? 5/31 Dosing Advice

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Michaellh33

Michaellh33

Member Since 2015
Brody's numbers have still been very high lately. Should I consider upping the dose or is it possible the insulin is bad?
 
Hi Michael - here's your last post from May 28. We link the previous posts so people can go back and check what's been said before, if needed.

You've got 10 cycles at 2.75u. If we knew for certain he wasn't getting any lower than a blue number, I'd suggest increasing by 0.25u. Is there any way you can get a test in the pm cycle, like right before you go to bed? It's just hard to be confident without some tests here and there in the pm cycle. Many, many cats have lower numbers then.

  • Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
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.
 
You need to get some curves and start getting a before bed test. On the basis of the info that you have there is no way to tell how low this dose is taking him and that is what the lantus dose is based on. It's quite possible you're already giving too much insulin as you've increased pretty quickly with nothing to base it on. Your higher preshot numbers could be caused by going too low and then bouncing.

It doesn't look like there's anything wrong with the insulin but please get some more data before even thinking about increasing again.
 
Hi, Michael.

I'm going to echo what Julie and Serryn said. There's no way to know if Brody's numbers are dropping mid-cycle. It looks like you've opted to follow Tight Regulation. With this protocol, you should do your best to get at least one test per cycle in addition to your pre-shot tests. The reason for this is that Lantus dosing is based on the nadir (lowest point in the cycle) and not the pre-shot values. Do you think this will be possible?
 
I would get tests tomorrow's and Thursday's pm cycles and those tests, combined with the preshot tests, ought to be enough to make a decision about increasing.

The reason I'm specifically saying 3 days in a row is because if there is any bouncing, there should be at least 1 cycle that the bounce clears somewhere during that 3 day period.

Since your dosing decisions are made based upon the low points, it becomes super important to catch the low points.
 
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