? 1/20 Edward AMPS 254

Discussion in 'Lantus / Levemir / Biosimilars' started by SnowKat, Jan 20, 2020.

  1. SnowKat

    SnowKat Member

    Joined:
    Jan 11, 2020
    (Yesterday's post)

    Good Monday morning to you all! It feels strange to be back to work after our first 3 days of starting the Lantus and monitoring Edward so closely.

    So... I am happy that Edward has had his lowest AMPS since starting the Lantus 4 days ago. However, the past two days his BG seems to have bottomed out above 200, which still seems really high to me :( I am considering increasing his dose from 1u x 2, to 1.25u x 2. (?)

    I have read and re-read the TR protocol, which I would like to implement, as he is so cooperative with home BG testing. However, with my and my husband's work schedules, we won't be able to do a +3 test. I might be able to swing a +6, and I would definitely always be able to do a +8 and onward. Is that enough monitoring to be able to do TR?

    I sure would appreciate some veteran advice!
     
    Last edited: Jan 20, 2020
    Briere Fur Mom likes this.
  2. Briere Fur Mom

    Briere Fur Mom Well-Known Member

    Joined:
    Sep 19, 2019
    Copied from the sticky dosing methods:
    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.

    I'm not one of the experienced board members but, hopefully someone can give you a definitive answer soon. IMO I think it's too soon for an increase. Edward had blue #s in his very first cycle. The #s you're seeing now are likely a reflection of him bouncing from those blue #s. An untreated kitty get's use to their glucose levels being higher. Once you begin to treat them with insulin, their #s start to decrease. Because their lil bodies got accustomed to the higher #s, when they begin to get lower #s, their liver panics and starts to dump glucose bringing #s back up. When their body gets use to the lower #s, you usually see less bouncing. ECID though. Some cats always bounce. Hope that made sense. I'm not the best at articulating:rolleyes:
    Someone else can probably explain it better than me:p
    At any rate, my reply will bump you back up for others to see:)
     
  3. SnowKat

    SnowKat Member

    Joined:
    Jan 11, 2020
    Thank you for your response, @Briere Fur Mom. I had not considered the “bounce” that you mentioned. Sounds like it will be best to "hold steady" at this point!

    Ugh, I am so looking forward to when this all becomes routine, and I'm not second-guessing myself or my interpretation of the information here on FDMB every other hour.
     
    Briere Fur Mom likes this.
  4. SnowKat

    SnowKat Member

    Joined:
    Jan 11, 2020
  5. Briere Fur Mom

    Briere Fur Mom Well-Known Member

    Joined:
    Sep 19, 2019
    It's incredibly overwhelming at first, but it will get easier. You're doing really good at digesting all of the info. And don't be hard on yourself. The confidence will come in time. There's a learning curve with Lantus and diabetes in general.
    I'm still learning, like alot of peeps on the board. Different scenarios will present themselves, which will give you experience...resulting in confidence. You've got this!!!
     
  6. Tina Marie (GA) and Jan

    Tina Marie (GA) and Jan Well-Known Member

    Joined:
    Jul 24, 2019
    Hi Kat :) I love your name - I have a friend I cat sit for; her name is Kathryn, she goes by Kat, and she also has three cats!

    I am pretty sure you can still go with TR. I am home based, and didn't have your decision to make. I started more slowly, and then went to TR. Just because you start with one method doesn't mean you can't change.
    Either way, you might want to provide small snacks for Edward in an auto-feeder, or leave food out. I know that can mean separating cats, and I don't like doing that for long periods, but I did it for a few hours at a time without a problem. Only you know how well that would go over at your house!

    I agree with Briere that it might be a bit early to increase. Since this is all new, waiting a week might be good. Our vet said stay steady for two weeks, which I couldn't do! I started to say you could increase in the morning, but increasing on a day you'll be leaving could worry you too much - ? I like increases when I can watch closer. Every person is different, just like every cat. Try your best to blend your lives a little:):cat: if that make sense. Back to, I agree with Briere about holding a little longer.
     
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  7. SnowKat

    SnowKat Member

    Joined:
    Jan 11, 2020
    @Tina Marie and Jan - Wow, that is a big coincidence - Kat, Kathryn, 3 cats, LOL! Am I sure I don't know you in the real world? ;)

    I have always free-fed all my kitties with wet food. I would have a mutiny on my hands if they were not able to graze throughout the day! I actually tried limiting them to 2 meals per day, picked up after an hour after I put them down, and my boys were having none of it. So, back to free-feeding and all is well.

    OK cool... I sooo appreciate the consensus on holding the current dose. I get anxious and want good numbers ASAP... I need to cool my jets and let the medicine do its work. I will re-evaluate this weekend, when I can observe him closely if I decide on a small increase.
     
    Last edited: Jan 20, 2020

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