Had follow up appt and vet wants to increase dosage

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missMeows

missMeows

Member Since 2015
Hi everyone,

I took my kitty to the vet for a follow up. Probably the last one (for BG levels) since I'm trying to be consistent with testing myself. Plus, her levels were pretty high today and although we've only done a nadir ourselves once before, the vets results were way higher. I definitely think stress.

Anyways... she recommended I up her dosage from 1 unit 2x day, to 2 units 2x a day. I voiced my concerns about upping her that high (from what I read from this forum) and she agreed that 1.5 dose would probably be fine if I can manage that (I told her about using calipers). But she was certain that hitting her hard with dosing earlier was key to getting her to remission.

So I bought some calipers, after reading Marje's links, and was measuring out what 1 unit would be (came to 1.4mm on a BD syringe). That would make 1.5 units be 2.1mm. I checked what that would look like on the syringe and it appears that because the zero mark on the needle is a bit higher, that I've been giving her about 1.5 units anyway? Does this sound right/normal to you all? If I really have been giving her 1.5 units all along, maybe I SHOULD give her 2? But dosed out with the caliper instead of using just the syringe?

Any thoughts?
 
Ok. I'll up it half a dose from where I've always measured. So whether its 1.5 or really 2... She is still getting only a half dose increase. Thanks for taking the time to answer!
 
I use prozinc, not lantus. While I agree with the vet, getting those numbers down early is key, and while my sliding scale for numbers like your kitty is showing translate to about 3.5 units in prozinc, my understanding is with lantus, you really need to GO SLOW. Changes can take days to be fully reflected in the numbers with this insulin.

Your vet sounds like a bit of a cowboy/girl and while I agree with her sentiments, I think 1.5 units with an adjustment up to 2u in a few days if you don't get control is good. You might look around the web for tight regulation protocols with lantus as a sliding scale. I don't know if there are any such, but as a treatment goal, you really want to be getting numbers sub 150 asap to have the best chance at remission.

Hope that helps.
 
It turns out there is a tight regulation protocol for lantus:
lantus TR protocol

While I've not used this myself, I'm using something analogous with prozinc, I strongly recommend the investment of time and energy in doing this. Frequent testing and dosing early in a diabetic feline's course can really make a difference. There is a notion that hyperglycemia kills pancreatic beta cells, so the longer a cat sits like that the smaller the chances for a remission. That's why I was so aggressive to the point of firing my vet and driving an additional 40 miles to get a vet who would extract my sluggo's abscessed teeth ASAP when he came out of remission, started spiking sugars and shooting him with prozinc was like firing blanks. At that point, "I can't see him today or even tomorrow..." provoked rage in me and a review like this:

altas palmas review

and for the new vet 40 miles up the road:

[url=http://www.yelp.com/biz/nolana-animal-hospital-mcallen?hrid=YcIer0DKeaIuntilru7Rgw]nolana review

But here I digress...

My point is vets are sort of like shirts from sears. Some are smart, good, and on the ball. Some are worse than bad and if they were human doctors would have killed more than dr. josef mengele. You are best served by taking matters into your own hands, following a tight regulation protocol for your cat & if you aren't getting good answers from your vet, finding another one.[/URL]
 
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Generally with Lantus we only increase 0.25 units at a time especially while kitty is still on a low dose. Even a small increase as you approach and then reach the right dose can have a dramatic effect and as there's no way of knowing what that right dose will be until you reach it, increasing by 0.5 units at a time could mean you end up skipping over the best dose. The other thing to remember is that vet stress can increase a cat's BG level - by a lot. So you might find that you'd have been getting lower numbers testing at home than by having tests done at the vet - you should start finding out by how much once you're able to get more tests done at home. Was the 185 the number you got at home?
 
Well I gave her 1.5 units last night and this morning. I'm reading up on the tight protocol stuff and I'm feeling very overwhelmed by it, and down, and I'm a bad kitty momma. I didn't test her levels last night, or this morning.

She is pretty much hating me right now from trying to test her. She even attacked my foot last night when I blocked her from going outside. She's never attacked before. She growls whenever I pick her up. I'm trying to give her treats and playtime and love but she's just getting crankier each day. This is tough. I know I need to test her, especially with a dose increase, but its tough :(

The 185 the other day was a home test. The really high number two nights ago I'm attributing to our neighbors above us yelling and slamming doors for most of the night...
 
I guess I'm lucky sluggo is such a mellow kitty. But he sees me bringing the testing stuff & runs also. It's tough but you just gotta do it. Can't go shooting blind... Tough love.
 
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