Kris & Teasel
Member Since 2016
Lantus is acidic and she might be extra sensitive to that even though the dose is small.
? Hoping for some advice
- Thread starter C.W. Gortner
- Start date
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Critter Mom
Member Since 2014
Another possibility: do you get a fair amount of blood when you poke Mommy's ear with the lancet? If yes, then you might be hitting the vein and not the 'sweet spot'.
Here's a helpful diagram to check against:
If hitting the vein, this can be a bit painful. There are very few nerve endings in the 'sweet spot' area.
Mogs
.
Here's a helpful diagram to check against:
If hitting the vein, this can be a bit painful. There are very few nerve endings in the 'sweet spot' area.
Mogs
.
C.W. Gortner
Member Since 2016
I never dose her in the same place twice, at least not on the same day. If I shoot in her scruff in the morning, then I shoot in her flank or side shoulder in the evening.
And this abrupt change in her behavior unfortunately does correlate with trying to establish a routine of home BG testing. She flinched every time I poked her, though I wasn't jabbing indiscriminately and I gave her all the extra attention, treats, and affection as recommended. But, it's still a poke to draw blood, slight and quick as it may be. Before I started home testing - and I've only managed thus far to get in one day of two-daily BG tests to date, which led to the reduction in her insulin, as she was hitting low-to-mid 70s in the mornings before her shot - she was perfectly fine with the shot itself, she didn't even seem to feel it. She'd start eating, I'd shoot, kiss her, and she'd keep right on eating, then lick my face. She's a cat, so who knows, but she's an ex-feral cat with a highly-tuned survival instinct, despite having lived with us for 7 years, safe and sound. Poking her ear is probably not her idea of a good time. The other night, as we swiped the pillow under the bed to get her out, by the time I'd cornered her for her shot, she was hissing, her ears were flat, and she was clearly very stressed out. I held her in my arms, trying to soothe her, and her heart was pounding. She doesn't scratch or bite, thank god, but I was a mess, too. I can't do that every time I need to dose her; it's not fair to her. The more I push, the worse it will be. She needs a break and so do I. At this rate, she's reverting to the terrified cat she was when I first brought her home. I've not seen her like this since the first month of her arrival, when she camped out under the bed for three solid weeks, only venturing out for food and the litter box. She's very sweet and loving now, but she's always been more wary and fearful than Boy. She survived for years in a public park, chased by dogs and raccoons, living on her own under a bridge, with only me coming up to feed her twice a day and her son Boy as company. She's not fully domesticated, that's the reality of it. Hell, I've hired the same live-at-home cat sitter, a dear friend, every time we've gone on vacation and not once has my sitter managed to even get near one of my cats. They completely evade her. They eat and poop, but they're not interested in any contact with her - and they know who she is, they know her smell by now. I request proof of life while I'm away and my sitter sends me pics, of them huddled under the bed as if the sitter is a monster.
I'll get a fructosamine test done on the 23rd and see where Mommy's at. Believe me, I completely understand how vital home BG testing is. I saw her levels lower to a point that Dr Dick agreed to reduce her dose, so the proof is in the pudding, as they say. But not every cat cooperates. It takes time and patience - and I'm dealing with a cat who's not been home-raised. She loves us and clearly, we adore her, but I can't terrorize her into a corner every time. She's eating well, she's playing with Boy at night again, her pee output and volume have decreased noticeably, especially since we reduced her dose to 1u, and while I realize potential hypo remains a concern, for now I'll have to risk it and pray we're on the right course. Fructosamine tests aren't ideal to monitor her and, of course, are expensive and stressful, requiring the dreaded haul to the vet, but for now, at least we have that recourse. I've done everything possible to follow the guidelines, I've devoured every thread on this forum, but if she opposes me as she's currently doing, something has to give. She needs her insulin, she nearly died a month ago, her pancreas was failing, and she was probably an uncontrolled diabetic for at least 18 months before she ended up in crisis. I remember her gradual weight loss, increased pee and thirst; and I chalked it up to aging. It's my fault for not bringing her in sooner, as looking back now, I realize she had the symptoms, but getting her into a carrier was a hurdle and . . . well, there we have it. Coulda, shoulda, woulda. I can't beat myself up over it. I did the best I could with the knowledge, or lack thereof, that I had at the time.
