Ramone 06/15 AMPS 335- Dosing question

[Jerica&ramone]

Hi All.

So although I busted Ramone eating some of his brothers dry food earlier last week, it looks as though the anitbodies/ tumor or doing their thing again and we are back to high #'s and increasing the dose again.

Question is - Do I stick with the same protocols (TR) when you have and Acro/IAA kitty ? I bumped him up to 8 units and did not give it the full 3 cycles but I was monitoring as much as I could and could tell the 7.5 wasn't enough. I want to get his #'s back down but of course want to do it safely.

Is there a rule of thumb when it comes to this ? Can I bump up a unit each time or just shorten the time between as long as I'm getting some mid cycle tests and continue to do the .5 unit increases ( I know I need to do better night time testing ) I will set my alarm this week to get a +6 for the PM cycle. And will get +3 before bed.

I am going out of town next weekend just for 2 nights, so I'm keeping that in mind that if he's maybe a smidge on the higher side it will be OK. But I would like to try and get his #'s down a bit more. I'm home all week so over next 4 days I can get a lot of tests done.


http://www.felinediabetes.com/FDMB/threads/ramone-06-11-amps-283-6-284.230832/ Link to last post.

 

[Wendy&Neko]

You'll probably get more dosing help if you post in the Lantus/Basaglar/Levemir forum. But I'll add my comments here anyway. First, most of us with acros/IAA are or were following TR. Over 5 units total dose you increase by 0.5 units, over 10 units you go to 1 unit. Unless of course in both cases you are seeing some greens and just want to "fatten" the dose, in which case you'd do half that amount. Think of the increase as a percent of the total dose. And yes, hold the dose at least six cycles, especially since you were seeing some blue on 7.5 units. You need to let the depot build to see what a dose can do. So hold a minimum of six cycles, longer if low blues or greens show up. There are certain cases where the cat is solidly in numbers all above 300 that you can increase sooner. Ask for help if you see that happen.

You need to know how low the dose is taking the cat before you can safely increase. Following TR (or even if you are following SLGS), you MUST get some night time tests. Many, probably most, cats go lower at night. Neko once went a stretch of three months going low at night, often earning reductions, and bouncing during the day. Drove me crazy! But if I hadn't done any night time tests I would have increased when she actually needed reductions. A second possibility for worsening numbers is that Ramone is now overdosed. Only by testing each and every cycle will you find out which scenario you are looking at. I'd try to find out scenario you are looking at before going out of town.

 

[Jerica&ramone]

You'll probably get more dosing help if you post in the Lantus/Basaglar/Levemir forum. But I'll add my comments here anyway. First, most of us with acros/IAA are or were following TR. Over 5 units total dose you increase by 0.5 units, over 10 units you go to 1 unit. Unless of course in both cases you are seeing some greens and just want to "fatten" the dose, in which case you'd do half that amount. Think of the increase as a percent of the total dose. And yes, hold the dose at least six cycles, especially since you were seeing some blue on 7.5 units. You need to let the depot build to see what a dose can do. So hold a minimum of six cycles, longer if low blues or greens show up. There are certain cases where the cat is solidly in numbers all above 300 that you can increase sooner. Ask for help if you see that happen.

You need to know how low the dose is taking the cat before you can safely increase. Following TR (or even if you are following SLGS), you MUST get some night time tests. Many, probably most, cats go lower at night. Neko once went a stretch of three months going low at night, often earning reductions, and bouncing during the day. Drove me crazy! But if I hadn't done any night time tests I would have increased when she actually needed reductions. A second possibility for worsening numbers is that Ramone is now overdosed. Only by testing each and every cycle will you find out which scenario you are looking at. I'd try to find out scenario you are looking at before going out of town.

Okay thank you. I wasn't sure if posting on the lantus board would make sense since he's acro/iaa . But I will post there from now on .
And will do my best for night time tests. I literally go to bed at 9-930PM PST. And I set alarms but sometimes I just turn them off and don't realize and fall right back asleep... ugh.
So do I continue with the 8 units or go back down to the 7.5 units. I didn't give it 3 full cycles... I should have done 7.5 one more day shot. Or just carry on with 8 units ...

How would I know if he's getting too much insulin now ? With the sudden jump in his #'s that continued? I know too much insulin can look light not enough but how am I to know ?

Should I have decreased when his #'s started jumping up again ? So confusing.

My gut says is that its not enough and I have to go back up... just like we had to go up to 9 units 3ish weeks ago to get his #'s down and then decreased from there once his #'s improved.
I'm really trying my best. With my other cat being sick too its a lot to manage plus all the other things in life.

 

[Wendy&Neko]

This forum is pretty quiet and has people using different types of insulin. Dosing question best on the insulin specific forum.

The way to find out if he's on too little or too much insulin is to get tests every cycle. If he's on too much, he will go low at some point.

And will do my best for night time tests. I literally go to bed at 9-930PM PST. And I set alarms but sometimes I just turn them off and don't realize and fall right back asleep... ugh.

Two options, one is to change the shot time so you are up later in the cycle. Second, drink a large glass of water before bed - your body won't let you fall right back asleep. I don't know what time shot time is for you, but even getting a +2 is helpful in telling you what the cycle might look like. If he's dropping at +2, drink an extra large glass.

 

[Jerica&ramone]

This forum is pretty quiet and has people using different types of insulin. Dosing question best on the insulin specific forum.

The way to find out if he's on too little or too much insulin is to get tests every cycle. If he's on too much, he will go low at some point.

Two options, one is to change the shot time so you are up later in the cycle. Second, drink a large glass of water before bed - your body won't let you fall right back asleep. I don't know what time shot time is for you, but even getting a +2 is helpful in telling you what the cycle might look like. If he's dropping at +2, drink an extra large glass.

That's a good idea!! Glass of water before bed.

I've thought of changing his shot time -- but once I'm back to work at the office which could be any day.... I'd just have to go back to how it is so I will just leave it as is..
I will do better at the evening tests.

And I didn't know that was a sign of dosing being to much - so good to know. I will get his #'s throughout the night this week so I can be sure.

Thank you as always

 

[Wendy&Neko]

And I didn't know that was a sign of dosing being to much

All I'm saying is that without testing, you could be missing some lows. That combined with increasing more aggressively that TR, which is already an aggressive method, is not a good idea.

 

[Jerica&ramone]

All I'm saying is that without testing, you could be missing some lows. That combined with increasing more aggressively that TR, which is already an aggressive method, is not a good idea.

100% makes sense!
And I got a test in last night! Even though I did turn off my alarm without knowing. I woke up 1 hour later and SHOT out of bed and got his PM +7 last night.