4/25/14 Jose AMPS 231 1u +5/255 PMPS 345 2.4u +7/174 +9/167

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Rebecca & Jose

Rebecca & Jose

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Jose's numbers keep getting higher! I know everyone keeps saying it's the ABs and possible bouncing but how am I supposed to keep him lower? I am going to give him the 2.4 u tonight and I'll monitor his numbers closely. It looks like the insulin is doing absolutely nothing! At his usual nadir +5 he was higher than his AMPS and now his PMPS is close to 400. I'm sick of these numbers. Could his insulin possibly have gone bad?

Very frustrated :cry:
 
Re: 4/25/14 Jose AMPS 231 1u +5/255 PMPS 345 :'-(

My guess is that he is in some pain and the infection/antibiotics are also rasing his numbers. Yes, you can certainly raise the dose but be sure to monitor. If it's outside stuff causing the higher numbers, they could drop.

Unless the insulin has floaties in it, it should probably still be good..
 
Re: 4/25/14 Jose AMPS 231 1u +5/255 PMPS 345 :'-(

If you're home to monitor, you might consider shooting TID, or every 8 hours. This would overlap the doses a bit and help keep the level flatter.

You total the insulin per day, then divide by 3.

With the duration running about 8-10 hours, you would have overlap of 0-2 hours, reducing any ending spike upwards as the insulin wears off.

It does require more testing and more supplies.
 
Re: 4/25/14 Jose AMPS 231 1u +5/255 PMPS 345 2.4u +3/322

I have been dosing using a sliding scale depending on his PS numbers. How would I decide how much insulin for the whole day? I will be home this weekend to do it but I work during the week. I will talk to my mom about giving him his insulin while I am gone. She has been testing him at nadir for me everyday so I'm sure she would be willing to do it.
 
Re: 4/25/14 Jose AMPS 231 1u +5/255 PMPS 345 2.4u +3/322

Your sliding scale is for 12 hours, so a guess would be to use 2/3 of what you would do for 12 hours if you want to try every 8 hours.
You'll want to see how that works on a day you can be home to monitor and adjust the dose, and steer the glucose levels if he decides to go lower than expected.

Also take a look at what Lucian gets to give you some ideas. She waits until he's high enough to shoot, but before he gets too high, if possible.
 
Re: 4/25/14 Jose AMPS 231 1u +5/255 PMPS 345 2.4u +3/322

That makes sense. Thank you for the suggestion! I think I'll try it tomorrow and see what happens. I don't know if I'll do TID for the long run but just until he's done healing and off antibiotics. I'm going to call the vet tomorrow to see if I can get some more pain meds and to talk to them about switching his ABs from Orbax to Clindamycin.
 
Re: 4/25/14 Jose AMPS 231 1u +5/255 PMPS 345 2.4u +3/322

While dosing BID I have been testing before every shot and then at Jose's usual nadir +5. At what hours should I be testing to monitor when shooting TIB?
 
Re: 4/25/14 Jose AMPS 231 1u +5/255 PMPS 345 2.4u +3/322

Whenever you adjust a dosing schedule, it is an experiment until you learn how that works for that specific diabetic cat. And even then there can be surprises. The idea is to control what you can and learn what works from the data you collect.

The first couple of times, I would check +2 to see if he has much of a food spike OR drop (what the Lantus folks call an 'active cycle'), and also around the time he usually hit nadir to see if it still falls similarly to BID dosing. You may find that the 2/3 of what you'd do for BID dosing needs to be tweaked up OR down, so doing this when you'll be awake and someone is home to monitor is strongly advised.

There will be more overlap, and the numbers should be smoother, however ECID!
 
Re: 4/25/14 Jose AMPS 231 1u +5/255 PMPS 345 2.4u +7/174 +9/

Thank you for all the information. I forgot that I have to be out of town today, so I'm going to hold off on trying TID. Tomorrow would work better. Here is what his curve looked like last night.

AMPS 231 1u
+5/255

PMPS 345 2.4u
+3/ 322
+5/ 197
+7/ 174
+9/ 167
 
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