Napoleon - Am I moving too fast with doscreases

[Nicole and Napoleon]

I decided to increase to 2.5u tonight. I feel like a made a mistake. The 2U left him with a 131 AMPS about a week ago, am I possibly overlooking the correct dose by increasing and not giving each enough time? Having one hell of a frustrating night. My gut is telling me to go back to 2 units and just let it settle for a week, but I don't want to do more harm than good. Any advice would be very, very appreciated. Thanks so much.

 

[Ele & Blackie (GA)]

I'm sure others will chime in - I am not a dosing advisor. But according to the protocol you should wait at least 6 cycles before increasing and it looks like you increased after 4 cycles. You have to remember that Lantus builds up, so if you increase too fast you could end up with some really low numbers.

 

[Sienne and Gabby (GA)]

Here's the info from the Tight Regulation Protocol:

Most cats need to have their dose increased. Do it in 0.25 IU or 0.5 IU steps (0.25 IU if the cat is getting a low dose and/or relatively low BGs, 0.5 IU if the cat is getting a higher dose and/or relatively high BGs). Hold each dose for 5-7 days. However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU ( if the cat is getting a low dose) or 0.5 IU (if the cat is getting a higher dose).

So, you can increase as soon as 2 days if necessary. There's no hard and fast rule that says you must increase by the third day. It is a matter of weighing any risk associated with being above renal threshold with what you know about your cat. It may take Napoleon more than 3 days to adjust to a new dose. I don't think the 2.0u was holding. Generally, if you get a blue or green number, you would hold that dose for 5 - 7 days. You did that and it looks like that one run of blue was the exception, rather than the rule. Your gut is good but the protocol is there to help guide you.

 

[Libby and Lucy]

what Sienne said. :smile:

I increased Jazzy every 4 cycles at first, because she was high and flat and I was fairly sure (due to her past history) that she needed a higher dose. Now that she's getting some movement out of the insulin, I've slowed down the increases. There's nothing wrong with being a bit more aggressive if you're aware of what you're doing, and if you're able to monitor and make adjustments as needed.

 

[Nicole and Napoleon]

Thanks everyone. I'll be able to run a full curve on Saturday and will be able to see where he is at with this dose from there. I'll stick it out with the 2.5 till then.