08/07 Grandpa AMPS 498. Increased to 1.75U.

[Beck and Philly]

Yesterday

He's just not himself. It took a whole lot of coaxing to get 1/2 can of food in him. A week ago he was growing at the vet while he gobbled dinner. I'm considering a vet visit, but they will assume it's the cancer. It may be, but he was like this before and bounced back.

His numbers are still very high. I increased to 1.75 this morning. We're down to the last test strip so I'm hoping Amazon prime comes through today.

 

[Mandy & Rex (GA)]

Good luck with the increase. It is possible Grandpa is feeling icky at those high numbers and that's all.

 

[Kris & Teasel]

Sending good energy to you and Grandpa.

 

[Beck and Philly]

Thanks! He ate more Halo at snack time. Not a ton, but something at least. We have one test strip left and Amazon delivery isn't scheduled until tomorrow. We can use the Freestyle Pro to ensure he isn't in any danger zones, but it won't give us a good idea of how his increased dose is doing.

 

[Squalliesmom]

Prayers and vines for Grandpa to feel better and eat well!

 

[Olive & Paula]

You are missing some data on the ss. Lantus likes consistent dosing, s there a reason the last couple of days it hasn't been consistent?

 

[Beck and Philly]

We were late one day on Sunday. No pet sitter available. We have canceled our vacation to stay home with him, but there are a few days we still have to be late. My roommate felt that it would be best toi shoot 1U that night. Otherwise we have been gradually increasing by .25.

 

[Susan&Felix(GA)]

Hope Grandpa keeps eating his snacks and is feeling better as the day goes on.

 

[Sue and Luci]

We were late one day on Sunday. No pet sitter available. We have canceled our vacation to stay home with him, but there are a few days we still have to be late. My roommate felt that it would be best toi shoot 1U that night. Otherwise we have been gradually increasing by .25.

I believe @Olive & Paula may have been asking you about the amount of the dosage - not the time. Why are you changing amount given several times in a row? From 1.25 to 1.5 and then to 1 to 1.75 - Lantus dosing should never be changed more than .25 in any direction - once you change it you really need to stick with THAT dose for several days in a row - based on the protocol (TR or SLGS)? Please don't change the amount - we all have time constraints and issues - those can be worked out - but please try to hold the dose....

 

[Beck and Philly]

I believe @Olive & Paula may have been asking you about the amount of the dosage - not the time. Why are you changing amount given several times in a row? From 1.25 to 1.5 and then to 1 to 1.75 - Lantus dosing should never be changed more than .25 in any direction - once you change it you really need to stick with THAT dose for several days in a row - based on the protocol (TR or SLGS)? Please don't change the amount - we all have time constraints and issues - those can be worked out - but please try to hold the dose....

If you read my thread from 8/5 you'll see why we went up from 1.25 to 1.75 quickly.

What I recommended was bumping him up by 0.25u to 1.5u after four consecutive cycles at 1.25u or up by 0.5u to 1.75u after six consecutive cycles. However, you are past four cycles at 1.25u so now the other option, which is per the TR protocol, is to raise him by 0.5u after six consecutive cycles so your new dose would be 1.75u. .

So we adjusted up to 1.75 rather than holding at 1.5

With the exception of one dose on Sunday night where we made an incorrect judgment call based on unusual circumstances and gave 1U, we have followed what we have read and understood about protocol. We stuck with the initial dose for the recommended 5 to 7 days even though we started low. We then stuck with the 1.25 for the recommended 3 days before going to 1.5. We learned that we should have gone to 1.75 instead so we adjusted to that and are currently holding there for 3 days before we will go to 2.0 which gets us back to where we were with Vetsulin.

We understand that the 1U should've been 1.5 and had talked about it the next day. All we can do at this point is choose a dose to hold and move forward. Right now that dose seems to be 1.75. If that is incorrect, we can change, but that means another adjustment.

 

[Marje and Gracie]

I believe @Olive & Paula may have been asking you about the amount of the dosage - not the time. Why are you changing amount given several times in a row? From 1.25 to 1.5 and then to 1 to 1.75 - Lantus dosing should never be changed more than .25 in any direction - once you change it you really need to stick with THAT dose for several days in a row - based on the protocol (TR or SLGS)? Please don't change the amount - we all have time constraints and issues - those can be worked out - but please try to hold the dose....

Remember that if nadirs are greater than 300, dose increases are done by 0.5u after six consecutive cycles. Also, with high dose kitties, which Grandpa is not at this time, we often recommend much higher dose increases and reductions so there are times when dose changes are done in larger increments than 0.25u.

