? Niki - question about increasing dose

N

nikkiaz2forhobbes

Member Since 2020
Hello all -

we are back with a question…

while we are waiting to find the appropriate antibiotic, can we increase his insulin dose to get his BG numbers down?

(Short version of a long story)
Niki has been fighting various infections due to a trauma in July. He basically has an infection of some kind going on, along with an issue with his mammary glands which causes him to leak milk. It is enough where he develops pockets that need to be massaged to be drained every 2-3 days. A tissue sample was sent out and it only showed inflammation in the area (no cancer). He was put on a med to reduce progesterone; it is unclear if this has helped. He is scheduled for an ultrasound on November 24 - the earliest we could get in. Vet was wondering about the adrenal glands being involved. Every time he has been on antibiotics it has helped to lower his BG, even if it doesn’t totally heal his wound or clear up the inflammation. Right now we are waiting (again) for another analysis of the goop/milk to see what kind of antibiotic we need to try next. Unfortunately, our vet is not open again until Monday and we have no idea when to expect the results.

anyways, he seems ok (hates the cone head and the onesies though), eating and eliminating fine. Frantic to eat b/c his BG is high. He hates being massaged to get the milk out.

any insight or suggestions or an answer as to whether we can increase his dose would be most welcome!

thanks all for reading!

Nancy and Niki
 
I’m a bit confused. I don’t see a spreadsheet for Niki. When I look for your last message I find one dated 10/28. We aren’t there yet!
 
tiffmaxee said:
I’m a bit confused. I don’t see a spreadsheet for Niki. When I look for your last message I find one dated 10/28. We aren’t there yet!
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I'm so very sorry! My automatic sign in must have used my other sugar cat's info.

Here is the real info for Niki!

So very sorry for the confusion...


Nancy

Nancy & Scott/ Niki's Spreadsheet
M, b. 2014/ Dx Dec 2019 in shelter/adopted Feb 2020/Lantus/Relion meter/FF wet
 
Try reading the dosing methods again :cat:
https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

You have on your SS
Diagnosed: 12/16/2019 Adopted 2/9/2020 from PACC Dosing Method (SLGS or TR): TR
So Niki is a long term diabetic
Looking at your SS it looks like your does are all over the place
We increase and decrease by how low his BG is dropping (nadir)

Looks like you need to be testing more after the AMPS shots,can you do that ?


Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
Reducing the dose:

The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive. Let's keep all our kitties in the Lantus, Basaglar, & Levemir ISG safe by taking reductions when appropriate.
  • 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, attempt a reduction when the cat regularly has its lowest BGs in the normal range of a non-diabetic healthy cat (50 - 80 mg/dL) while staying under 100 mg/dl overall for at least one week.
 
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If diagnosed in 2019 Nikki is a long term diabetic so you would reduce if three times in the 40’s or once under 40. I’m going to look at his ss now.

You can increase tomorrow morning unless you see green tonight. I believe tonight is cycle 6 on 1.0. You did shoot .75 once but I don’t know why. There were times in the past you didn’t reduce when you saw 30’s though. I’d be careful about that.
 
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tiffmaxee said:
If diagnosed in 2019 Nikki is a long term diabetic so you would reduce if three times in the 40’s or once under 40. I’m going to look at his ss now.
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Hi Elise I posted that #5 her doses are all over the place, what do you think she should continue with and then follow the correct dosing method
@tiffmaxee
Thanks Elise :cat:
 
Thank you both. Obviously we have continued to screw things up by not consistently following one protocol. We will rectify that immediately based on your advice. I was not able to talk to Scott before he increased to 1.25 units after PMPS of 412 tonight.

We are not able to get other readings after his AMPS reading except on weekends or the rare day off.

thank you. One day we will get this… maybe. I’m just in tears thinking about how badly we continue to get this wrong.

thsnn you.
Diane Tyler's Mom said:
Hi Elise I posted that #5 her doses are all over the place, what do you think she should continue with and then follow the correct dosing method
@tiffmaxee
Thanks Elise :cat:
Click to expand...
 
nikkiaz said:
Thank you both. Obviously we have continued to screw things up by not consistently following one protocol. We will rectify that immediately based on your advice. I was not able to talk to Scott before he increased to 1.25 units after PMPS of 412 tonight.

We are not able to get other readings after his AMPS reading except on weekends or the rare day off.

thank you. One day we will get this… maybe. I’m just in tears thinking about how badly we continue to get this wrong.

thsnn you.
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Please don't be in tears :bighug: It takes awhile to understand things, Just ask when you are not sure about something.
Just remember to put tonight's PMPS and doae on your SS
I understand you both work, maybe you can get a test in after one of you gets home from work even if it's a +9 or a +10. If not that's OK :bighug::bighug::bighug:
@nikkiaz2forhobbes

If you want to start posting on the Lantus forum let me know and I will tell you how to do it.
A lot more eyes on there , a lot of Lantus users :cat:
I'm sorry about all of the infections he has, I hope you will find out what antibiotic to try next
Good luck with the upcoming ultrasound
@nikkiaz2forhobbes
 
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Sorry for getting you upset. :( Being consistent in a way that works well with Lantus on cats is the best way we can help you.
 
nikkiaz said:
Thank you both. Obviously we have continued to screw things up by not consistently following one protocol. We will rectify that immediately based on your advice. I was not able to talk to Scott before he increased to 1.25 units after PMPS of 412 tonight.

We are not able to get other readings after his AMPS reading except on weekends or the rare day off.

thank you. One day we will get this… maybe. I’m just in tears thinking about how badly we continue to get this wrong.

thsnn you.
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I’d stick with 1.0 and start following the method.
 
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tiffmaxee said:
We were all new once!
Is it possible to change your shot time so you can get a +2 or even a +1.
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we will try, thanks. It’s just difficult with our work schedules to keep close to 12 hours apart for the shots. We both work about an hour away from home so it’s always a big rush in both the am and pm to get everyone fed and medicated. :-)
 
Thank you all so much. Hopefully sticking to the protocol will help him by reducing his BG as we wait to see what else can be done for his other issues. Waiting for medical answers is just so frustrating and stressful.
 
nikkiaz said:
I understand and thank you! I just get overly emotional when it comes to our critters - I feel so helpless a lot of the time.
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I understand. My kitty has a bunch of other things going on in addition to the diabetes so I empathize. It's important though to stick with a method so that our emotions don't get in the way of giving our cats what they need. That's the beauty of it. Hang in there. :bighug:
 
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