Thomas 4/19 362 AMPS 3+ 310 4+ 345 5+ 360

[Sonya]

Thomas has been relaxing on the bed all morning so I have extra blood tests. Evidently living the life of leisure raises your blood sugar! I am officially kicking his butt out the door.

Based on his numbers today, I believe it will be safe to bump him up to 2 units tonight. I appreciate any insight. You have all been very supportive and helpful.

Sonya

 

[BJM]

If he isn't a grazer, you might see if it helps to freeze 1 can of the FF and put it down with 1 fresh can, so he can't eat all of it at once. It may let the insulin bring him down a bit better by reducing any food spike. Some cats have a obvious upward jump if they eat a lot all at once.

Maybe do that first and hold the dose another 2-4 cycles (1-2 days). Remember - Lantus doesn't do quick changes and you could overshoot the best dose if you go too fast.

Or, if the others think it reasonable, maybe only increase 0.25 units - a "read between the lines" measurement. I find that clip on magnifiers to my glasses really helped wiht that!

 

[carolynandlatte]

Hey Sonya!
Looks like you're getting some good practice in with testing! Hope that Thomas is getting lots of yummy treats! :mrgreen:

It's a tough call what to do since you are going out of town and your neighbor may not be able to test. Most people end up reducing the dose if the cat cannot be tested. Any luck on teaching your pet sitter?

Here is the protocol if you are following tight regulation (meaning you are testing frequently):

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.

On one hand, it looks like he is probably staying high/flat everyday (but we don't know for sure). In that case, the .50u would be a very reasonable increase.

On the other hand, you are going out of town. It is unclear if your sitter will be able to test (even preshots). To increase a dose and give it blindly for days at a time seems risky.

You could compromise with a smaller increase (still risky), but the 1.75 will be challenging for a petsitter to accurately dose.

*sigh* I dont know if I feel comfortable offering any suggestions. If you were going to be home/test, I would say bump it up per protocol (.5u). What do you think?

 

[Sonya]

To complicate matters, the timed cat feeder I ordered arrived today. So, instead of increasing his dose tonight, I'm thinking I will give him a can of food as usual, then 1/2 can four hours later and the other 1/2 8 hours later.

I don't want to change the diet and the dose at the same time, the last time I changed his diet his numbers dropped to that scary range.

I am leaving Saturday morning so I will be able to check tomorrow morning, evening, and Saturday morning.

It is so hard to know the right thing to do. We all just want what is best for them and to help them feel better.

Sonya

 

[BJM]

Go with Safety first.

The timed feeder and the same dose seems safest to me, although I'm not sure about the time intervals. You might take a look at Sienne and Gabby's spreadsheet to see how she portions it out - it looks like most food is towards the 1st 6 hours, when the Lantus is kicking in and eased off when the Lantus is wearing off, to try to match the glucose increase to the Lantus onset and duration.