unusual dosing advise from Dr Lisa

Discussion in 'Lantus / Levemir / Biosimilars' started by Wendy&Tiggy(GA), Oct 24, 2013.

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  1. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 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.
     
  2. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    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.
     
  3. Bo & Jake

    Bo & Jake Well-Known Member

    Joined:
    Dec 28, 2009
    That advice is not from Dr. Lisa Pearson!
    FDMB member Lisa and Witn!
    Don't think that Dr. Lisa give advice on board!
     
  4. 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:

    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:
    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".
     
  5. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    I don't see any advice "on the board"....I found several references to "Dr. Lisa Pierson" in the remarks on her spreadsheet though
     
  6. 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.

     
  7. Picknickchick

    Picknickchick Well-Known Member

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    Aug 21, 2013
    Wow. This is very thought-provoking.
     
  8. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    i wasn't concerned as much as curious!
     
  9. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    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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