Hello! New to FDMB

Hello! Floyd is not a new diabetic, but he's still not regulated after MANY months of mis-steps. But we are close, and some support would be great!

Just don't be too hard on his vet (who has made some mistakes), because she is me.

Floyd is on 4.5 units of Lantus BID. He eats a home cooked diet formulated by Dr. Pierson.

He was diagnosed in May of 2017.

 

Welcome! Do I understand from this that you're a vet or are you looking after his FD treatment without a vet's guidance? Either way we can help.

 

Welcome!

 

If more vets would be willing to admit mistakes and to search for and accept assistance, there would be less 'horror' stories. Welcome!

 

I am a vet. Sorry about the confusion!

Most of my patients are dogs, so I can't remember my last diabetic cat. This is a learning experience for sure!

 

How can we help? I think it's great that a vet came here to FDMB.

 

Welcome. You'll find lots of great help and experience here for sure!

 

Hi and Welcome! Can you set up a Spread Sheet and fill in as much data as you have. Then we can see patterns and trends better and can offer more assistance. It will help to see how low the dose is taking Floyd and when and if he needs an increase or a reduction.


There is so much knowledge on this board for sure. So very glad you are here!

 

Thank you for the warm welcome! I have been using the spreadsheet for a couple weeks (and added info from previous curves). I've added it to my signature and would love some feedback.

 

Since you have your spreadsheet set up and plenty of data, a good place to get input is the Lantus Forum. The folks there can help you sort out what’s going on with Floyd. Here’s the link
http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/

 

The Lantus forum has a lot of very experienced people to help. Have a look at the yellow info stickies on that forum to acquaint yourself with the two basic dosing methods, TR and SLGS.

 

This is super supportive place to be! I'm greatful everyday to have found this group right at the beginning of my cat Diamond's Dx. You being a vet and coming here shows your open mindedness. Willing to learn something from people who maybe don't have a degree in veterinary science but may actually know more is awesome. A great virtue to have! Welcome!

 

Definitly go to the lantus forum and read the yellow stickies at the top. They have great info in protocols that have been shown effective. Lantus being a deposit insulin is dosed very differently than noon deposit.... And the protocols developed have been methodically thought out. You definitly have enough data to see what's going on. I don't use lantus, so I won't coment on dose, but I know pretty much what they are going to say based on the info on the spreadsheet. In reality glad you are here and open to trying a different strategy.

One thing I will speak to is the leg weakness you mentioned in the comment section not long ago. I'm wondering if you are giving b 12 methylcobalamin supplements? Many find them very helpful in conjunction with lowering bg, of course. A popular one folks in the US use is zobaline which is found on Amazon. It's 3mg and tasteless and easily Crushed with just fingers to sprinkle on food.

 

I am assuming you are using an AT2 meter? ( Only because you are a vet and all the vets love that meter) however there are a lot of us here, myself included that are using human meter as the Tight Protocol (TR) was written for human meter.

What I noticed looking at your Spread Sheet (SS) , you are switching up the dose back and forth in size and it's hard to know what each dose is doing. Unlike Prozinc, a sliding scale doesn't work with Lantus; since Lantus is a depot insulin, it craves consistency and the dose needs to be held the required amount of time to fill and you would hold that dose according to whether you are going to be following Tight Regulation (TR) or Start Low Go Slow ( SLGS), but of course if Floyd goes below 68 on an AT2 or 50 on a human meter he would earn a reduction of .25 of a unit.

Also, your SS is going backwards from the current day to the past and that will get confusing for peeps trying to see what it is going on. I am glad you shared some the ProZinc history as well.

Night time is when most kitties run lower so please always get a test in at least before you go to bed to see how low he is going. For instance on March 9 th PM cycle he was 242 and you shot 4 units and no more test. The next AM cycle he was 600. He most likely went lower than he is use to going and he bounced the next AM into the 600's. Bouncing is frustrating for sure but all that can be done is to let the bounce clear and it will take up to 3 days or 6 cycles sometimes to clear.

Come on over to the Lantus group and as others said, read over the stickies at the top where you will learn so much on using Lantus. Also, please start posting over there so all the veterans over there can help you with dosing. For now, we need to find a dose to get Floyd on that you will shoot consistently so we can see where he is in terms of dose. We don't want him to run over the best dose with switching around the dose . We recommend changing the dose in increments of .25 of a unit for just that reason. Sometimes too much insulin can look like not enough.

See you over in Lantus!

 

Feeling overwhelmed yet?

 

I will head over to the Lantus group for sure, but I'll address a couple things you mentioned here.

I do use a human meter - ReliOn Micro.

As a far as changing the dose, I was told by Dr. Pierson to curve after 6 doses and adjust based on that. Maybe I misunderstood her. (The order of the SS from current down to oldest is also on her recommendation)

I will start testing him more at night. The high mornings have been very frustrating and I am just starting to understand the workings behind that. Thanks for the input!

Off to test one last time before bed.

 

The L & L forum is very "busy" but very helpful. Some days my thread will get buried. However, if I have something that needs to be addressed, there are a few people over there who seem to "keep an eye" on me and help out. Now that I've got a feel for who seems to know their stuff, I will just tag them in my post. See you over in Lantus Land.