1/18 Felix AMPS 530

1/17 viewtopic.php?f=9&t=2961

http://www.tillydiabetes.net/en_6_protocol2.htm
In many cases, the starting dose of Lantus or Levemir has been 0.25 IU per kg of the cat's ideal weight and is always dosed BID (two times a day, 12 hours apart). If the cat received another kind of insulin previously, the starting dose should be raised or lowered by taking this information into account. When selecting a starting dose, it is important to know that while Lantus and Levemir have a longer duration than other insulins, they also have a lower potency in most cats.

The cat should be monitored closely on the first 3 days on Lantus/Levemir: do curves between the AM and PM-doses, e.g. AM pre-shot, +3 hours, +6 hours, +9 hours, PM pre-shot. Generally the starting dose is kept for 3 days. Test for ketones daily. Cats that have a tendency to get ketones and/or who are getting relatively high flat curves after the switch should have their dose raised earlier (after 24-48 hours). It is extremely rare that a cat will need to have its dose reduced in the first 3 days, but if the cat falls below 50 mg/dl, reduce the dose.

Increasing: Most cats need to have their dose increased. Do it in 0.25 IU or 0.5 IU steps (0.25 IU if the cat is getting a low dose and/or relatively low BGs, 0.5 IU if the cat is getting a higher dose and/or relatively high BGs).

I'm confused. I went to the Tilly Diabetes page and read the protocol that appears to be used here. Felix's numbers are very high and they appear to be flat (I assume that means there's not much difference between numbers). According to the protocol, I should have raised his dose after 24-48 hours. He's been on this dose now since Jan. 4! I did a curve between the AM and PM dose yesterday, every two hours and it's obvious he's not dropping low. I've been looking at a lot of the other new cats and it seems like somebody tells them when it's time to increase, but nobody has told me to increase. Am I supposed to wait? Also, I don't see any relationship between when people tell them to increase and when the actual protocol tells them to increase. Exactly how is the protocol here modified from Tilly? Can I follow Tilly but still post here? Another new person commented about the "forum police" - do people get in trouble for asking questions and not doing what strangers tell them to? I'm sorry, but I see that Tilly is published and researched and I can't find anything on this site or the Internet about the actual protocol used here. I see that cats go into remission, which is great and I see that people are around all the time to help, which is also reassuring, but I'm uncomfortable following an unknown protocol. Can someone help me understand? I don't want to cause trouble, but I can't blindly follow a bunch of strangers on the Internet.

As grumpy as he is, i love my little Felix and want to do what's best for him.

 

Re: 1/18 Felix AMPS 530 dose please.

 

Hi ((April))..

I'm so sorry to hear that Felix is not feeling well today. Those higher numbers really can make them feel lousy..
I hope that you are testing for ketones with these higher numbers.

Yes.. it can be very difficult trusting a website, but what we have found here from others experience is that it works.

Glad to see that you are getting more spotchecks. Keep it up! This way others can look at Felix's SS and help you make decisions with dosing per the Tilly protocol.

As Helene mentioned, it definitely looks like Felix is ready for dose increase. What do you think?

Hope to hear back from you and how Felix is doing..

 

hello there. i was asked to come out of my sick bed to post to you.
yes no one has suggested an increase to you yet on your second day of posting here for a number of reasons but let's start with that there was only PS tests and lantus dosing is based on nadir (the lowest number of cycle) of which there was none.

your post confuses me though, i don't quite understand what you want from us. here maybe this will help...we here in LL use the tilly, "published and researched" protocol might we might suggest modifications or tailoring to an individual cat's needs if we see that cat needs that after we get to know the cat and owner has collected a lot of data. we only suggest or give helpful hints however, it is your cat and your decisions as to how you want to manage his diabetes. and we strongly suggest you work with your vet. have you shown the vet what numbers you have been getting so far and discussed whether or not s/he still wants you to hold the starting dose for 2 full weeks?

 

Hi April & Felix, and welcome to Lantus Land! Now that you are testing and tracking Felix's number here, it will be easier for the more experienced folks to help you with your questions and dosing. With the high numbers Felix is experiencing, it's no wonder he's grumpy! cat(2)_steam My Morris is much lower and still grumpy...he has no excuse...but I love him anyway. cat_pet_icon

Looking forward to reading your daily condos and watching Felix come on down!

