New, Need Help

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Jan and Topper

Member Since 2013
http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=94003

Can anyone help me? I don't know what to do about Topper's dose.

I've posted on the Health Forum but apparently I'm supposed to be posting here.
I'm trying to help my cat, I wouldn't be here on FDMB if I weren't, but apparently I'm doing nothing right. I'm not doing TR so I probably shouldn't post here anyway. I tried to make it clear in my first post about my limitations, personally and with Internet access, but what I'm understanding is that Topper can't be helped if I don't post every day?

I've been told Topper might be getting too much insulin, or not enough, no way to tell.

I don't know what to do.
 
First of all, you are doing a great job! You are getting a preshot test and a mid cycle test for both morning and night and that is a big accomplishment. :-D Did Topper start Lantus on March 26 at 4.25u? Any other health issues? How much does he weigh? Any chance you could create a profile? Here are the instructions.

I will wait for a more experienced member to weigh in but that seems like a very high starting dose, according to the protocol that we follow. How long until you shoot tonight?
Liz
 
Hi Liz and thank you for the reply. Topper was started on .25u of Lantus twice a day, nine months ago. He doesn't have any other health problems that have been found in blood or urine.
This is from my original post on the Health Forum:

My cat Topper was diagnosed with diabetes 9 months ago. Several years ago I had another diabetic cat, I home tested him but this time , with Topper, I didn't feel up to it. I'm old, not well, can't see well,can't hear well, can't think, can't figure things out. I decided to just have the vet take care of it. I've gone through 4 vets, spent thousands of dollars I'm struggling to pay off and Topper is a mess. I'm on a low fixed income and have no more money to spend and I'm crying my eyes out. This is my last attempt to save Topper.

I was taking Topper in to be curved and dose adjustment every 10-14 days. All of the vets wanted to raise the dose by 1 unit at a time. I refused and raised by .25u. According to the vets this is what *I* did to mess Topper up.

Last Fall he had a UTI that required two rounds of antibiotic. His bg was dropping so his dose was lowered. He went from 3.5u to 2u. The infection cleared up and his bg started coming up again. His dose was slowly increased again. Someone gave me a Bayer meter and test strips so I could test him but my hands don't work well and Topper faught the testing and I didn't test.
His dose got up to 4.25u twice daily, he was not "right", I had someone help me test and his bg was PS 320 +3 296 +7 294 +9 316. Other cycles were similar with no real movement.
Vet said he was getting too much insulin and to reduce dose to 3.75. Did that, I saw little change in numbers then he dropped from a PS 315 to +6 70. Vet said to lower dose to 3.25.

Background: Topper was a neutered stray I took in 6 years ago, he was abandoned by his people when they moved. He's around 9 years old. Since I've had him he's only been fed Fancy Feast Beef Feast Classic and Fancy Feast Chicken Feast Classic. No dry food. Bites of chicken at shot and test. This was the diet my other diabetic went on after diagnosis and I thought it might keep Topper from developing diabetes. He's been healthy except for the diabetes and UTI. He's gained a pound and a half since starting insulin and isn't losing it despite being fed less. He has Lantus insulin 3.25u 2x a day.
Click to expand...

I'll see if I can create a profile!
 
Jan and Topper said:
http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=94003

Can anyone help me? I don't know what to do about Topper's dose.

I've posted on the Health Forum but apparently I'm supposed to be posting here.
I'm trying to help my cat, I wouldn't be here on FDMB if I weren't, but apparently I'm doing nothing right. I'm not doing TR so I probably shouldn't post here anyway. I tried to make it clear in my first post about my limitations, personally and with Internet access, but what I'm understanding is that Topper can't be helped if I don't post every day?

I've been told Topper might be getting too much insulin, or not enough, no way to tell.

I don't know what to do.
Click to expand...

The reason you were re-directed into this forum is because you now have a spreadsheet up. :thumbup Don't worry; :YMHUG: you can post wherever and however often you like, but in this forum, there are more Lantus-specific eyes to offer assistance with dosing questions. You don't have to follow the Tight Regulation Protocol to post here and there's also the Lantus Relaxed forum if you prefer (just not as many people around to look at your posts).
 
Welcome to Lantus Land!

I posted in your initial thread on Health and I said then, I don't think you're doing anything wrong. We'll do our best to lend you a hand and get Topper on track. Please don't worry about needing to post every day. Not everyone here opens a daily thread (we call them "condos"). Some people do find it easier to post on a regular basis at the beginning of this process but it's by no means necessary. Likewise, not everyone here follows the Tight Regulation Protocol. If you've not taken a look at it, there's a different approach, Start Low Go Slow (SLGS) that many people follow. Personally, I think it's helpful to have a set of guidelines to follow. Whichever you choose is fine. We'll do our best to give you the help you need.

