Re: 3/10 Do Lou pmps 306 vet wants to raise DOSE??

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Lisa and Do Lou (GA)

Lisa and Do Lou (GA)

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AMPS 397 2u
+3 338 well what does all those with experience think are we making progress??? He seems perkier today :-D he has been up at the window its warm enough to open and even with his limited sight he was watching the birds puts a smile on Moms face
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+8 229 I was to call my vet today with a BG report on how he has been doing and give him numbers and he wants him to go 2.5/2.5 do you guys think its too soon for a increase its not that I do not trust my vet he is wonderful but he has not had a cat on lantus in a year he said so I would like input from here before I go with a raise tonight

pmps 306 2U
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http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=8543
 
Re: 3/10 Do Lou +8 229 vet wants to raise DOSE??

So AM was c6 of 2U and you are getting some action from this dose already.

IMO... shed isn't full and it's premature to raise dose.
Also.... 0.5 is a very agressive dose increase for lantus. It is my experience that vets don't think we can measure little wee amounts of insulin... but we can with BIG ugly glasses! :lol: a tiny drops makes a difference sometimes.

Wait and see what others have to say, but there's my 2 cents.
 
Re: 3/10 Do Lou +8 229 vet wants to raise DOSE??

I agree with Helen. Normally we dosecrease (up or down) by 0.25u rather than 0.50u Plus, I believe the protocol says when you start on lantus, to hold your initial dose for a minimum of 5 days (10 shots). But, please keep in mind, I am just an average joe here learning the ropes still! I would wait for 1 of the more experienced dose helpers to come along & give their 2 cents worth before making a decision.

Have you given your vet a copy of the Tilly protocol? My vet is not very familiar with Lantus either, so I gave her a copy of the protocol & it makes things much simpler when we talk. I also drop off updated copies of Morris' ss to her office on a regular basis so she knows what we are up to. She reviews the ss when she has time & will call me to discuss any concerns/questions she may have.
 
Re: 3/10 Do Lou +8 229 vet wants to raise DOSE??

Gwen and Morris said:
I agree with Helen. Normally we dosecrease (up or down) by 0.25u rather than 0.50u Plus, I believe the protocol says when you start on lantus, to hold your initial dose for a minimum of 5 days (10 shots). But, please keep in mind, I am just an average joe here learning the ropes still! I would wait for 1 of the more experienced dose helpers to come along & give their 2 cents worth before making a decision.

Have you given your vet a copy of the Tilly protocol? My vet is not very familiar with Lantus either, so I gave her a copy of the protocol & it makes things much simpler when we talk. I also drop off updated copies of Morris' ss to her office on a regular basis so she knows what we are up to. She reviews the ss when she has time & will call me to discuss any concerns/questions she may have.
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No I have not given my vet any kind of info it was a struggle just to get him to switch Do Lou to it he has used it off and on for very few cats my clinic where I work thinks novolin is the best insulin to use so when my cat was not doing well and I saw all the good of lantus here on this forum I started my quest to get him to switch but I do not think he has read much on it recently I could be wrong
 
Re: 3/10 Do Lou +8 229 vet wants to raise DOSE??

This cat is seeing action-this is good!
You have seen how many cats are on here, and the wealth of experience we have here with lantus..
You just started here, and have gotten good advice today--Not to raise yet!
My old vet kept wanting me to raise Moonie's dose, until he said 4u and I said NO! I left him for a better,lantus experienced vet.
I also gave my new vet her spreadsheets & and a copy of the Tilly protocol..She was impressed!

There comes a time when we need to listen to the voice of experience here, and step out & know how many hundreds of cats have been helped here, on FDMB! Not to say your vet is bad, just doesnt know anything about lantus..
Your cat is perkier & seems better--Look At The Whole Cat! HIS Actions, 5 P's(peeing, pooping, playing, preening, purring!), how he is more outgoing & looks better, etc.... This is the first indicator that it is working..
You are doing very well!! So is Do Lou! :mrgreen:
 
Re: 3/10 Do Lou +8 229 vet wants to raise DOSE??

Hi Lisa,

Yay for yellow!