 

Hi April. Can you tell us about Felix's history, his symptoms, when did you notice something was wrong and how long he was 'not doing right' besides the grumpiness? What were his numbers at the vet's office? Any other health issues going on? Also what food are you feeding, did you use any other insulin before your vet started Felix on Lantus? How old is he again? Did you mention that already, sorry if I missed it.

Are you able to test at home during the day or do you work outside of the home? The more information you can give about Felix the better to understand what is going on.

Hope Felix feels better soon.

P.S. No forum police here, goodness what a funny thing to say! Just lots of kitty owners who try to help each other by sharing experiences, sharing information, and giving lots of support and encouragement. :thumbup

 

It might simply things if you could put together a profile when you have a chance. The form and instructions for a profile and linking it to your signature are in the Tech Forum. Having a profile will keep much of the information that people are asking you about (e.g., food, medical history) all in one place and make it accessible to everyone.

 

Re: 1/18 Felix PMPS 491

Thank you for all the replies.

I've answered some of these questions already, but to make it easier, let me answer again. Felix has no other health issues that I know about and only eats wet food. He was diagnosed on 1/4/09 and has been on Lantus the whole time. My vet follows a protocol where she holds all doses for two weeks and recommends prescription food and curves in the office. After what I have learned on this site, I don't think my vet knows how to treat diabetes. I am feeding Fancy Feast varieties from the Janet & Binky lists.

I work long hours and can't come home during the day. I can get a spot check when I get home, if it's not too late, and before I go to bed. Then, on days I don't work, I can do more. Is that enough?

I realize I've only posted here for a few days, but considering I have a full curve and that the numbers are terrible, I decided to raise his dose tonight to 1.5. It seems the right thing to do based on the information I pasted (Helene & Tizon, I did get to the protocol from the stickies). I hope that is okay, but if it's not, please explain why I shouldn't follow the protocol.

April

PS - "Forum police" was not my word (but it's a little disconcerting). It was in a condo I read the other day. It seemed like people were mad because the person was asking questions and somebody mentioned "forum police".

 

Thank you Sienne & Gabby. I will work on a profile to make things easier.

 

I believe you mentioned that you have a vet appointment soon. Had you given any thought to sharing the Tilly/Tight Regulation Protocol with your vet? The Health Board recently put a sticky up that provides links to materials that may help your vet to better understand how Lantus and Levemir are used. You might want to bring some of those materials with you to your vet. It's always best if you and your vet can be partners in managing your cat's FD.

 

Welcome to LL April. Don't ever feel weird asking questions. If you were to follow some of my threads, I am always the worry wart and asking all sorts of questions. Everyone has been very wonderful. However, they do like to get a feel for what is going on with Felix before they suggest some changes.

I got help on where to start our dose at. I have been posting on here since last month and every day I learn something new. My vet also talked me into taking Webber in for the day for the first day of insulin. However, she gave him a whopping 4U!!

I have increased Webber's dose twice with advice from this board and my overall feelings as well. You are correct, you don't have to follow us (those you do not know) but it helps to make you feel better and get a concensus in the least.

Hope Felix starts to feel better. Sending <<purrs>> to you and him!!! cat_pet_icon

 

Hi, April, Welcome to Lantus Land!

I'm not one of the more knowledgeable people, but something you said in your first post really touched me -- your concern about blindly taking the advice of strangers.

When I came here last June, my sweet kitty had been in a protocol similar to the one your vet was using, and he was not doing well at all. I had never thought about going against a vet's advice, but I was losing my kitty, I could see it. When I found this website, I felt so let down by my vet that I, too, was cautious about whom to trust next.

Only you can decide what to trust. But read as many of the posts here as you can, and profiles, and you'll see the quality of information that is shared here. You'll see "ECID" -- every cat is different -- and you'll see how much support and experience you have for applying the protocol to Felix's situation.

Hope to see you regularly here.

p.s. Fear no police here! The dumbest questions are welcome. I know. I asked them all! :lol:

 

Re: 1/18 Felix PMPS 491

i don't think i've had a chance to stop by to welcome you to the group, april... and felix, too!
you've held the dose for 2 weeks as your vet suggested. it would seem your vet would think it's the right thing for you to do. try to get mid-cycle spot checks when you can. they'll give you a better idea of what the dose is doing.

oh, and don't worry about the "forum police". they're the good guys. the bad guys are the trolls that try to stir things up or cause trouble.
you'll be able to spot them a mile away once you've been here for awhile. :lol:

good luck with the new dose! hope it pulls those numbers down.
also hope to see you posting often...