2-8, Frankie, dosing?

[Shelley7]

Hi. This is my first post on the Lantus section, so hope I’m doing it right. I haven’t been super aggressive with testing because Frankie is on a pred wean and I wasn’t planning on increasing the insulin dose until he was further along. The first 2 weeks was a half pred dose/day, then to every other day plus daily budesonide.

I was hoping I’d see much lower sugars on the budesonide-only days but that hasn’t been the case. He has another full week of the pred qod/daily budesonide and then a couple weeks of 2x/week pred before that stops and becomes only budesonide.

Do you think I should increase the dose from 1 to 1.25 at this point? Maybe there isn’t enough data to decide? Thanks in advance.

 

[FrostD]

Tagging @Wendy&Neko and @Katherine&Ruby

I personally would not leave him in these high numbers while waiting out the pred effects. But I think it would be prudent to get more night tests and/or a curve before deciding. Right now there's a few too many gaps in testing (plus that blue awhile ago) for me to say increase with certainty.

 

[Shelley7]

Is it usual to go down more at night (2nd cycle) than during the day? And I have an idea of what a curve entails but can you remind me how many checks it is? Also if I didn’t do the curve, how many nights would you test before deciding?

 

[Sandy and Black Kitty]

Your ss indicates you are following SLGS.

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

 

[Shelley7]

Your ss indicates you are following SLGS.

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

Ok, thanks for reminding me. I’m wondering if it’s usual that the night/early morning would be lower? Would it be more valuable to do the curve during the night time cycle?

 

[Sandy and Black Kitty]

Ok, thanks for reminding me. I’m wondering if it’s usual that the night/early morning would be lower? Would it be more valuable to do the curve during the night time cycle?

if you can swing doing a curve on a PM cycle that would be great but either cycle works.

 

[Wendy&Neko]

I’m wondering if it’s usual that the night/early morning would be lower?

Absolutely common for cats to go lower at night. But not all the time of course, they like to mix it up. The 18 hour curve gives you a sample of both the day and night cycle.