4/7 Rex AMPS 435 12 hour curve dose increase?

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Mandy & Rex (GA)

Member Since 2017
Hi. Please look at the spreadsheet for all the numbers. I've done the curve up to +6. +8 spot check will be in an hour. I think a dose increase is necessary. Someone said yesterday to do 1.5U. Yes or no?
 
For continuity, here is your last post here: http://www.felinediabetes.com/FDMB/threads/4-5-rex-amps-472-5-495.175902/ and here is the one where someone mentioned the increase you referred to: http://www.felinediabetes.com/FDMB/threads/evo-question-with-lantus.175850/
We like to include the links to our previous post, so people can easily go back and see the history.

As for the increase, you are right, it's time. Time to take him up to 1.25 units as per SLGS. Even if you were on Tight Regulation you would still do just a 0.25 unit increase, because you saw that 207 on April 1st. Good luck with the new dose!
 
Yup, that what the SL Go Slow means. But Lantus is a depot insulin and it takes time to work. It really teaches you patience.
 
There are different degrees of regulation, depending on your goals. Tightly regulated generally means most of the time in green. That's the best range if your goal is remission. A cat can still be well regulated if they are under renal threashold - which varies by cat but is somewhere in the mid blues to low yellows. Due to her acromegaly, I knew that the chances of Neko getting remission were slim, so I aimed for regulation mostly under renal threshold. Most vets aren't comfortable with numbers as low as we have them here, but we also do a lot more monitoring than the majority of caregivers of diabetic cats.
 
Update: 468 at +10.

I'll have to read the sticky on TR. That would be fantastic if Rex goes into remission. He's only 10.5 y/o.
 
If you followed TR, it would allow you to increase faster and possibly by larger amounts. The sooner you can get a kitty into tight regulation, the better the odds of remission. However, Rex would have to be on 100% wet food for you to use TR. Maybe something to consider when you've finished the transition. The other requirement would be getting at least two tests per cycle, one at preshot, and one in the middle somewhere. Since TR is more aggressive, you need to do a little extra checking to make sure it's safe to do an increase.
 
I read the sticky. I'm not sure how that would work because after the morning shot, I wouldn't be able to test until +10. Then I could do +3 or +4 after the night shot.

Also, I'm not sure about moving to 100% wet food due to my other cat having a sensitive stomach. Could it be done if it was a low carb dry food? As far as I can tell, Rex barely eats the dry food now. He has a couple bites before walking away.
 
The two "mid cycle" tests don't need to be the absolute middle of the cycle, just enough to give us an idea how the dose is doing. The protocol stipulates all wet food. Dry food is metabolized at a different rate than wet.
 
I had 414 at PMPS and gave 1.25u. +2 is 465.

I'm thinking of trying TR. I might just take the bag of EVO back to the store because I've used maybe 1 cup. Fromm's can be my HC dry food in emergencies. Are Friskies in gravy cans good HC foods? I do have honey and Karo on hand.
 
On the catinfo food list, some of the Friskies Gravy Sensations are high carb (15% carb), but some are just medium carb. You'll have to look at the individual flavours. You might want to start out with something a little higher carb, until you find out how sensitive Rex is to carb. I ended up only needing 16% carb, but I started with 18-19% until I knew how Neko handled carbs. I've seen some cats need over 20% carbs.
 
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