5/10Jack AMPS=459 Second day Semglee...dose amt?

Jack & Mopem'sMom

Jack & Mopem'sMom

Member Since 2020
Jack seemed to be high over night, now this AM he is 459 with 0.8 blood ketones. I only dosed 1 unit (2x) yesterday as per vet. Am I really jumping his dose to 4.5 safely? Despite reading a bunch on here, I am still unclear how the depot insulin works...Could I get away with 3units today and then see numbers before going to 4.5? It seems like it's harder to reduce a dose of Semglee than increase one?

Yesterday's post:
https://www.felinediabetes.com/FDMB...rst-day-on-semglee-pm-dose-suggestion.263086/
 
I’m not sure what you are asking?
I am very surprised to see you have gone from 5 units of Prozinc down to 1 unit of Lantus (Semglee) when you swapped over insulins. Not sure your vet knows much about FD.
I am glad you are testing for ketones with that large drop in dose.
INSULIN DEPOT INFORMATION
 
Bron and Sheba (GA) said:
I’m not sure what you are asking?
I am very surprised to see you have gone from 5 units of Prozinc down to 1 unit of Lantus (Semglee) when you swapped over insulins. Not sure your vet knows much about FD.
I am glad you are testing for ketones with that large drop in dose.
INSULIN DEPOT INFORMATION
Click to expand...
Everyone here seems surprised at the dose, and yeah, I don't think most vets know much about FD. Since we started at 1unit yesterday, and Jack went down to 274 at the +6 hr mark, I was concerned about raising the dose to 4.5 as was suggested by other members. That seems a drastic increase, and to my understanding the glargine stays in his system longer, so any increase in dose is also acting off the previous dose. I'm doing fluids at home to manage the ketones, but don't want to get into a hypoglycemia situation. I'm working from home so I can watch and test frequently, but still don't want to get to that point. I'm trying to rearrange my thinking as suggested by other members to not focus on the AM & PM PS numbers, but when I saw 459 and 0.8 blood ketones this morning, I must admit I was unhappy. Sienne and Gaby suggested trying 3.75units since that's about a 30% switch but I had already given him 3units by the time I got back to see the post. What should I do about the PM shot? Stick to 3units? Go to 3.75? Go to 4.5? I was trying to do SLGS because that got my other cat into remission, but upping the dose every time doesn't follow that. I just want to do what is best for the cat and that doesn't give me a stroke from stress. I appreciate any and all advice. Thank you.
 
Jack & Mopem'sMom said:
I'm trying to rearrange my thinking as suggested by other members to not focus on the AM & PM PS numbers, but when I saw 459 and 0.8 blood ketones this morning, I must admit I was unhappy. Sienne and Gaby suggested trying 3.75units since that's about a 30% switch but I had already given him 3units by the time I got back to see the post. What should I do about the PM shot? Stick to 3units? Go to 3.75? Go to 4.5? I was trying to do SLGS because that got my other cat into remission, but upping the dose every time doesn't follow that. I just want to do what is best for the cat and that doesn't give me a stroke from stress. I appreciate any and all advice. Thank you.
Click to expand...
Seeing you had already given the 3 units when you saw Sienne’s advice, I would stay with that dose (3 units) and see how the nadirs are. Semglee likes consistency not chopping and changing the dose.
Keep testing at least once a day for ketones and post immediately if they appear….you will need to increase if they do.
How is Jack eating….make sure he eats well. Food helps keep ketones away as well.
How much subQ fluids are you giving a day?. It looks like you have given 250 mls in less than 24 hours…..that is a lot.
 
He is eating well, although not what he should be. (50/50 mix of YA Zero and Dr Elsey's Pure Protein...too much YA gives him diarrhea) I'm testing ketones 2x a day- at AM and PM PreShot. He has been showing blood ketones consistently between 0.3 and 1.0. We went to the vet at 0.8, and she recommended 150-200 mls a day. Yesterday he was being good and ketones were high (1.0) so he got the extra 50mls. I'll be lucky to get 150mls into him today- i had help from a friend yesterday but am on my own today. I'll stick to 3.0 tonight....how many cycles at that dose? OR are we still looking at BG and ketone numbers? Vet originally said 1unit for 6 cycles then increase by .5units. Should I do 3 units for 6 cycles and then increase by .5u or look at numbers?
 
Jack & Mopem'sMom said:
He is eating well, although not what he should be. (50/50 mix of YA Zero and Dr Elsey's Pure Protein...too much YA gives him diarrhea) I'm testing ketones 2x a day- at AM and PM PreShot. He has been showing blood ketones consistently between 0.3 and 1.0. We went to the vet at 0.8, and she recommended 150-200 mls a day. Yesterday he was being good and ketones were high (1.0) so he got the extra 50mls. I'll be lucky to get 150mls into him today- i had help from a friend yesterday but am on my own today. I'll stick to 3.0 tonight....how many cycles at that dose? OR are we still looking at BG and ketone numbers? Vet originally said 1unit for 6 cycles then increase by .5units. Should I do 3 units for 6 cycles and then increase by .5u or look at numbers?
Click to expand...
Are you making sure the previous subQ fluids have been absorbed before giving more?
If you are doing SLGS you are supposed to hold the dose for 7 days. But with ketones in the picture we can increase earlier if necessary. You would need advice on that from an experienced person. For lurkers and others, this is advice for Jack only…this is not advice you can follow.
I would suggest you post every day so we can comment and give advice. Keeps the SS updated and put the ketones result in the remarks column of the SS each day so we can see at a glance please.
Make sure you get tests in during the pm cycles as well if you can please as the more data you can get, the easier it is to help you.
 
Yes, he absorbs the fluids pretty quickly, generally within two hours. The ketones are in the remarks column of my spreadsheet and I update it throughout the day. I get as many pm cycle numbers as possible with my work schedule. I'll continue to post every day; and stick with the 3units for at least 3 days/6 cycles and then get advice from here. Thanks again for all of your help--it is very much appreciated!
 
I am glad you are keeping on top of the ketones. If they start to creep up at all, we can consider bumping Jack's dose up closer to where he should have started glargine. But do wait for an experienced person to help you out with that. As Bron said, Jack is a special case.
 
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