Considering changing protocols

Discussion in 'Lantus / Levemir / Biosimilars' started by Voula, Apr 10, 2016.

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  1. Voula

    Voula Well-Known Member

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    Sep 15, 2014
    Hi everyone. I haven't posted much as I have been busy keeping doctors and vets in business. In the past month I have had one surgery and Lucy has had her dental with four teeth needing attention and last week I had a procedure for my varicose veins and now I have an infection after the procedure that is being treated. In addition elderly family members who live some distance away have needed assistance with their medical issues. So I have done my best with my Lucy's insulin doses but I have not been able to stick to the tight regulation protocol for some months now due to everything I have to deal with including doing some casual work when I can to help pay for our medical expenses. In addition I have my ongoing issues with my Crohn's disease. I am okay with not achieving remission at this point. I think that focusing on regulation is probably the best option for us right now and if remission comes it will be most welcome indeed. My Lucy is doing very well and she only has obvious diabetes symptoms when we skip a dose. Our vet suggested a looser regulation protocol so we could do the Roomp/Rand looser regulation protocol which uses weekly glucose curves or the Start Low Go Slow protocol used on this board. Our vet suggested we aim for glucose levels of between 5 (90) and 14 (252). The vet suggested we can continue on as we are doing with lowering or skipping doses when needed, or we can change to a looser regulation protocol as I have stated. I have been thinking that a looser regulation protocol might be better because I could give my Lucy more consistent insulin doses and less skipped doses. I don't have a lot of confidence with weekly curves alone so I will always do AMPS and PMPS tests before insulin and get another test in between doses when I can. Suggestions and advice are most welcome thank you. I hope everyone and their kitties are doing well and thank you again.

    My previous post:
    http://www.felinediabetes.com/FDMB/threads/our-update.154371/#post-1630242
     
  2. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Changing to SLGS is fine if it works better for you, but I disagree with your vets recommendations

    14 (252) is too high and could continue to damage her kidneys....renal threshold can be as low as 150

    You really are changing her dose too much though, even on SLGS you want to keep the dose consistent...the 1 unit dose doesn't look like it's taking her too low so I'd probably try that, but if you're really concerned, you could always go to .75

    Is there a day you can plan on getting a curve in? (understanding that stuff happens and you can't guarantee anything)
     
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  3. Voula

    Voula Well-Known Member

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    Sep 15, 2014
    Thank you Chris. Yes I just looked at our spreadsheet and it is hard to tell what dose we should be at because the dose has been changed so much. I think 1 unit is where we should begin and I can give that consistently the next few weeks as I hopefully have no more hospital stays and no work. So it will be a good time to start and see what happens with that dose. I can fit in a weekly curve in addition to daily tests. I test Lucy's glucose for urine and the renal threshold seems to be about 12 (216) most of the time. I have felt very confused and overwhelmed lately with everything so while I am recovering and have some time to reassess I thought I would write to the board members for guidance and opinions. I hope China is doing well after her dental and I read she earnt a reduction in dose which is good. All the best with that. Thank you again.
     
  4. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    (((Voula)))) so good to see you and Lucy! You have so many things going on - any one of them would be enough, but you've got several. I think you know Lucy really well and I know you have only her best interests at heart. I probably would try to keep her under renal threshold, so 200 or so if your previous tests said 216, just to protect her kidneys as much as possible.

    All you can do is your best and I know the health issues alone have been alot. Don't forget one other option for dealing with lower preshots (instead of reducing the dose) is to increase the amount of food, or the carbs in the food that you're leaving for her. That's one way that people who are gone to work all day manage. If you're going to be gone, you can always mix her cat food with a little water and freeze it in either ice cube trays or muffin pans. Then they'll thaw at different rates and be fresh for her to eat later.

    Please check in sometimes and let us know how you and Lucy are doing! Many healing vines to your side of the world! I hope your infection clears up and you get some relief from the Crohn's. :bighug:

    [​IMG]

    julie
     
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  5. Voula

    Voula Well-Known Member

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    Sep 15, 2014
    Thank you so much Julie. :bighug::bighug: I have felt quite overwhelmed at times. Overall though we are doing okay and I will aim to keep Lucy's glucose levels under the renal threshold and yes I can leave out higher carb food and frozen food too and I do always leave out food when I go out. I hope you and your family are all doing well and thank you again from me and my Lucy too. Much love to you.
     
  6. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    Love to you, too, Voula! I miss seeing your regular posts. :bighug:
     
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  7. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    I vote for the looser regulation (under the renal threshold) so that you can be consistent with her dosing. Hopefully that will keep her away from those stinky pinkies. I think it would be better for her long term health to keep her under the renal threshold more of the time than it is to have her making the odd quick trip to the lagoon but then spending so much time in higher numbers when circumstances don't permit you to monitor well.

    Sending vines for you Voula. I hope your infection clears up quickly. Also sending scritches for your beautiful Lucy.
     
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  8. Ella & Rusty & Stu(GA)

    Ella & Rusty & Stu(GA) Well-Known Member

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    Jan 11, 2010
    Hi Voula and Lucy,
    I agree with the others: a safe, consistent dose that will keep Lucy below the renal threshold. You are dealing with so much right now, and that approach to Lucy's diabetes would take a lot of the stress away.
    We hope that your health will improve and are sending bunches of beautiful vines to you and to those in your family whom you are helping.
    :bighug::bighug::bighug:for you and lots of scritches for dear Lucy,

    Ella & Rusty
     
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  9. suki & crystal (GA)

    suki & crystal (GA) Well-Known Member

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    May 4, 2014
    (((Voula))) you have so much going on in your life right now with various health issues, it must be very difficult for you to focus on keeping Lucy below renal threshold all the time. I hope you manage to find a looser regulation that works for you and keeps Lucy safe. My strongest healing vines for your post op infection to soon clear up and for an improvement in your general health :bighug::bighug::bighug:
    Scritches to sweet Lucy:bighug:
     
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  10. Voula

    Voula Well-Known Member

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    Sep 15, 2014
    Thank you so much Serryn. My Lucy and I appreciate your support and sending pats to Vyktor too.
     
  11. Voula

    Voula Well-Known Member

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    Sep 15, 2014
    Thank you so much. I have a lot to deal with right now and I think a more relaxed but more consistent approach to my Lucy's diabetes is best. We are staying with my sister at the moment and it is lovely here. She has what is called here a granny flat behind her house and Lucy and I have recently started staying here after my surgical procedures and we both love it and it is very relaxing indeed. We will be going home soon but it has been so nice to have some time with family the past week.
     
  12. Voula

    Voula Well-Known Member

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    Sep 15, 2014
    Thank you so much Suki and sending you many hugs too. :bighug::bighug::bighug: It has been very difficult at times lately but my Lucy keeps me smiling and we have been enjoying some time with family the past week.
     
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