11/10/2022 Bugs AMP 140 Dosage 0.25U

You are gathering data now that will help determine the no shoot number. So today you shot a 140 with .25 units and if you can get a +6 or 7 and even a +8 it would help so much for us to see how she does on that small dose when starting out below 150. You are doing such a great job!
 
SKittyMom said:
https://felinediabetes.com/FDMB/threads/feeling-discouraged-need-advice.269429/
@FrostD
I will follow the recommendations you shared for dosing Bugs.
  1. What number is considered the no shot # where we would know not to dose?
  2. If Bug's AMP is showing consistently under 150, should we still follow the protocol of an additional test prior to AM or PM dose? Or consider it safe to dose now that doing a micro-dose?
Thank you!
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1. Like Suzanne said we're trying to (safely) figure out the no shoot number/what doses to give in these lower numbers. Based on what I see, I'd say 125 for now but it's really up to your comfort level.

2. It appears to be safe to give 0.25U above 140, you've done a few of them and she's not going low. Now I always get a little nervous coming into these lower numbers when it's not my cat! So I always like nadir checks around +6 in these images, but I certainly understand having to balance other things in life.

Let's see how tonight's shot goes ...the 0.25U isnt quite cutting it so far may need to increase that.
 
FrostD said:
1. Like Suzanne said we're trying to (safely) figure out the no shoot number/what doses to give in these lower numbers. Based on what I see, I'd say 125 for now but it's really up to your comfort level.

2. It appears to be safe to give 0.25U above 140, you've done a few of them and she's not going low. Now I always get a little nervous coming into these lower numbers when it's not my cat! So I always like nadir checks around +6 in these images, but I certainly understand having to balance other things in life.

Let's see how tonight's shot goes ...the 0.25U isnt quite cutting it so far may need to increase that.[/

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I agree with all of this. I see you got a 99 last night on the .25 dose. Way to go on this testing! I'm very proud of you for that. Hold this dose for a week (14 cycles) and let's see how it goes -- unless of course you have a super low preshot (below the 125 that Melissa mentioned). You can make a decision then if you want to shoot a smidge, skip, etc. based on the exact number and other factors such as whether you can monitor BG and intervene with high carbs, if necessary.

After a week, we can reassess the situation. Post here with any questions. You're doing great!
 
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@FrostD @Suzanne & Darcy

After Bugs BG of 99 on the 10th we did give her a spoon of her lower carb wet food.

We did a 0.5U dose yesterday both AM and PM due to her numbers at the 160 range.

This morning she had a BG of 219 so we gave 0.75u. We did a +6 test after AM dose and she was down to 89. (We did two readings 10 minutes apart to make sure accurate) Bugs did eat after.

If you get a moment, could you please look at her current numbers. I want to make sure we are dosing correctly based off how the last couple days have gone.

All your guidance is so appreciated! Bugs and I both thank you.
 
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Bug's spreadsheet looks nice. I would prefer that you find a dose and stick to it (unless the preshot is really low, of course, or he has a lime nadir.) The reason I say this is because I prefer that people follow the Start Low Go Slow dosing method. Here's an excerpt from a portion of it (have you read through the whole ProZinc dosing methods yet?):
Starting Dose:
  • 1u BID if kitty is not on a wet/canned low carb diet
  • 0.5u BID if kitty has been switched to a wet/canned low carb diet
  • If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
  • Generally, shots are to be given 12 hours apart.
Hold the dose for at least a week:
  • Unless your cat won’t eat or you suspect hypoglycemia
  • Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.

Reducing the Dose:
  • Anytime the BG drops below 90 mg/dL, reduce the dose by 0.25u at the next shot.
Lather, Rinse, and Repeat!
 
Did you do a test after the 89 today? Technically, anytime she drops under 90, she is due a reduction by .25 unit (which would get you to the .5 unit dose anyway.) I know it's so hard to wait and hold a dose! Having said all that... you are doing very well. Keep up the testing because ProZinc can occasionally be unpredictable and give a surprising low.
 
@Suzanne & Darcy @FrostD
I didn't do another test after her +6 when we got the 89. I will make sure to do another moving forward when we have a lower number. Would you recommend a +2?

I did read through the ProZinc dosing when I initially joined the forum. Reading through again is very helpful.

  • Just to make sure I am doing the correct dosage, I should be sticking with the 0.5U for 14 cycles (even if her numbers rise) and after that time do either an 18 or 12 hour curve?
  • But if she drops below 90 reduce by 0.25 or not dose.
Thanks again!
 
In these numbers I do still prefer the mid cycle spot checks trying to catch nadir as opposed to a curve.

You may soon end up in a position where you may need to choose the MPM method. She is a good candidate for remission (though never guaranteed), and MPM does allow for a stronger remission - but your schedule, ability to monitor, and comfort level all factor in as well.
 