I wish it were different, for both our sake. I wish I could explain to her that I'm doing all of this for her own good, that she's being an hysteric, but she doesn't understand words. She reacts to my deeds. I'm hoping that if I back off from the ear pokes until the vet visit, she'll settle down and return to the previous comfort zone we had with her shots.
And this abrupt change in her behavior unfortunately does correlate with trying to establish a routine of home BG testing. She flinched every time I poked her, though I wasn't jabbing indiscriminately and I gave her all the extra attention, treats, and affection as recommended. But, it's still a poke to draw blood, slight and quick as it may be. Before I started home testing - and I've only managed thus far to get in one day of two-daily BG tests to date, which led to the reduction in her insulin, as she was hitting low-to-mid 70s in the mornings before her shot - she was perfectly fine with the shot itself, she didn't even seem to feel it. She'd start eating, I'd shoot, kiss her, and she'd keep right on eating, then lick my face. She's a cat, so who knows, but she's an ex-feral cat with a highly-tuned survival instinct, despite having lived with us for 7 years, safe and sound. Poking her ear is probably not her idea of a good time. The other night, as we swiped the pillow under the bed to get her out, by the time I'd cornered her for her shot, she was hissing, her ears were flat, and she was clearly very stressed out. I held her in my arms, trying to soothe her, and her heart was pounding. She doesn't scratch or bite, thank god, but I was a mess, too. I can't do that every time I need to dose her; it's not fair to her. The more I push, the worse it will be. She needs a break and so do I. At this rate, she's reverting to the terrified cat she was when I first brought her home. I've not seen her like this since the first month of her arrival, when she camped out under the bed for three solid weeks, only venturing out for food and the litter box. She's very sweet and loving now, but she's always been more wary and fearful than Boy. She survived for years in a public park, chased by dogs and raccoons, living on her own under a bridge, with only me coming up to feed her twice a day and her son Boy as company. She's not fully domesticated, that's the reality of it. Hell, I've hired the same live-at-home cat sitter, a dear friend, every time we've gone on vacation and not once has my sitter managed to even get near one of my cats. They completely evade her. They eat and poop, but they're not interested in any contact with her - and they know who she is, they know her smell by now. I request proof of life while I'm away and my sitter sends me pics, of them huddled under the bed as if the sitter is a monster.
I'll get a fructosamine test done on the 23rd and see where Mommy's at. Believe me, I completely understand how vital home BG testing is. I saw her levels lower to a point that Dr Dick agreed to reduce her dose, so the proof is in the pudding, as they say. But not every cat cooperates. It takes time and patience - and I'm dealing with a cat who's not been home-raised. She loves us and clearly, we adore her, but I can't terrorize her into a corner every time. She's eating well, she's playing with Boy at night again, her pee output and volume have decreased noticeably, especially since we reduced her dose to 1u, and while I realize potential hypo remains a concern, for now I'll have to risk it and pray we're on the right course. Fructosamine tests aren't ideal to monitor her and, of course, are expensive and stressful, requiring the dreaded haul to the vet, but for now, at least we have that recourse. I've done everything possible to follow the guidelines, I've devoured every thread on this forum, but if she opposes me as she's currently doing, something has to give. She needs her insulin, she nearly died a month ago, her pancreas was failing, and she was probably an uncontrolled diabetic for at least 18 months before she ended up in crisis. I remember her gradual weight loss, increased pee and thirst; and I chalked it up to aging. It's my fault for not bringing her in sooner, as looking back now, I realize she had the symptoms, but getting her into a carrier was a hurdle and . . . well, there we have it. Coulda, shoulda, woulda. I can't beat myself up over it. I did the best I could with the knowledge, or lack thereof, that I had at the time.
I wish it were different, for both our sake. I wish I could explain to her that I'm doing all of this for her own good, that she's being an hysteric, but she doesn't understand words. She reacts to my deeds. I'm hoping that if I back off from the ear pokes until the vet visit, she'll settle down and return to the previous comfort zone we had with her shots.
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C.W. Gortner
Member Since 2016
Another possibility: do you get a fair amount of blood when you poke Mommy's ear with the lancet? If yes, then you might be hitting the vein and not the 'sweet spot'.
Here's a helpful diagram to check against:
If hitting the vein, this can be a bit painful. There are very few nerve endings in the 'sweet spot' area.
Mogs
.
