6/16 New- need advice on dose increase

[Danelle and Flick]

Flick
6/15 PMPS 481, +1 375
6/16 AMPS 324

Flick didn't look good last night and sure enough, 481! Our highest # since going insulin. He did gobble down his FF but other than that just laid there with no energy. I gave his PM shot an hr early and within an hour I could tell he was already feeling better. Tested and he was back in the 300's. Was this a bounce from the dose increase and if so do I keep him on the same dose and allow his body a few cycles to adjust or do I lower the dose? Based on his AMPS and PMPS and the output in the litterbox I decided to increase his dose but maybe I shouldn't have until I had a better curve??

One other bit of info, my kids were home all day and I noticed only a little of the Fancy Feast I had left out for the cats in the morning was eaten. I suspect Flick camped out all day upstairs and didn't venture down to eat as he normally would when the house is kid free. He's not a huge fan of little kids. I'm wondering if this caused his BG to drop lower than usual and then triggered a bounce??? I don't know. So frustrating! Just can't stand seeing him like that.

 

[kate and lucky]

Hi,

can se your reasoning why you increased, but yes would be good if you could get some mid cycle tests, especially between +4-6 (this is usually when you get nadir, the lowest number in the cycle and when insulin working hardest on bg numbers)

Lantus/Lev dosing based more on nadir number than preshot (though need these numbers, especially when in the realm of lower numbers-it's how you get your pattern of what effect the insulin dose is having on bg numbers)

If your unable to get a mid day test, can you perhaps set your alarm and get up in the night?
No way of knowing if he dropped to a lower number (sometimes going to just 200 the cats body thinks this is a low number when been in high numbers for a while and reacts by dumping glucagon into bloodstream-life saving response and natural defence and thus you then get a subsequent high number) or having kids around stressed him some.

Try not to dose hop-but you did the right thing sticking with the 1.5u for 5 days, goodamount of time to see what insulin dose doing.
Some cats are more carb sensitive and insulin sensitive than others. ECID (Every cat is different)

Important to monitor how much eating, pooping, preening, what coat looks like and how acting-giving you the pieces of the jigsaw.
Try and get that mid cycle number-will guide you what dose best.

Often have to go up with dose to then get a breakthrough and start going down the scale.It's a marathon,not a sprint :mrgreen:

 

[Carrie & Trouble]

I'm too new to give any advice, but I hope you are able to get the answers you need. You are certainly in the right place. It gets easier with time. There are so many knowledgeable people here that I am sure you will do fine!

 

[Sienne and Gabby (GA)]

Welcome Danielle!

Thank you for getting a spreadsheet and profile together so quickly! And so sorry you had a bad experience with an vet who was a charlatan.

From what I gather, your work schedule makes it difficult/impossible to get spot checks during the AM cycle. A couple of thoughts... If you can get an additional test in before you leave for work and when you walk in the door that would be great. If not, getting tests in during the PM cycle will also help to give us a better picture of what's going on with Flick. As Kate pointed out and given your vet's inexperience with Lantus, dosing is based on the low point (nadir) of the cycle not on your pre-shot values. Also, Lantus likes consistency. It's best to shoot as close to every 12 hours as you can. You noted that you shot early tonight. That means your AM shot tomorrow should be 12 hours from your PM shot time. Unless you have tremendous flexibility with your schedule, early shots are not a great idea. In addition, an early shot acts like a dose increase; a late shot like a decrease.

I'd like to encourage you to read the starred notes at the top of the Board, especially the note about the Tight Regulation Protocols. They will help guide you with dosing. I really think you need to get more mid-cycle tests before changing the dose. It's very easy to miss a dose reduction if you are only getting pre-shot tests. If you look at Gabby's SS back on Nov. 2, her pre-shot tests were in the 400s but she earned a decrease with a low of 47 at AM +4. If I hadn't been testing, in all likelihood, her dose would have been increased.