6/2 Guinness AM350(.25uR)|+2.5 305|PMPS 257|+1 289|+4.5 181

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linda and guinness

linda and guinness

Member Since 2009
Guinness treated me to a nice high 350 this am, his highest number in 3 days. I added a little R to his plan this am and his number dropped to a 305, still a pink. I'm hoping to guide him back to the yellows and blues again soon.

Dosing question: I've done 6 cycles at 8.5 units and now need to ask advice about upping his dose again this evening (4:30pm PST). Should I continue with the .5u increases that seem to be working well, or drop back down to the .25u increases. I've lost my confidence about my plans and am not sure how to proceed.

Thank you in advance for your thoughts.
 
Re: 6/2 Guinness AMPS 350(.25uR)|+2.5 305 Dose Increase toni

Hi Linda, you and I know I'm no dosing expert, but this is my take...because Guinness' nadirs have been less than 300 but greater than 200, you need to increase by 0.25u. After 6 cycles, if his nadirs remain like this, you can again increase by 0.25u. However, if his nadirs are great than 300, you would increase by 0.5u. Hope this helps!!!
 
Re: 6/2 Guinness AMPS 350(.25uR)|+2.5 305 Dose Increase toni

When you have a chance, take a read back through the Tight Regulation sticky. Now that Guinness is getting nadirs that are routinely under 300, the protocol indicates that you should be increasing by 0.25u. It's when the nadirs are above 300 that you are able to increase in larger amounts. Of course, Guinness is also on a relatively large dose of insulin so that makes things less clear. Given Jill's feedback yesterday, I'd consider increasing by 0.25u and evaluate how Guinness does.
 
Re: 6/2 Guinness AMPS 350(.25uR)|+2.5 305 Dose Increase toni

I'm glad Sienne brought that up. It's been mentioned before that cats on larger doses of insulin need to make adjustments in larger increments. With Guinness on over 8u b.i.d. and Champ on 3.75u b.i.d., if Guinness ony goes up by 0.25u, his adjustment isn't nearly the same as when I increase Champ's dose by 0.25u. It kinda seems it's going to take you twice as long to see the same results as I would with Champ. There are so many variables, and I think sometimes it's just a crapshoot.
 
Re: 6/2 Guinness AMPS 350(.25uR)|+2.5 305 Dose Increase toni

sorry I'm late to the party. I see on your spreadsheet that you went with 9 units, and also that Guinness gave you a nice PMPS number. Let's hope he can do something with it! No R since this morning, right? So this is a pretty "clean" PMPS reading and we can get some good data from it.
 
Re: 6/2 Guinness AMPS 350(.25uR)|+2.5 305 Dose Increase toni

Thanks Libby! (and all). You are correct, I did end up going with the .5u increase. I just kept reading back through old posts about a .5u increase in a high dose cat not being the same as in a lower dose cat and I am making so much head way right now, I don't want to push his numbers back up. His PMPS is R free...I've given no R since this am and his +4.5 after PMPS is 181. I will get another +5 or +6 and see how he is doing with this dose.

Thank you all for you thoughts and help, Guinness and I both appreciate it very much!
 
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