Well, therein is my problem. I was hitting the vein, actually. My first ham-handed attempts were not good; that sweet spot area yielded no droplet, but the vein, which I can clearly see as her ears are translucent in light, immediately produced results. And poking the vein once, quickly, versus several pokes in the sweet spot area, seemed easier, as after three futile pokes in the sweet spot, she'd had enough. I can re-try the sweet spot once a period of rest has passed, and see how it goes, but since I'd hit the vein already, she now obviously associates the process with pain. Not that it makes me feel any better
Critter Mom
Member Since 2014
Neither were mine, that's why I thought to ask about where you were poking! I caught the vein with Saoirse several times before my technique got better.
Couple of questions:
1. What are you using to warm Mommy's ear?
2. What are you using to support Mommy's ear ready for the lancet poke?
Mogs
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C.W. Gortner
Member Since 2016
Neither were mine, that's why I thought to ask about where you were poking! I caught the vein with Saoirse several times before my technique got better.
Couple of questions:
1. What are you using to warm Mommy's ear?
2. What are you using to support Mommy's ear ready for the lancet poke?
Mogs
.
1. I'm using a warmed cloth to warm up her ear, though rubbing/ caressing it with my fingers seems to be equally effective. Or not, as the case may be.
2. I support the underside of her ear with my free hand, to ensure I don't poke through it, and she seemed to prefer it, as she reacted poorly to a cotton pad placed on the underside of her ear while I poked. I bought a pack of make-up cotton pads.
As I said, I'll revisit my entire technique once the dust settles here. To my relief, she just jumped up onto the bed for lunch and was acting like herself again, until the moment I shifted away to actually fetch the popsicle stick I use to wad up her food, as she likes it wadded into a pyramid, because she licks it all over the dish and then won't eat the stray smears (can you say princess?). Then she fled under the bed. She must have thought I was going to poke her. She's not stupid.
C.W. Gortner
Member Since 2016
One thing we're going to do this weekend is block off part of under the bed, as in, buy sweater storage containers and fill them with books (I have dozens of foreign editions of my novels that are just sitting in the garage) and create a corner for her, where she can hide if she needs to, but will impede these mad pillow swipes at night. We'll organize it in a way that I can still reach her flank and shoot her if need be, even if she's camped out there. I did that several times before at the start, shot her under the bed, and she was fine with it, staying close enough for me to reach before she developed this fear of the ear poke. I just need to keep her from crawling into the middle section under the bed, which is impossible to reach. That way, if she's under the bed but in a part where she can't flee because of the storage containers and the door to her suite is closed, there's nowhere else in the room she can hide where I can't reach her.
At this point, whatever it takes.
At this point, whatever it takes.
Critter Mom
Member Since 2014
She might not like having something bulky in her ear. Saoirse certainly didn't. Here are some things I found helped us enormously.
Getting the sweet spot really, really, really warm is really key to testing success, especially in the early days when you're waiting for more capillaries to form at the sweet spot (each poke you make encourages this, even if you're not successful in getting a sample each time). I was really worried about hurting Saoirse and I was beyond surprised at how very warm I needed to get her ear in order to get good blood flow to the sweet spot.
Things got much easier test-wise for Saoirse and myself when I started warming her ears with a plastic pipette filled with heated water (see below). Some people use a small plastic pill bottle containing hot water.
I heat the water in a cup in the microwave, fill the pipette, then stand the bulbous end of the pipette in the remaining hot water in the cup to keep it warm until I'm ready to apply it to the ear. I found it much easier to apply heat just to the test area at the edge of the ear using the pipette and Saoirse certainly found it much more comfortable. (I initially tried the warmed up cloth in a baggie but she hated the bulk and used to really wriggle when I tried to warm her ear. Consequently I couldn't warm the ear well enough and found it tricky to get reliable blood samples. Saoirse was much more calm and still when I used the pipette and my testing success rate increased exponentially!)
I apply a very thin film of Vaseline to the sweet spot area to help the blood bead up instead of wicking into the fur.
I also use folded 1" strips of kitchen towel as a support. (Note: having the support under the ear helps with one's own nervousness because one isn't subconsciously worried about pricking one's own finger.) I place the folded kitchen paper under the test site then wrap the ear and the paper strip round my index finger, holding the edge of the ear slightly taut with thumb and middle finger. That little bit of tension makes it easier to break the skin with the barest prick of the lancet.