By the protocols we follow here, the next dose increase would be by 0.25 units, because Do Lou had a nadir over 200 but under 300. The Tight Regulation protocol states to hold the starting dose for 3 days, which you have done, then to increase by 0.25 units. The modified protocol that we use in this forum would have you hold the starting dose for 5-7 days before increasing by 0.25 units. It's up to you whether you want to be more aggressive and how much you want to test.

Link to protocols: viewtopic.php?f=9&t=1581
 
Re: 3/10 Do Lou +8 229 vet wants to raise DOSE??

The vets where I take Shadoe know nothing about Lantus, sadly. I give the vet all the info I can, and I make sure that it is clear that I am following the protocol used on this site. I take in an updated ss as well on each visit.

About the increases, they are to be small, only by .25u each time. If you get into higher doses, you may increase by .5u, but not on your current dose of 2u. All increases I made were by .25u until we got to 6u BID. At that point, our increases were .5u each.

Since you have just started on Lantus at this dose, and you are seeing results, you could wait for a bit more and see how Do Lou responds, but I would definitely not increase the dose by .5u; it's too much.

I think it's your call if you want to hold or increase, but I am betting the advice you will get would be to stick with the smaller increase.
 
Re: 3/10 Do Lou +8 229 vet wants to raise DOSE??

Gayle and Shadoe said:
The vets where I take Shadoe know nothing about Lantus, sadly. I give the vet all the info I can, and I make sure that it is clear that I am following the protocol used on this site. I take in an updated ss as well on each visit.

About the increases, they are to be small, only by .25u each time. If you get into higher doses, you may increase by .5u, but not on your current dose of 2u. All increases I made were by .25u until we got to 6u BID. At that point, our increases were .5u each.

Since you have just started on Lantus at this dose, and you are seeing results, you could wait for a bit more and see how Do Lou responds, but I would definitely not increase the dose by .5u; it's too much.

I think it's your call if you want to hold or increase, but I am betting the advice you will get would be to stick with the smaller increase.
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If I increase tonight I will only go .25 not sure how to measure that will have to go look at my syringe is pmps was 306 so I would like to see his numbers go lower but I also do not want to go too fast I know thats bad as well confused_cat
 
The original Tight Regulation (Tilly) Protocol was recently changed. As Libby mentioned, the modified protocol that we use suggests holding the initial dose a little longer (i.e., 5 - 7 days) than the Tilly Protocol now recommends (at least 3 days). So whether you increase is up to you.

Do you have syringes that are in half unit increments? If not, you may want to track them down. Walmart's brand, Relion, does come in half units. Otherwise, you may need to order them on-line since most of the retail pharmacies do not seem to routinely stock them. I order through Hocks (there's a link at the top of the page). They are reliable, FDMB gets a commission, and they ship quickly.
 
Sienne and Gabby said:
The original Tight Regulation (Tilly) Protocol was recently changed. As Libby mentioned, the modified protocol that we use suggests holding the initial dose a little longer (i.e., 5 - 7 days) than the Tilly Protocol now recommends (at least 3 days). So whether you increase is up to you.

Do you have syringes that are in half unit increments? If not, you may want to track them down. Walmart's brand, Relion, does come in half units. Otherwise, you may need to order them on-line since most of the retail pharmacies do not seem to routinely stock them. I order through Hocks (there's a link at the top of the page). They are reliable, FDMB gets a commission, and they ship quickly.
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How do you dose .25 and I have already been to the page with the pics of the syringes that does not help me at all with looking at my relion syringe I can see how to up by .5 but there are no .25 marks so you are just making a guess??? for the .25 I am not overly comfortable with that either so need help I think :oops: :oops:
 
Hi Lisa, if it were me I would hold the current dose at least a couple more cycles. You know it took you a few days to see action on the current dose. I held our first dose for about 7 cycles before increasing by 0.25 units. As you know it takes time to fill up that shed and I would hate to increase it before you get to see the full affect of what this dose can do. If you don't see any blues in the next couple cycles you could increase, but as Libby said "it is up to you".

Honestly, after my vet told me to start off at 4units a day I never spoke to her again and trusted those more experienced here on the message board.

