PMPS 450, +3: 323, +4: 264

Tucker's Mama CS

Tucker's Mama CS

Member Since 2019
Hi all,

I have Tucker's spreadsheet completed with the last few month's data, thanks to Marje's help. I have a little bit of his story in the remarks at the top to fill you in on everything that he's been through (he is such a fighter!).

He had been on Vetsulin 5U BID thru 3/16/19 and began Levemir on 3/17 with a starting dose of 1U BID per the vet. Any suggestion for a dose increase yet?

Thank you!
 
Great to see that data in there, thank you both for getting that spreadsheet done. (@Marje and Gracie )

I don't know if you've had a chance to look at the Sticky Note on Dosing Methods yet. We have two, the Tight Regulation Protocol and the Start Low Go Slow Method. People here follow one or the other. In your case, with recent ketones, an all wet food diet, and starting the dose too low, I'd like to suggest that TR is the way to go, at least to start. It does require 4 tests a day, the two preshots, plus one other each cycle. Is that something you can do?

Whether or not you end up on TR ultimately, I think with recent DKA it makes sense to be a bit more aggressive to start. I think it'll be safe for you to increase to 1.5 units tomorrow morning, provided you see nothing below 300 before then. Let's see if some others think a even larger increase is a good idea. I'd be tempted, but it depends on your ability to monitor closely.
 
Wendy&Neko said:
Great to see that data in there, thank you both for getting that spreadsheet done. (@Marje and Gracie )

I don't know if you've had a chance to look at the Sticky Note on Dosing Methods yet. We have two, the Tight Regulation Protocol and the Start Low Go Slow Method. People here follow one or the other. In your case, with recent ketones, an all wet food diet, and starting the dose too low, I'd like to suggest that TR is the way to go, at least to start. It does require 4 tests a day, the two preshots, plus one other each cycle. Is that something you can do?

Whether or not you end up on TR ultimately, I think with recent DKA it makes sense to be a bit more aggressive to start. I think it'll be safe for you to increase to 1.5 units tomorrow morning, provided you see nothing below 300 before then. Let's see if some others think a even larger increase is a good idea. I'd be tempted, but it depends on your ability to monitor closely.
Click to expand...

Thank you Wendy. Yes, I have looked at all of that information now, but I did focus my attention on the SLGS protocol because that was what the vet said to me, though I am not opposed to TR. I can certainly do the 2 pre-shot tests, but I am afraid my work schedule may interfere with the daytime cycle test. I typically work Mon-Thurs, leaving at approx. 7 am and getting home approx 6:30 pm (sometimes earlier, sometimes later depending on patient load), and every other week I work Friday until about noon or 1 pm. So the timing may be tricky.
 
We got our first number in the 300's tonight! PMPS 450, +2 409, +3 323

Do you still think I should increase to 1.5 units tomorrow morning?
 
Great news! The depot is building. I would keep holding the dose at least a couple more days. Unless of course, your daily ketone testing shows anything above trace.
 
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