? DOSE INCREASE??? Buddy 12/11 103 AMPS 368

[Kelly and Buddy]

I am seriously baffled by Buddy's numbers. Two weeks ago, he was hanging nicely in blues and greens at .5 units. On the morning of 11/27, I woke up to find him completed disoriented. The vet still has no idea what happened but he appears to have made a complete recovery - except for his BG!! (Click HERE for my post from that day). Because of the low numbers he was having and I was going to be gone from 6:00 a.m. - 1:00 a.m. for 3 days (driving 90 minutes round trip to do his evening injection), I dropped his dose to .25. Since then, his numbers have skyrocketed. I am now back up to 1 full unit and he is still consistently in the upper 200s and 300s.

1) Is this normal? I know there are fluctuations but this a pattern that is seen commonly?

2) I did get a new insulin pen when he started going back up. Is it possibly linked to that? I hate to toss a $100 pen and I can't imagine it's bad (still clear and has been refrigerated) but the timing was bad since he had just had his "episode".

3) What is the minimum time that would be safe for me to wait before increasing again? I've done 3 dose increases in the past 12 days and he is STILL SO HIGH. I really feel like I need to increase again but don't know if that's too many increases in such a short time.

I love this cat and would do anything for him but this journey continues to make me scratch my head, pull out my hair, and then .

 

[Olive & Paula]

If you are doing TR protocol you can increase after 6 cycles on same dose. If doing SLGS you increase after 14 cycles of same dose.

Hope Buddy heads down for you soon.

 

[Kelly and Buddy]

If you are doing TR protocol you can increase after 6 cycles on same dose. If doing SLGS you increase after 14 cycles of same dose.

Hope Buddy heads down for you soon.

I'm on SLGS but I hate the thought of leaving him at this high of a number for so long. With that said, I don't want to make things worse by increasing too quickly. Some time ago, I thought someone posted that I could follow the TR protocol temporarily as long as I could monitor while making more frequent dose increases. Unfortunately, I can no longer find that post again to reread.

I hope he heads down soon. Thanks for you input.

 

[Olive & Paula]

I'm on SLGS but I hate the thought of leaving him at this high of a number for so long. With that said, I don't want to make things worse by increasing too quickly. Some time ago, I thought someone posted that I could follow the TR protocol temporarily as long as I could monitor while making more frequent dose increases. Unfortunately, I can no longer find that post again to reread.

I hope he heads down soon. Thanks for you input.

It looks like you have been doing TR since 11/28. Raising dose every 6 cycles (3 days). Review TR, I think you can do it. You would test minimum before each shot and 1 time each mid cycle. A lot of people will test before they go to bed or if they get up during the night for bathroom test then. You could switch back to SLGS if TR proves to be to much. But you don't want to be switching weekly, you want to stick to one for as long as possible. Sometimes you just might have to change up a day but still be able to stay on TR. I had to change a day in October because I was away for the entire 12 hrs. There are ways to do it but something you want to limit happening often. Just like kitty having a dental, just a few adjustments for the one day. For me personally its only 2 or 3 time a year if that. Its something to think about.

 

[Wendy&Neko]

Here's the link to your previous post here:
http://www.felinediabetes.com/FDMB/threads/buddy-11-27-scare-this-morning-possible-hypoglycemia-over-night.207119/
Including those links helps both you and us go back and take a look at the history.

I'm on SLGS

Could you put that in your signature? That'll help us help you.

You've been increasing the dose too fast for SLGS and even if you were on TR, too fast for that too given the amount of testing you can do. The numbers you were getting at 0.5 units would have you hold the dose at 0.5 units. In other words, his nadirs were between 90 and 149.

I would not increase, but rather slow down, gather more data and see what this dose is really doing. It's too early to tell. Your spreadsheet commented that he feasted outside a couple nights ago. That could also cause temporary high numbers.

 

[Kelly and Buddy]

Here's the link to your previous post here:
http://www.felinediabetes.com/FDMB/threads/buddy-11-27-scare-this-morning-possible-hypoglycemia-over-night.207119/
Including those links helps both you and us go back and take a look at the history.

Could you put that in your signature? That'll help us help you.

You've been increasing the dose too fast for SLGS and even if you were on TR, too fast for that too given the amount of testing you can do. The numbers you were getting at 0.5 units would have you hold the dose at 0.5 units. In other words, his nadirs were between 90 and 149.

I would not increase, but rather slow down, gather more data and see what this dose is really doing. It's too early to tell. Your spreadsheet commented that he feasted outside a couple nights ago. That could also cause temporary high numbers.

Thanks, Wendy!

I have "SLGS" right under the link to Buddy's SS. I thought that was the signature but I must be wrong because you aren't the first person to ask me to add it. Can you clarify and I will definitely add it to the appropriate area?

I see your point about how fast I've increased. I probably could have tested more but since he was running SO high, I was giving his ears a break. In hindsight, probably not the right decision. I see what you mean by the lower nadir on 12/1; I guess when I saw his PS numbers still going up, I got worried and increased.

At this point, do you think I hold the 1 unit dose for a week, unless he drops too low? I go on Christmas Break next Wednesday so I'll have two weeks where I will have more opportunities to test and monitor.