And I am about to tear all my hair off my head!!!!!! The good news: he's home. He's eating. The bad news: Just look at his SS. I'm going to hit my head against the wall to make myself sleep. I am beyond obsessed and anxious. It doesn't help that the specialist wants me to give him 9 units in the morning and 6 units at night. Which goes against everything that there is for Lantus. Maybe if he was still on PZI, then that kind of dosing might be okay for him. Anyway, hi, I thought I would give my lovely family here an update. Currently, Ming is sleeping. I know he's high and feels horrible. I think I would feel better if I didn't essentially have to "lie" to my vet about his numbers. I'm supposed to report to them on Monday. He's been so messed up because of how they want to dose him in the past week. Anyway, I'm sorry. I wish I was giving a happier update. Here's a photo of Ming during the night shift when I let him run around the hospital:
Crista, you can come here to vent anytime you need it! Ming is a darling kitty! You're in a tough place trying to follow advice on dosing from your vet(s) that goes against everything we here on FDMB know about getting the best results from Lantus. My two cents: he needs the same dose AM and PM the high doses recently along with the big change in dose AM to PM have scrambled his responses and created "depot chaos" the two long cycles you had to use have muddied the waters so you can't judge Lantus yet he's a volatile kitty like my guy and these frequent changes have got him totally off the rails you need to have a heart to heart with your vet(s) and ask them to humour you for a week (at least!) while you try a reasonable consistent dose with, at most, a tiny fraction of a difference to allow for the steroid (get L forum help with this) even with the optimal dosing method it can take a kitty a long time to settle and reveal the effectiveness of the dose - it WON'T happen in a few days the Lantus forum is ideal for getting the best dosing advice and that includes trying one of the two guides, SLGS or TR. I wish I could help you with the stress created by trying to follow your vets' advice. It takes a big leap of faith to depart from that and to be up front about what YOU, Ming's caregiver, want to do for your kitty. It's much harder for you because you work where your vets practice and have needed them to treat his DKA. If he was at home and the DKA was further back in time you could do the "nod agreeably and go your own way at home" thing. I think having a candid discussion about wanting to try consistent dosing is your best bet. It'll be difficult but Ming's wellbeing is paramount.
Aw Crista, you are ALWAYS welcome over here! I'm so glad you decided to come by and give us an update! I can't give any Lantus advice but I can listen when you need an ear and give you a virtual hug when you need it. I know it's tough when your vet is giving you some advice that directly contradicts what we say and what you know. I do think that 2 different doses will be bad. From what I know of Lantus, that depot is going to be really messed up by switching the dose up like that. I know it's tough when your vet is also your employer, but I agree with Kris...have a long heart to heart and let them know you really want to try something different for now. See if they will give you a little time and space to work things out. And we're always here if you need to vent or anything, Crista! We care about you and Ming!
The only thing I can suggest is if you haven't print out the stickies how lantus works and give it vet to read. He/she is still using it like in out insulin. Lantus does not work like that. What would happen if you forget to update them on Monday? http://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/
Thanks Rachel and Kris It really helped to hear from both of you. I’m calmer and even though I’m having breakdowns all over this forum, it’s nice to be reassured and welcomed(? Is that the right word to use?? Haha!). Sometimes I think: what did I get myself into?! I have BAD thoughts like, if I never adopted Ming, I’d be carefree!!!!! But then I’d never know love. I know having Ming in my life has made me more patient, more optimistic, and has shown me unconditional love is possible. It has also given my family a lot of pride and joy. My parents talk about Ming to their friends like proud parents haha! And I’ve learned SO MUCH. I was watching Sandy and Black Kitty’s tribute video and there was one photo that said: “You can sleep when you die” which made me laugh so hard!!! It’s so true Anyway, sleep helped and Ming woke up and bothered me for food which made me feel better too. He’s high but not as high as last night and he’s acting much better. I hate seeing him sleepy and possibly dizzy/feeling horrible. He was sleeping in my mom’s room after his PM shot last night which, as nice as it is for my mom, my mom and I both know that means he’s feeling bad (another thing I’m proud of: learning Ming Language haha! I’m not 100% fluent but I’m definitely one of the best interpreters of this particular cat language ). Thanks again all I’d be a bigger mess than I already am without all the lovely words and virtual hugs and hand holding
They will def call me. But I think, for today at least, I’m not going to stress (too much. I WILL stress but I’m going to try my hardest to adopt the phase: ~ ignorance is bliss~~ ) about what my vets want me to do. I’m just going to focus on Ming and doing what’s best for him. And thank you! Sounds like a great idea to print stuff out for them when it’s heart to heart time. I kinda hope this all goes well and I don’t have to go back to the vet until months later. Fingers croooosssedddddd!!!
Thats what voicemail is for. Then delete voicemail. Smile and nod, works well. They don't live with you to know what you gave for dose.
Haha!! Yes! When I inevitably need to answer them: “He’s great! The 9 units in the morning TOOOTALLY work perfectly with the 7 at night ” When he has another issue that needs medical attention, that’s when I’ll come clean lol. I don’t see it happening soon. Maybe sooner if I followed their dose recommendations.
Well I am glad that Ming is home and looks pretty good in your photo. I am too new here to contribute anything scientific but I understand your stress and sympathize. I too have been challenging my vet and I know nothing compared to most on this forum but what I do know is I see what’s going on daily and have to take that into account when making dose decisions. Take some deep breaths and yes have some wine and hug Ming. Wishing a peaceful day to both of you. May I ask how long you had Ming on Prozinc and what prompted the switch?