When doing the poke, make sure that the bevelled side of the lancet is facing upwards. Also, poke at a 45 degree angle to the ear, aiming about 1mm in from the edge of the ear.
After sipping up the sample onto the meter test strip, I fold the kitchen paper over the ear and apply a little pressure to the test site for about 15 seconds to help prevent bruising.
Hope some of the above might be of help to you when you are looking to refine your technique.
On the positive side of things, you do know how to test now and you've got the meter there ready to use. If ever you're unsure about Mommy's behaviour and you're worried she might be running low you're in a position to check her straight away and intervene should the need arise.
Mogs
.
Getting the sweet spot really, really, really warm is really key to testing success, especially in the early days when you're waiting for more capillaries to form at the sweet spot (each poke you make encourages this, even if you're not successful in getting a sample each time). I was really worried about hurting Saoirse and I was beyond surprised at how very warm I needed to get her ear in order to get good blood flow to the sweet spot.
Things got much easier test-wise for Saoirse and myself when I started warming her ears with a plastic pipette filled with heated water (see below). Some people use a small plastic pill bottle containing hot water.
I heat the water in a cup in the microwave, fill the pipette, then stand the bulbous end of the pipette in the remaining hot water in the cup to keep it warm until I'm ready to apply it to the ear. I found it much easier to apply heat just to the test area at the edge of the ear using the pipette and Saoirse certainly found it much more comfortable. (I initially tried the warmed up cloth in a baggie but she hated the bulk and used to really wriggle when I tried to warm her ear. Consequently I couldn't warm the ear well enough and found it tricky to get reliable blood samples. Saoirse was much more calm and still when I used the pipette and my testing success rate increased exponentially!)
I apply a very thin film of Vaseline to the sweet spot area to help the blood bead up instead of wicking into the fur.
I also use folded 1" strips of kitchen towel as a support. (Note: having the support under the ear helps with one's own nervousness because one isn't subconsciously worried about pricking one's own finger.) I place the folded kitchen paper under the test site then wrap the ear and the paper strip round my index finger, holding the edge of the ear slightly taut with thumb and middle finger. That little bit of tension makes it easier to break the skin with the barest prick of the lancet.
When doing the poke, make sure that the bevelled side of the lancet is facing upwards. Also, poke at a 45 degree angle to the ear, aiming about 1mm in from the edge of the ear.
After sipping up the sample onto the meter test strip, I fold the kitchen paper over the ear and apply a little pressure to the test site for about 15 seconds to help prevent bruising.
Hope some of the above might be of help to you when you are looking to refine your technique.
On the positive side of things, you do know how to test now and you've got the meter there ready to use. If ever you're unsure about Mommy's behaviour and you're worried she might be running low you're in a position to check her straight away and intervene should the need arise.
Mogs
.
C.W. Gortner
Member Since 2016
Well, the detente with Mommy continues. She's definitely changed in behavior as far as the shots go. Before, she was just fine with them, didn't seem to notice or care. Now, the moment she knows it's shot time (it's as if she has a wrist watch she can check, down to the minute) she's right under the bed. I've resorted to blockading parts under the bed with pillows to corner her, just for the shot itself, and then shoot her under the bed as best I can. It's baffling to me. She'll then stay under the bed for most of morning into the late afternoon, creeping out to nibble food and use the box (not nearly as much now) but otherwise avoiding me. I talk to her, sing her song while she's hiding, so she can see I'm not always there with a needle, and she blinks at me, but if I reach under to pet her, she scoots away. Sometimes, like yesterday, when I bring up her lunch, she'll be out, waiting; she'll accept affection and won't flee the scene, though she'll recoil if I reach out to her too fast - which is very unlike her. I feel as if all the effort I've made over these past years to make her feel safe here at home with us is coming undone.
Granted, she's always been a "bush" cat; she has trust issues and prefers hanging out in safe places, like under the bed, but I'm starting to wonder if perhaps even 1u 2x a day is too high for her now, the shots are making her feel lousy, lowering her BG too much, so she's resisting them. It's been 7 days since my last attempt to BG-test her, she's been on low-carb wet food only for nearly nearly six months - so, before her diagnosis - but I was reading here that some cats will dive into remission fast once they get proper insulin and/or require a significant reduction in dose as they get better. I thought that would never happen to her, as if she was uncontrolled for so long, but her numbers weren't overly high on the few sporadic tests I took once we started insulin, and in fact were trending toward too low on 2u. And we've reduced her dose already by 50% since she started treatment little over a month ago. Ideally, of course, I should be checking every day to see how her BG is trending on 1u but for now, that's impossible because she's being such a freak about it. I want to associate her sudden change in her to the bad experience of BG testing = pain, therefore shot must also = pain, but really? After 7 days and she's still hiding at shot time to avoid it, as if I might clobber her?
