6/14 kit relion. AMPS 296, +3 298, +6 312, +9 299. PMPS 322, +3 271

Good news on the barfing, hope it's in the rear view mirror.

With as much data as you are already getting, you don't really need to do a curve. An official curve is more for those who can't otherwise get any mid cycle data or enough spot checks to see how low the dose is taking the cat. I know I said hold for 7 days, but I think you have enough data to say that Kit needs an increase. We don't want Kit lingering in these higher numbers. I would to to 4.25 units at your convenience. Pick one of those curve days you had planned, cause that means you'll have the time to monitor.
 
Wendy&Neko said:
I would to to 4.25 units at your convenience. Pick one of those curve days you had planned, cause that means you'll have the time to monitor.
Click to expand...
great, thanks so much for checking in and giving the dose increase advice.

we will do 4.25U, hopefully mon 15jun, without a curve day before.

it seems like today she's actually running a touch higher than we've seen :( so glad we can move forward.

questions:

1. on a dose increase day.
what's the recommendation for testing intervals? is it every 2 hrs like a curve if numbers are not diving deeply? or is there a different recommendation that we should follow?​


2. on our data knowledge while still in these early days.

2a. should kit start to PS lower than 200, but higher than 150, do we have enough data to think about what a course of action would be?
i.e. any particular "better option" from the "three options" or something perhaps more specific for kit?

Until you collect enough data to know how your cat will react [...]
Between 150 and 200 (8.3-11.1 mmol/L), you have three options: you have three options:​
      • a.) give nothing
      • b.) give a token dose (10-25% of the usual dose)
      • c.) feed as usual, test in a couple of hours, and make a decision based on that value
2b. since we saw a PMPS 202 (09jun2020) and took the mis-step of lowering, i.e. we could have shot full 4U, how does that 202 impact our knowledge? specifically
Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.​
meaning, since we are still early days w lantus does our "knowledge" about this item also re-set with the dose increase? and what percentage reduction would be the recommendation in this case?​


tia, jw
 
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There isn't really a recommended testing interval. You will have to learn how Kit reacts to increases. Some cats react right away, some don't until 5-6 cycles after the increase. The depot has to build up again. A good test for you to get is the +2 test. With Lantus, it often indicates how the cycle will go. A big drop from preshot means an active cycle that needs closer monitoring. A similar number to the preshot means a typical Lantus curve, but can still go down. A higher +2 means a quiet cycle - good for errands and catching up on sleep. Note that these guidelines are ECID - they work for a lot of Lantus cats. Not mine of course. :rolleyes: Her onset was later than typical - never did like to follow the "rules".:p So for now, try the +2 and use it as a guide to how often you'll have to test. Take a look at Kit's spreadsheet on Lantus - are you able to predict what type of cycle he had with those early tests? Unfortunately you did get an early test on the PM of the 11th, but you will have plenty more time to build your data. Once you start seeing more blues, the patterns will become more obvious.

The what to do with a lower preshot depends on a number of factors. Your experience level, the amount of data you have showing what Kit does with a meal - I knew Neko went up around 30 points with dinner, your ability to monitor, and whether you've got high carb food and plenty of test strips should things go sideways. What also comes into play is when a can nadirs - my girl often nadired near shot time, so her numbers then would naturally be lower. Similarly her onset was later, so I knew she'd be going up for a few hours before the next insulin dose kicked in. Learning onset and nadir can be useful tools, though nadir can move around. The best guidance I can give, if you aren't certain what to do, is ask for help. Also, take a look at other posts, try to find someone else who is relatively new and in the same situation. My first low number, no one was around to help, but I'd read enough and new what the suggestions would be.
 
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