Hi Lisa! Thank you I treated myself with a bowl of poke and iced coffee. Kinda my version of wine. I haven't taken up the nice habit of drinking alone yet hahah but I love some good beer with friends. Anyway, enough of my yabbering. Ming was on Prozinc since he was diagnosed in March 2018. I didn't do any home testing as my vet then didn't think it was necessary and his main reason was so I didn't break the relationship with my cat. I started home testing in September when I learned how to by talking to a coworker that had many diabetic cats (3, I believe and are all in remission) and from learning at work (I started as a vet assistant in July). It was nice. I understand PZI enough that I felt comfortable within a month changing doses by myself. I still asked advice when something weird would happen and something weird ALWAYS happened because Ming was probably actively getting another pancreatitis flare up. Then he had full blown pancreatitis AGAIN (probably the 6th or 7th time since March...). Hospitalized for 2 weeks. The last week was kinda unnecessary and just really for the doctors to monitor his BG but REALLY Ming was NOT having it. He was probably just so stressed at the vet and the vets didn't understand Lantus so he was all messed up when he came home two days ago. (I had A GREAT day with Ming today btw!!!) I opted to try Lantus because Ming bounces so much and goes up and down so crazily. Kris suggested it! Lantus is supposed to give nicer flatter curves but imo, it's more complicated than PZI because the last dose affects the next cycle so you gotta be careful. With PZI, if I'm correct, it seems unless you don't overdose, the effects will stay within the 12 hour cycle. Someone should correct me if I'm wrong. I'm new to all of this too but because Ming is such a complicated kitty, I thought I would try Lantus so he doesn't have to go up and down so much and it would help his pancreas a lot more.
Hi Christa! I am glad to read this update on Ming. He is a lucky kitty to have you as his CG. Yes, I have read that the L insulins provide flatter curves; however, our Three Wise Women on here — Rachel, Djamila, and Kris & Teasel — have also taught me that when ProZinc is dosed well, it should last 14 hours, so while there’s not a depot per se, as with the L insulins, there can/should be an “overlap” that can be “shot through.” That shooting-through-the-overlap is what we are trying to learn to do. *sigh*
Oh I love the Three Wise Women here. Kris even spreads her wisdom on the Lantus forum. She is so wonderful! That's interesting about the 14 hour cycle! It would've been nice to achieve that flat and overlapping curve with Ming on PZI. Good luck with Josie though. And I see right now you're actively working on an overlap dose! Oh, Josie
Thanks for the compliments! I try hard to convey what I've learned from my EXTREMELY complicated to dose boy. He was diagnosed in January 2016, put on Lantus, then ProZinc, then Lantus again, then Levemir and back to Lantus - need I say more?? He's had two bouts of DKA and has completely bamboozled my vet(s). I control his FD treatment with the blessing of his regular vet who trusts me to act responsibly and cautiously. The ProZinc forum is small but you have Rachel and Djamila here. I'm here too and also post on the Lantus forum but not as frequently. That's because I don't follow the TR or SLGS methods closely. Teasel has his own very customized dosing regimen.
Kris' generosity with her time and experience is a huge benefit to all of us! And Rachel has the wisdom of having been here for a long time and seen some of the shifts and changes and history to what works best, and the many variations of that. I'm honored to be included in their company! And yes, as Jenna said, Prozinc does have overlap when it's being dosed well, and while you don't have to wait as long to make changes (a benefit for kitties with other health conditions that require adjusting insulin in response), it is important to consider several cycles together in deciding on the best approach. So it's not quite in and out the way Vetsulin is. And in several articles on FD, Prozinc is listed right along with Lantus as a long acting insulin. Even on the sticky here in Prozinc though, it calls it in and out, so I think that has led to some misconceptions about how to dose it.
Thanks for correcting me, all! I knew I wasn't right LOL I hope @Lisa and little read you guy's replies So far Lantus land... is wild. All I can say is.. wild. Ming seems to sleep A LOT. He's really only active during the morning it seems, right before breakfast. I wonder if he's still recovering from his 2 week stay at the hospital?
DKA can knock the stuffing out of them. It can take weeks for normal energy to return. He's also getting used to a new insulin and isn't yet at his proper dose range. He'll get there!
Aw you guys are so sweet! Kris and Djamila have been a true blessing to have on this forum. I'm so grateful both of them are here and willing to give of their time and energy and wisdom! If I recall, part of the reason for the switch to L was also the DKA. You can shoot on lower numbers with Lantus (though I'm no expert on that...I just know it can be done) which can really help with a ketone prone kitty since getting insulin into them is key and it's harder with Prozinc sometimes since it has a deeper curve. Poor Ming! I'm sure he needs a break and just some home relaxing time after the stress of the hospital stay, the DKA, and probably just the changing of insulins and doses!
Yes, thank you for reminding me! I'm having many moments where I think to myself, what the heck did I get myself into?! PZI was easy!!! My big problem in Lantus land right now is Ming going LOW FAST and then bouncing SPACE high. And then worrying about that back up insulin creeping up on him. I never really had this problem with Prozinc. I was happy to even get a 140 ahahah! I miss prozinc in that it seemed more straight forward but Lantus seems much more attractive in the long run when Ming and I get there.
