4/11 - Zokni - AMPS=233,+3=171,+6=240,PMPS=277,+2=245 - what next?

[Zsofi & Zokni]

Hi everyone,

I'm new to this group.
I had a thread yesterday in the main forum: http://www.felinediabetes.com/FDMB/...0-new-member-intro-zokni.228139/#post-2555475

I've done Zokni's first curve yesterday, but the group in the above thread concluded 3U Lantus (that I've been giving him for weeks based on vet's advice) was too much for him, as he kept dropping all day. I skipped last night's shot and reduce to 1U starting today. His numbers today were as follows: AMPS=233, +3=171, +6=240, PMPS=277, +2=245.
Food wise he's transitioning to wet food slowly as advised. It's day 3 of wet + dry.


I have a few questions:
- Since I've just reduced the lantus from 3 to 1, should I keep doing the curve in the coming days? Or what would be the most helpful way to get enough data to get his dosage right?
- Are these yellow numbers ok for now? Or did I decrease too much the insulin?
- I saw his peak was a lot earlier than AMPS+6, is that ok?

I would appreciate any advice

 

[Nan & Amber (GA)]

Hi again Zsofi!

Have you had a chance to look at any of the yellow stickies at the top of this forum? There's a ton of information there, one of the really important things to read through is on the two dosing methods, Tight Regulation (TR) and Start Low, Go Slow (SLGS). While you're still feeding dry food, you can only use SLGS (later on when Zokni is on a wet food only diet, you can decide if you want to switch to TR).

On that method, you don't have to do a curve until you have been on a dose for a week, but if you are able to get some "extra" tests on the days before that, it will only help in assessing what that dose is doing for Zokni. You can get them at various times on different days, and then after a while you'll start to get a picture of Zokni's patterns.

- Are these yellow numbers ok for now? Or did I decrease too much the insulin?
- I saw his peak was a lot earlier than AMPS+6, is that ok?

They're OK, and you got some blue today too, so not too bad given the big reduction. We'll just have to see where he goes from here. One possibility is that he's "bouncing" a little bit, in high numbers in reaction to the nice (but unfamiliar) green numbers yesterday, in which case he'll come back down. If he stays up in yellow for more than a few days, though, he may need some more insulin, we just don't have a way to predict that given that we don't have a ton of data for him yet.

As for the nadir, cats nadir when they feel like it! If you're lucky, he'll develop a consistent pattern, but not all cats do, and some cats have a consistent pattern until they change to a different consistent pattern... All you can do is do what you're doing and monitor his BG, and do your best to interpret what he's doing!

 

[Nan & Amber (GA)]

Just wanted to clarify something: the reduction down to 1.0U was in part specific to the situation you were in last night (big dose, surprisingly low numbers, very little data, in the process of switching foods). It's a fine starting dose for SLGS, but it is, as you mention, a pretty big change from what he was getting.

Given this history, although SLGS only increases on a weekly basis, if we see clear signs over the next few days that it's not enough, then, in my opinion, we can think about increasing at a faster pace than is usually done at the start of SLGS. But that's a few days away, plenty of time to see what he's doing and get others' opinion about this!

 

[Deb & Wink]

Given this history, although SLGS only increases on a weekly basis, if we see clear signs over the next few days that it's not enough, then, in my opinion, we can think about increasing at a faster pace than is usually done at the start of SLGS. But that's a few days away, plenty of time to see what he's doing and get others' opinion about this!

Agree with Nan on the possibility of needing to increase the dose more rapidly than SLGS (Start Low, Go Slow) normally calls for.

But, Zokni may have been switched over to all wet food by that time, and Zsofi will be ready for TR. (Tight Regulation) protocol.
So we'll have to see what the blood glucose tests look like in a few cycles.