? Help with dosing? 0711 Brody AMPS 123 (+11.5), PMPS 167, 218, +2.3 206

drdrbrody

drdrbrody

Member Since 2019
Here's the thread from yesterday. I meant to get +9 but I just straight up slept through the alarm I set.

Brody has only been on insulin for about a week (Lantus 1U BID), but his numbers have started coming down really quickly, to the point where we had a near hypo episode yesterday. (AlphaTrak 2)

PMPS 143, +3 78, +3.5 85, +4 83, +4.5 81, +5 92, +6 91, +7 91 and now +11.5 123.

Should I skip his morning dose? Should I reduce to 0.5 or 0.75?

Thank you so much!
 
Since you are following SLGS, Brody earned a reduction to 0.75 units by going under 90 last night.

If you are not able to monitor today, it's probably best to skip the shot to keep Brody safe. You don't have enough data to know what he'll do.
 
Good advice from Carla this morning! it's really nice to see Brody experiencing such nice numbers! I hope he's one of the lucky ones that get a quick and easy remission :)
 
His PM"PS" was 167, a full 24h after his last dose of lantus o_O. Vet said not to reduce the dose yet as we're still in the 14 day trial period, but just to not shoot if he's <150 or if he's <200 and not eating robustly. He's only had a few tbsp of his dinner so far, so it might be another no shot cycle for us. I don't know if I could do another night like last night again so soon!

So many thanks to all of you here for supporting this total newbie! I've never seen a group of people so kind and helpful. :)
 
Great he is still low even after skipped shot, that is a good sign. Tough call on what to do tonight, especially is you can’t be up all night. Sorry I am not much help. Normally they would say to shoot the reduced dose of .75, the vets instructions are out the window when last night he went low. So his “new” dose should be .75, but seeing he is still within a good range at this preshot, unless you are willing to be up if necessary, you could skip or consider a reduced dose below the .75. See excerpt from SLGS.


There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
You could check him once more say 30 minutes after first PMPS test, if he has risen considerably then you may want to give something?
 
Julie and Honey said:
Great he is still low even after skipped shot, that is a good sign. Tough call on what to do tonight, especially is you can’t be up all night. Sorry I am not much help. Normally they would say to shoot the reduced dose of .75, the vets instructions are out the window when last night he went low. So his “new” dose should be .75, but seeing he is still within a good range at this preshot, unless you are willing to be up if necessary, you could skip or consider a reduced dose below the .75. See excerpt from SLGS.


There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
  • Below 150 mg/dl (8.3 mmol/L), don't give insulin.
  • Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
    • a.) give nothing
    • b.) give a token dose (10-25% of the usual dose)
    • c.) feed as usual, test in a couple of hours, and make a decision based on that value
You could check him once more say 30 minutes after first PMPS test, if he has risen considerably then you may want to give something?
Click to expand...


That's a good idea! I'll test him again and see. Given that he's still low without an AM shot, I suspect he may just metabolize the insulin slower than normal cats. So his nadir may be more of a flat line that lasts 18-24 hours. He's getting a full 16h curve on Saturday, so we'll see! If he's closer to 200 after his dinner, I'd feel pretty okay giving him his shot (maybe "skinnied up" to 0.75-0.8). I'm also not too worried about skipping again if I need to since he didn't rebound way up into 400+ again.

And you have been incredibly helpful! (especially last night) It's been SUCH a learning curve.
 
Hi, Brody is looking great.
I just want to say if you are following the SLGS method, Brody has earned a reduction in dose down to 0.75 units.
I disagree with your vet about holding the dose for 2 weeks because 'you are still in a trial period'. That is head in the sand type of attitude. The whole purpose of testing is to ensure kitties don't drop too low. To say stay with the same dose when you have tested and found he has dropped low would be asking for trouble.
 
drdrbrody said:
That's a good idea! I'll test him again and see. Given that he's still low without an AM shot, I suspect he may just metabolize the insulin slower than normal cats. So his nadir may be more of a flat line that lasts 18-24 hours. He's getting a full 16h curve on Saturday, so we'll see! If he's closer to 200 after his dinner, I'd feel pretty okay giving him his shot (maybe "skinnied up" to 0.75-0.8). I'm also not too worried about skipping again if I need to since he didn't rebound way up into 400+ again.

And you have been incredibly helpful! (especially last night) It's been SUCH a learning curve.
Click to expand...
Don’t want to jinx anything, but he may be headed for remission sooner than later, it is surprising he stayed low all day with no juice and the higher second test tonight was probably a little from the food too.

You may be one of the lucky ones on this, here’s hoping;)
 
Julie and Honey said:
Don’t want to jinx anything, but he may be headed for remission sooner than later, it is surprising he stayed low all day with no juice and the higher second test tonight was probably a little from the food too.

You may be one of the lucky ones on this, here’s hoping;)
Click to expand...

Gosh I don't want to jinx anything either, but here's hoping. I'm pretty sure we got lucky and caught it super early (a few weeks) and he's much younger than most diabetic cats, so hopefully he's still got some healthy pancreas hanging on! It was an absolute trial finding LC wet food that he would actually eat (a couple of scary <100kCal days) but I think it's probably the one thing helping the most at this point!
 
drdrbrody said:
Gosh I don't want to jinx anything either, but here's hoping. I'm pretty sure we got lucky and caught it super early (a few weeks) and he's much younger than most diabetic cats, so hopefully he's still got some healthy pancreas hanging on! It was an absolute trial finding LC wet food that he would actually eat (a couple of scary <100kCal days) but I think it's probably the one thing helping the most at this point!
Click to expand...
A few weeks is nothing really, they say cats can go into remission If caught in first 6 months, so you are looking really good there.
 
Hello and a belated welcome from me.

Brody is looking good for a recently diagnosed kitty. I am looking forward to seeing some data from that curve this weekend.

And speaking of the R word, I don't want to put a damper on things, but your first goal should be regulation. That's the requirement to anything that may or may not follow afterwards. :)
 
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