12/13 Colorado Gizmo - Increased Dosage - Highest PMPS yet 412

Discussion in 'Lantus / Levemir / Biosimilars' started by Adrian B., Dec 13, 2017.

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  1. Adrian B.

    Adrian B. New Member

    Joined:
    Nov 2, 2017
    Hey all,

    This is really just an update to my previous post.
    So I finally have my spreadsheet linked below. And we did get out to the vet last week, the vet was encouraged by Gizmo gaining a pound since he was last in. However, the fructosamine levels were higher than they were when Giz was first diagnosed and the glucose tested up in the 460's on the vet's alpha track meter.

    The doc suggested we increase the dosage to 3u twice a day and hold off testing until a week later. Well we did increase it a week ago and today, just before his evening shot, Gizmo was at 412.

    I know this may take awhile and perhaps there are other issues impacting his levels, so I'm just going to keep monitoring for a couple days and call into the vet with the results.

    Anyways, thank you all for your support!

    Adrian & Gizmo
     
  2. Stacy & Asia

    Stacy & Asia Well-Known Member

    Joined:
    Oct 2, 2017
    So much could be going on, but there are no tests in between the shots to give an idea. Lantus is dosed by how low they go in the middle of a cycle, not on preshot numbers. Some vets don't realize this because some of the older insulins are dosed by preshot numbers. Most increases here are done 1/4 of what your vet is having you increase at a time.

    Gizmo could have had a low number in this cycle or the last and is bouncing from it to the 412, you could have passed by a good dose (just for example, pretend the good dose for Gizmo was 2.5 units) and now you're at 3. Too high of a dose can also give you those numbers. Is there any way you could get a test or 2 tonight or anytime in between cycles to get an idea of what is going on in there? There's nothing to do without that info besides guessing.
     
  3. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Stacy is right, we are very data driven here. Your vet's advice to hold off on testing is poor advice. Keep monitoring and filling in some tests at random times in the middle of the cycles, and we'll be able to get a better idea of how Gizmo is doing on this dose. Neko's absolute worst preshot numbers were when she finally started to see greens in the middle of the cycle, hence the resulting horrible bounces. We have seen some cats here start at black preshots, dive down and earn a reduction (below 50) mid cycle, then back up to red or black by the end of the cycle. Without mid cycles tests, it's hard to say if the dose is too little or too much.

    As for the fructosamine - same thing happened to Neko, subsequent tests went up. Her vet said that happens and not to worry. Shortly after that I figured out it was cheaper and a better representation of what his happening, to buy more tests strips, gather data on what was happening at home, and save money on getting fructosamines done. I had a non diabetic cat that tested in the 200's at the vet and 53 at home the next day. Fructosamines are averages, not a true picture of how low a dose is taking a cat
     
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