DOSE QUESTION

viewtopic.php?f=9&t=54527

Missy has been kind of lethargic today....it is the right terminology after watching her.
Her BG was 306 AMPS; +4 1/2 319 and + 6 304.
I went out and got an Abbott Precision Xtra meter to test for ketones, but nobody has the strips! grr_red
I found a local pharmacy that will have them in tomorrow. In the meantime, I got some ketostix and will see if I can catch her in the act. May go out tonight and buy that Breeze litter box. (preshot time)
I have been mulling over increasing her dose, but was going to wait until I had some PM data. But she has been steadily increasing her numbers and pretty much has been pink for the last two days.
So my question is this:
Do you think I should increase her dose to 4.5 units tonight, even though I don't have PM data and then stay with her and test her through the night? Do you think it is safe...as safe as it can be with my lack of data?
I have a hypo kit and I bought some glucose gel today, as well.
I am worried about her.... nailbite_smile
And now, my father in law was just admitted to the hospital with very low blood pressure and he has a MRSA infection. OMG, when it rains it pours!

Re: DOSE QUESTION HELP PLEASE

Dear Mares,

I'm not very good at interpreting spreadsheets and yours looks particularly daunting! I'm sure that someone more knowledgeable will be along to help you. However, if you are worried about Missy going too low if you increase tonight, you can always wait until tomorrow morning to increase. Don't forget that it will take a few cycles for Missy's shed to fill to the new level in any event, so I don't believe that it will make much difference if you increase tonight or tomorrow. Why don't you wait until tomorrow morning to increase the dose, but also try to get in a couple of tests tonight? That way you will have an idea of how she does at night on her present dose.

What criteria did you use to establish Missy's dose when you began Lantus? Did you start at a somewhat-high dose because of her great weight? What caused that string of greens in the summer? Please forgive me if I am not up to speed on your situation. I don't think I've visited your condo before and I don't know Missy's story. Good luck with figuring out the dose.

I hope your father-in-law will be OK and am sending some healing vines his way,

Ella & Rusty

Re: DOSE QUESTION HELP PLEASE

Hi Mares - I'm glad you're getting the Keto strips tomorrow...test often OK; especially at the higher numbers.

We've talked about the importance of getting those night tests so I think Ella's suggestion is a great one. Why don't you start testing and see how it goes tonight and make your decision in the morning!

I'm so sorry to hear about your father in law. We'll be thinking of you!

Re: DOSE QUESTION HELP PLEASE

If you're home to test tonight, I see no reason why you couldn't raise the dose. However, there will be more people around in the morning to help you out in case Missy does get into lower numbers. I think it would be a good idea for you to increase her doses per protocol; i.e., increase every three days (six cycles). I say this because her numbers are so high and you really do need to get her down into healing numbers as quickly as is safely possible. I almost always raise Champ's dose every six cycles (unless I can't be home to monitor) and it really does work to get them into green and then be able to start reducing. There's a saying here...you need to raise the dose in order to lower the dose (or words to that effect :lol: ). You're already doing a great job. I love the fact Missy is steadily losing weight. If you could let me know how you're doing it, I would appreciate it!! I'm having a heck of a time getting Champ's weight down. How much are you feeding Missy in a 24-hour period? Keep up the good work!!

Re: DOSE QUESTION HELP PLEASE

super healing vines to your FIL.
When it rains it pours indeed.

When you get either a urine test or a blood test you'll know how to proceed.
In the meantime Make sure she is eating, and make sure and mix some water into her wet food, enough to loosen it up a bit.

I still can't recommend an increase, I'm not sure that she isn't bouncing from a low (relative to Missy) number that was missed perhaps on 10/15/am cycle.
If that is the case, it should be clearing soon and tonights cycle will be a good one to spot check and find out.

Has anyone told you about "sleep testing" ? That's when the bean set's' their alarm (or alarms) to wake, grabs a quick test and goes right back to bed (btb). Might that work for you tonight?

Re: DOSE QUESTION HELP PLEASE

hi mares, i am also a fan of increasing every 6 doses - as long as it isn't on a bounce. i know getting up at night is a problem, but is there any way you can move her shots earlier in the day overall so that you can get a +4 or so every evening? or at least at the last minute before you go to bed? what + time would that give you?

