Question about dose

Status
Not open for further replies.
Yes, I think it was fine to do that. You did have the 49 on the 1.25u dose, but you waited 10 cycles after that and the lowest tests (out of many!) was 190. So I think it was reasonable to increase.
 
julie & punkin (ga) said:
Yes, I think it was fine to do that. You did have the 49 on the 1.25u dose, but you waited 10 cycles after that and the lowest tests (out of many!) was 190. So I think it was reasonable to increase.
Click to expand...
Hi Julie. I wasn't sure as I only waited for seven cycles as I skipped a dose on the morning of 11/5/15. And because we did get one reading under 200 maybe I should have waited another three cycles before increasing the dose. Thank you.
 
BJM said:
You don't have any units listed for 11/05/15; did you shoot then?
Click to expand...
Hi BJM. We had a skipped dose on the morning of 11/5/15 so we only had seven cycles at 1.25 units. Though we had four cycles at 1.25 units before that skipped dose but I think that doesn't count due to the skipped dose.
 
So just checking I understand properly. If we had no numbers under 200 for six cycles it would have been okay to increase the dose. If we had blue numbers then you wait for ten cycles before increasing the dose. I increased the dose because we only had one number under 200 and that was 193 so it was not very much under 200. So I wasn't sure if I did the right thing to increase the dose and whether waiting three more cycles was needed.
 
I missed that 0.00 in the dose column. Here's what the guidelines say:

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.
  • After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

  • After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
So yes, you would've held it a little longer.

However, you've already increased it for 3 cycles, you are an experienced caregiver, and you've got a flare-up of the herpes which is likely increasing her blood sugar. So for now I'd just carry on with the current dose knowing that as the herpes flare resolves, her blood sugar may come down and you may need to reduce the dose when/if that happens.

There's another thread going for Lucy now and I'm unclear which is today's. You can include questions like this is your regular condo/thread. It's just a bit confusing because now 2 posts are bumped up.
 
Thank you Julie. This is today's thread. The other one is yesterday's thread and you are probably confused because you are a day behind there. :) I think given the 2.7/49 at 1.25 units when I gave Lucy high carb food as well as the fact I should have held the 1.25 dose a little longer plus my anxious nature I could decrease the dose back to 1.25 units. I will see what today's test results are but I think I will reduce back to 1.25 units because whilst I am home all weekend next week I do have some appointments to attend. Thank you again.
 
I wouldn't take her back down until she earns it now, remember that lantus likes consistency. Also she's looking like she needs the extra - prove me wrong Lucy! I don't see mention of the herpes issue in her spreadsheet (I assume it was mentioned in a condo I've missed) it would be good to note it in there. It's good to note anything that could be effecting the BG for later reference.

I would send you some patience pants but all of mine are in tatters!
 
I also wondered yesterday whether the first 1.50 units dose was responsible for the green and blue readings because it usually takes a few doses of an increased dose or after a skipped dose to see a lowering of the glucose so after more reflection I will reduce the dose back to 1.25 units. Thank you Julie and BJM too.
 
Hi Serryn. Well now you have confused me more than I already am confused. :joyful: It is a fine line as either decision will probably be fine. That is so funny about your tattered patience pants.
 
Vyktors Mum said:
I wouldn't take her back down until she earns it now, remember that lantus likes consistency. Also she's looking like she needs the extra - prove me wrong Lucy! I don't see mention of the herpes issue in her spreadsheet (I assume it was mentioned in a condo I've missed) it would be good to note it in there. It's good to note anything that could be effecting the BG for later reference.

I would send you some patience pants but all of mine are in tatters!
Click to expand...
I smiled about the statement that lantus likes consistency because between syringes with no half unit markings and tiny air bubbles consistency is something I aim for but probably rarely achieve no matter how carefully I draw the dose. Let's put it this way that the insulin would last twice as long if I could meet the challenge with less attempts to draw the correct dose. :)
 
Voula said:
I smiled about the statement that lantus likes consistency because between syringes with no half unit markings and tiny air bubbles consistency is something I aim for but probably rarely achieve no matter how carefully I draw the dose. Let's put it this way that the insulin would last twice as long if I could meet the challenge with less attempts to draw the correct dose. :)
Click to expand...

