1-23 Howie AMPS=93, +2=146 +3=120, +5=97, +6.5=95

Howiesmom

Howiesmom

Member Since 2020
I was not anticipating Howie dipping into greens early this AM. His nadir more often than not is his PS so I’m not *too* worried he got really low while I was sleeping. This is the 2nd time ever he hit greens, with the first time on 1/20 (right before the inauguration!!) https://www.felinediabetes.com/FDMB...-5-83-6-5-87-9-79-10-74-11-69-pmps-78.241802/

@Wendy&Neko gave me great advice about holding his dose for 10 cycles. This morning was his 7th cycle at his current dose of 55u BID of Levemir. I’m wondering if I hold the dose longer since I hit greens again? Or increase after the 10 cycles? As you can see on his SS, he’s been in mostly blues and some yellows at this dose and previous doses. This is foreign territory for me to know when hold as I know I can’t be blasé about sitting on a dose too long.

Because he is so high dose (acro and IAA), his next increase would be to 60 units (10% increase).
 
When a high dose cat hits greens, your next dose increase could try to "sneak" the dose up a bit, instead of going for the full 10%. What you want to do is bring the nadirs down, just a little bit, when you need to. You could experiment whether a 2 or 3 unit increase would work.

The thing to consider is that with acro in the picture, your goal is not really earning reductions, but rather to get him to a dose where he spends as much time as possible under renal threshold. Howie is pretty much at that spot with this dose. Nadirs in the 60's don't leave you a lot of room to increase. I found, for Neko, a dose where she had nadirs in the 70's kept her under renal threshold most of the time. So I held doses with good nadirs a little longer, until the good numbers drifted away. You are right that you can't sit forever on this dose, just keep an eye on whether the nadirs are where you want them to be. Increase when they drift up.
 
Wendy&Neko said:
When a high dose cat hits greens, your next dose increase could try to "sneak" the dose up a bit, instead of going for the full 10%. What you want to do is bring the nadirs down, just a little bit, when you need to. You could experiment whether a 2 or 3 unit increase would work.

The thing to consider is that with acro in the picture, your goal is not really earning reductions, but rather to get him to a dose where he spends as much time as possible under renal threshold. Howie is pretty much at that spot with this dose. Nadirs in the 60's don't leave you a lot of room to increase. I found, for Neko, a dose where she had nadirs in the 70's kept her under renal threshold most of the time. So I held doses with good nadirs a little longer, until the good numbers drifted away. You are right that you can't sit forever on this dose, just keep an eye on whether the nadirs are where you want them to be. Increase when they drift up.
Click to expand...
Thanks, Wendy! I’ve read different things about what the renal threshold is. What number/range do you go by? Im Also wondering with giving him his R...Sandy did not give me any indication that I should give it if he is under 175. Since I have not found the dose that drops him significantly yet, what are your thoughts on what the minimum BG level is that I should/could give it? He hasn’t had any since 1/19.
 
Renal threshold varies by cat, but on a human meter it's somewhere from upper blues to lower yellows. You can either use ketodiastix to determine it (at what BG does he start passing sugar in his urine), or what I did was test Neko before she went in for a urinalysis at the vet. For Neko, it was around 220, but I've seen quite a bit lower.

I do see evidence that R is helping him some. I'm comparing some similar cycles where you gave R to others you didn't, and the R seems to be keeping a lid on his numbers rising as much as if you didn't use it. At this point, I wouldn't lower the "don't shoot R" number.
 
Wendy&Neko said:
Renal threshold varies by cat, but on a human meter it's somewhere from upper blues to lower yellows. You can either use ketodiastix to determine it (at what BG does he start passing sugar in his urine), or what I did was test Neko before she went in for a urinalysis at the vet. For Neko, it was around 220, but I've seen quite a bit lower.

I do see evidence that R is helping him some. I'm comparing some similar cycles where you gave R to others you didn't, and the R seems to be keeping a lid on his numbers rising as much as if you didn't use it. At this point, I wouldn't lower the "don't shoot R" number.
Click to expand...
You are so wise! Thank you so much! Can I get the ketodiastix at Walmart or do I have to order them? Are pet ones different than human?
 
Last edited:
Wendy&Neko said:
Use the human ones. I don't live in the US, so not sure where you can get them.
Click to expand...
I’m soooooo frustrated and got a fur shot tonight. He flinched during the 2nd syringe and bent the needle. Does this change anything that I need to do moving forward?
 
Hold the Levemir dose. R can be used to help with the BG's that rise. Unless you want to stay up tonight, I'd wait until tomorrow to use it.
 
You must log in or register to reply here.
Back
Top