9/22 Sooty PMPS 301... Spreadsheet done...

Status
Not open for further replies.
Perry and Sooty

Perry and Sooty

Member Since 2010
Spreadsheet is now saved and published, I just hope the link in my sig will work...!

After working on this SS and seeing what a mess itr really is, I now clearly see that we have been very hit and miss as regards monitoring and decisions on dosage changes do not seem to have really had proper justifications other than spot checks or the occasional AMPS/+6/PMPS - but in our defence this was largely to do with just following the Vet's instructions (which have never included daily checks.. )

At least we do now have a full 12Hr Curve that was done 9/18 after he had been stable at 3.5U BID for a while - but this was only after the visit to the Veterinary referral center and a long chat with one of the vets there, where he agreed it might be a good idea....

I am now seriously wondering if the best bet from here might not be to just start completely over - do it all again from step one - only properly (now that we know what 'properly' is!!!)?

Anyhow I chall not change anything yet, as I am still hoping for some advice on where we are now and how best to go forward from here - including the suggestion to get a new vial of Lantus. That brings its own set of questions about what to do about dosing - in the event that the current vial really has been bad (for who knows quite how long?)

OK it's 11:35 now and I am tuckered out it has been a very long day!

All the best to you all!
Perry
Looking forward to getting some clarity - !!
 
haven't had a chance to stop by to say hello and welcome to the group! :-D

i've spent some time looking at sooty's spreadsheet. lack of data, dry food being in the picture the first month, increases made in increments of 0.5 - 1u, dose increases made by your vet when numbers could have been influenced by "vet stress", and the possibility of your insulin having lost potency all cloud the picture as to which way to go from here. there is no clear cut path to take. obviously there are three options: start over, reduce the dose, or continue raising the dose until you see a break in the numbers. each of these options have their own set of pros and cons.

starting over --- the plus is you could "do it right" this time. at least we'd know if sooty's dose has been surpassed putting him in chronic rebound. we could easily make suggestions which could fast track sooty up the dosing scale if he's not responding.

reducing the dose --- may or may not help. it's kind of a shot in the dark since you'd just have to pick a dose to reduce to and hope it was the right choice. sometimes we're lucky choosing this method.

continue increasing the dose using the guidelines suggested in the tight regulation protocol --- this *could* cause a sudden break in the numbers, but if sooty really does need a higher dose... you'll get there faster with this choice. however, you must monitor very, very carefully and have your hypo kit ready since we have no idea if sooty should be at a higher dose. one of the pluses with this option is once a kitty is used to being in higher numbers, it often takes more insulin to cause a break in the numbers.


a few questions:
  • has sooty ever had ketones or been in DKA?
    the answer to this question may influence which way to go with this.
  • what is sooty's ideal weight (not actual weight)?
    based on the guidelines in the tight regulation protocol, a typical lantus/levemir starting dose for a newly diagnosed kitty is calculated at 0.25u per kg of the cat's ideal weight.
  • how closely can sooty be monitored? is someone who can test him home with him during the day?
  • are you willing to commit to both posting and testing often?


buying new insulin is costly, but it would definitely eliminate one variable from the equation.
making a commitment to monitor carefully everyday will help a lot. data obtained from monitoring are like pieces to a puzzle. the more data you have collected, the easier it is to see the whole picture. kwim?

will check back with you tomorrow...
 
Hi there

welcome to the group!

Jill has covered the bases here, hopefully you can check back and help with her questions.

Please read the stickies full of information (up above with the "starred" icon) and check back with us!
:razz:
 
Jill & Alex said:
haven't had a chance to stop by to say hello and welcome to the group! :-D

i've spent some time looking at sooty's spreadsheet. lack of data, dry food being in the picture the first month, increases made in increments of 0.5 - 1u, dose increases made by your vet when numbers could have been influenced by "vet stress", and the possibility of your insulin having lost potency all cloud the picture as to which way to go from here. there is no clear cut path to take. obviously there are three options: start over, reduce the dose, or continue raising the dose until you see a break in the numbers. each of these options have their own set of pros and cons.

starting over --- the plus is you could "do it right" this time. at least we'd know if sooty's dose has been surpassed putting him in chronic rebound. we could easily make suggestions which could fast track sooty up the dosing scale if he's not responding.