I think many of us have similar issues. I'd be willing to bet it accounts for some of the bouncing.
 
tiffmaxee said:
I think many of us have similar issues. I'd be willing to bet it accounts for some of the bouncing.
Click to expand...
Hi Elise. I agree with you about that. There is also the issue of air bubbles in the insulin where sometimes there is more air than insulin in the syringe. Sometimes when I think the dose is not exact I start again with a new syringe and when I expel the contents of the previous syringe into the sink I find it was one big bubble and very little insulin and I have thought that this could be an issue in higher glucose levels sometimes too. Though this does not happen often it has happened a few times. Some bubbles would not be as much of an issue for people who have diabetes as they are on much higher doses but for cats a few small bubbles which are sometimes difficult to get out can be an issue in higher glucose levels too.
 
Hi Voula,
Good luck with the new dose. It is hard to measure with no half unit markings.
I find I get less air in the syringe and the vial if I push in the plunger tightly before inserting it into the vial. Maybe you do that already.
 
Bron and Sheba said:
Hi Voula,
Good luck with the new dose. It is hard to measure with no half unit markings.
I find I get less air in the syringe and the vial if I push in the plunger tightly before inserting it into the vial. Maybe you do that already.
Click to expand...
Thank you Bron.
 
I found that pushing the syringe plunger in really hard also helped reduce the air bubbles. They are a devil, aren't they!?!

Do whatever works for you, Voula. You have good instincts and it's ok to take into consideration the constraints that you deal with. :bighug:
 
Hi Julie. Thank you for the handy tip. I am not overly worried about staying at 1.5 units at the moment as I am home most of the time and as I said really given the difficulties with not having access to half unit syringes sometimes the doses do vary in any case. It's not like I suddenly increased the dose by half or one unit so I will see what this weekend's glucose readings are and then decide. I think the bounce is starting to clear now so see what happens this weekend. It was really only that one reading not much under 200 that is the reason that strictly speaking I should have waited a few more cycles to increase the dose and if I had done another test soon after it might have been just over 200 so it isn't a big issue. I guess I like to follow the protocol as it is written and I wasn't sure so I thought given the continuing higher readings and only one reading not much under 200 that I would increase the dose. Thank you for your nice comments about my instincts too.
 
I was just thinking that really it all depends when we do the tests as to what decisions we make about increasing and decreasing doses. For example, if I had tested more during the night I might have found more lower readings under 200 but I guess we have to base decisions on what we find not what could have happened when we didn't do tests.
 
Air bubbles - my technique is, after pushing the syringe in and out a couple of times to loosen it up, to push the syringe in tight before inserting into the vial draw a little extra than the dose, then flick any air bubbles to the top of the syringe and expel them while adjusting for the correct dose. If the air bubbles I've flicked to the top don't line up nicely to be expelled I draw a little additional air in and it joins together and can then be expelled.
 
Vyktors Mum said:
Air bubbles - my technique is, after pushing the syringe in and out a couple of times to loosen it up, to push the syringe in tight before inserting into the vial draw a little extra than the dose, then flick any air bubbles to the top of the syringe and expel them while adjusting for the correct dose. If the air bubbles I've flicked to the top don't line up nicely to be expelled I draw a little additional air in and it joins together and can then be expelled.
Click to expand...
Thank you Serryn. I will try drawing in a little additional air too. I am getting better at removing the bubbles now. You are all a true blessing in helping me and my Lucy and I thank God for finding all of you and this wonderful message board too especially after losing our Rosie last year when I was so overwhelmed so thank you again.
 
And with an online translator, you can get the gist of what is written. Glad you're all doing well.
 
Status
Not open for further replies.
Back
Top