? 12/31 Panic AMPS 222 - Dosing advice needed

[Panic]

So Panic has been on Lantus 7 days now and this is Day 8. She's been cruising in the low 200s but no dips to blue at all. SLGS protocol says to increase after a week but I'm not sure if I need to wait a couple days more due to the first 3 days being the depot loading period? Any advice?

 

[carfurby (GA)]

With SLGS you do a curve once every 7 days and adjust the dose based on the curve and the past week's numbers. You don't have to wait for a depot loading period. You should increase the dose to 1.25 units.

 

[Crista & Ming]

FYI, The depot takes about 6 cycles to fill. That’s why if you’re following TR, you’d be able to increase as quickly as 6 cycles.

Of course, ECID and sometimes need more than 6 cycles.

Judging by Panic’s numbers, an increase would be safe to do Good luck with the new dose!

 

[Panic]

Thank you both, will try her out tomorrow on 1.25 and see how it goes! <3

 

[Sienne and Gabby (GA)]

Let me do some clarifying.

It takes the depot 5 - 7 days to become established. This is the case regardless of whether you're following TR or SLGS. With TR, you do not adjust the initial dose until after the depot has formed unless a dose reduction is indicated. Once the depot has become established, it takes most cats 6 cycles to see a response to a dose change and for the depot to again stabilize after the change. This is the case regardless of whether the dose is either increased or decreased.

With SLGS, if you're able, can you get a curve today? It would be great if you're going to be home this evening to monitor since I'm guessing a dose increase is going to be needed. I don't know how comfortable you would be with increasing the dose and not being home given the holiday.

 

[Panic]

Oh thank you for the clarification, that helps a lot!

I can absolutely get a curve today, I have no New Years plans so I'll be home tonight and all day tomorrow. I plan on increasing in the morning since Linda has advised against dose increases in the PM.

 

[MrWorfMen's Mom]

Just to clarify.....you can do dose increases at night if you choose but I always did them on day cycles because you want to monitor the cycle of the increase and that's harder to do at night.

 

[Wendy&Neko]

Increasing on a day cycle is indeed an ECID sort of thing. Cats like to surprise us. Some will give a hint in the first cycle as to what the new might look like, some do nothing first cycle and save the drops for night time. Just keep track of what happens with Panic to learn when is the best time for you to increase. I preferred PM increases.

As for a curve, if you have sufficient spot checks each and every cycle to give you an idea what happened that cycle (like you do!), then a curve is not as important for determining an increase. Basically you want to be able to answer the question "how low is this dose taking my cat?" Curves are good for other data of course, figuring out Panic's onset, nadir and duration for example.

 

[Panic]

Yes that's what I was referring to, lack of monitoring in the PM! Plus I can't completely trust my alarm to go off for spot checks anyway. I've had more than one time where she was running low so I set my alarm to recheck and it just...didn't go off.