Lkldcatlady said:
I was told by my regular vet to draw in tooth prozinc and shoot the rest back in the bottle so I never did all those steps. I'm using Terumo 29 gauge x 1/2" needles 1/2cc. All there are are 4 little marks and then a 5, 4 little marks, then a 10. No half units, right? I don't mean to sound stupid, I'm just amazed at how all the dose is compared to what he was getting with the prozinc and the u40 needle.
I tried to follow all those steps posted and I got lost too! Talk about making something simple into a huge complex project! OK moving on....
I take it you have U100 syringes and on the barrel, the max is 50units.... those do NOT have the half unit markings, but you can use them for doses that are full units, so you can just go and pick up a box of syringes that are 3/10cc with the max of 30units. Be sure to ask for syringes with the 1/2 unit markings.... I usually got the BD syringes and on the end of the box, there was a little diagram showing that the syringes had 1/2 unit markings. You will see 5, 10, 15, 20, 25, and 30 with the same 4 lines on one side, but also more lines on the other side that are staggered.
Anyway, some insulins need to be rolled to mix it, but Lantus and Levemir need no rolling as there's nothing to mix. Alot of people switched insulin and just treated the new insulin the same and had problems.
If you have a vial, some people are not told that they need to replace the insulin they draw out of the vial with air. So, how you put the air into the vial matters if you want the insulin to last for months.
You can have the plunger in the syringe pulled back up to maybe 1unit with air, then with the vial sitting upright, insert the syringe needle into the vial, push the plunger to put the air into the vial, then with the needle still in the vial stopper, turn the bottle upside down and draw out your needed amount of insulin.
For your next purchase of insulin, get the pens or cartridges.... if something goes wrong with your vial, you are out 10ml of insulin and lots of money, but if you have a problem with a pen, you are out only 3ml..... you also don't have to worry about the insulin going bad in the 3ml pens, but with the 10ml vials, it could happen. And you also don't have to worry about the replacing of air because you will see there is no air inside, only insulin.
I am glad you switched to a longer lasting insulin.... let's hope you get to some good numbers now.
There's still a chance that you are dealing with acromegaly, IAA or a combo of both, but put that aside till you know for sure by way of the dose rising high again, and numbers still showing resistance.
Because you were at 4u with prozinc, your starting dose of 2u is just fine.
Prozinc has no depot, shed.... it's an insulin that you give and it's all used up, then the numbers rise and you have to give more. Lantus and Levemir are a bit diff.
To start, you are doing much like medicine your dr gives to you.... you know how you are told you may not feel better for a few days because the meds have to build up in your system? Same deal. You start to feel better maybe around day 3 or 4, yes?
OK, you can give the 2u dose am and pm for at least 3 days, and watch to see how the numbers are going. It's said to hold for 5 days, or 10 cycles, but as you have taken a bit of a reduction in dose, I am thinking by day 4, if you are not seeing any changes in the numbers, you can start your climb in the dosing. Go by the protocol where you raise the dose every 3 days by a 0.5u increase or a 0.25u dose if you are in the 200s and lower. Don't worry about the tiny increases for now as I think you will be fine with the 0.5u increase for a bit.
You do not need to be going to the vet for fructosamine tests.... they are expensive and all they are is the average of your cat's BG numbers over the past 2 weeks. You can get that number from your own meter that you use to test at home; it's not a magical test, so save your money.
You may think you are seeing an awesome specialist but by what you say on the dosing, it does not sound like anyone special to me. Raising a dose by full units is just not right.
What has the cat's weight and measuring food and water intake have to do with home testing and seeing the cat's blood glucose numbers in reaction to the insulin? Are you going to be measuring output as well on a scale? Seriously, what has weight got to do with anything? Many cats lose weight before diagnosis, but you are not new, and a weight gain now would be more indicative of acro because cats with acromegaly do gain weight. How do you know what type of success she has had with others? Are the other owners home testing and there are numbers to prove the cats no longer need insulin or are well regulated? It sounds like they have drawn lots of blood and urine and run a bunch of expensive tests with no findings..... other than what you knew before you paid $2000 and that is the fact that Bob's diabetic.
When you see your vet next, get hard copies of all the tests that have been done and just say you want to keep them in your binder at home as you have been tracking your cat's medical history in case something happens to you. For the big chunk of money you are being charged, the papers should be trimmed in gold.
Forget about cushings; not sure why that was mentioned unless your cat has very very thin skin that rips often.
For the pancreatitis test, find out what was the number result of the fPLI test.
How were liver problems ruled out? Did they do any Xrays or an ultra sound?
The next tests that this specialist wants to do, ask why. Right now, Bob's not sick, is he? He's got diabetes and you are giving him insulin. You will raise the dose slowly and safely until you reach the dose that produces nicely regulated numbers.
By feeding a good low carb wet diet, and giving insulin, Bob can reach regulation, even if his dose is high... no tests are needed, just food and insulin, then maybe tests for acro and IAA if the dose gets higher and gets around 6u am and pm with no improvement in his numbers.
Gayle
I will purchase the half unit syringes tho. Makes sense to me to not skip over the correct dose! Just really praying the Lantus works for him. Thanks again for the info!