@FrostD @Suzanne & Darcy, hope you are having a great week. Bugs BG levels have been holding pretty steady both AMP and PMPD for the last 5 days. She has been getting 0.5U for her dose both AM and PM. Would you mind looking at her spreadsheet? Should we do anything different at this time?
Thanks!
 
Looks good! I suspect she could use a small increase but I'd like to see a daytime curve (or at least +3 to +7) before saying that for sure.
 
SKittyMom said:
@FrostD @Suzanne & Darcy, hope you are having a great week. Bugs BG levels have been holding pretty steady both AMP and PMPD for the last 5 days. She has been getting 0.5U for her dose both AM and PM. Would you mind looking at her spreadsheet? Should we do anything different at this time?
Thanks!
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I agree with Melissa. You are doing very well! It does look like she could do with an increase but I agree on filling in some gaps in our picture on the spreadsheet. It’s the weekend. Do you think you will be able to get those extra tests in so we can be sure?
 
@FrostD @Suzanne & Darcy

We did the additional tests today. Post AM shot a +3 and a +7. We also did a post PM shot +4. Let me know if you recommend changing the current 0.50u dose or if we should do some additional testing tomorrow.
 
With that 94 that you got yesterday, I am very hesitant to recommend a full .25 unit increase. For today at least, I would try to get a few more tests in today -- especially in the early part of the cycle (before +6 or 7.) I think it should be similar to yesterday's cycle, but we will see. I might recommend "fattening up the dose a bit" but not doing a full .25 unit increase, which may be too much. All of this depends on your ability to monitor Bugs during the future cycles. Can you refresh my memory on your work schedule/ability to get tests done? Thanks.
 
@Suzanne & Darcy

Morning,

We'll do additional testing again today I work from home so I can test throughout the day if her dose is changed. I'll send a message this evening so we know if her AM dose should be adjusted.
Thank you!
 
Another nice cycle today! You have been seeing greens! :D Interestingly, Bugs doesn’t seem to drop lower at night like a lot of cats do… unless it’s occurring after +4. I still would be hesitant to recommend that full increase - maybe just a fattened dose - depending on your goals for Bugs. Let’s see what Melissa also has to say when she can stop by. :)
 
Hmm the 81 tonight makes it a tough call. His preshots seem to be on a downward trend so my vote is hold for another week
 
@FrostD @Suzanne & Darcy

I hope you a had a great holiday.

We just completed the full week of the 0.5u dose for Bugs both AM and PM. Please take a look at her numbers when you get a chance and let me know if we should make any adjustments to the current dose. Bugs has been holding pretty steady with her readings and we are so pleased with the progress we've made.

Thanks again!
 
You have really made great progress. I would stick with the .5 dose for now and keep filling in the spreadsheet at different points. You are getting greens :D I bet Bugs is feeling a whole lot better than she was at diagnosis. Your consistency is paying off!
 
Morning @Suzanne & Darcy and @FrostD Hope you are both doing well.

Just checking in to see if we should make any adjustments yet to Bug's dosage. We continued with the 0.5u over the past week both AM and PM dosage, spreadsheet is current. Her BG levels are continuing to hold pretty steady.

It is SO rewarding to see the improvements with Bug's health since we started with the forum a couple of months ago.
 
Good morning! It's really great to hear how Bugs is happier and feeling much better now. I bet that makes you smile :-) It's kind of up to you about increasing. Bugs does seem to have very steady numbers (thank goodness for that! so many cats around here are bouncy... consider yourself lucky there!) You have held this dose long enough to consider an increase, but without being able to test some during the middle of the cycle, you will not know how low the dose is taking her. Is it possible to do some additional testing on the weekends? What I mean is, if you do an increase of her insulin, would you be able to test and do something like a curve? We want to keep that sweet girl safe! What is your opinion @FrostD ?
 
@FrostD @Suzanne & Darcy after the .25u increase AM bugs numbers dropped low. We have completed a +2, +4 and +6. We'll do a +8 as well Based off the numbers should we go back to the 0.5 for her pm dose? I read the information on the forum if she drops below 90 to decrease by 0.25 so I'm thinking yes but want to make sure. (Spreadsheet is current). Thank you.
 
Yes. I am glad that you reduced. I don’t like that lime on her spreadsheet. I would stick with the .5 for now. I was afraid that a full .25 increase might be too much, but now we know. At some point, you may consider fattening the dose, but you should probably consider getting digital calipers for that. Jist stick with the .5 and hopefully she will continue to do very well.
 
@FrostD when we got the lime, we took a second reading to make sure. Thank goodness for all the great info on the forum. I was able to make an accurate decision because of the info.
Happy Holidays!
 
Hi there. I was just checking in on Bugs. I’m dying to know what happened between the 164 and 137 today. It looks like Bugs is doing really well. :cat:
 
Hi @Suzanne & Darcy
Bugs is doing great. We did a +4 after her pm dose and her BG was 113! We gave her a bit of a break the last couple days on + tests after her Sunday curve. Bugs feeling and looking like her old self is the best Christmas gift this year! Thanks for checking in on her!
 
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