4/14 Niko +11 PM 86, AMPS 70 - vacation dose question

[Niko's Mom]

Prev: https://felinediabetes.com/FDMB/threads/4-11-niko-pmps-343-pm-11-40-amps-135.299991/#post-3263650

So, Niko earned a dose reduction last PM. I just realized it was on the 5th cycle of his 1.50, so I'm hoping I wasn't too hasty and that it wasn't surplus depot... I guess we will find out. Unfortunately his liver is still in school, trying to graduate.

Couple questions for you folks:

- We are going away for a day and a half on Easter weekend coming up. I have a great friend who we taught to test and inject coming to stay with Niko and give 3 of his shots. However, because Niko has been throwing up these limes, I am afraid of him having a low event with her. She knows what to do, I am leaving her a binder and all the hypo protocol instructions, but would I am thinking of doing a 'vacation dose'. Is a vacation dose usually .25 less than the typical dose? And once we come back, do we bump him back up or hold the dose?

- Another unrelated question. Before committing to this forum, I started out as part of the FB group FDSG. Can someone attest to what dosing protocol these folks are following? I have another CG who reached out to me about Niko because I switched communities and I tried to explain TR/SLGS to her, since her kitty was have a hard time with the doses. The moderators over at FDSG keep telling her to hold a dose for 10-14 days (!) even when her kitty is consistently showing pink and high yellow nadirs, and they are advising she only increase in drops (instead of .25 increments) or decrease completely because "too much insulin can look like too little insulin". I think that FB group has good resources like FMDB, but every time I tried to get dosing advice from them, they told me to go lower with Niko (it's what prompted us to reset at 1.00U a few months ago, which actually elevated his ketones).

HAPPY MONDAY EVERYONE!

Niko photobomb:

 

[Helen + Noogi]

Don't have any answers to your questions I'm afraid Ana, just want to say congrats on the reduction, go Niko!
And love the pics - he is so cuuuute!

 

[Niko's Mom]

Don't have any answers to your questions I'm afraid Ana, just want to say congrats on the reduction, go Niko!
And love the pics - he is so cuuuute!

Thank you! I hope I wasn't too fast w/ the reduction, he was juuuust barely lime last night. I sure hope his liver gets on board soon.

Yes, he is so very cute helps me forgive him when he is a nasty yelling gremlin in the early AM

 

[Bandit's Mom]

So, Niko earned a dose reduction last PM. I just realized it was on the 5th cycle of his 1.50, so I'm hoping I wasn't too hasty and that it wasn't surplus depot... I guess we will find out.

Nope. By the 4th cycle the previous depot would have been out of the picture at this size of dose. Congrats on the reduction!

- We are going away for a day and a half on Easter weekend coming up. I have a great friend who we taught to test and inject coming to stay with Niko and give 3 of his shots. However, because Niko has been throwing up these limes, I am afraid of him having a low event with her. She knows what to do, I am leaving her a binder and all the hypo protocol instructions, but would I am thinking of doing a 'vacation dose'. Is a vacation dose usually .25 less than the typical dose? And once we come back, do we bump him back up or hold the dose?

When do you leave and when are you back? A vacation dose is usually 0.25U less than the current dose (if the current dose is giving low to mid greens). It's begun around 4 cycles before you leave so that you know what he is doing on the dose before you leave. And yes, you would go back up in dose when you are back - unless he decides to work the vacation dose!

- Another unrelated question. Before committing to this forum, I started out as part of the FB group FDSG. Can someone attest to what dosing protocol these folks are following? I have another CG who reached out to me about Niko because I switched communities and I tried to explain TR/SLGS to her, since her kitty was have a hard time with the doses. The moderators over at FDSG keep telling her to hold a dose for 10-14 days (!) even when her kitty is consistently showing pink and high yellow nadirs, and they are advising she only increase in drops (instead of .25 increments) or decrease completely because "too much insulin can look like too little insulin". I think that FB group has good resources like FMDB, but every time I tried to get dosing advice from them, they told me to go lower with Niko (it's what prompted us to reset at 1.00U a few months ago, which actually elevated his ketones).

I don't know what dosing protocol they follow, but I do know that they love dose resets - which often leaves the cats with glucose toxicity/high numbers!

 

[Niko's Mom]

Nope. By the 4th cycle the previous depot would have been out of the picture at this size of dose. Congrats on the reduction!

Awesome, happy to see Niko working down the ladder. Let's hope 1.25 is good for him...

When do you leave and when are you back? A vacation dose is usually 0.25U less than the current dose (if the current dose is giving low to mid greens). It's begun around 4 cycles before you leave so that you know what he is doing on the dose before you leave. And yes, you would go back up in dose when you are back - unless he decides to work the vacation dose!

We are gone this Friday PM (so we will give him his AM shot), and our friend is taking care of his Friday PM, Saturday AM/PM, and we are back Sunday to give him his Sunday AM. Awesome, sounds good, I'll see how 1.25 is treating him and make a decision then. ty!

I don't know what dosing protocol they follow, but I do know that they love dose resets - which often leaves the cats with glucose toxicity/high numbers!

