4/3 Prince AMPS-371. Dose increase not working?

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Emily

Emily

Member Since 2014
Last condo (3/30): http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=116352

Good Morning Everyone,

I increased Prince's dose from 2.25 to 2.5 the evening of 3/30. However, he has been steadily in the 300's since. He even went up to 400 one morning. The lowest he has dropped is 296, for one evening. Do you think this is some sort of bounce, or should I start thinking about a dose increase?

Thank you!
 
Hi guys .. no dosing advice from me, but fingers crossed Prince starts showing some lower numbers soon .. have a great day guys!
 
How would you feel about holding this dose for another 2-4 more cycles to see if Prince improves or not? Sometimes kitties may need another day or 2 to decide what they want to do. If his #s don't look better by then, then consider doing another increase.

Good luck, and try not to get too discouraged (I know... Easier said than done.)
 
I'm of a different opinion than Angela. I don't think this is a bounce unless Prince dropped particularly low on 4/1.

I would encourage you to stick with the protocol and increase Prince's dose every 3 days/6 cycles if his numbers aren't below 200. So, I would go ahead an increase. In my mind, the question is how large the increase should be:

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
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If you think that for the majority of the cycles, the lowest point of the cycle was under 300, then you would increase by 0.25u. However, if you think that his nadir was over 300, then you would increase by 0.5u.
 
i'd definitely increase. you've got 8 cycles at this dose and it's not getting him into greens - that's your goal. i'm unsure about the amount either, although i'd probably lean towards the 0.5u because he's been so high. but a person could make a case for the 0.25u increase if you think that he's mostly been yellow nadirs.
 
Thanks, everyone. I am going to increase by .25 tomorrow evening, because I have to be out for the day tomorrow. I guess I am a bit confused because I just had to reduced his dose from 2.5 to 2.25, and now I'm increasing it again. I guess I thought that getting him regulated would be a bit more simple and predictable. Again, thank you soo much for all the help and support. Invaluable!!
 
frequent adjusting of the dose is normal. The protocol suggests evaluating a dose every 6 cycles, then making a decision on what to do. You'll get used to it before long.
 
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