unusual dosing advise from Dr Lisa

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Wendy&Tiggy(GA)

Wendy&Tiggy(GA)

Member Since 2011
Dr Lisa Pierson is apparently recommending this newbie shoot different dose at the AM and PM.. plus the newbie isn't getting nighttime tests .. Supposedly she is also considering recommending an insulin change too.. any thoughts on this?

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=106306

Edited to add - I just mentioned this because it was interesting and outside of our normal protocol. I am interested to see how it will work and would like to understand her logic because it may be applicable to other newbies. I also don't want to contradict her advice to the newbie.
 
Wow, that is interesting!!

I wonder if she's recommending the different doses because they aren't (or can't) test at night and she thinks Oreo is going too low at night and then bouncing by AMPS?

Will have to keep my eyes on it and see if they give us any reasons.
 
That advice is not from Dr. Lisa Pearson!
FDMB member Lisa and Witn!
Don't think that Dr. Lisa give advice on board!
 
Hi Wendy. I'm not alarmed by Dr. P's advice. Only because about a year and a half ago, she posted a few times in the PZI forum in the threads on a prozinc caregiver.

I think this might address what I'm trying to say:
...the bottom line is that I just have to take it case-by-case, cycle-by-cycle and am loathe to follow a set, rigid protocol that demands a curve and not a slant. (I was kicked out of Girl Scouts for not wanting to conform….)

I digress, yet again…...In my youth I was more stubborn in thinking that "there is a right way and a wrong way, by golly!!" and would accuse others of doing it "wrong" or state that they were "making a mistake" if they were not doing it *my way* Now I just see that there is more than one way to get to the same place and I am less judgmental when others are doing things differently. Also, it gives me more flexibility with each patient.

Don't get me wrong - the vast majority of my patients are handled the FDMB way with a set amount of insulin twice a day but, with some patients, I step outside of the rigid 'box' and try a hybrid management protocol and it has worked very well for my patients.
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I certainly don't want to put words in her mouth. But my sense is that...

She doesn't necessarily favor one insulin over another. Or at least, she has a great deal of experience with all of them.
She doesn't strictly adhere to any one protocol.
She considers and advises on each case believing that every cat, and every caretaker is different.
She is really good at "thinking outside the box" if a case warrants doing so.
She stresses that glucose toxicity from prolonged hyperglycemia is "the crux of feline diabetes".
She thinks this place is awesome and refers people to come here.
Her words, not mine:
Again, you guys do a GREAT job here and the diabetic cats of the world are incredibly lucky to have you GENEROUSLY donating your free time to their health. You have saved a lot of lives and increased the quality of life of many deserving furry critters. No doubt about that at all.
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What I am sure of is that I'd put the care of any of my cats in her hands without blinking. But if you happen to meet a new member who has spoken with her, don't be surprised if what she has advised them to do doesn't completely "fit" into how we do things, whether it's tight regulation/lantus or Prozinc with or without a "sliding scale".
 
Bo & Jake said:
That advice is not from Dr. Lisa Pearson!
FDMB member Lisa and Witn!
Don't think that Dr. Lisa give advice on board!
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Actually, if you read the whole thread, I think some of the advice is from Dr. P. My take is that the caregiver has been doing phone consults with her?

And in the PZI forum, in the threads I was talking about, Dr. P. does say that she has a "hard and fast rule aabout posing dosing advice on the board", which she "bent" in the one case by advising a dose increase for Lori and Copper.

I am going to break my rule here and comment on dosage. I would be raising it. I understand the issue of possible rebound but, generally speaking, I see it worried about far too much.
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As I have mentioned several times on this board, the last thing I would ever want to do is scare someone off and I regret breaking my hard and fast rule regarding posting dosing advice here. I have never taken the 'I am vet - hear me roar' stance. Well...except when it comes to dry food and blocked cats....then you will hear me roar very loudly.
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Interesting points, Carl. In particular, in looking at the SS, my first thought was whether glucose toxicity was an issues.

I believe there are notes on the SS about the consultation with Dr. Lisa.
 
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