long term for his asthma and I have had to adjust his insulin for it. ECID (every cat is different) so. You will have to watch Annie and see how it affects her.
 
Re: 5/9 Annie AMPS 356, +2-335, +4-358 - talked to vet final

well see this is what i've learned from Lantus users.... same dose every 12 hours.... so i really don't get it.... but he only treats his feline diabetic patients with Lantus and said he's had tons of experience with Lantus.
 
Re: 5/9 Annie AMPS 356, +2-335, +4-358 - talked to vet final

Staring at spreadsheets is a good thing! (You can go cross eyed but it's a good thing!!)

I'm going to respectfully disagree with your vet. (And while he may have tons of experience with Lantus, how many of the cats he's treated have gone OTJ or are tightly regulated?) I'd try the 1.5u twice a day. Here's my thinking...

You're right -- Lantus likes consistency. One reason why shooting different amounts is often unsuccessful is that you keep "messing" with the insulin depot/shed. Every time you adjust a dose, the shed needs time to settle. If you dose different amounts at AM and PM, you never allow the shed to level off. As a result, overlap between doses is effected and you end up with very wonky numbers. Think of it as a swimming pool. You add water and there are ripples. As soon as the ripples subside, you take water away and there are then more ripples. You never let the pool reach an even level.

The other factor that isn't being taken into consideration is dawn phenomenon. In animals as well as people, our bodies begin to prepare for the stress of the day ahead. As a result, during the night, the body starts putting out a stress hormone (i.e., cortisol) to help the body prepare. This hormone is a naturally occurring steroid and the result is that AM numbers are often higher than PM numbers. As Annie gets better regulated, the AM numbers will come down.

Having her teeth cleaned can have a huge impact on numbers. Dental issues have been known to bring an OTJ cat back from the Falls.

Your vet wants to run an awful lot of expensive tests. You might ask to have the vet prioritize the tests and to give you an estimate. I'd be frank about the expense. There may be other practical ways of determining what's needed. For example, trying Annie on novel protein foods (e.g., duck or venison) to see if that stops the vomiting. Or eliminating beef and fish which some cats are allergic to. Trying a week of Pepsid may be a far less expensive intervention if the cause is due to acid stomach.
 
Re: 5/9 Annie AMPS 356, +2-335, +4-358 - talked to vet final

Thank you for the info... i knew some of what he was saying didn't seem right and that is why i'm so confused. I really think Annie has earned a 1.5 BID dose right now..,. i believe her recent numbers are just what they are, and i think she is going to stay in these yellow/purple numbers. I think i am going to go and do the 1.5 BID dose and hold that for a bit to see.

i mean i understand vets would be out of business if they didn't push these tests and procedures, so i understand why he does it, but he said to me today, if there's anything i don't want to do, i don't have to, he's here to work with me not against me... etc.
 
Re: 5/9 Annie AMPS 356, +2-335, +4-358 - talked to vet final

Excellent info from Sienne. The only thing I'd like to add is that your vet is talking about dosing based on preshots. We dose primarily on nadir with some consideration given to preshots.

From the modified protocol we use:
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Click to expand...

As an example, let's say kitty's nadir is 80 but her PS number is 200. If you give a higher dose because the PS is higher, the nadir will likely drop. But that "80" is a normal nadir and giving more insulin based on the PS could
drop the nadir below 50 mg/dl.

I know you like your vet and that's great. Perhaps this is an opportunity to give him some good information about dosing based on PSs and using the info Sienne gave you, why consistency is best.

Good luck with the dosecrease!
 
Re: 5/9 Annie AMPS 356, +2-335, +4-358 - talked to vet final

Yes, i read that about basing it on nadirs. makes total sense.

i really like my vet, and am totally comfortable talking to him about stuff, i've been honest with him about not following his advise and told him why, but he did not get mad, he just explains his reasoning.
 
Re: 5/9 Annie AMPS 356, +2-335, +4-358 - talked to vet final

question too about the nadirs.....

how do i know when a dose change is good because her nadirs are so up and down... will they level out more the closer i get?

sorry if that's a dumb question, i have a lot of jumble going on in my head right now..... :?
 
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