((((huggs)))) You do have to trust your gut and your cat and only you know Do Lou!!! :mrgreen:
 
paige said:
Hi Lisa, if it were me I would hold the current dose at least a couple more cycles. You know it took you a few days to see action on the current dose. I held our first dose for about 7 cycles before increasing by 0.25 units. As you know it takes time to fill up that shed and I would hate to increase it before you get to see the full affect of what this dose can do. If you don't see any blues in the next couple cycles you could increase, but as Libby said "it is up to you".

Honestly, after my vet told me to start off at 4units a day I never spoke to her again and trusted those more experienced here on the message board.

((((huggs)))) You do have to trust your gut and your cat and only you know Do Lou!!! :mrgreen:
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I did not increase him tonight I agree I do feel like he will in the end need a increase and I may tomorrow IDK but for now I gave him 2U tonight and will be testing him again tomorrow and go from there I do intent to take Tilly protocol to my vet when I see him next as well
 
Unfortunately, you can't get any syringes with .25u markings, so you have to eyeball it, positioning the top of the plunger between two markings.
It is way better to be off a drop or two when measuring between the two markings than to raise the dose too high for your kitty.

Don't worry; with the 1/2unit markings on syringes, you will be a pro in no time!
 
You could fill up the syringe to 2.5 units. Then I have found that twisting the plunger rather than pushing it helps to remove a little bit at a time. Basically if you can get the end of the black plunger to sit between the 2unit line and the 2.5 unit line that is good. It is about one drop to remove from 2.5 to 2.25u.
 
paige said:
You could fill up the syringe to 2.5 units. Then I have found that twisting the plunger rather than pushing it helps to remove a little bit at a time. Basically if you can get the end of the black plunger to sit between the 2unit line and the 2.5 unit line that is good. It is about one drop to remove from 2.5 to 2.25u.
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Ok I feel like a idiot you know not knowing how to do something as simple as that but if i raise his dose I would rather it be in .25 then the .5 and I wanted to make sure I would be doing it right thanks for the tip :oops: ;-)
 
Increases and decreases are usually in 0.24 increments. You'll get used to it. Just wait until you are doing fat and skinny doses! (We use micro dosing.) No worries. It just takes a little getting used to!!
 
(((lisa))) Don't feel like an idiot. I did not know about the twisting trick and everthing I learned was from someone else telling me :lol:

We are all family here!! :mrgreen:

BTW - I am taking some pics and I am going to try and post them of a .25 image. Wish me luck
 
paige said:
(((lisa))) Don't feel like an idiot. I did not know about the twisting trick and everthing I learned was from someone else telling me :lol:

We are all family here!! :mrgreen:

BTW - I am taking some pics and I am going to try and post them of a .25 image. Wish me luck
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Ok thanks so much for all the support I would be lost without this lantus forum now :smile: cat_pet_icon
 
Sienne and Gabby said:
Increases and decreases are usually in 0.24 increments. You'll get used to it. Just wait until you are doing fat and skinny doses! (We use micro dosing.) No worries. It just takes a little getting used to!!
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Thanks I just love all this wonderful support its making me feel so much better tonight
 
Believe me we were all like you!!-Moonie was also on N--Lantus is so so much better!
You will be happy here, and you will see results-And Do Lou will feel better! :-D
 
Okay let's see if this helps :? I don't have syringes with 0.5 unit markings, so the lines are whole units.

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I got myself a BIG magnifying glass on the end of a goose neck that has a clamp at one end. You could look in some place that has crafts where people need to magnify their works like needlepoint and beading.
There is no possible way that I could have come close to measuring some tiny dose like .1u, and was grateful that the .1u dose was raised to .25u. Even with the magnifier, I go cross eyed every time I measure a little amount. I think you could also find some magnifying glasses too.
it's not easy but it's doable.
 
Gayle and Shadoe said:
I got myself a BIG magnifying glass on the end of a goose neck that has a clamp at one end. You could look in some place that has crafts where people need to magnify their works like needlepoint and beading.
There is no possible way that I could have come close to measuring some tiny dose like .1u, and was grateful that the .1u dose was raised to .25u. Even with the magnifier, I go cross eyed every time I measure a little amount. I think you could also find some magnifying glasses too.
it's not easy but it's doable.
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Yes I think a magnifying glass would help will look for one
 
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