? 16/8 ~ Milo ~ Need dosing advice please, AMPS due in 11 hrs.

Mariaana and Milo

Mariaana and Milo

Member Since 2021
Hi again!
Milo had a Curve done today, and has been on 1.75 Units for 8 days. Should i increase
his next dose to 2 Units maybe? His lowest BG over the 8 days was 99, and it was today.
Also this evenings PMPS /Shot may have been a partial Fur Shot.
There is a fat green line on the Spread Sheet at the very end to the left, that i cant seem to get rid of..
if someone can help me out please. Thank You.
 
Bandit's Mom said:
Since you are following SLGS, you would hold the dose with nadirs in the 90s.

Tagging @Bron and Sheba (GA) for comfirmation.


Link to your previous post:
https://www.felinediabetes.com/FDMB...dosing-advice-for-pmps-in-1-hr-15-min.251103/
Click to expand...

Bandit's Mom said:
Since you are following SLGS, you would hold the dose with nadirs in the 90s.

Does that mean that i should continue to shot 1.75 Units for another 7 days? Can you clarify please? Thanks.

Tagging @Bron and Sheba (GA) for confirmation.


Link to your previous post:
https://www.felinediabetes.com/FDMB...dosing-advice-for-pmps-in-1-hr-15-min.251103/
Click to expand...
 
Bhooma is correct
From the SLGS method:-
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)

Mariaana, have you thought about changing over to TR? If you got a test in every night, you are testing enough to do it as long as you are not feeding any dry food.
 
Bron and Sheba (GA) said:
Bhooma is correct
From the SLGS method:-
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)

Mariaana, have you thought about changing over to TR? If you got a test in every night, you are testing enough to do it as long as you are not feeding any dry food.
Click to expand...

Hi Bron, Your response was super helpful ~ Thank You so much! I think i may have read this in the sticky notes early
on when i was very new.. so a great reference and refresher for me!
As to changing over to TR i have had that question before... Honestly I'm a bit afraid to shot at lower numbers.(Greens) even though that's really the goal to get a cat into remission i guess.(?)
I need to read up on the TR protocols of course if i decide to switch. (Milo is only eating FF canned pates)
 
That is a good idea to read up on the TR and see what you think. It is totally up to you and you have to be comfortable with it all.
One of the benefits is you can increase after 3 days and if a reduction fails you can go straight back to the last best dose, you don’t have to wait 7 days like you do with SLGS. Do you go out to work, or work from home?
 
Bron and Sheba (GA) said:
That is a good idea to read up on the TR and see what you think. It is totally up to you and you have to be comfortable with it all.
One of the benefits is you can increase after 3 days and if a reduction fails you can go straight back to the last best dose, you don’t have to wait 7 days like you do with SLGS. Do you go out to work, or work from home?
Click to expand...

Bron and Sheba (GA) said:
That is a good idea to read up on the TR and see what you think. It is totally up to you and you have to be comfortable with it all.
One of the benefits is you can increase after 3 days and if a reduction fails you can go straight back to the last best dose, you don’t have to wait 7 days like you do with SLGS. Do you go out to work, or work from home?
Click to expand...

Hi Bron, Question: If you can increase/decrease the insulin dose after 3 days, on the TR Protocol; how often do you do a curve then? I must say i am i bit intrigued now.
By the way, Milo had a Vet checkup last week including a Fructosamine test, ketones, full senior blood panel, Urine~ C&S ~ everything came up 'clean' except his Fructosamine levels were still high, but has gone down some.( from 600 to 500) He has
also gained back some weight. Our Vet is very pleased and in full support of FDMB!
I am so very grateful to have found this wonderful and supportive group. Thank You.
BY the way; I'm retired so no problem with testing at any time.
 
Mariaana and Milo said:
Hi Bron, Question: If you can increase/decrease the insulin dose after 3 days, on the TR Protocol; how often do you do a curve then? I must say i am i bit intrigued now.
Click to expand...
With TR, you don’t do a curve. We look at the BG tests you get during the time you have been using that dose. If you do decide to try TR, I would. Post every day and get feedback and help when needed. That way the helpers will get to know you and Milo.

From the TR protocol
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.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300

Mariaana and Milo said:
Our Vet is very pleased and in full support of FDMB!
Click to expand...
That is really good to hear.


Mariaana and Milo said:
BY the way; I'm retired so no problem with testing at any time.
Click to expand...
That makes it much easier for you.
If the BG drops under 50 Milo earns a reduction in dose.
Make sure you have well kitted out hypo box with all you need….you don’t want to be chasing around looking for something if the numbers drop.
I was very nervous of doing TR at first as well but loved it.

 
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