3/13 Richard AMPS 299 +6 286 PMPS 421

[Alex&Richard]

3/12 Shot time is 7:30 daily.

I think Richard is finally starting to adapt to Lantus!
For past 2 shots I can even see the curve on CGM! It is kind of high, but the sensor is always showing higher numbers on high BG. E.g. 367 (20.4) on sensor today AMPS is actually 299 (16.6) according to the meter and at +6 ~360 (~20) sensor is 286 (~15.9) meter. Similar observation were provided by the Vet during the hospitalization: the higher the BG the higher CGM inaccuracy, but closer to normal or low numbers it behaves better.
Still no idea regarding offset, nadir, etc. Probably need to collect more data to start seeing patterns.
Ketones are still there though, but hope they will drop in a few days if he'll stay below 300 most of the day... He ate quite a lot today, guess that's why duration is too short (already "high" on CGM at +7). Or its just the CGM things.. +9 is 328 (18.2) via meter, but "high" on CGM.

I thinks we should keep the dose for a few more days (as yesterday AM was panic reduction and potentially a bounce), right?

CGM

Once again, thank you all for this great source of information and all the tips! You are awesome!

Regards,
Alex

 

[Allie & Gen]

You can definitely hold the dose; under SLGS, you take reductions under 90, so he's just fine where he is.

Looks like you're using a different CGM (several of us here use the Freestyle Libre) ... it's interesting that it reads high on higher numbers! That's the opposite from what we often see with the Libre (though it varies), which can give exaggerated lows.

 

[Allie & Gen]

Sorry, just realized you were probably asking about holding the dose vs. an increase, not a reduction.

Under SLGS, you typically hold each dose for 1 week, unless your cat does drop below 90 (which earns an immediate reduction). If we ignore yesterday's AM dose (which I'd just pretend was a partial "furshot"/accident and ignore, but that's me), Richard is on his 5th day of the current dose, so you'd hold it for a couple more days before considering an increase.

Someone more experienced should chime in, though! I'm still relatively new at this.

 

[Alex&Richard]

You can definitely hold the dose; under SLGS, you take reductions under 90, so he's just fine where he is.

Looks like you're using a different CGM (several of us here use the Freestyle Libre) ... it's interesting that it reads high on higher numbers! That's the opposite from what we often see with the Libre (though it varies), which can give exaggerated lows.

Yes, CGM is dexcom one+. Libre is not licensed here, so have to use what is available.

And yes, I also think that it is probaly worth to keep the dose for a few more days to see that the behavior is consistent. Just wanted to get a second opinion.
Thank you!

 

[Jessica & Indy]

I agree with Allie. Hold the dose 2 more days. Nice to see the start of a curve! <3

 

[Mary & Jude]

Hi Alex, Under SLGS, here are the instructions for dose increases:

"Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

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)."

When you have a question on the forum, if you'll edit your title and select the prefix on the left hand side of the page and select "?" this will attract more attention to your post. You also could add in your title "question about dosing."

We typically work in .25 unit measurements, so you'll want to get some advice about the amount to increase (when you get the advice to do so).