MrWorfMen's Mom
Member Since 2015
My little sugar baby Menace has been on Lantus since February this year. Insulin was started at 0.5u and a curve was done at the hospital before I brought her home. I have been doing curves at home, sending them to my vet and getting advice re: dosing. Each time I was advised to keep her on the new dose for 3-5 days but I soon found that she didn't really settle on the new dose for at least a week and sometimes two. So I started waiting a little longer between dose increases. Her numbers essentially remained the same despite dose increases. In fact when I look back at the initial curve done at the vet hospital just after Dx, they may even be a smidge higher now.
The last time I got vet advice about dosing, she suggested going up a full unit from 2u to 3u. I noticed what appeared to be a very slight increase in her numbers at 3u so I started wondering if we had missed her "sweet" spot. I kept her on that dose long enough to know it wasn't a bounce or the right dose. My vet then advised me to take her back down to 2 u which I did and her numbers lowered just a smidge back to her previous levels. After a couple of weeks at 2u, I increased her to 2.5u to see if that would give her a little nudge down but her numbers are still running in the same range as they always have.
So off to the vet we went to check for something else that might be interfering with her numbers. We couldn't get a urine sample from her that day but did a blood panel and fructosamine. Her blood panel came back normal including liver, kidney etc. but I was absolutely blown away when I saw her Fructosamine level indicated she is under "good" control.
Menace is still drinking and peeing more than normal but she has gained back 2.5 of the 3 lbs she lost before diagnosis. She also is still less active than her norm and sometimes excessively hungry, some days more than others. So between her home glucose readings and the ongoing symptoms, I am hard pressed to understand how accurate or relevant the fructosamine test really is.
Thankfully I have a wonderful vet who admitted outright that vets usually use ONLY the fructosamine to judge whether a cat is regulated or not these days. She also admitted she has NEVER had any client do as much home testing as I do and agreed that the daily numbers and symptoms don't tell the same story as the fructosamine. This was an eye opener for her and she is now sharing my data and Menace's blood values with a specialist to get a 2nd opinion.
I am wondering if perhaps Lantus is not the right insulin for Menace. I notice some people on the board have switched from Lantus to Levemir for a variety of reasons and wonder if anyone who made the switch had an experience similar to mine. Menace's numbers are proving very stubborn (but not out of this galaxy high or bouncing significantly to suggest Acro or IAA) and they don't seem be moving no matter what dose of Lantus is given.
In the meantime, I've certainly learned an invaluable lesson and my vet has too. Home testing is a PRICELESS tool and we have to look at all the facts including the cat and the daily numbers....NOT just one blood test...to see if a cat is truly getting regulated.
What a ride this has been so far and the journey continues.......Any thoughts?
The last time I got vet advice about dosing, she suggested going up a full unit from 2u to 3u. I noticed what appeared to be a very slight increase in her numbers at 3u so I started wondering if we had missed her "sweet" spot. I kept her on that dose long enough to know it wasn't a bounce or the right dose. My vet then advised me to take her back down to 2 u which I did and her numbers lowered just a smidge back to her previous levels. After a couple of weeks at 2u, I increased her to 2.5u to see if that would give her a little nudge down but her numbers are still running in the same range as they always have.
So off to the vet we went to check for something else that might be interfering with her numbers. We couldn't get a urine sample from her that day but did a blood panel and fructosamine. Her blood panel came back normal including liver, kidney etc. but I was absolutely blown away when I saw her Fructosamine level indicated she is under "good" control.
Menace is still drinking and peeing more than normal but she has gained back 2.5 of the 3 lbs she lost before diagnosis. She also is still less active than her norm and sometimes excessively hungry, some days more than others. So between her home glucose readings and the ongoing symptoms, I am hard pressed to understand how accurate or relevant the fructosamine test really is.
Thankfully I have a wonderful vet who admitted outright that vets usually use ONLY the fructosamine to judge whether a cat is regulated or not these days. She also admitted she has NEVER had any client do as much home testing as I do and agreed that the daily numbers and symptoms don't tell the same story as the fructosamine. This was an eye opener for her and she is now sharing my data and Menace's blood values with a specialist to get a 2nd opinion.
I am wondering if perhaps Lantus is not the right insulin for Menace. I notice some people on the board have switched from Lantus to Levemir for a variety of reasons and wonder if anyone who made the switch had an experience similar to mine. Menace's numbers are proving very stubborn (but not out of this galaxy high or bouncing significantly to suggest Acro or IAA) and they don't seem be moving no matter what dose of Lantus is given.
In the meantime, I've certainly learned an invaluable lesson and my vet has too. Home testing is a PRICELESS tool and we have to look at all the facts including the cat and the daily numbers....NOT just one blood test...to see if a cat is truly getting regulated.
What a ride this has been so far and the journey continues.......Any thoughts?
I love it when I get to educate my fellow medical professionals even if I have been retired for years and am a little old school! 
I seriously love my vet and can forgive this lack of knowledge because she admits when she is stumped and is taking my Levemir question up with the consultant too!