? Frustrating numbers and dose question

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Sue484

Sue484

Member Since 2015
Frankie is now on his 5th cycle since he has seen any blue numbers and he seems to be surfing but in the red numbers!!! I really just want to increase his insulin now but I know I have to wait until the weekend. If he stays the same between now and then, should I increase by 0.5 or the usual 0.25? The last time he was on this dose (just at the start of this month, 2nd June) he was getting nice runs of blue numbers, and even went into greens which is why his dose was decreased. How can things change so much in such a short space of time?
 
I just looked at the SLGS guidelines and it says to hold for a week and increases are in .25 increments. Cats are cats and their needs change for no apparent reason. It's frustrating but the nature of the beast. :bighug:
 
It looks like you are using SLGS, which is always only an increase of .25 based on nadir of your weekly cure. And even if you were doing TRP you probably would only increase by .25 as well. Although if he is still having a nadir over 300 then I think you could increase by .5 on TRP. Plus, you are using an Alphatrak so the numbers would be slightly different for you. Probably he would need to be over 375 nadir in order to increase by .5 unit.

You seem to be testing enough to do tight regulation, but that would be up to you.

Oh, and it does happen where the first time a kitty sees a specific dose they earn a decrease but then at some point they have to go back up. I don't know why, but I see it a lot.
 
Well, there's the protocol and there's what may be best for your cat. Given that Frankie is recovering from pancreatitis and is in high numbers, I'm leaning toward an increase as soon as you can. I'd really not like to see ketones appear -- which is always a risk with an inflammation/infection. If this were my cat, I'd be increasing this evening.
 
Sienne and Gabby said:
Well, there's the protocol and there's what may be best for your cat. Given that Frankie is recovering from pancreatitis and is in high numbers, I'm leaning toward an increase as soon as you can. I'd really not like to see ketones appear -- which is always a risk with an inflammation/infection. If this were my cat, I'd be increasing this evening.
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How much of an increase would you suggest?
 
His last bout of pancreatitis was over a year ago and he has been fine since touch wood. Would you still suggest to increase tonight? How much of an increase? His next shot is due in 30 minutes
 
I would go with an increase this evening as well. The amount is a bit of a personal judgement call, since you are sort of teetering between TR and SLGS.

Another question - how old is your insulin? I'm wondering if it's losing its potency. And overall Frankie seems to be feeling fine?
 
Frankie is feeling fine and his appetite is good. The insulin I have had since the start of April. Tonight he threw a curveball and was 17.3 (311) at PMPS down from am +11. I therefore injected his usual amount and see how he goes overnight. If he is still high I will increase in the morning. Was that the right thing to do?
 
Yep, shooting the same dose was certainly a fine decision, too! You're monitoring and on top of what he's up to, so giving this dose one more cycle isn't a bad idea since he was heading down at PMPS. I would increase in the morning if you still don't see much movement...you don't want his body to get too used to these higher numbers. It will be interesting to see what he does tonight!
 
I also agree that you test more than enough to go to Tight Regulation where we would be suggesting increases more often than the once a week on SLGS .

Is there a particular reason you chose SLGS? I think some people choose it because it sounds somehow "safer", but since you can obviously test enough to keep Frankie safe, I'd suggest you switch to TR so we can hopefully get those numbers down sooner
 
The only reason I don't do TR is because I am out of the house all day and the sitter usually comes in about midday for a test and snack. I would hate for him to go low while I was out. Plus the human numbers confuse me, I have no idea what they relate to on AT.
 
Good luck with the increase tomorrow.

Sue484 said:
Plus the human numbers confuse me, I have no idea what they relate to on AT.
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You can still follow TR using the AlphaTrak. The only real difference is that the reduction point of 50 on a human meter becomes 68 on an AlphaTrak. Any nadirs over that (200's, 300's, 400's), it doesn't really matter if it's a human meter or the AlphaTrak - those nadirs mean more juice is needed.
 
Ok. I'll see how he goes tonight and if I do need to increase tomorrow I will start TR then, otherwise it will be the weekend.
 
Sue --

I honestly don't think SLGS offers any protection from numbers dropping low when you're not home. I've been following TR for the entire time I've been here. When I joined, there wasn't a Lantus/Lev SLGS option and I don't think I would have opted for that given that the chances for remission were better with TR. As well as I know how Gabby's cycles "usually" go, there's never a guarantee. I don't think that differs if you're using SLGS. When a kitty is tired of a dose, they let you know. You're in a better position than I am if you have a sitter who comes by to check on Frankie. Even if I had my sitter stop by, Gabby won't let her test.

The difference between TR and SLGS is that you increase the dose sooner with TR. With either approach, you need pre-shot and some spot checks. You also reduce the dose at a higher number with SLGS than TR. In Frankie's situation, I wouldn't want to be waiting overly long for dose increases.

 
Just noticing that you had a blue 182 3 nights ago and he's been high ever since. Then tonight you've got a +4/229. It looks to me like it's possible that he bounced from that 182, even though he was blue the night before, and he may be clearing the bounce tonight. I'd definitely get another test in around +6 tonight if you can bear it.

When you increase, personally, I'd go with 0.25u. Remember you're dosing based upon how LOW the dose can make him go, not the creepy annoying high numbers in between the lows. This dose can get him at least into blue numbers, so I'd save the larger increases for another time.
 
Well, it seems he listens to you lot and not to me. I threaten an increase and nothing, then a few of you here do and what happens? At +8 he's 6.7 (121)!!!!

I am also changing my protocol back to TR. Thanks for all your help tonight.
 
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