1/23 Kim's Simon amps 166, flat blue

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kim and simon

kim and simon

Member Since 2012
Missed my +2 and nadir today (his nadir seems to be between +2.5-4) because the little beans and the drooler needed tending and dropping off and picking up after our trip. Simon is looking pretty good, and I may change him to .75u depending on what I see the next few days.

Yesterday http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=61795

Happy Monday!

How do I do the code to make my yesterday condo look like a linky link without all the http mumbo jumbo? (I mean, make a hotlink that just says "Yesterday" that goes to the post).
 
Re: 1/23 Kim's Simon amps 166

Hi guys .. simon is looking good today .. Nice solid blue! Good luck with the dose change if you take it .. Not sure how to change text in the link, but others can help I'm sure .. have a great day!
 
Re: 1/23 Kim's Simon amps 166

He stayed very blue all day. Relatively smooth and flat. What does this indicate and what would be next steps? He probably dipped into green while I was gone. Will get nadir tonight.

How does one determine dose changes? Is there any thread or document on FDMB with this info?
 
The Tight Regulation Protocol sticky has information on dose changes.
"General" Guidelines:
  • Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive 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 consecutive cycles).
  • Each subsequent dose is held for a minimum of 3 days (6 consecutive 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.

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Reducing the dose:
  • If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
  • If an attempted reduction fails, go right back up to the last good dose.
  • Try to go from 0.25u to 0.1u before stopping insulin completely.
Click to expand...

With Lantus, you want to give the same amount of insulin at AM and PM shot times. Given that you've been shooting a fat 0.5u in the AM and 0.5u at night, you need to pick a dose and stick with it. Once you select a dose, you'll need to start the count -- 3 days/6 cycles at a dose and then evaluate whether it's effective. If Simon's numbers drop below 50, then you reduce his dose.
 
Sienne and Gabby said:
The Tight Regulation Protocol sticky has information on dose changes.
Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
Click to expand...

With Lantus, you want to give the same amount of insulin at AM and PM shot times. Given that you've been shooting a fat 0.5u in the AM and 0.5u at night, you need to pick a dose and stick with it. Once you select a dose, you'll need to start the count -- 3 days/6 cycles at a dose and then evaluate whether it's effective. If Simon's numbers drop below 50, then you reduce his dose.
Click to expand...

What is the official "normal range" that is referred to above?

Ok, so if his nadir never goes below 50 after holding .5 for a few days, I ought to try .75. I skipped that due to the vacation reduction.

I will probably do this next Monday. I would probably just go to .75 sooner but I have a weekend pet sitter who can't test. . .again. Not usual for us to be gone two weekends in a row. We will be home for awhile after this.

Simon did not meet criteria for reduction while at 1.0u, but my vacation dose change seems to be giving better BG's. . .I guess we can chalk that up to his being a cat.

I messed up typing--I was doing fat .5 every time except did a regular .5 dose on that one night when his pre shot was so low. I was chicken :)

Sorry to ask so many ??
 
Hi Kim:

Simon is looking great and wow...that is something that his numbers are better on the lower dose. It's possible that his liver just decided to get over liver training school and he just quit bouncing. That does happen quite suddenly in some cats.

Normal numbers are 50-120.

Ok, so if his nadir never goes below 50 after holding .5 for a few days, I ought to try .75. I skipped that due to the vacation reduction.
Click to expand...

If he goes below 50 any time during his cycle, he gets a .25u reduction. It doesn't have to be his nadir. Nadirs can also move around in a cycle; when Gracie was on lantus, I never could figure out when her nadir was. So, for a reduction, any number below 50 and you take him down .25u.

Insofar as taking him up, if he is getting into green numbers just about every cycle, I wouldn't take him up. The "below 50" refers to reducing him, not increasing him. If he starts getting only blue in his cycles, then we can talk about taking him up a bit. Right now, he's looking very nice and I wouldnt' increase him at this point.

When you get a low PS like you did when you shaved his dose a bit, keep in mind that a dose can affect several subsequent cycles so you may not see higher numbers the cycle that you shot a BCS in. You can see he still got into green that night.

We're here to help you so ask away!!!
 
Hi, Kim! Thanks for putting up a profile -- you have a beautiful fur family. Simonese! I love that.

Simon is doing great, and so are you.
 
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