4/30 Meadow AMPS 488, Dose?

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Hi, Amber & Meadow!! I am not a dosing advisor, but typically in Lantus Land we increase in .25 increments, you absolutely did the right thing by putting "Dose" in your subject line, someone with more experience will come on by & advise. I see you increased by .50 last time, so maybe there are special circumstances here. Wishing you a fabulous Friday & a lot of luck with your dosecrease!! :mrgreen:
 
Amber & Meadow said:
Not sure how much I should increase dose by: 0.25 or 0.5?
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hi amber. generally speaking, we follow these guidelines:

Increasing the dose...
--- Hold the dose for 3 - 5 days (6 - 10 cycles) if nadirs are less than 200 before increasing the dose.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

--- After 3 consecutive days (6 cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

more guidelines can be found here: STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOLS

hope this helps...
 
Jill and I asked a couple of questions in your condo yesterday:
  • Can you get more spot checks (e.g., out the door tests in the AM, in the door tests when you get back from work, before bed tests - or additional tests - in the PM)?
  • Are you going to get Meadow checked out by your vet for the inappropriate urination? If she has a UTI or crystals, the infection/inflammation will raise BG levels so it's worth getting checked out.
Ordinarily, with numbers above 300, the dose increase is 0.5u. You have the option of increasing by 0.25u since you do not have much mid-cycle data, though.

There is a reason we are pushing getting the mid-cycle spot checks. First, dosing decisions with Lantus are based on the lowest point of the cycle (the nadir). The other reason is that if the high numbers at AMPS and PMPS are the result of a bounce from low numbers at mid-cycle, we will have no way of knowing this without those data.
 
Re: 4/30 Meadow AMPS 488, +3 250

I had Meadow's urine tested at the last vet visit. It was negative for UTI, crystals, etc. I'm pretty sure she is doing this because she is sick and doesn't feel well. As for the additional tests, I try. I test 1st thing in the morning, give the injection, feed, and then leave. I don't get home until the 12 hour dose is due. I try to test 3 hours after that but sometimes I'm already in bed. The weekends are when I have time to do more. I'll increase the dose tonight by 0.5. Thanks for your help and patience.

Update: BG at +3 250. Will call the vet in the am and see what they think about UTI.
 
Do you have a timed feeder? It may not be necessary but as Meadow's numbers start coming down, you will want to think about how you can make sure there is food available throughout the day to offset any mid-cycle drops.

Let me make another suggestion since I know I will forget and I suspect that others will keep bugging you about mid-cycle tests. Several of the people here who have schedules like yours put a note in their signature line that they are at work for what amounts to an 11-hour day. Check Mousie/Cindy's condo for an example. That way,if there's a note to remind us, we'll reduce the amount of nagging we will be doing!
 
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