Melissa and Celle said:
I'm a little disappointed that Celle's settling in to 0.6 seems to have left her higher rather than lower. But she's still flat. Is it time to try 0.7 again? I'm assuming that even the low 400s aren't rebound here given how high she's staying. Does that seem right?
There doesn't look like any rebound going on here to me. If this were Tigger I would be increasing the dose according to Tilly but in smaller increments than .25 units for Celle like you have been doing. Use Tilly as a
guideline to gradually move up the dosing scale until you see some better numbers.
(underlining below mine)
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
"Many Lantus and Levemir users in this forum have been successful following a somewhat modified version of this Tight Regulation Protocol for the last few years. These "general" guidelines are based on anecdotal evidence and personal experiences of laypersons frequenting the forum.
"General" Guidelines:
* Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
* Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
* Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Increasing the dose...
* Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose.
* 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.
Reducing the dose...
* If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit.
If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.
* If an attempted reduction fails, go right back up to the last good dose.
* Try to go from 0.25u to 0.1u before stopping insulin completely.
Random Notes...
* Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.
* A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
* Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose."
Also Melissa, I am not sure if you have printed off the instructions in the event a hypoglycemic event occurs. Not to scare you but just so you are prepared in case. Plus just having the higher carb food in the house (listed in the Tool Box) gives you some peace of mind too.
jojo's post on what to have in your Hypo Tool Box:
http://www.felinediabetes.com/phorum5/read.php?8,1661316,1661798#msg-1661798
jojo's list of hypo symptoms:
http://www.felinediabetes.com/phorum5/read.php?8,925783,925783#msg-925783
Melissa's post on how to recognize and treat hypoglycemia:
http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122
One more thing...sometimes you have to go up in the dose before you can start coming down again. This is because of the glucose toxicity that has built up from the high numbers causing possible insulin resistance.
Any health problems that you are aware of going on with Celle?
