12/13 - Leo - Time for an increase?

Susan Shropshire

Susan Shropshire

Member Since 2021
I had started to see a little improvement at 7 units. We were seeing more yellow and a sprinkle of blue. I increase to 7.5 units and today is day 9. We did see a blue in the 10th cycle. Since then however it has actually gone up?? I am seeing lower numbers at night but higher during the day. He eats 2x a night so it's not that he is fasting during those hours. We are still hovering at low 200's and high 100s even at night and then in the 300's during the day. I though about increasing to 8 this morning but his pre-shot was in the mid 200's so I decided to see how he did today. It's actually gone up since his injection.

I am thinking I need to go to 8 units. I have tried to test a variety of times so I could see if at some point he is dropping and would be having a rebound. I don't think the #s are low enough to be causing a bounce during the day? I had hoped 7.5 would get a closer to where we need to be but it seems like it went the other way??

Should I go ahead and increase to 8?
 
With TR, we hold doses with blues for 6-10 cycles total. You don't start counting from when you see the blues. For higher blues, I tended to hold shorter numbers of cycles. You could have increased after 6 cycles. You've held this dose for 17 cycles so far, which is far too long. There is something that is causing insulin resistance with Leo and a need for a higher dose of insulin. With insulin resistance, you cannot sit on a dose too long if it's not getting numbers you want (high green nadirs on that AT preferred).

So yes, Leo needs an increase. Don't hold doses as long as you have been, that can cause glucose toxicity on top of things. It basically means his body gets used to higher numbers and you have to got to an even higher dose to break through.
 
Wendy&Neko said:
With TR, we hold doses with blues for 6-10 cycles total. You don't start counting from when you see the blues. For higher blues, I tended to hold shorter numbers of cycles. You could have increased after 6 cycles. You've held this dose for 17 cycles so far, which is far too long. There is something that is causing insulin resistance with Leo and a need for a higher dose of insulin. With insulin resistance, you cannot sit on a dose too long if it's not getting numbers you want (high green nadirs on that AT preferred).

So yes, Leo needs an increase. Don't hold doses as long as you have been, that can cause glucose toxicity on top of things. It basically means his body gets used to higher numbers and you have to got to an even higher dose to break through.
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I guess I am confused??? I thought they told me to count from the blue forward?? I'll have to go back and see if I can find that post. So really I should have increased his dose back around the 8th or 9th?

So I started the 8 units on the 14th so I have gone through 5 cycles (counting today during the day). So I would increase to 8.5 units starting tomorrow? That would be 6 total cycles. I am trying to not get into the days we won't be home as much due to holiday parties. So this Sunday & Monday (the 19th-20th) we will be gone most of the day. He usually gets a little higher the first day after a change so if I change tomorrow to 8.5 units (the 17th) then the 18th he would be a little higher and possibly drop on the 19th and/or 20th. That worries me.
 
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Quoting from the dosing methods Sticky Note:
Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
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Leo is not new to blue numbers. You might hod 10 cycles if seeing some greens, which he's not.
 
Wendy&Neko said:
Quoting from the dosing methods Sticky Note:
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Leo is not new to blue numbers. You might hod 10 cycles if seeing some greens, which he's not.
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tiffmaxee said:
You need to wait 10 cycles from the blue on the current dose before increasing.
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I was going off this answer I quoted above

So I should only be holding 6 cycles until he is seeing green? So that would mean I could increase in the morning to 8.5 units and hold that tomorrow 17th (2 cycles), 18th (2 cycles=4) and the 19th (6 cycles total) and increase on the 20th if I am not seeing greens?
 
With some blues, you can hold the dose longer than 6 cycles. I tended to hold longer for low blues, shorter for high blues. Since you saw a mid blue, maybe 8 cycles? That would also be 6 cycles after a bounce from that 144, and give you a chance to see if he's going to see blue again post bounce.
 
Wendy&Neko said:
With some blues, you can hold the dose longer than 6 cycles. I tended to hold longer for low blues, shorter for high blues. Since you saw a mid blue, maybe 8 cycles? That would also be 6 cycles after a bounce from that 144, and give you a chance to see if he's going to see blue again post bounce.
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So I changed to 8 units on the 14th (2 cycles), 15th (2 cycles = 4) today (2 cycles = 6) so hold tomorrow am & pm which would be 8 and increase again on the 18th unless by some chance I see green?

Then normally I would increase after 8 cycles (4 days) if seeing blue but not seeing green yet. But, if I see maybe a low blue wait 10 cycles (5 days)? Does that sound correct?
 
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