As I said previously, I think you've been doing a great job getting tests in. You may want to think about getting tests at some random times so you have a sense of what's going on during some of the times other than pre-shot and +6. Getting tests before you go out, when you get home, before bed, or for whatever reason helps to fill in the white spaces on your SS.

Given what the curves you've done look like and that you did raise Topper's dose systematically, I'd encourage you to raise Topper's dose. Regardless of whether you follow Tight Regulation (TR) or SLGS, you don't want to hold a dose overly long that's not bringing your cat into numbers that are at least below renal threshold. (This varies from cat to cat but I'd look to get Topper's numbers in the low 200s or below.) Letting numbers sit in higher ranges can make it more difficult to get the numbers to come down since the cat's body begins to treat those high numbers as "normal." Would you be comfortable increasing Topper's dose to 3.75u?
 
To answer your dosing question, I would probably raise Topper's dose another .25u. But, someone with a better eye for spreadsheets might suggest differently, so wait for a second opinion. ;-)

ETA: Sienne has offered the "second" opinion already. :lol:

You're doing everything right regarding dose increases. :thumbup If you increase too fast by too much, you can easily skip over the correct dose.
 
Jan

Welcome to you and Topper! You are doing a great job of getting tests and if you can test like this routinely, you can follow the Tight Regulation Protocol. You are also more than welcome to follow the Start Low Go Slow Approach and post here. We have members who are following SLGS. The advantage of posting in this forum is the number of members and there is almost always someone on 24/7. About the time the West Coasters are going to bed, the East Coasters are getting up.

If you wish to follow SLGS, please just put it in bold letters in your signature block so when we are offering you suggestions, we will know you are not following TR.

I'd like to go back and read through your Health posts to see where you got where you are now. However, because of the amount of testing you are doing, I think you should raise the dose to 3.75u; you were seeing some nice numbers at that dose. Too bad your vet panicked. ;-)

I'm just curious about who set the starting dose because unless Topper is a very, very big girl, that's a pretty high starting dose. But I'm not seeing any evidence of her dropping into numbers that would warrant a reduction yet. Sometimes too much insulin can look like too little but Topper isn't having inverted curves which might be one clue.

If you prefer to raise the dose in the morning cycle, that's fine. You don't have any tests for today other than the AMPS so as long as she hasn't come way down today, then you are ok to raise the dose this evening.

Please let us know whether you are going to follow SLGS or TR because dose increases come at very different times. Again....I believe you are testing enough to do TR and TR will give Topper the best chance of going into remission.

And you don't have to post every single day.....we are pretty laid back here about that. Post when you can or when you need help. We are happy to answer questions.
 
:-D :-D :-D I see Sienne and I posted at the same time. I guess Great Minds Think Alike because we didn't even discuss it with each other ;-) ;-)

I just read through all your posts and I have to tell you how much I admire you!!! You have done a fabulous job! How smart of you to insist that dose increases be done in .25u increments. You are an awesome mama!!!!

I hope you will like us here enough to stay because I think we can help you and Topper.

I'm really impressed with everything you've done!
 
Thanks so much.
I will raise Topper to 3.75 tonight. His +6 was 327, I can't seem to get the SS to work.

I've been trying to set up a Profile but am having trouble, will see if I can get someone to help me figure it out.

It seems to me when Topper was originally getting the dose of 3.75 and he dropped to 70, he should not have been reduced to 3.25. Looking back it just doesn't seem like a big disaster. But what do I know.

I think SLGS is better for me, I'm not able to test Topper a lot by myself, and I also sometimes fall asleep and don't wake up for a long time. I'll be 80 soon and nothing functions right, primarily my brain. I really don't feel comfortable taking Topper down to very low numbers.
 
Well I think you are doing super and you are amazing.

I am MORE than happy to help you with the Profile....I can have the basic form done for you to edit in two shakes. AND I can also get a picture up of your boy.

Could you PM me please at your convenience and I'll take care of those two things for you.

Good luck with the increase.....and don't worry about the reduction back when he got the 70. We'll just start moving forward.
 
Jan, you are doing wonderfully!!! I have to say that your brain seems to be functioning far better than I see in many of the younger people around me!! And Topper is very lucky to have you as a MamaBean. Shame on your vet for yelling at you and blaming you for Topper's issues! You obviously know way more about treating FD than he does, that's for sure!

Please keep posting here and asking as many questions as you need. As you can see, the folks in LantusLand are very generous with their knowledge and support...we are one big family here. Welcome aboard!!
 
Welcome to tight regulation board! There are many people here who can help you and Topper. And by the way you are doing great.. You found us and are doing great at testing etc. 80 is only a number!

I am looking forward to seeing his profile and hope we can bring him at least out of the pinks soon!
 
Jan --

If you're having trouble with your SS, make sure Google didn't bump you out and you need to sign back in. Look in the upper right corner. If you're signed in, your name should appear there.
 
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