I'm trying to be patient, to not push or traumatize her. That she's never been treat-motivated (she's never cared much for treats at all) sucks, as I can't entice her with yummy extras. But the trauma of every shot - she hisses at me in the morning, while at night, she has to be held by hubby so I can quickly shoot - is driving us both nuts.
I might bite the bullet tonight, have hubby restrain her and get a BG test in to see where she's at before her PM shot.
Granted, she's always been a "bush" cat; she has trust issues and prefers hanging out in safe places, like under the bed, but I'm starting to wonder if perhaps even 1u 2x a day is too high for her now, the shots are making her feel lousy, lowering her BG too much, so she's resisting them. It's been 7 days since my last attempt to BG-test her, she's been on low-carb wet food only for nearly nearly six months - so, before her diagnosis - but I was reading here that some cats will dive into remission fast once they get proper insulin and/or require a significant reduction in dose as they get better. I thought that would never happen to her, as if she was uncontrolled for so long, but her numbers weren't overly high on the few sporadic tests I took once we started insulin, and in fact were trending toward too low on 2u. And we've reduced her dose already by 50% since she started treatment little over a month ago. Ideally, of course, I should be checking every day to see how her BG is trending on 1u but for now, that's impossible because she's being such a freak about it. I want to associate her sudden change in her to the bad experience of BG testing = pain, therefore shot must also = pain, but really? After 7 days and she's still hiding at shot time to avoid it, as if I might clobber her?
I'm trying to be patient, to not push or traumatize her. That she's never been treat-motivated (she's never cared much for treats at all) sucks, as I can't entice her with yummy extras. But the trauma of every shot - she hisses at me in the morning, while at night, she has to be held by hubby so I can quickly shoot - is driving us both nuts.
I might bite the bullet tonight, have hubby restrain her and get a BG test in to see where she's at before her PM shot.
Critter Mom
Member Since 2014
That's not an unreasonable concern, C.W. I think your plan to just go for it and check her BG tonight is wise. If you could sequester her in a bathroom for a couple of hours and also get a test in mid-cycle tonight to see how low the dose is taking her that would also be wise for Mommy's safety. If you don't have success, I'd suggest you get Mommy to the vets as soon as you can for a fructosamine test. While not as revealing as regular BG checks, in situations like yours the fructosamine test would be valuable.
Mogs
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C.W. Gortner
Member Since 2016
We have a vet appointment on the 23rd but if I can't get a test or two in before then, I'll call on Tuesday to see if we can get in earlier for blood work.
Critter Mom
Member Since 2014
I think that 's a good plan, C.W. Let us know how you get on.
Mogs
.
Mogs
.
C.W. Gortner
Member Since 2016
Thing is, based on what I've read, she does meet some of the criteria for remission and/or a significant dose reduction:
She's older (for some reason, older cats go into remission more)
She's on a low-carb wet food diet.
She was dosed on high insulin for 4 weeks at 2u 2x daily.
Her BG, albeit judging by my few home tests and her recent labs from the vet, were within normal range after only two weeks or so on insulin. 0n 12/12, her BG was 92 via labs from the vet.
She's older (for some reason, older cats go into remission more)
She's on a low-carb wet food diet.
She was dosed on high insulin for 4 weeks at 2u 2x daily.
Her BG, albeit judging by my few home tests and her recent labs from the vet, were within normal range after only two weeks or so on insulin. 0n 12/12, her BG was 92 via labs from the vet.
Critter Mom
Member Since 2014
I think the sooner you get her checked the better, C.W. I'd also give a call to the vet tomorrow to ask for advice on what to do about insulin dosing until you can get her in for testing/bloodwork.
FWIW my Saoirse started to avoid her Caninsulin injections because the drops in BG it produced made her feel lousy (and she was in fairly good numbers at the time). She was happier when I changed her insulin (much smoother BG throughout the day) and the avoidance behaviour stopped straight away.
