Hi
Muffin was doing so good yesterday during the day in blues and then PMPS started yellow and she turned to pink and remains there this morning. We already shot the .75 This is a tough one because I was concerned to increase the dose while doing so good in blue and dealing with a hypo at the sanctuary would be horrendous since so many other kitties to take care of. Sorry to be such a pain. Please advise.
today will be 7 days on the dose, on TR I think you would take him up.
from the TR guidelines. INCREASING THE DOSE:
GENERAL GUIDELINES:
Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
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.
But do I recall that you were erring towards slgs?? With slgs you would look to hold with nadir under 150.
SLGS guidelines for dosecrease After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours:
Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet.
If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
