Continuing from the discussion: Once again (part 1) Wolvi https://felinediabetes.com/FDMB/threads/once-again-with-new-account.252858/ Once again (part 2) Wolvi https://felinediabetes.com/FDMB/threads/once-again-part-2-wolvi.256924/ Good Evening! Could you please take a look at Wolvi’s SS. He is on 1.6U for 10 days. Do you still think he is bouncing? I should hold this dose or rise to 1.8U (or try my best to 1.6 F) tomorrow morning… He had two occasional greens but his “nadirs” are always almost between 100-200… Of course I will keep a close eye on him. @FrostD @JanetNJ (I don't know if Janet is still advising but in all my last posts (made on mobile) I was not able to tag her) Thank you
Hmm. Did you ever choose a dosing method? If SLGS then no, no room to increase. If MPM, then you could try but I'd watch him very closely
@FrostD In fact I never choosed a dosing method but I supose I'm doing SLGS... Do you think that I could try the modified method, in fact one of this days I thought asking you if there is TR for Prozinc like in Lantus... Mainly what is the difference between SLGS and the MPM? - more testing? I can do it, I just don't do that because I afraid of hurting him... I just want the best for him - he is in higher numbers so much time of the day. My only problem is during the night - my fibromialgy goes crazy if I don't sleep
I definitely understand! MPM you reduce below 50 (you already test enough for it). SLGS you reduce below 90, but you hold the dose for a week then do a curve. Here's my thought - I suggest a custom SLGS. Let's start with reductions below 80 (instead of 90), and hold each dose for about 4 days (longer if he's bouncing, wait for bounce to clear) before considering an increase/decrease. No need to do curves and hold for a week if you keep testing the way you do. Can you commit to a before bed (+2 or +3) test every night? Cats often go lower at night, and seeing some of his bounces I do wonder if he's going lower. We can make reasonable estimations if we have +2/+3 data. Could you also do one middle of the night (+5 or +6) test each week? You would want to do it on a night that the +2/+3 shows a decent drop.
@FrostD Good morning Thanks for helping me, I really want to try my best for Wolvi. Did you saw his number this morning - 534 I will try this new customed method for a while and if we don't get any results I will talk to my vet to change to Lantus (to get the prescription). What do you think? The PMPS + 3, I already do most of the days. And I will do the + 5 or + 6. I shot at 7 AM and 7PM. So plus +5 is midnight and its perfectly Ok for me. And during the day? It is necessary to test more? That decent drop is more or less how much? 200 less? Imagine he has 450. The decent drop would be around what number? So shall I increase it to what dose? Can I start tonight? TY you so much ❤️❤️
Poor guy. I do think he would benefit from Lantus anyway, because it looks like he just isn't getting enough duration from ProZinc. So I think you should still talk to the vet, because it will take some time for the vet to write the script, and for you to send it in and get the lantus. Do they have Semglee in Portugal? Here in the US it's a much cheaper insulin that's biosimilar to Lantus. You do a good job of testing during the day, I'm not too worried about that. Just try to catch nadir when you can As for the drop, I'd say 15% of the preshot number. So if he's 450, and the +2 or +3 is 380 or lower, that's probably a good time to check again middle of the night. Or if the +2/+3 is blue or green, middle of the night test.