Mogs
.
FWIW my Saoirse started to avoid her Caninsulin injections because the drops in BG it produced made her feel lousy (and she was in fairly good numbers at the time). She was happier when I changed her insulin (much smoother BG throughout the day) and the avoidance behaviour stopped straight away.
Mogs
.
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C.W. Gortner
Member Since 2016
Today she flattened herself against the far wall under the bed, hissing like a serpent, so despite my once-effective if traumatic pillow blockade, I had to pull her out by her scruff to deliver the goddamn shot. I cut her dose back last night to .75u to see if that makes any difference in her attitude. I couldn't get a BG test last night, she was totally uncooperative and I'm too exhausted to struggle with her.
Calling the vet is pointless. They'll just tell me to bring her in, and we already have an appointment with Dr Dick scheduled for the 23rd. She loathes me right now, she's avoiding all contact. Not with hubby, though he has to seize her unawares and forcibly bring her onto the bed to be petted and brushed, and then she relaxes. But I'm persona non grata at the moment. I'd be relieved that she clearly feels well enough to be such a stinker, except this change in her is so unsettling, I have to wonder what is going on. I pray she's in remission. We can't go on this way. It's killing me to see her acting so traumatized. She's eating well still and peeing much less, so at least there is that.
Calling the vet is pointless. They'll just tell me to bring her in, and we already have an appointment with Dr Dick scheduled for the 23rd. She loathes me right now, she's avoiding all contact. Not with hubby, though he has to seize her unawares and forcibly bring her onto the bed to be petted and brushed, and then she relaxes. But I'm persona non grata at the moment. I'd be relieved that she clearly feels well enough to be such a stinker, except this change in her is so unsettling, I have to wonder what is going on. I pray she's in remission. We can't go on this way. It's killing me to see her acting so traumatized. She's eating well still and peeing much less, so at least there is that.
Critter Mom
Member Since 2014
I'm really sorry things are so difficult for you all right now. 
Mogs
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For safety, the best thing I can suggest to you, C.W., is to get Mommy in to the vet as soon as possible to get the fructosamine test (and maybe a BG spot check at the surgery - might be stress-influenced but at least it would give you some information on what's going on) and also to discuss what to do about Mommy's dose until you can be sure she's safe. If she's showing that level of avoidance behaviour at injection times it's wise to at least consider the possibility that it might be Mommy's way of telling you something's amiss.
Mogs
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Nan & Amber (GA)
Member Since 2016
I'm not sure if anyone has suggested this yet, but in addition to a fructosamine test at the vet you also might look into getting some kind of "health monitor" additive for the litter box. I haven't used them in a long time, but I think there are several out there that will let you know whether Mommy is spilling glucose in her urine (possibly some will even give you an idea of the magnitude of the spillover). Never as exact as day-to-day blood monitoring, or even the fructosamine test, but better than nothing!
Red & Rover (GA)
Member Since 2016
Feliway?
C.W. Gortner
Member Since 2016
I do approach her often at home, we've always had a loving relationship. And she was just fine with the shots until I started home BG testing. I realize home testing is our goal here and I totally understand how important it is, but some cats just aren't into it; as we all know, you can't force a cat to enjoy something they don't. I've tried various new methods in the past weeks to reduce her stress and reinstate home testing; thus far nothing has changed in her attitude, other than she's less hissy with her shots, though she still obliges me to corner her under the bed. As for the home testing, I got one in on the fly, and she ran 115 at the time, about mid-cycle. It is what it is. She dislikes it.
However, we returned to the vet today for our follow-up and she's doing really well. Her spot-check BG was 124 at the time, about an hour and a half after her a.m. shot, plus she probably manifested the usual BG stress rise due to the vet visit itself. In any event, the vet wants to reduce her Lantus dose again, this time to 1u once a day, and see if she continues to stay regulated on it. He thinks it's entirely possible that she's nearing remission, based on her weight gain and overall well being, but I'm a bit nervous about reducing her dose in half once more. I'm not finding much online to support that once-daily dosing is less effective, though it's definitely linked to less likelihood of remission. But if she's indeed nearing remission anyway, of course it would be wonderful. He said to keep a close eye on her appetite and pee / drinking on the new dosing schedule, and should her symptoms increase, to reinstate twice daily dosing and call him. He didn't think a fructosamine test would add extra information at this stage.
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