? 3/16 Rae - AMPS 204, dose increase needed?

Rae's Family

Rae's Family

Member
Hi everyone, it's been a while since I've been on but Rae has been doing really good on the Lantus. We increased to 1.5u last week at the suggestion of our vet, but she's still hovering around 200s pre-shot. I might do a curve this week to get a little more info about what's going on.

Our vet has been slow to respond so I figured I'd ask here: I feel like she is okay to go up to 2us, is there any reason I shouldn't do that yet?
 
Little more context: you can see in the SS that she responded really well to the Lantus at first. Then we switched food (related post here) and she spiked a little, probably as a result of processing the new food, but she hasn't really come back down since. Maybe it's food-related, I'm just not sure
 
With SLGS which you need a curve to see how low the current dose is taking her as dosing us based upon that and not preshots. You gave not done a curve nor do you have have any tests mid cycle. Increases are no sooner than 7 days and in .25 increments. If you are following your vet’s dosing please change SLGS to Custom by vet.

If you get curves and still see nadirs over 300 you could then consider going up by.50 but I would not do that without more testing to catch the nadirs. Cats often are lower at night.


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
 
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tiffmaxee said:
Cats often are lower at night.
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Out of curiosity, how do most people here do overnight curves? I don't really understand how people can consistently test every 2 hours during the day, either, to be honest. Do most of the people with full daily curves WFH or something? I'm just trying to understand how I could possibly do that. I'm gone usually 10-11 hrs a day, 4 days a week. I'm also pretty hard to wake up, and my husband also works, so I just don't know how I'm supposed to do an overnight curve.

Any advice is much appreciated!
 
Rae's Family said:
Out of curiosity, how do most people here do overnight curves? I don't really understand how people can consistently test every 2 hours during the day, either, to be honest. Do most of the people with full daily curves WFH or something? I'm just trying to understand how I could possibly do that. I'm gone usually 10-11 hrs a day, 4 days a week. I'm also pretty hard to wake up, and my husband also works, so I just don't know how I'm supposed to do an overnight curve.

Any advice is much appreciated!
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So glad Rae has been doing well! I do think most have the flexibility with work from home or retired. I've questioned how anyone who works outside the home could manage FD well. Challenging for sure! :bighug:

Your days off would be great to get some data on what's happening in the middle. Depending on your hours worked can you get at least one test in after the AM and PM shots?
 
You do a curve for one cycle -- one 12-hour period. Very few people opt to test every 3 hours over an 18 hour period. You don't have to do a curve overnight (unless your sleep cycle is during day hours). Most members do a curve during the AM cycle. I'm not sure why you were thinking that the curve needs to be during the PM cycle.

I suspect that Rae's numbers aren't where you want them is because you're holding the dose for too long without increasing. Rae's body will start treating the higher numbers as her new "normal." This is why the dosing guidelines are set up to increase the dose after a specific period of time if your cat isn't seeing lower numbers.
 
I think you asked about an overnight curve because of my comment about cats often being lower over night. Am I right? I didn’t mean to imply you need a night curve. I’d just get a test once and awhile between +2-5 just to see what’s happening at night. As you get closer to the breakthrough dose that will come in handy.
 
Sienne and Gabby (GA) said:
. I'm not sure why you were thinking that the curve needs to be during the PM cycle.
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Oh that was just in response to Tiff's comment about nadirs being lowest at night. I figured a daytime curve would be sufficient, I just feel like I see a lot of SS on here that are much more full and I always wonder how people do it.

Sienne and Gabby (GA) said:
This is why the dosing guidelines are set up to increase the dose after a specific period of time if your cat isn't seeing lower numbers.
Click to expand...

Yeah, I reached out here after the vet took 2 weeks to respond to me to get the dose bumped up to 1.5 :confused: I'll have to look at the SLGS guidelines again because I thought I was following those and didn't realize what I was doing was different... I'll report back when I have a better understanding! :bookworm:
 
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