 

[Marje and Gracie]

If you read my thread from 8/5 you'll see why we went up from 1.25 to 1.75 quickly.
So we adjusted up to 1.75 rather than holding at 1.5

With the exception of one dose on Sunday night where we made an incorrect judgment call based on unusual circumstances and gave 1U, we have followed what we have read and understood about protocol. We stuck with the initial dose for the recommended 5 to 7 days even though we started low. We then stuck with the 1.25 for the recommended 3 days before going to 1.5. We learned that we should have gone to 1.75 instead so we adjusted to that and are currently holding there for 3 days before we will go to 2.0 which gets us back to where we were with Vetsulin.

We understand that the 1U should've been 1.5 and had talked about it the next day. All we can do at this point is choose a dose to hold and move forward. Right now that dose seems to be 1.75. If that is incorrect, we can change, but that means another adjustment.

Just a reminder that you can’t make the best dosing decision if you don’t know how low the dose is taking him. If he were mine and I had enough data both cycles to see he only had one BG below 300, I’d increase by 0.5u after six consecutive cycles. But with no nighttime data the last two nights, you don’t know how low the dose is taking him....or how high it’s leaving him.

 

[Beck and Philly]

I had already raised him to 1.75 when I ran low on test strips. I ordered more immediately and thought they would be here today. They are scheduled for tomorrow. We used the human meter and his reading tonight was 326. It didn't make sense to me to lower the dose again since he has been consistently high. Maybe I'm wrong.

So, the options as I see them are
1. To back down to 1.5 and hold for 6 cycles before going back up to 1.75 or
2. stay at 1.75 for 6 cycles before going up to 2.

 

[Marje and Gracie]

I had already raised him to 1.75 when I ran low on test strips. I ordered more immediately and thought they would be here today. They are scheduled for tomorrow. We used the human meter and his reading tonight was 326. It didn't make sense to me to lower the dose again since he has been consistently high. Maybe I'm wrong.

So, the options as I see them are
1. To back down to 1.5 and hold for 6 cycles before going back up to 1.75 or
2. stay at 1.75 for 6 cycles before going up to 2.

IMHO, I would not decrease his dose....he hasn’t earned a reduction so why put him at risk for further hyperglycemia? I wasn’t suggesting you decrease the dose.

I’m suggesting you try to get at least two tests at night......a +2 and a before bed would give you some data. If you are up really early, you could also get a +10. Then you’d have some data to base your dosing decision on.

If you get more data and he stays above 300, I’d increase by another 0.5u to 2.25u after six consecutive cycles at 1.75u. If you start seeing some yellow numbers, I’d only increase 0.25u to 2u. But you need a few more tests to make that determination.

 

[Beck and Philly]

As soon as the strips come today I will increase his tests.

 

[Marje and Gracie]

As soon as the strips come today I will increase his tests.

You might also think about whether you’d like to switch to a human meter which is what most members use. The strips are much, much cheaper and more readily available. A lot use ReliOn Micro or Contour...they use the same strips and you can easily get the strips and meter at Walmart.

If you decide to do this, let me know and I can convert the SS so you can continue to use the same one but just modified formatting for the numbers.

 

[Beck and Philly]

I've been considering it. I started with a human meter and switched to the AlphaTrak 2 a month or so ago. The strips are horribly expensive, but I think I'l stick with it for awhile at least now that I've made the investment. I may pick up a small supply of Freestyle Lite strips and do a comparison since some here say they can be used with the AT. Thanks for the spreadsheet offer!

 

[Marje and Gracie]

I've been considering it. I started with a human meter and switched to the AlphaTrak 2 a month or so ago. The strips are horribly expensive, but I think I'l stick with it for awhile at least now that I've made the investment. I may pick up a small supply of Freestyle Lite strips and do a comparison since some here say they can be used with the AT. Thanks for the spreadsheet offer!

I would just add a word of caution.....I would not use a human strip in a pet meter. I know members are doing that because the strips look the same and they’ve run comparisons. But the companies have changed and the company that now makes the FS meters/strips no long makes the AT.

Ask yourself this question....if you were diabetic and pet test strips were cheaper, would you test your own BG with a pet test strip in a human meter? I don’t think it’s worth the chance in either situation. Common sense should prevail

 

[Shawna & Davidson (GA)]

Well said. FYI, the ReliOn Prime meter at Walmart is $9 and 100 test strips are $17.98....pretty cheap investment to get accuracy and use of a meter that many of us use on here you can keep the one you have as a back up, since we should have that any way.

 

[Beck and Philly]

Noted. I have a fresh supply of AT strips so we're good for awhile.