Take your best shot

My Andre does not seem to be responding well to Lantus. He dropped originally and now is in a stalled pattern.
When first tested he was in the High fours and fives.
And now he hovers in the mid threes despite a complete diet makeover and it is close to the same number middle or end. It is flat.
He is no getting 1.75 units u100 BID.
it's time to change. I have opinions on doses from 0.5 u BID start to 1.75 u BID times 70% start.
What say you?
Keep in mind I have to take him to the vet to be tested at this point. Maybe later I can test him again.

No horror stories or threats please..I know the score. Been doing this for many years with PZI and home testing.

 

I'll be real honest with you - it's nearly impossible to suggest a starting dose without seeing several weeks of numbers that include PS test and spot checks at different times in the cycle. We also don't know his starting dose on lantus or how fast it was raised. Was "vet stress" factured into the decision to raise the dose based on vet-tested numbers? And so on...

Has your vet done a fructosimine test? It is so hard to know if the 1.75u is too much or not enough or lmaybe antus is just not the right insulin for him. Can you test for ketones at home? If so, maybe starting at .75u would be a safe compromise and might be low enough to show improvement if he has been getting too much. But if it isn't enough I would not want to risk ketones while he sits in higher numbers again.

He is eating a low carb diet, correct? "Complete diet change" could mean different things and I don't want to assume anything.

And now, being quite frank, I find your "request" for "No horror stories or threats" pretty offensive. Maybe you want to delete that from your post? (And I, in turn will delete this whole paragraph). I don't think anyone here has been threatening to you in a post or presented horror stories. I have not known this group to do that. You might want to save comments like that until you have a reason for them, OK?

You could, however, put a comment in your signature that says, "Andre is difficult to test, so no SS yet" or something. People are pretty understanding here when they know you are dealing with a difficult to test cat, or any other issues.

 

He started at 1u BID then moved to 1.25u BID over a nine week period. Then three weeks ago went to 1.75 u BID because of his still high numbers in the threes at +12. Today it was the same number at +6.

He has had every test imaginable. However, he never seems to show sugar in the urine. The fruc test was high.

I know nothing about Lev except the few things I have read. The system by which Lev works is different and may be what he needs. I fought the doc on this from the getgo. So i'm with a different vet.

But you are right no one can predict or recommend, but you know how it works and how it shows itself. Does it have one of those NDW things?

 

NDW?

I do know how it works and shows itself, but that is how it shows itself with several BGs test per cycle. For instance, some cats respond "significantly" in the first 3 cycles and we see that in the spot checks.

Oh! New Dose Wonkiness? Sort of - see above. Beau was one of the ones that had an immediate response on the first dose - no shed building needed. And by the 3rd shot he hit the 30s. But....without home testing you aren't going to see that.

Has Andre been tested for Acro or IAA?

 

Yes and he's good there.

 

Just another thought on "NDW":

Yes, you can get higher numbers for a cycle or two when changing the dose on lev. This is different than what I mentioned above, which would be New Insulin Wonkiness, I guess, when changing insulins.

 

I know ECID but in head to head comparison if it was stated in numbers the affect of an insulin would have on BGs to knock down numbers how would they compare? If the number five stood for the max effective force and one stood for the least.

At the vets getting blood from his hind leg he sits and purrs and loves the one specific girl i ask for. When I try and do it home he runs, hides and fights me !!! And my touch is as gentle as you can. I barely touch him.

I am flying so blind it is disheartening.

 

The big reason that question can't be answered is, as you pointed out, ECID.

EVERY insulin can be both a 5 and a 1. It depends on the dose, the cat, their environment, etc., etc. Sorry I can't be more helpful.

I will say that I think lev is a great insulin for cats. It is easy to work with and can be used by those who want tight regulation (TR) as well as those with weird schedules or weird cats ( :roll: ) that need some creative approaches. Many cats are being switched to lev lately with the hope that they will feel and act better on it. And it seems like they are - or the owners think they are would probably be more accurate.

I am sorry you are having so much trouble with home testing. You aren't trying to take blood from him leg vein are you? My vets told be I had to do it that way or Beau would be "one pissed off cat" from the ear sticks. Say what? I don't know of anyone that can single handedly draw blood from a cat's leg vein, so no way could I do that at home by myself.

Can we help in any way with testing tips? Beau learned to cooperate fully with testing by jumping up on the table and sitting on his blanket. He purred the whole time. Probably had something to do with the treats he got afterwards. I use the same process with Jeddie, but he often hides under the table or behind the sofa and I always have to go get him. He usually tolerates the test with only a few complaints. He did, however, need to be "burritoed" in the beginning and I got bitten badly when I first attempted to test.

I'm sorry you feel disheartened about it. You just have to keep trying, I guess. Tell us what you have tried. Maybe we have some more ideas.

 

I was testing him with mild complaint until two vet techs from my old vet brutalized and scarred hi ear. He was freaking out!!!

I was yelling for them to stop and they just smiled at me and kept on until I yanked him from them. The vet walk in and asked why Andre was freaking out. I wanted to poke him in the eye at that point. Ever since then no one can touch his ear without a fight. He had a black line down it on the edge for a week.

I'll just have to keep bringing him to the Vet three days after a change and otherwise every ten days until i can get him to comply.

I used to test my Ber three to four times a day and he never budged and even purred most of the time just because I was touching him.

 

if he is sensitive about his ears what about testing on the paw? Will he let you handle his feet like for trimming nails? That might be an area that you could test if his ears really upset him. You use the big non-weight bearing pad on the foot instead of the ear.

Mel, Maxwell, Musette & The Fur Gang