To have the Lantus or Semglee it only takes one or two days - because if my vet agrees to change (we already talked about that once), I just need to go to her office and pick up the prescription and go to the pharmacy to buy it. Here in Portugal we have Semglee - pen pre-filled 3 ml - 36 euros, and Lantus is around 53 euros. So I will try this new modified SLGS for a month, no more, and if we didn't go anywhere with it I will talk with the vet - because before changing I want her to know that I tried everything. Back in 2019 he took around 5/6 month to remission. So what do you think? Shall I increase it to what dose? 1.8U? Can I start tonight? @FrostD
Ok good! Here it can take 1-2 weeks for everything to go through and get more "affordable" insulin The 88 you got a few days ago doesn't leave enough room for an increase. Give him 2 more days and if no low blues or greens try 1.8U - but keep a close eye on him when you do, in case it's too much
Good morning Could you please take a look at Wolvi's SS... Such nice numbers last night and today grrrr What should I do? @FrostD
Looks like just bouncing and dropping, bouncing and dropping lol There's nothing more you can do at this point to try to make ProZinc work, I would go ahead and talk to vet about switching. You could give it another week or two, but I think he'd do very nicely on Lantus/semglee
Hi @FrostD Already talked to my vet and she can prescribe Lantus for me. She is a great vet and always very helpful I will go there next week to buy another medicine for one of my girls and I will have the prescription for Lantus. We only talked by whatsapp but she will phone me later. I'm really nervous about this change but maybe it's the best for Wolvi. I've been reading the Lantus forum and the organization is so different... What dose should Wolvi start with? Just imagine that I even had doubts about how much I fill the syringe to be 1U? Should I began with SLGS or TR? It's better to buy the pen, bottle or cartrige? How do I move from this forum to the other? So many question
Make sure you also get the U100 syringes! The day before you switch post on the Lantus forum and ask for dose advice. They're all very nice over there and will help guide you on dose, format of posted etc. I would start with SLGS until you get comfortable, but you also test enough for TR. That's really your call, you can always change at any time. I prefer.oens or cartridges because they're usually cheaper per unit, but also they stay fresh longer. Once you open a 10mL the 6 month window starts, and at his low doses you might not use it all before it starts to lose efficacy. But the pens/cartridges are 3-5mL usually and it's pretty guaranteed you'll use it all before it goes bad
I think you'll like it a lot better. It seems scary, but really isn't. A lot of experienced people on that forum helping out
Hi @FrostD Thanks for the encouragement. My boy is really crazy Today at AMPS - 459 and now at + 6 - 77 I gave him 1.6f I already use u100 seringues this ones http://www.alldaypharmacy.co.uk/pro..._Syringe_0.3mm_(30G)_x_8mm(1)__69587_zoom.jpg But imagine that I need to give him 0.25 U how I manage to do that?
Ok I am rather confused at the moment. Next time you give a shot can you take a picture of the syringe filled with insulin? I just want to verify your current dose
https://drive.google.com/file/d/1gN9koZZmWrrTXOuObaakXJ1pxV1cSC2J/view?usp=drivesdk https://drive.google.com/file/d/1gMBhUbOpQ8Nbo-AfvOwclFpvoyHbctdJ/view?usp=drivesdk can you see it? I use that convertor chart. I was talking about Lantus. If he needs 0.5 U draw to the first short line, 1U I draw to the first big big line. But if he needs1.6U or 1.2U? Hope you understand me... sorry my english, don't know how to explain better
I do! I figured you were using the conversion but wanted to make sure. Your English is very good. All doses for Lantus are in increments 0.25U. we just estimate to the best of our ability. So 0.25U would be halfway between 0 and the first line (0.5U). Some people use calipers, but I don't find them useful unless on a very small dose, or if the cat seems especially sensitive to insulin
Just check wolvi's Ss please. I only gave him 50% I know that you wrote to reduce if he goes lower then 80 but... oh well, I was afraid. Already bought Lantus Tomorrow I will post on Lantus forum. @FrostD
Let's see how he does! But finally back in these numbers. I'm guessing he'll bounce again. Are you switching to Lantus tomorrow? I would post now for dose advice. They'll probably also want the rest of your signature completed (age, date he was diagnosed, diet, etc)
No, I just want to begin on Monday because this Sunday I need to go out a bit in the afternoon and for the first days I want/need to stay at home with him. I'm already making a text to put on Lantus forum for introduction but I can complete the signature now as much as I can
Ok great! I would change to say 8,5kg in the signature by the way. Over here, the comma denotes thousands, and some people may not readily realize that (though I hope they would realize Wolvi does not weight 8 thousand kilograms!). I think shortening would help, and also give you more space to add anything else if needed