2/21 AMPS 298 - I waited too long to ask for Viamo's new dose!

Teo

Teo

Member Since 2020
Hi, my last thread was this one.

This morning's injection begins Viamo's tenth cycle with 2.5 U. It's time to have a new dosage. Should I increase a quarter of a unit?
 
Are you following TR or SLGS method?
I would encourage you to get a before bed test in every night. A lot of cats drop lower at night. If the before bed test is lower than the Preshot BG you may need to set the alarm and get up later to check the BG again.
 
I am not sure what method I should be using. TR is very time- (and money-!) consuming, as far as I've read, because I should have to test Viamo constantly. If I were to follow it, however, I don't feel confident deciding when I should adjust the dosage. I found it a bit complicated to understand from the articles I've read.
 
With TR you need to be feeding a low carb wet diet only. You need to test before each shot and at least once inbetween the cycles. You can increase each three days if needed and decrease if the cat drops under 50.

With SLGS you hold the dose for a week then do a curve. You decrease the dose if you drop under 90. And always test Preshots.
I would encourage you to read the yellow sticky about the two methods... found on the Lantus page and choose one. If you are able, I would do a curve today or tomorrow before you increase.
 
Do you suggest we do a curve during the day cycle and increase at night if his values are not too low?
 
Bron and Sheba (GA) said:
I would encourage you to read the yellow sticky about the two methods...
Click to expand...

Thank you for making me read this again! The important part that I had missed was where the exact decision procedure for increasing the dose was given:

  • 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.
So if I understand your suggestion correctly, I should do a curve to know in which of those two cases we're in. We actually don't know at this point if his nadir is greater or lower than 300.
 
Teo said:
Thank you for making me read this again! The important part that I had missed was where the exact decision procedure for increasing the dose was given:

  • 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.
So if I understand your suggestion correctly, I should do a curve to know in which of those two cases we're in. We actually don't know at this point if his nadir is greater or lower than 300.
Click to expand...

I was suggesting a curve as you don’t have a lot of recent inbeteeen tests. Normally if you are doing TR you don’t need a curve because you have enough tests to make a decision.
I would try and make a decision on what method you think will work for you and put the method in your signature.

I would get a curve done today or at least some extra tests in, if that is suitable for you. It’s good data and then you can increase if the curve suggests it.
 
We're thinking about increasing the dose 0,5 units. This is what the TR protocol suggests according to today's data. Any opinions against it?

This would be done this night (that is, in an hour)
 
If you do that increase, monitor tonight. At least a +2 and see which direction the BG (blood glucose) is headed.

It's been found that the +2 was like an "early warning" for most cats!

If the +2 is about the same as the PS, it's usually a pretty normal cycle...gradually down to nadir and then gradually back up again

If the +2 is higher than the PS, that usually signals a bounce, and those are the cycles when you can usually take a pokey break.

If the +2 is lower than the PS, that's your "Early warning" that kitty might be going much lower later in the cycle so it's important to plan on getting another test or two (or 6) in.
 
I won't be able to get a +2 but a +3. I don't expect he'll get a low cycle now because it has previously taken him some cycles to get low numbers using 3U dosage. Anyway I'll measure when I get home and see which way he's headed.
 
Wendy&Neko said:
You are seeing below 300 on this dose, which means 0.25 increases, not 0.5 units.
Click to expand...

You are right, which means that we may have actually taken the wrong decision changing the dosage to 3 units. That is why I asked it before. Still, the first 3U injection has already been given, so we should wait and see how he reacts to it, right?
 
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