7/6 Farine AMPS 164 - should we change the dose ?

[kimouette]

Hi everyone,

As you might already know I am currently helping a friend who is dealing with a diabetic cat. Farine has switched from Caninsulin to Lantus 3 and a half days ago.
Based on the TR protocol, we were prepared to increase dosage from 0.75u to 1.0u this morning, but after seeing Farine's PS numbers we decided to wait a little.

Could you guys look at Farine's numbers and tell us if (and why) you would stick with the current dosage for another day or two, or if you would increase it...

https://docs.google.com/spreadsheet/ccc ... hZ1E#gid=0

Thanks a lot for your help!
Kim (and Alain who will be following this thread)

 

[Wendy&Neko]

The TR protocol would have you hold the dose for a few more cycles:

"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.

Farine has only had 7 cycles of Lantus, so you should wait at least 3 more before increasing. This is for the initial dose only, then you go to quicker increases.
The numbers are starting to look really nice! I noticed that there was no mid cycle test last night. Even a before bed test or a +10 test if you are up before PS time will help tell us what the cycle looked like.

 

[kimouette]

Hi Wendy!

Thanks for the super quick reply!

I thought that if first 3 days showed a high (even though it's not THAT hight) flat curve, then we could go ahead and increase dosage a little.
Are you saying we should wait a total of 10 cycles because her bg levels could keep on getting lower during the next 3 cycles? Or is it something we should do nomatter what results show up?

As for the PM cycles, Alain is doing his best! He's already kind of putting his life on hold for these numerous tests, and he will try to do one more before going to sleep, but it's not that easy!

Thanks again!
Kim

 

[Wendy&Neko]

As Farine's Lantus depot is filling, the numbers are coming down. I think of high flat curves as continuous pink and/or reds or higher.

The before bed tests will get faster as testing gets easier. I get ready for bed, brush my teeth, test the cat, set the alarm, turn out the light. Often kitties will go lower at night than during the day so it's important to get at least one night test. My Neko is an extreme case of this lately. 95% of her greens since mid February have been at night.

 

[Sienne and Gabby (GA)]

At this point, with Farine seeing a beautiful blue cycle, I would suggest holding the current dose, as well.

As Wendy was alluding to, it's important to get at least one test during the PM cycle. Many cats experience lower numbers at night. As you can see, Farine dropped into blue numbers during the PM cycle on 7/3. In addition, if you don't test at night, you're missing half of your data.