Yeah, I have heard a lot of the dose resets from that group. I can see the intent behind it and it may work for some kitties over there but it just did nothing for Niko made him worse actually. I hope that CG that reached out to me is able to get a good dose for her cat. She tests enough for TR but I think she isn't fully on board yet... I believe her kitty has glucose toxicity because of the slow increases (her kitty used to mostly see yellows pre-insulin but now is pretty pink).

 

[Marielle]

Initially, before coming here, I was following both the FDSG (https://www.facebook.com/groups/207764985923899/) AND the FB group affiliated with this forum (FDMB) (https://www.facebook.com/groups/felinediabetes). I stopped following the FDSG group because I found that their advice often conflicted with FDMB FB group. A red flag for me was that one time I tried to share something on the FDSG group from the FDMB group, and I was told that I couldn't because the groups were not in alignment in terms of treatments, etc. I was like, okay. The FDMB FB group and forum have so much more research and guidelines posted, including dosing methods (with research), and that information is organized so much better, and they have these message boards, which are, in my opinion, the lifeline to helping us CGs offer the best treatment to our sugar babies, so I left the other group rather than continuing to receive conflicting and what I feared might be incorrect information.

 

[Wendy&Neko]

Good luck with the new dose. And have fun on the time away. One thing to consider for a vacation dose (besides the nadirs), is how easy it is for the petsitter to draw the dose. On the line is always easier, so here's hoping that means 1.0 units while you are gone. I'd also fill a used syringe with the dose for reference, fill it with coloured juice, tea, pop etc.

A little history lesson on FDSG. We used to have a ISG on FDMB called "relaxed Lantus" for folks who were following a looser form of of SLGS. They kept mostly to themselves, didn't ask for help, or want it. I personally saw the reset have deadly consequences. A kitty that saw ketones and worse after reducing the dose, when what he needed was more insulin. . Later on the two Lantus forums were joined together - this one was originally just for people following TR. So we then supported two dosing methods. There is really more commonalities than differences in using Lantus so I think it was a good idea. The folks on Relaxed Lantus decided they didn't want to stick around and started their own FB group. I'll stop there, I could say more.

 

[Niko's Mom]

Initially, before coming here, I was following both the FDSG (https://www.facebook.com/groups/207764985923899/) AND the FB group affiliated with this forum (FDMB) (https://www.facebook.com/groups/felinediabetes). I stopped following the FDSG group because I found that their advice often conflicted with FDMB FB group. A red flag for me was that one time I tried to share something on the FDSG group from the FDMB group, and I was told that I couldn't because the groups were not in alignment in terms of treatments, etc. I was like, okay. The FDMB FB group and forum have so much more research and guidelines posted, including dosing methods (with research), and that information is organized so much better, and they have these message boards, which are, in my opinion, the lifeline to helping us CGs offer the best treatment to our sugar babies, so I left the other group rather than continuing to receive conflicting and what I feared might be incorrect information.

thank you for sharing your experience. It took me a hot second to realize the FDSG and this forum had conflicting information. I rely on the info and support here but still peruse FDSG since I’m cheering on some CGs/kitties in their journey. I’ve definitely stopped looking at the FB for any dosing advice after our initial experience. Following TR here has been a life saver for Niko.

 

[Niko's Mom]

Good luck with the new dose. And have fun on the time away. One thing to consider for a vacation dose (besides the nadirs), is how easy it is for the petsitter to draw the dose. On the line is always easier, so here's hoping that means 1.0 units while you are gone. I'd also fill a used syringe with the dose for reference, fill it with coloured juice, tea, pop etc.

This is good to know! We have a caliper which she knows how to use but I also plan to find some 'well marked' syringes so the 1.00U is accurate, and also fill a sample one with some colored juice for reference.

A little history lesson on FDSG. We used to have a ISG on FDMB called "relaxed Lantus" for folks who were following a looser form of of SLGS. They kept mostly to themselves, didn't ask for help, or want it. I personally saw the reset have deadly consequences. A kitty that saw ketones and worse after reducing the dose, when what he needed was more insulin. . Later on the two Lantus forums were joined together - this one was originally just for people following TR. So we then supported two dosing methods. There is really more commonalities than differences in using Lantus so I think it was a good idea. The folks on Relaxed Lantus decided they didn't want to stick around and started their own FB group. I'll stop there, I could say more.

Thank you for explaining this, it makes sense to me. I do see that the protocol they seem closest to following there is a relaxed SLGS, except I've seen them sometimes apply it to other insulins like ProZinc (which, from my understanding, functions differently and isn't a depot insulin).

Niko had a very similar experience to what you described. I'm not sure if you remember but when I introduced him to the forum here, he ran very high with ketones but was asymptomatic (cost us 2k just for the vets to tell us to start him on insulin, and after that they were stumped). However, with the dosing advice I received over there, it made his ketones worse because we kept lowering the dose. As I can see by following TR here, we made all the way to almost 2.50U before he started showing steady improvement. Even though his pre-insulin BGs were 'relatively low' and not too far from the renal threshold, he still needed a good bit of insulin.

Niko is lucky because he is ketone sensitive but his body just kinda continues working despite high ketones (they develop quickly and come down quickly). Not every kitty is lucky like that so I think that's why I don't agree with the protocol over there, but it does seem to work for some other kitties!

 

[Wendy&Neko]

I do remember the ketones concerns at the beginning, scary!