9/3 Atlas AMps 362, +4 395, +6 388, +8 355, +10 386...Dose?

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Re: 9/3 Atlas AMps 362, +4 395

Hi Blue and Atlas, Everything and anything can have an effect on bg numbers!! Just roll with the punches! Glad to see that you got your spreadsheet up and working, but sorry to see all those REDS and PINKS!! He'll get straightened out, but it might take some time. Lantus is a "go gradual" insulin and often you won't see improvement until at least 6 12-hour cycles . So hang in there!

Ella & Stu
 
Re: 9/3 Atlas AMps 362, +4 395, +6 388

I know it is a go gradual thing. Now let's see if I can go gradual!! :lol:

Well, back to work on the bathroom floor. Replacing a few loose tiles. Got to keep me busy so I don't go bonkers studying a blank spread sheet. Or spend too much time on pc_work
 
Re: 9/3 Atlas AMps 362, +4 395, +6 388

Hi Blue...it's nice to see Pinks on Atlas' SS...and this is the ONLY time it's nice to see pinks.. :lol:
After you've had REDS for awhile, pink, pink is just fine!

Just wondering if you have any canned High Carb gravy on hand...it is part of our HYPO kit as well as Karo syrup.
We used the higher % carb foods listed on the Janet & Binky List...for emergencies... to bring up their BGs should they drop. It's always good to talk about thee things way in advance...but sometimes they do drop to <50 or so and we need to used only the gravy from those HC varieties. By giving them a little o the gravy, it doesn't fill them up too much inc ase we need to keep administering something to get the BGs up to a higher number. So maybe take a look at the list and have some cans on hand for such times... http://binkyspage.tripod.com/canfood.html
I used HC gravy last night but had to add a drop or three of Karo syrup too to bring Shadow up....the karo is a good investment and it lasts forever...

Hope you are getting lots of good information from the starred stickies at the top of the page....any questions so far?
 
Re: 9/3 Atlas AMps 362, +4 395, +6 388

Pat+Raja+Shadow said:
Just wondering if you have any canned High Carb gravy on hand...it is part of our HYPO kit as well as Karo syrup.
Hope you are getting lots of good information from the starred stickies at the top of the page....any questions so far?
Click to expand...

Actually because the Humilin N was acting so very erratically I have a hypo kit sitting on the counter! Atlas does tend to be a sneak up on low numbers. He doesn't show any signs...you have to be checking. One time he was snoozing away in the sunbeam streaming through the window. I happened to be home and checked him at his nadir on N. It was a flippin' 43! When I woke him up he was walking, purring, and was more than willing to eat on his own. The kit was handy enough, but now it sits on the kitchen counter in plain sight.

Yes, I have been reading the stickies at the top. I actually do have a question:

The one research paper indicates in determining dose if the numbers are not below 300 in the first 24-48 hours to increase the dose by a 0.25-0.50 units. (See I said my impatience could get the better of me.) I am contemplating a dose increase as it appears the "depot" isn't being filled sufficiently. It seems to take a long time from Atlas to come down from his morning meal spike and then it is just a few points?

I know Lantus is a very different acting insulin and I watched the video about the "depot."
 
Re: 9/3 Atlas AMps 362, +4 395, +6 388, +8 355, +10 386

Blue, what was the last Humilin N dose Atlas was on? (His SS starts at the Lantus dose)
This is the 4thd cycle on 1.0u,correct?
Due to the fact that he was on insulin previously, it might be that you should increase ~~ perhaps you can put "dose?" in your header to alert the experienced people here who will take this into consideration. You are doing a great job of testing and he has been in solid pink all day today, eh?
His numbers are really telling otherwise...see below...
I am sure someone will be by to talk to you about it if you can put that in your heading, ok?


"General" Guidelines:

--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
 
Re: 9/3 Atlas AMps 362, +4 395, +6 388, +8 355, +10 386

Pat+Raja+Shadow said:
Blue, what was the last Humilin N dose Atlas was on? (His SS starts at the Lantus dose)
This is the 4thd cycle on 1.0u,correct?
Due to the fact that he was on insulin previously, it might be that you should increase ~~ perhaps you can put "dose?" in your header to alert the experienced people here who will take this into consideration. You are doing a great job of testing and he has been in solid pink all day today, eh?
His numbers are really telling otherwise...see below...
I am sure someone will be by to talk to you about it if you can put that in your heading, ok?


"General" Guidelines:

--- Hold the initial starting dose for 5 - 7 days (10 - 14 cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 cycles).

--- Each subsequent dose is held for a minimum of 3 days (6 cycles) unless kitty earns a reduction (See: Reducing the dose...).

--- Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Click to expand...

Yes he was on 1.5 to 2.0 units of N. We were working with a sliding scale. Off the meter 2.0, under 400 1.5. With high pre-shots no matter what!

Yep. It is the 4th cycle on Lantus.

Yep. I think he was trying to be pretty in pink today, but started to rise more late in the cycle.

I am really looking at the first guideline. To me his numbers are telling me 1.0 is not enough. Right or wrong, I already made the decision to up the dose to 1.5 tonight. He seems to be already coming down...so maybe we caught a bit of overlap. I'll be keeping an eye on him again tonight.

Cleaning the house tonight. The Cat Committee Chairperson is stopping by to visit me and Atlas tomorrow. She hasn't seen him since he was 6lbs. and near death. She's in for a surprise!
 
It you're referring to the first guideline (i.e., hold the dose 5 - 7 days unless the numbers tell you otherwise), the numbers telling you otherwise typically means unless you get low numbers.

Since you've already increased, I would try to hold this dose for at least 3 days so the shed actually fills. It may be that Atlas was on too low of a dose but you don't want to increase too fast, either. Numbers may run higher than you'd like until the shed fills and if you increase too much too fast, you could easily miss an optimal dose.

One of the things you will consistently hear is that Lantus requires patience.
 
good luck with the dosecrease!

With numbers that high, it's ok to increase after 4 cycles. Once Atlas starts getting some action, that won't be a good idea but for now I think you're fine.
 
Libby and Lucy said:
With numbers that high, it's ok to increase after 4 cycles. Once Atlas starts getting some action, that won't be a good idea but for now I think you're fine.
Click to expand...

Thanks for the feedback. I know I read in one of the pDf. files linked in the stickie, that if the cat remain high and flat for the first 24-48 hours, then up the dose by a .5 unit during the first 3 days of being on Lantus.

http://felinediabetes.com/Roomp_Rand_2008 dosing_testing protocol.pdf

There were a few extra parameters listed there too. Such as previous insulin use, which I found vague as we were using N, ketone risks, etc.
 
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