? 2/16 Viamo AMPS 475 - Need help adjusting dosage? over 400 for months!

Teo

Member Since 2020
Viamo had reached good low values some weeks ago, we lowered the dosage, now he's just over 400 again. It seemed he was getting better each day but now his BG jumped again.

I'm giving 2,25. Should I increase the dosage?
 
Anyway I know my attention should be put on the nadir rather than the PS numbers, so I'll measure again at +6, but I don't know if theese results are ok...
 
Hi Teo and Ana,

It's not only testing at +6 that needs to be done. But 1 or 2 hours before that. Or 1 or 2 hours after that time.
Filling in the blank spots on the SS (spreadsheet).
Gathering more test data, to see how this particular dose is working for Viamo.
Sometimes, you will want to test a few hours after giving the insulin.
Sometimes you will want to test a few hours after the middle of the cycle.
Sometimes you will want to test a few hours before the middle of the cycle.
That is because +6 is not always the time when the insulin will reduce Viamo's blood glucose to the lowest number, to the lowest level.
So vary the times you do the tests.
Always try to get a test sometime in the middle of the 12 hour period, the dosing cycle.
It does not always have to be at +6.
Some days, that middle of the cycle test could be at +5.
Other days, that middle of the cycle test could be at +7.

The results are still very high.
I think Viamo needs more insulin.
You have been giving Viamo the 2.25 unit dose for almost a week now.
I think it's time to increase to 2.5 unit dose.

Please do this increase when someone is at home to monitor the blood glucose closely.
I know that both you and your mom Ana are able to test.
So vary, change, switch with each other as to who will be responsible for testing during the 12 hour period.

Please remember to link the previous days thread (post) at the start of the new day's post. Here is yesterday's thread.
2/15 Viamo AMPS=357, +2=290 Dose suggestions? Testing suggestions?
 
Tool a look at Viamo's spreadsheet this evening.
See that you raised the dose to 2.5 units.
Let's see what this dose does to help Viamo out of those high blood glucose numbers.

Will look for a new thread for Viamo on Monday 2/17/2020.
 
Not sure why you reduced from 3 units to 2 units. Maybe someone suggested it? The numbers you got on 3.0:units meant a reduction earned down to 2.75 units. Going down to 2 units was too big a reduction, so that’s why you started seeing so much red. I am glad you increased to 2,5 units.
 
Hi Wendy. A little background information for you.

Teo only had an insulin pen at the time, to adjust in 1u increments.
No insulin syringes. Of any kind.
He was away on vacation.
Cat sitter for the first half of vacation.
A cat sitter who was not going to home test.
Both Teo and his mom went on vacation.
Ana, his mom, returned 1 week before Teo did.
His mom was taking care of Viamo.
She does not understand English as well as Teo does.
Teo is back.
He is still trying to get the "hang" of posting in the lantus forum.

He and Ana are still trying to understand when to test.
Spanish is his and his mom Ana's primary language.
His mom Ana rescues cats in Argentina.
Viamo is their first diabetic rescue cat.

I was the one to suggest reducing the dose from 2U to 3u.
Did that while Teo was still away on vacation, out of the country.
While they only had the use of the insulin pen, and no insulin syringes.
Did not want to talk a Spanish speaking only cat sitter through low BG numbers and what to do.
Did not want to talk a Spanish speaking only cat sitter through how to use an insulin syringe to withdraw from an insulin pen.
But they did not have the insulin syringes then anyway.

Then, I did not want to have to talk his mom Ana through feeding low blood glucose numbers.
Or how to bring the blood glucose up with testing every 20 minutes and feeding food.

When her (Ana's) understanding of English is not as good as Teo's.
Nor does she write English as well as Teo does.

I know that reducing from 3U to 2U was too much.
But it was the best option at the time and under the circumstances.

A judgement call on my part.
Now we can try to get Viamo back on track.
Get those blood glucose levels back down.
That will help the diabetic neuropathy.

Any other questions?
 
I remembered Teo had gone on vacation, but had no idea when that started and when he came back. Including vacation start/stop in the Remarks section of the spreadsheet is very helpful. As is commenting about only having pens. This forum is a busy one, it's hard to remember all the exact details of each cat here.

Reducing for vacation was fine. But now he's back and has some, though limited numbers of syringes. When a caregiver returns from vacation, we suggest going back to the last good dose. If you just go back up in 0.25 unit increases after a larger vacation reduction, you linger in higher numbers for longer. And glucose toxicity becomes a concern. Teo, that just means their bodies become used to higher blood sugar values and you may have to increase a little higher to get over the glucose toxicity.
 
Including vacation start/stop in the Remarks section of the spreadsheet is very helpful.
I've just added some details about what happened. Thank you.

Reducing for vacation was fine. But now he's back and has some, though limited numbers of syringes. When a caregiver returns from vacation, we suggest going back to the last good dose. If you just go back up in 0.25 unit increases after a larger vacation reduction, you linger in higher numbers for longer.
Ok, we were not able to lower the dose in a smaller increment because we did not have syringes. Now that we do have syringes (and we know where to buy them here!!) what should we do?

You say we should go back to the last "good" dose. But which one was good? When the dosage was 3 units he achieved the best results. Should we jump straight from 2.5 to 3? This would not make sense if 3 was too big a dosage, which was the reason to reduce it in the first place!
 
At this point, I would stay with 2.5 units for at least six cycles, then decide what to do next. That will allow the depot to build so you can see what the 2.5 unit dose can do.
 
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