reducing the dose --- may or may not help. it's kind of a shot in the dark since you'd just have to pick a dose to reduce to and hope it was the right choice. sometimes we're lucky choosing this method.

continue increasing the dose using the guidelines suggested in the tight regulation protocol --- this *could* cause a sudden break in the numbers, but if sooty really does need a higher dose... you'll get there faster with this choice. however, you must monitor very, very carefully and have your hypo kit ready since we have no idea if sooty should be at a higher dose. one of the pluses with this option is once a kitty is used to being in higher numbers, it often takes more insulin to cause a break in the numbers.


a few questions:
  • what is sooty's ideal weight (not actual weight)?
    based on the guidelines in the tight regulation protocol, a typical lantus/levemir starting dose for a newly diagnosed kitty is calculated at 0.25u per kg of the cat's ideal weight.[/list
    • how closely can sooty be monitored? is someone who can test him home with him during the day?
    • are you willing to commit to both posting and testing often?
    Yes.

    buying new insulin is costly, but it would definitely eliminate one variable from the equation.
    making a commitment to monitor carefully everyday will help a lot. data obtained from monitoring are like pieces to a puzzle. the more data you have collected, the easier it is to see the whole picture. kwim?

    will check back with you tomorrow...
Click to expand...

  • Yes kwym indeed - thanks! (and for the welcome, too!)
    Here's some answers!
    • has sooty ever had ketones or been in DKA?
      the answer to this question may influence which way to go with this.
    No, neither.
    • what is sooty's ideal weight (not actual weight)?
      based on the guidelines in the tight regulation protocol, a typical lantus/levemir starting dose for a newly diagnosed kitty is calculated at 0.25u per kg of the cat's ideal weight.
    Not sure how to determine ideal weight? (is it in a sticky I 've missed?) but he has been pretty steady at 6.8Kg for a long time (before and since Dx)... looks fit & heathy, no excess fat on him at all. Does that help?
    • how closely can sooty be monitored? is someone who can test him home with him during the day?
    Best bet is mornings & evenings weekdays we can really only do daytime monitoring at the weekends. Could try for a +6 weekdays, if we think it is needed though.
    • are you willing to commit to both posting and testing often?
    Yes.
 
Hi Perry...welcome to you and Sooty!

Congratulations on getting your SS up and linked. Great job! Just wondering how old that insulin is...tht might have an influence on your dosing choice. I will go abk and look through your previous condo to see if you hae mentioned tht.
Speaking of which, we post a new condo each day with our AMPS...and we link the previous condo (thread) to the post so that people can just click and see what transpired the previous day.
Here is the link to yesterday(You must put space between the last word and the link so it works properly. It will turn blue when you post to indicate that it is working: viewtopic.php?f=9&t=25571

There are starred stickies at the top of the page that Ronnie mentioned. Please read through them and come back to post any question s you might have, okay? A good place o start is with the first for newcomers: New to the Group? viewtopic.php?f=9&t=18139

Does Sooty have any other issues or medications?

So good to see you here. I hope to see your condos for Sooty each and every day! :razz:
 
Ok Perry...about the insulin....how old is it exactly? Are you using a vial or the pen?
The pens are more economical and maybe some Lantus people will give you some idea of where to purchase them.
The manufacturer recommends replacing after 28 days but some of our people have gotten a tad more time out of it.
If you have not replaced the insulin regularly, that may mean that it is toast and you are virtually not giving anything. I apologize if you have answered that question ...I seem to have missed it?
It is important though...so just post when you changed it. We usually put it in the notes section on our SS so we have a record of the exact date! Any other things that are of note can be put there too ...so glad you have your SS done! :razz:
 
Pat+Raja+Shadow said:
Perry...I am a pest, I know...here is the link to your Post in Health: viewtopic.php?f=28&t=25570
If you are using the same Lantus that you first started with, you might want to discuss the starting over....

Oh, and here is your post about the Lantus smell... viewtopic.php?f=9&t=25674
Click to expand...
Thanks! Yes it's the same vial we started with; I know about the 28 days but also that many people on many sites say it can last up to 6 months if stored correctly, ours is ~ 3 months. We'll have a new vial by this afternoon anyhow... one less thing to eliminate!!
 
Status
Not open for further replies.
Back
Top