Dose increase time?

After a weird AMPS yesterday I am a little nervous to increase, but all signs point to yes. I guess I just want some verification before I go to 1.50.

 

I wouldn't............you reduced him by .50 the other day and he shows a bounce and more then likely needs some time for the dose to settle with his depot. If you keep increase or decreasing the dose you'll get bounces and numbers all over the place. Even tho the numbers are high, I'd keep this dose for the period the SLGS states.

 

So here's the dilemma....

I know you're following SLGS and the "rules" are a bit different. With TR, if you change the dose (e.g., shooting a reduced dose like you did yesterday), your shot clock starts over. With SLGS, given that doses are held longer, I suspect it's OK to increase the dose.

FWIW, I don't think the AMPS yesterday was weird. If you look at the PM cycle, you see that numbers were dropping from PMPS. The numbers dropped almost 200 points from PMPS to +4. That's a big drop and it carried through until your AMPS. The numbers then bounced up due to a combination of the reduced dose and the lower than usual numbers. For the future, when you get a lower than expected pre-shot number that you're not used to shooting and you opt to stall, if the next test is a rising number (more than about 20% of the first test number), it's likely that you're good to shoot.

 

Well said Sienne!

 

Given where he’s at today (much higher than usual), I feel like I should increase to 1.50 but I’m also worried that this is a bounce and than I’m going to cause more of a bounce by increase. @Sienne and Gabby (GA) @Shawna & Davidson - what do you guys think? He’s been on 1.25 for a while and seems like his numbers are even more all over the place than at 1 unit. Ugh, I know I need more patience, but I’m so scared I’m not doing the best thing for him. Increase? Or wait?

 

I know this isn't what you want to hear but bounces are inevitable. To some degree, every cat bounces -- some just seem to do it a LOT better than others! The problem is that if you don't increase, your cat sits in high numbers which is not good and there's a good chance that glucose toxicity will develop (i.e., your cat gets used to being in high numbers and it's harder to get them to get used to lower numbers. In other words, the potential for bouncing increases.)

This is my long winded way of saying it's fine to increase the dose.

 

Thank you so much. I’ll increase his dose tonight to 1.50. Is there anything else I can do better to help him come down and stay down? Am I missing something, or is this just part of FD and I need to get used to it?

 

The biggest lesson Lantus will teach you is patience. We all desperately want our kitties to feel better and get into being regulated as quickly as possible. Ninja was diagnosed less than a month ago. I'd suggest tempering your expectations or you will be bald from pulling your hair out in short order.

 

Take a look at Davisdson SS............I have NO patience, yet I have to try as he has been increased when in my mind I want him to decrease. Sienne is right - sometimes we have to increase to boost the system and get the numbers to drop. Now Davidson is surfing the greens and I still hope to be able to decrease the dose and get him into remission a second time - I have no choice, it is all Davidson and how he adapts to the doses. WE ALL do what we can and hope for the best.........just takes time.

 

@Sienne and Gabby (GA) and @Shawna & Davidson thank you both I guess was just feeling like I was failing Ninja. It helps tremendously to know I’m not alone and that this process is exactly what I’m seeing. I increased his dose to 1.5 today, so we’ll see how he does. Would my feeding schedule be effecting his numbers? (I feed him four times a day, but it’s out until he finishes it. I only take it away about 2 hours prior to shot time, if it’s not already gone.

I did also check out Davidson’s SS, you were able to get his numbers down fairly quickly - are you doing TR? If so, is it as intimidating as I think it is? (I’m ridiculously paranoid of a hypo episode, especially since my husband and I are out of the house SO much during the week).

At any rate - I am so thankful for you both, and your time. Also very thankful for the amazing community here.. it’s been a life saver for Ninj and I both ❤️

 

It's hard to know how food may influence the cycle. Cats differ widely in that regard. I tend to encourage people to feed their cat prior to nadir. If you feed later in the cycle, there's less insulin available to offset the effect of food.

 

Oh, that makes sense. Thank you!
If you have a moment, would you be willing to give me some input about Ninja’a SS yesterday and so far today? I don’t know if it’s a bounce, or if it’s something else possibly? The numbers are staying high and steady.

 

ECID so what works for Davidson may not for others..........he recovers from bounces quickly but remember this is his second time on insulin after coming off remission from his DX 4 yrs ago. I do the TR, but I am home 24/7 if need be so it's easy for me. Intimidation is about confidence and knowing your cat. Last week Davidson was in the "hypo" range but showed no signs, but I was here the ENTIRE time beside him. Some CG's can't do that so you need to use your own level of knowledge, confidence and experience and then decide. I think the SLGS method is best for you since you're not home to monitor Ninja.

 

I'm just getting back on the Board -- sorry it took so long to reply to your question.

It'a possible that this is still a bounce. However, I tend to think that Ninja likes pink.

Is there a particular reason you opted to follow SLGS. It seems like you're getting enough tests in to follow TR. With TR, you could increase the dose after 6 cycles.