1/7 Wally AMPS: 413, +6: 337, PMSP: 417 ...is tomorrow again 5U?

Today my first day back to the office, this means I could not monitor closely, but happy anyway about the numbers! I see the numbers are (slowly) going in the right direction.

I also see Wally has a nicer fur and he's active when we are home with him...

Tomorrow I guess we will stay with the same dose 5U (this was the 4th cycle).... what do you think? For the whole week until saturday we will not be able to monitor as closely as I would like to.

How do you usually manage this situation when the cat is not well regulated?

By the way i forwarded my endocrinologist with a link of http://www.tillydiabetes.net and his feedback was not that positive. He didn't know the protocol and he didn't take it seriously...

I know that most of you are on the other side of the world, but do you have any Idea on how I could find a good vet with expertise on diabetes in north Italy? Maybe there's someone else reading in this post my area....

In case of emergency I need someone that can assists us and don't blame us because we didn't follow his unknown protocol.

Thanks you as always for your feedback

 

A better reference to send to your vet is the published version of the protocol. This is the publication reference: https://www.ncbi.nlm.nih.gov/pubmed/19592286 and here is a copy of the article itself: https://drive.google.com/open?id=1CNgMewMsOsui_jx7GJOkJ9HajlIS6ww-

I would personally increase the dose. You've done 4 cycles with this dose and you're still above 300. I'd move up to 5.5ui. You won't go from the numbers you have now to a hypo in two cycles with an increase from 5 to 5.5. If you are worried because of your absence and inability to monitor as much as you'd like, you could go up 5.25 -- but I think 5.5 is safe enough. If you start seeing yellow values then we can slow down the increases.

What do you think?

 

I'll let others advise you on dosing.

Many if not most of us are in the same situation. There's excellent advice here on FDMB, Stefano. You can always post here if something comes up that you need help with. It took many of us a long time to break away from the idea that we need a vet's guidance to treat feline diabetes.

 

Thank you Stephanie for your opinion.... About your question I don't know what to think ...I am personally happy that I don't see black all the time like last week!

Should we give Wally some more time to adapt to 5U considering he's behaving well lately?

Do you see any side effect to wait 2 more cycles? I also want to hear other opinions! .... I would love to increase when i can monitor him to see what's going on!

 

The choice is yours if you want to increase or hold the dose for one more day. 5.0 units is not the right dose, so you will need to increase, whether tomorrow or the next day to 5.5 units. The advantage of holding for the full 6 cycles periodically, is that then you know the depot is full. That may help with discussions with the vet or give you some comfort that we aren't increasing too fast.. If that's not so important to you, I would increase. Typically we slow down to increases every 6 cycles once you start to see yellows.

 

One more thing, the fact that Wally is feeling better and looking better is a good sign.

 

I'm scared we'll reach 10units in a few days Yes I'm worried of my vet opinion and I also have the hope (maybe just a dream) that Wally could get better even without increasing insuline.


I will measure tomorrow AMPS and decide what to do...Do you think that I can't expect any better number without dose increase?

 

A cat needs however much insulin they need. Try not to worry about the size of dose, but instead worry about the blood sugar numbers. Those are what are important.

Honestly, you might see a slightly better number (lower pink), but still not where you want them to be. Wally will need a dose increase, probably several more yet. My Neko got to 8.75 units of insulin, we have had cats here on much higher doses. At this point we can't say what dose will move Wally's blood sugar. Just keep increasing as per protocol. Years ago we had a vet tech that was a member. She had a saying "be the tank, the tank always gets where it's going".

 

@Krystina & Nelli Stephano's vet started Wally on too low a dose when he switched to Lantus. This was also shortly after a DKA incident, so we had him increase more quickly than normal, up to the dose he should have started Lantus. You will note that the ketone numbers improved as the dose increased. After that, he has been increasing as per protocol. If nadirs are above 300, doses can be increased by 0.5 units.

Here is the link to his previous post, if you want to start reading the history of how he got where he is.

 

Thanks Wendy

 

I looked over that copy of the published version and that is exactly what you need!! If that doesn't make a difference for your Vet than searching for a new Vet makes sense.