8/01 Taffy, AMPS 198, NOT urgent, need input

Oh dear it's been so long since we've posted here! So very grateful for the support I had early on with Taffy's Dx it has made my experience and his life so much better and I'm sure he wouldn't be here today without fdmb!
I sawt post about how to properly do our daily postings and honestly I don't remember please feel free to correct me Etc. Also I do not have a currently or even near to recent updated spreadsheet. (I record his daily readings in a notebook.) Taffy has been doing so well for so long. He's approaching 17 years old and diabetic for almost 4 years. His senior Wellness checks are fantastic. Everything's good except occasional elevated pancreas enzymes so I have to be diligent with his diet. He eats very well. High dose Probiotics are essential for him.

We have been on a low dose of .25 or slightly less, lantus, for quite a while and his numbers stay good. I am quite comfortable with his maintenance, but here are my questions: (mostly I need help on how to address these things intelligently and informed with my vet. I love my current vet but she is worried about Taffy going too low and wants me to make changes to one shot per day.)

Taffy's most recent fructosamine was 130. My vet said this is low and may indicate that he is going too low too frequently. I assure her that I test him daily &w I am concerned about him being low and that he is always okay. Taffy also shows no glucose in his urine. So she has had me do a trial of one shot per day in the a.m. of .25 units, but when I try this, BG slowly creeps back up and I always go back to twice a day. I also need help explaining to her why using my ReliOn meter is fine as opposed to the alpha track. the alpha track always runs higher. how do I explain to her which one is accurate etcetera.
THANK YOU!

 

I can’t give dosing advice without a spreadsheet but Lantus needs to be given two times a day almost always. Rather than dose on e a day it’s best to dive the dose and give half of what you are giving every 12 hours. If you test when you see Taffy approaching 50 until in the rise again you should vd able to catch it if dropping too low.

 

Right. And this is what I've been doing for so long twice a day dosing .25 sometimes a little less sometimes a little more but we stay right in this range depending on his blood sugar readings.it's my vet that's stressed out not me she says his fructosamine level indicates that he is low too frequently I don't know how to intelligently discuss this with her. I was doing the trial of one shot per day sort of just to appease her and show her that his blood sugar will creep back up on this regimen.

 

Hard to give advice without looking at a spreadsheet. Can you start one for 2020? Even two months worth of data would be a great help.

By giving only one shot a day, you are losing the famed and quite necessary Lantus depot. That is why her numbers are creeping up.

Tell the vet that the AlphaTrak strips are not affordable in the long run and you are doing what you can afford.

 

I'm glad Taffy is doing well overall. Your vet must not understand how Lantus works with the depot. One shot per day constantly drains the depot and his numbers will keep going up and down. She is probably worried about how low his numbers are going because most people don't home test. You might try explaining the depot to her. I believe TR is based on using a human meter. If you show her the protocol maybe that will help her understand why you are using a human meter.

 

Our dosing methods were created using human meters. Back then, not so long ago, there were no AT's. Since then the company Abbott has done an incredible job marketing to vets. So if you are following a doing method created with human BG meters, best to use one.

Even two weeks worth of data in an SS is worth looking at.

Scritches to Taffy.

 

Until you have a spreadsheet for us to look at, what about picking a few days across a 2 week period and getting curves. This will give you (and your vet) a bigger picture.

If your vet is adamant about your using a pet specific meter, you can suggest she lend you one and provide the strips. Maybe the vet will appreciate the cost to her patients' caregiver if she

 

Hi all, thank you for replying! I already started Taffy back on two shots a day last night and he's already back in a good range this morning. Honestly I'm pretty comfortable with what I've been doing. My vet has only been freaked out since his fructosamine levels came back from lab at 130. I don't know anything about fructosamine levels so I don't know what 130 means. She seems to think it indicated that he has gone too low. Looks great eats great has great values for liver and kidney Etc so I'm not really sure what her concern is I'm just sort of trying to discuss it with her but I needed to understand the fructosamine and how better to tell her why I use a human meter, besides the cost. Anyhow I may just go along with doing what I want and no is right for Taffy and not tell her won't be the first time I've kept my vets in the dark!

 

Here are his recent labs. Should I be worried about the low fructosamine value, should I get it redone?

 

Reference Ranges for Fructosamine Test It says 254 in the document you posted, not 130, which had me panicked at first! 254 is still a bit low for a cat on insulin. I think I'd do some proper home BG testing instead of redoing the fructosamine.

 

Oh my dear you are exactly right! I don't know why I didn't notice this I'm sure the vet had said 130 and everything I was looking up 1:30 seemed extremely low and I didn't know why it would be.anyhow I think I'm not going to worry about this anymore Taffy is doing really well and I will just continue to test him and get him his regular senior blood panels.thank you so much for pointing that out,I can't believe I hadn't noticed.