? 6/3 TILICA AMPS 285|+2 348|PMPS 375|+2 307 Should I increase the dose?

[Andreea&Tilica]

Hi L&L
Usually I shoot 2,5 ui but I noticed that BG can be unpredictible. Today at AMPS he was in yellow but at +2 he became pink.
Other cycles when I was shooting the same dose the BG was dropping. about 70mg/dl after 2 hours. I tried to increase on 1 st March PMPS from 2.50 at 2.75 but the BG dropped very fast and at +4 I gave him HC for stop it. Every time when I increase the dose the BG decreses dramaticaly in the first 2-3 hours.
One month ago, I shot 3 ui but I had to reduce because of hypoglicemia which occured in the fisrt 3 hours for example 06/02, 09/02, 10/02.
He eats wet food royal diabetic 16% carbs and 20 g hills dry m/d per day. I tried to with othet type of food with <10% carbs but he reused. I made some progress because in January he ate only dry food. Now, he eats about 140 g wet food and only 20 g dry food.

 

[Tricia Cinco(GA) & Harvey]

Hi Andrea.

Good work on transitioning Tilica to wet food. If going slowly works best, that's what you have to do. At least you are making progress!

It's been several days since you've gotten any tests in the +4 to +7 time frame. Is there any way you can get a couple of those soon? I'm a little hesitant to encourage an increase without seeing if there are some lower numbers you might be missing around nadir. With SLGS, it is recommended that you hold each dose for 7 days (unless you get a BG below 90), then do a full curve once a week, and use those numbers to determine whether any dose changes are necessary. It would be very helpful if you could do a curve soon.

That said, with dry food in the picture, you are probably okay to increase, but I would try to pick a day when you can monitor a little more for the first couple of cycles. Just my opinion.

 

[Kris & Teasel]

Hi L&L
Usually I shoot 2,5 ui but I noticed that BG can be unpredictible. Today at AMPS he was in yellow but at +2 he became pink.
Other cycles when I was shooting the same dose the BG was dropping. about 70mg/dl after 2 hours. I tried to increase on 1 st March PMPS from 2.50 at 2.75 but the BG dropped very fast and at +4 I gave him HC for stop it. Every time when I increase the dose the BG decreses dramaticaly in the first 2-3 hours.
One month ago, I shot 3 ui but I had to reduce because of hypoglicemia which occured in the fisrt 3 hours for example 06/02, 09/02, 10/02.
He eats wet food royal diabetic 16% carbs and 20 g hills dry m/d per day. I tried to with othet type of food with <10% carbs but he reused. I made some progress because in January he ate only dry food. Now, he eats about 140 g wet food and only 20 g dry food.

It looks like 2.75 u could work but I'd wait to see what the Lantus experts think.

 

[Tricia Cinco(GA) & Harvey]

Are you feeding Tilica early in the cycle, like +2, +3? That can slow down the drops.

 

[Andreea&Tilica]

Hi Andrea.

Good work on transitioning Tilica to wet food. If going slowly works best, that's what you have to do. At least you are making progress!

It's been several days since you've gotten any tests in the +4 to +7 time frame. Is there any way you can get a couple of those soon? I'm a little hesitant to encourage an increase without seeing if there are some lower numbers you might be missing around nadir. With SLGS, it is recommended that you hold each dose for 7 days (unless you get a BG below 90), then do a full curve once a week, and use those numbers to determine whether any dose changes are necessary. It would be very helpful if you could do a curve soon.

That said, with dry food in the picture, you are probably okay to increase, but I would try to pick a day when you can monitor a little more for the first couple of cycles. Just my opinion.

Thank you, Tricia,

It's difficult to monitor him because I am at work . I 'll test him in weekend at +7 +10. Anyway he is unpredictible, even if I'll test him hourly, in the next cycle his BG may go any other way.
Indeed I have to test him a couple of cycles in a row in order to take a decision to increase. Two days of weekend aren't enough to take a decision but I thinl I can make an opinion myself.

 

[Andreea&Tilica]

Are you feeding Tilica early in the cycle, like +2, +3? That can slow down the drops.

In the morning I feed him at the time shot and I leave him about 5-8 g because I'm at work. In the evening I feed him at the time shot, and after at +3, at +4 or +4.5 depending on his hunger.
But when BG dropes drastically even if he eats HC at +2 it keeps dropping very fast, glucose given too.

 

[Andreea&Tilica]

It looks like 2.75 u could work but I'd wait to see what the Lantus experts think.

Hi Kris,

When I shot 2.75 I had to step in to stop the BG at 100, otherwise from my previois experiences it dropped about 60. I noticed that if in the first 2 hours the BG it goes down more then 150 mg/dl in the following 1--2 hours ( at +3, +4) it gets to 50-60.

 

[Wendy&Neko]

I agree with Tricia, try to get a few more mid cycle tests in and if you don't see any surprises, I think you can increase to 2.75 units. Remember that if you can consistently get a before bed test every night, that's a really good mid cycle test to get. Cats often go lower at night anyway.

When I shot 2.75 I had to step in to stop the BG at 100, otherwise from my previois experiences it dropped about 60. I noticed that if in the first 2 hours the BG it goes down more then 150 mg/dl in the following 1--2 hours ( at +3, +4) it gets to 50-60.

I don't see where Tilica has been on 2.75 units for any length of time. You have to hold the dose longer to build the depot and see what the dose can do. He had a good initial reaction on March 1st to 2.75 units, but then you lowered the dose again. Getting a good reaction to the first dose is common - it doesn't mean that's what he'll look like if you stayed with that dose. The numbers you got that night is the type of nadirs you want on SLGS. And what a cat did longer than 2 weeks ago isn't really relevant as far as predicting what he'll do now on a dose. Cat's insulin needs change over time.

 

[Andreea&Tilica]

I agree with Tricia, try to get a few more mid cycle tests in and if you don't see any surprises, I think you can increase to 2.75 units. Remember that if you can consistently get a before bed test every night, that's a really good mid cycle test to get. Cats often go lower at night anyway.

I don't see where Tilica has been on 2.75 units for any length of time. You have to hold the dose longer to build the depot and see what the dose can do. He had a good initial reaction on March 1st to 2.75 units, but then you lowered the dose again. Getting a good reaction to the first dose is common - it doesn't mean that's what he'll look like if you stayed with that dose. The numbers you got that night is the type of nadirs you want on SLGS. And what a cat did longer than 2 weeks ago isn't really relevant as far as predicting what he'll do now on a dose. Cat's insulin needs change over time.

Thank you Wendy, well said about the first reaction of a new dose.
I have to test the dose of 2.75 for at least 3 cycles because during the day he remains without being watched over and I'm afraid
On 1st March I gave him HC food at +2.5, at +4 otherwise I think that nadir could be even low.

 

[Wendy&Neko]

But on March 1st, his lowest number was 113. That's a long way from the danger zone of below 50. You also want him to spend more time in nicer numbers, or he'll keep bouncing every time he sees it.