5/5 Pete AMPS 353 / +3 499 / +6 499 / +9 476 / PMPS 486 - Planning dose increase (2.5>3u)

https://felinediabetes.com/FDMB/thr...8-11-258-tr-guidance-feeding-schedule.289535/

With meals more spaced out (full can at insulin, 1/2 can in timed feeder @ +4 and +8), Pete's numbers are looking a lot more consistent...with the exception of some occasional highs in the 400s, we're mostly in the mid 300s for every check. I'm not seeing any nadir or low point but since all of his numbers have been over 300 for more than 6 cycles, I'm going to try increasing by 1/2 unit (from 2.5 to 3) with either tonight or tomorrow morning's dose based on the TR guidelines.

I know this isn't much of a question but just looking for a little reassurance that I'm trying the right things? Is it ok/common that his numbers are more flat and varying within a range than resembling a curve?

Thank you!

 

Will he be okay if you feed him earlier in the cycle (say +2, +4 and +6) rather than at +8? Feeding after the nadir can reduce duration and lead to higher preshots.

He might be bouncing from the 168 he saw on 5/2. Which is why you are seeing numbers that are flat and high. Bounces can take up to 6 cycles to clear. This AM was cycle 6. He looks good for an increase, but you want to take him up to 2.75U and not 3U tonight. With a history of DKA, you don't want to hold a dose longer that 6-8 cycles if you are seeing nadirs over 150.

 

I agree with Bhooma, you are clear for an increase to 2.75 units. 0.5 unit increases is if their nadirs are all above 300, and they aren't.

 

Thank you! I did go up to 2.75 tonight. .25u difference feels like such an insignificant amount in that syringe.

He's been riding higher than usual in the 400s all day today. I did switch to a single flavor of Fancy Feast as of yesterday, so maybe the chicken and liver makes him run higher. Or maybe it's because of the +8 feedings. More data points for me to keep an eye on I guess.

Per Bhooma's suggestion, I'll try to move his feedings to +3 and +6 (full can at insulin, half can at two snacks, no food after +6 until next insulin). I'm trying to stick with two snacks and see if he can regulate on that based on the number of slots in my auto-feeder but if that doesn't work I'll split it up into 3.

Thank you again!