Dosing error?? 6/24 - Boots - AMPS 164 | +1 176 | +2 153 | +4 154 | PMPS 189 | +1 193

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Megan and Boots (GA)

Megan and Boots (GA)

Member Since 2015
AMPS 164
+1 176
+2 153
+4 154
PMPS 189
+1 193

Did I make a dosing error today? I was just double checking the "management of diabetic cats" study PDF and see that when preinsulin BG is <180 it should be a decrease, but I increased this morning by .25 from yesterday's dose (3 to 3.25) and kept that 3.25 dose again tonight. Doesn't seem to have done any harm today, he's been relatively steady all day (I like these relatively flat curves!). What should I do in the morning? I guess I was just thinking increase because we still haven't seen a single green number yet, nothing even below the 130s (at least not that we've caught and read).

Thoughts? Are his numbers the past few days good enough for the "hold the dose" phase maybe?
 
You are doing TR so you hold each increase for 3-5 days. You don't decrease unless your cat drops below 68 using AT I believe. I think you can continue with this dose but see what others say. You want your cat in normal numbers for as much of the time as possible which would be 68-140 I believe.
 
Ahh, you're right. I was reading the wrong guidelines. Ugh, there is SO much information, it's hard to keep straight. Tilly's Diabetes site, I need to just print it out or something and memorize the dang thing. I'll hold the 3.25 then for another 4 cycles at least, see where that gets us. Would love to see green this week, but who knows. fingers crossed :)
 
I think I might have suggested holding the 3U for awhile longer. We use a modified form of the TR protocol here (which is already very aggressive) and it says

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.
Click to expand...

That being said, now that you've given the 3.25, let's see how he does, but please don't increase again without letting some of the experienced eyes look at your spreadsheet. Number one rule around here is to be safe!!
 
There's a stickie with the guidelines at the top of the lantus/levimir home page. I'd print it out and also how to handle low numbers. That one is even more important if in doubt always post here for advice. It's good to post a daily condo if you can and link condos from day to day also.
 
OK, will do. I know I had read that and was reminded to hold up to 10 cycles, but I guess I don't know what exactly defines "new" to numbers under 200. Boots has been getting <200 readings now on 11 separate days, so I guess I figured I could do the increase after the short end (6 cycles) rather than waiting 2-4 more, since I don't consider that "new" - make sense? I guess maybe that could be defined a little differently in that explanation of increasing the dose. Maybe in number of days, or percent of days since readings began or something? "New" is open to interpretation :) But yes, definitely want to be safe! At least Boots has still been largely at the higher end of the 100s, just a few readings in the mid-100s and nothing really low 100s yet. So hopefully the increase will just nudge him lower into the 100s and maybe we'll see a green this week :)
 
No dumb questions here . This is your condo for today. Each time you start a new topic we call it a condo. Many of us do one every day.
 
OK. I wasn't posting daily, I guess I don't want to bore people if there's not much to report. But if it's helpful to everyone to start to see daily numbers for Boots, I can post them each night and any pertinent info about the day. Thanks!
 
You don't have to post daily but it helps to get people familiar with your cat. You don't have to write much. You can just post numbers and the link to the previous day unless you have questions. It's up to you. I would strongly suggest posting for advice before increasing though. By the way Welcome to LL.
 
When we first started we were told "condo" means "condition report"....or the place a lot of our cats spend a lot of their time in....How many cat condo's do you have?....LOL
 
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