Re: DOSE QUESTION HELP PLEASE

hi mares. i'm working for a bit longer so sorry... i have to post and run, but i'll be back later.

there's no one here who can responsibly suggest/recommend a dose increase without knowing how low the current dose is taking kitty.
it's not to be mean. it's to protect the cat.



edited to add: viewtopic.php?f=9&t=46013

Re: DOSE QUESTION HELP PLEASE

viewtopic.php?f=9&t=54527&p=590014#p590014

Here is the thread I started today. I guess I shouldn't have restarted with this one, but I was afraid I wouldn't get a response and I was feeling a bit panicky. Then left to go get ketostix and I also got the Precision Xtra meter in case I can't catch her in the act....
I will try to answer everything, but forgive me f I am scattered. I know I don't handle stress really well.
I emailed my vet about possibly doing some blood work to see if we are missing the reason she came out of remission and to tell her I was concerned about her today. She said to watch and wait, as long as she is eating, since she was on Clavamox (acne) for so long. She might be going to take a bit to get back to 'normal'. Bless her heart, she isn't all about money...one of the reasons I trust her so much. Otherwise, I would be in there tomorrow am.
Ella,
Missy's dose was probably not arrived at in a way that this board agrees with, but I didn't know any better at the time. Mainly, I think my vet started her at 3 units because Missy was/is a very big girl. I know now, that isn't the way the protocol starts dosage, but like I said, I had no clue. So we started out at 3units in March, put her on locarb wet food and by April, she was in remission. In retrospect, I should have gradually taken her off insulin, but again, I didn't know any
better. I had barely gotten out of that overwhelmed by the dx stage and she was down where she should be.
I spot checked her, for the most part, once a week, and she remained in normal numbers. I missed a couple weeks (my bad) and noticed she was asking for more food, again. So, I checked her, she was high, I took her in and they checked her for a UTI (culture, not blood work) and sugar in her urine. She was spilling sugar but had no UTI. She put her back on the dose she was on in March. We tried to figure out what could have caused the relapse and really the only thing I could think of was a flare up of her acne a week or two before. Nothing else changed...same food, same routines. So my vet put her on Clavamox to see if we could get rid of the acne. She just got off it a couple days ago.

Sandy,
I would rather stay on the couch. I can still set an alarm, but DH gets cranky if his sleep is disturbed. :mrgreen: It is
just easier....and I don't have to worry about falling down the stairs in a fog. :smile: Besides, he has his father to worry about. I wish there was a way to adjust my schedule to allow for later testing, but the fact is, with my MS I spend about 12 hours sleeping. It sucks, but it could be a lot worse. At least I am mobile, still.

Patty,
The biggest thing for us, getting Missy's weight down was to get her off Science Diet 'Light'. :lol: When I transistioned her to wet food, I went through nearly every brand on Binky's page....the ONLY canned food she will eat is EVO Chicken
and Turkey or the Turkey and Chicken. Fortunately they are very low in carbs.... My vet told me how many calories she wanted her to have a day and I divide the can up so she gets that amount of calories, roughly. The other thing that really has kept ME on track, is that I bought a baby scale. (the brand I have is Salter, but I don't think it really matters much) I try to weigh her once a week. What I liked about it is that if I slack off and give in...or give her too many treats, I have the facts right in front of my face when I weigh her. I am not so worried about how MUCH she loses every week, I just
don't want her to go up...and she has. It's a great reminder I need to stay on top of it.

Jill,
I look forward to hearing from you when you have a chance. And I don't think you are being mean, just realistic. I really have gotten an education once I posted on this board. It took me a while to.....I wasn't sure I was ready for it all. And, in actuality, I wasn't. I should have had more data. I was just so proud that I always tested her before the shot. :sad: I never really READ the protocol, I never understood how dosing was determined and how to increase it. My vet is very
good, I really trust her, but she wasn't all that into TR and too be honest, it was easier not to be. But, I see Miss is not going to remit like last time, so I decided to 'get some learnin' and, oh boy, did I! :shock: It has been good and you all are so generous with your experience, but it IS a lot to digest. I am lucky, because I am not still reeling from a new dx. But, I also had some health issues when she first relapsed and really wasn't able to get on board here until recently.

I just want to do the best thing for my Boo (nickname) and I want to see her feeling the way she felt in remission. It was SO obvious how much better she felt. Weight loss contributed, but a happy pancreas did most of it.

Ok, thank you all so much. It is SO nice to gave people who understand. While DH is good, he doesn't care about details...I guess I will hold off till tomorrow and monitor her tonight to see how low she is going. I just hate to see her so high all the time.....

And thanks for healing thoughts for my FIL!