Dosage changes when AM & PM don't jive

[Alison & Sarge]

What do you do when the nadir for one half of the day tells you to hold the dosage steady but nadir the other half tells you a .25 unit increase may be required? My quandary is if Sarge is getting into the green one half of day, will increasing the dose to bring down the high 12 hour cycle plummet the 12 hour cycle that previously hit normal numbers?

 

[julie & punkin (ga)]

it's common for cats to have differing cycles between am and pm cycles. Lantus dosing is based upon the lowest numbers that a particular dose gets a cat to - so you would go by the lowest numbers over the previous 3 days.

You want to give the same dose am/pm or you will see wonky numbers. In Sarge's case, I see 60's & 70's on 8/22-23, so I'd hold the 1.25u dose for a total of 10 cycles and then re-evaluate.
Tight Regulation Protocol

Increasing the dose:
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.

He's bouncing some from hitting normal numbers. You don't increase the dose to compensate for bounce number. read the post i just linked on bouncing and see if that makes sense.

 

[Alison & Sarge]

That was my suspicion. He is on track, just bouncing because it has been so long since he has experienced normal numbers and some new dose wonkiness. I'll ride it out a while longer and see what he can do. I just didn't want to wait and see if TR said that something should be happening sooner. Thanks for helping me navigate the finer points of TR!

 

[julie & punkin (ga)]

oh gosh - it takes a while to understand the protocol. Looks so simple at face value, but figuring out when a cat is bouncing, when they're having NDW, when you've reduced and it's the depot from the previous dose still influencing numbers . . . all of that takes some time.

you're welcome - other people taught me and i'm just paying it back. there are quite a few of us who stick around to help people learn how to navigate it all.