? 2/20 Frankie increase?

[Shelley7]

https://www.felinediabetes.com/FDMB/threads/2-16-frankie-pmps-382-3-299.259475/#post-2914970

I have mixed feelings about how aggressive to be in dosing the Lantus. He’s finally in the last 2 weeks of this pred wean that has seemed to go on forever. The last 2 weeks, he gets the pred 2x/week and budesonide daily. When he was able to go 3 days with just budesonide, the numbers went down nicely. Not normal but a nice nadir of 186. Then he got the pred and we are back up to 400’s, flat curve. I didn’t bother testing last night after PMPS because I knew it would be high and I needed sleep.

He gets the pred again 3 more times, about every 3-4 days over the next 1 1/2 weeks. So I’m assuming we’ll be on a roller coaster during that time. Should I go up to 2.75? 3? Or stay at 2.5 and wait until wean is over and base further increases on numbers once only on budesonide?

 

[Bandit's Mom]

I have no experience with with pred or budesonide, but some caregivers have found that budesonide does not affect BGs as much as pred does. But it is an ECID thing.
The highs you are seeing now could also be him bouncing from those blues a couple of nights back.

Once you see nadirs below 300, you increase in multiples of 0.25U. I would take him up to 2.75U.

You can always bring his dose down as he sees better numbers once he is totally off pred. You don't want him staying in higher numbers very long. Not only is that extra starin on the kidneys, you also risk glucose toxicity setting in.

 

[Shelley7]

I have no experience with with pred or budesonide, but some caregivers have found that budesonide does not affect BGs as much as pred does. But it is an ECID thing.
The highs you are seeing now could also be him bouncing from those blues a couple of nights back.

Once you see nadirs below 300, you increase in multiples of 0.25U. I would take him up to 2.75U.

You can always bring his dose down as he sees better numbers once he is totally off pred. You don't want him staying in higher numbers very long. Not only is that extra starin on the kidneys, you also risk glucose toxicity setting in.

Yeah, that’s the debate I’m having…he’s been high for so long I am worried that we already have toxicity and kidney damage but I also don’t want to get into dangerous hypos or long nights of managing that or even an ER visit because I was dosing for pred type numbers and then he tanks because the Budesonide effect doesn’t need that much insulin. I’m not that worried about 2.75 but am worried about going up every 3 days because of pred effect and then ending up with a hypo situation a week after last dose of pred. It’s a fine line with what to do with this pulse dosing, end of wean thing.

 

[tiffmaxee]

Even on non prednisolone days he isn’t dropping too low. I agree with Bhooma. You can wait longer than 3 days to increase once you start to see a lot more in the 100’s or lower. While many cats bg is not effected by budesonide, some are.

 

[Shelley7]

Even on non prednisolone days he isn’t dropping too low. I agree with Bhooma. You can wait longer than 3 days to increase once you start to see a lot more in the 100’s or lower. While many cats bg is not effected by budesonide, some are.

Ok, thanks to both of you for the feedback. I’ll go up to 2.75 tomorrow.