6/22/21 Sister AMPS 97; +3 88; +6 110; +9 144; PMPS 148; +3 117; +6 126

[Ann & Sister]

Sister's first Curve yesterday...

 

[Christie & Maverick]

Great job getting the curve data. Here is your previous post, we like to link them so if others come by, they can see some history.

https://www.felinediabetes.com/FDMB/threads/where-is-the-curve-schedule-posted.248896/#post-2807569

One important thing to note, while we say with SLGS you hold the dose for a week, then run a curve, it should be mentioned that per the SLGS guideline, that's unless you get a number under 90.

From your recent data, since you are following SLGS, any time Sister gets a number under 90, you need to take an immediate reduction. I saw you had kept the 0.5u dose on on cycle of 21-Jun, and again last night after she came down to 88 during the day, then held again today, Please reduce her next shot to 0.25u.

 

[Ann & Sister]

Great job getting the curve data. Here is your previous post, we like to link them so if others come by, they can see some history.

https://www.felinediabetes.com/FDMB/threads/where-is-the-curve-schedule-posted.248896/#post-2807569

One important thing to note, while we say with SLGS you hold the dose for a week, then run a curve, it should be mentioned that per the SLGS guideline, that's unless you get a number under 90.

From your recent data, since you are following SLGS, any time Sister gets a number under 90, you need to take an immediate reduction. I saw you had kept the 0.5u dose on on cycle of 21-Jun, and again last night after she came down to 88 during the day, then held again today, Please reduce her next shot to 0.25u.

I did not realize. Kept reading the cat need to earn a reduction so I thought much more testing needed. I will reduce evening to 0.25u. And I reduce even though her AMPS was back up to 125??

 

[Christie & Maverick]

That's ok, there is a lot of info to process. Here is a snippet of SLGS guideline from the sticky I sent you yesterday:

Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.

Lather, Rinse, and Repeat!

I did not realize. Kept reading the cat need to earn a reduction so I thought much more testing needed. I will reduce evening to 0.25u. And I reduce even though her AMPS was back up to 125??

Yes, regardless of the preshot numbers, since you are looking to see how low the dose is taking her, and with SLGS any number under 90 earns a reduction.