? Dosing help requested

[Emily Alsip]

Hello!
Holland's vet asked me to try no insulin for a bit because she didn't feel like the tiny 0.1 dose could be doing much. During that week, she didn't go horribly high. Highest was 265 and we were often in the blue zone. But we agreed to restart since she'd clearly benefitted.

Cue introduction of Chlorambucil three days after resuming insulin. She's doing fine on it now, but we had three days of dodgy tummy.

She's been having higher than typical BG at all times of day. Often at pre-shot time I also get the up arrow showing she's climbing fast.

So my question is... is the BG increase due to some kind of adjustment from restarting insulin? From the introduction of Chlorambucil? Or from the three days of icky tummy? Or all of the above?

And should I increase her dose? Or should I allow more space between the restart/new drug/tummy?

thank you!
Emily

 

[Chris & China (GA)]

Hey Emily! First of all, I have zero experience with Chlorambucil so I'm not sure how valid anything I say is, but first thing on PM cycle of 8/11, the PMPS and the +3 are close enough to be considered the same number. Remember, meters are allowed a 20% variance and she came back down to blue by AMPS of 8/12 so let's throw that part out

Now in the last 24 hours, she's been running yellow with it getting close to pink at PMPS tonight so if it were my cat, I'd probably want to bump the dose up to .25. If it's the drug causing the higher numbers, you're just going to have to dose around it if she continues to need it. If the "icky tummy" is contributing to the higher numbers, then when that gets settled down, IF her numbers start to come down too, you might need to reduce back to .01

Just my 2 cents!

 

[Emily Alsip]

Hey Emily! First of all, I have zero experience with Chlorambucil so I'm not sure how valid anything I say is, but first thing on PM cycle of 8/11, the PMPS and the +3 are close enough to be considered the same number. Remember, meters are allowed a 20% variance and she came back down to blue by AMPS of 8/12 so let's throw that part out

Now in the last 24 hours, she's been running yellow with it getting close to pink at PMPS tonight so if it were my cat, I'd probably want to bump the dose up to .25. If it's the drug causing the higher numbers, you're just going to have to dose around it if she continues to need it. If the "icky tummy" is contributing to the higher numbers, then when that gets settled down, IF her numbers start to come down too, you might need to reduce back to .01

Just my 2 cents!

Hi Chris! Thanks for the reply. Yeah, the icky tummy I'm sure was due to starting the Chlorambucil, but she seems to have gotten used to the medication quickly. She's been ok for five days, so I don't think the fact that she was sick would still affecting her BG. She's been eating well.
It does seem most likely that it's the Chlorambucil itself that's increasing her numbers. Maybe I'll hold off on increasing her insulin to 0.25 until Monday when I can speak with her vet, unless we go pink before then. In that case I'll increase on my own. It's a super not awesome time to be playing with dose changes as I'm heading back to full time work on Tuesday. So I need to proceed carefully. Thanks again!