Re: 01/11 Gentle AMPS 371 / +8 230 / PMPS 283 / +2 265
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Barbara and tuffy
Very Active Member
Re: 01/11 Gentle AMPS 371
Good Morning: Have you checked Gentle for ketones? I was looking at your ss and saw you have taken another decrease. Is there a reason for that? Usually we do not decrease unless the BG goes under 50. I know with Tuffy, frequently the decreases did not hold and I had to up the dose. I was also very conscious she was, at times, above the renal threshold. Perhaps one of the more experienced people will be along. Good luck, hope Gentle starts surfing blues and greens.
Good Morning: Have you checked Gentle for ketones? I was looking at your ss and saw you have taken another decrease. Is there a reason for that? Usually we do not decrease unless the BG goes under 50. I know with Tuffy, frequently the decreases did not hold and I had to up the dose. I was also very conscious she was, at times, above the renal threshold. Perhaps one of the more experienced people will be along. Good luck, hope Gentle starts surfing blues and greens.
Re: 01/11 Gentle AMPS 371
I just as curious as Barbara about the decrease. Was this because you weren't going to be home to monitor today? Inquiring minds want to know!
I just as curious as Barbara about the decrease. Was this because you weren't going to be home to monitor today? Inquiring minds want to know!
Pat or DC and Gentle
Very Active Member
Re: 01/11 Gentle AMPS 371 +8 230
Hi, well, it was my idea to try a dose decrease rather than an increase.
My rationale is; that Gentle had hit 50-60 each day and was rebounding.
I knew that an increase would begin to give him his lower numbers again, but I also believed he would continue bouncing.
So I wanted to try a small decrease, using the same feeding plan, and see if Gentle would surf back into a regular pattern of green and blue.
I wanted to try this for at least a few cycles to see if there was any movement either way.
He has no ketones, and has been in great health this week. We're trying to let the numbers go where they will??
if he remains yellow and above, we'll climb back up with the dose.
If he continues to go down in an even way, we'll stay at 2.75 until his body tells us where to go.
patrick
Hi, well, it was my idea to try a dose decrease rather than an increase.
My rationale is; that Gentle had hit 50-60 each day and was rebounding.
I knew that an increase would begin to give him his lower numbers again, but I also believed he would continue bouncing.
So I wanted to try a small decrease, using the same feeding plan, and see if Gentle would surf back into a regular pattern of green and blue.
I wanted to try this for at least a few cycles to see if there was any movement either way.
He has no ketones, and has been in great health this week. We're trying to let the numbers go where they will??
if he remains yellow and above, we'll climb back up with the dose.
If he continues to go down in an even way, we'll stay at 2.75 until his body tells us where to go.
patrick
Jill & Alex (GA)
Very Active Member
Re: 01/11 Gentle AMPS 371 +8 230
hello patrick. your rationale works well with some of the other insulins, but not necessarily so with lantus or levemir for the reasons explained in Tight Regulation with Lantus or Levemir for Diabetic Cats:
"Be aware that experimental studies in human diabetics over the last 15-20 have rejected the existence of the Somogyi effect (sometimes also called rebound). In cats, no studies have ever been done which properly demonstrate that such a phenomenon exists. Therefore, adjust the dose as described above, focusing on the nadir: don't do so-called rebound checks, as they only lead to unnecessary (and unhealthy!) hyperglycemia."
if you read through the suggested guidelines you'll see we generally make dose adjustments in increments of 0.25 unit based on nadirs. gentle is showing a very nice response to the insulin. i think you'll see an overall improvement if you choose this tried and true method.
just my thoughts...
Pat or DC and Gentle said:
hello patrick. your rationale works well with some of the other insulins, but not necessarily so with lantus or levemir for the reasons explained in Tight Regulation with Lantus or Levemir for Diabetic Cats:
"Be aware that experimental studies in human diabetics over the last 15-20 have rejected the existence of the Somogyi effect (sometimes also called rebound). In cats, no studies have ever been done which properly demonstrate that such a phenomenon exists. Therefore, adjust the dose as described above, focusing on the nadir: don't do so-called rebound checks, as they only lead to unnecessary (and unhealthy!) hyperglycemia."
if you read through the suggested guidelines you'll see we generally make dose adjustments in increments of 0.25 unit based on nadirs. gentle is showing a very nice response to the insulin. i think you'll see an overall improvement if you choose this tried and true method.
just my thoughts...
Jill & Alex (GA)
Very Active Member
Re: 01/11 Gentle AMPS 371 / +8 230 / PMPS 283
ps.............
with gentle's history of DKA, you're playing with fire by reducing the dose prematurely.
DKA is caused by low insulin levels combined with certain other systemic stresses: http://petdiabetes.wikia.com/wiki/Ketones
ps.............
with gentle's history of DKA, you're playing with fire by reducing the dose prematurely.
DKA is caused by low insulin levels combined with certain other systemic stresses: http://petdiabetes.wikia.com/wiki/Ketones
Pat or DC and Gentle
Very Active Member
Hi, great information, thanks !
the Tilly's Diabetes Homepage was very convincing and informative.
We'll go back to the level that was working well, and use that protocol as a guide.
thanks for taking the time to provide the links !
patrick
the Tilly's Diabetes Homepage was very convincing and informative.
We'll go back to the level that was working well, and use that protocol as a guide.
thanks for taking the time to provide the links !
patrick
Jill & Alex (GA)
Very Active Member
your welcome.
my own cat survived DKA... i guess it makes me nervous when i see a dose lowered prematurely with another DKA survivor.
my own cat survived DKA... i guess it makes me nervous when i see a dose lowered prematurely with another DKA survivor.
Pat or DC and Gentle
Very Active Member
thanks again, your spread sheets are amazing.
It's quite a journey.
p
It's quite a journey.
p
Jill & Alex (GA)
Very Active Member
Pat or DC and Gentle said:
lol! alex was in remission for almost 3 years when a needed dental pushed her right back into diabetic numbers. luckily, i learned a lot while she was in remission... enough to get her tightly regulated in a matter of weeks the second time. the systematic dose adjustments as suggested in the protocol work for most cats when newly diagnosed. i just had to push it a little harder the second time around...
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