1.14 Fa /amps 351/pmps 358/+3,304/+5,311/+7,306

http://www.felinediabetes.com/FDMB/...ps-353-3-277-5-284-7-281.224259/#post-2508741

Yesterday.

 

@Wendy&Neko

I think I will leave the increase to Friday night instead and do curve on Wednesday. I still cannot get past my fear of leaving Fa home by herself for the first few cycles.

Her onset seems to be from +2.5 possibly. I did not test +2 and wonder what it would be like.

Last night (Jan 13) the drop seemed to be slightly better maybe because we tried to give her more game/exercise time. Our vet did say preferably Fa can lose a bit weight (in a healthy way). She does need to move more I think.

 

It may be too late, but I wish I could convince you to increase sooner. All this time above renal threshold is not good for Fa. With just high yellows, you probably have several increases yet before you get get anywhere near to dangerous numbers in green. Tomorrow is day 7, you are holding the dose overly long even for SLGS, much less TR. Which means more glucose toxicity too, and ultimately having to increase even higher. If you increase Wednesday morning, you will still have two cycles you can observe.

The earlier onset is good for you. Testing just after onset and comparing it to preshot is a good indicator of how the cycle will go, and whether you need to leave out higher carb food for that cycle if you cannot be home.

 

Thanks Wendy. I did not check the message until the shot was given this morning.

I do understand that it is better to increase earlier, but in the long term I think I can only do SLGS and from the Wednesday in February, I can only be home for half day, so I won’t be able to try new dose until weekends anyway. Since Fa is on such high dose, I really feel scared to just dose her and leave her home by herself.

We been monitoring Fa for the first few cycles on Lantus, so it becomes a habit. With Lantus usually Fa had her nadir on it before +5, which made it easier to monitor and do the increase.

 

The thing about high dose kitties, is there is usually a reason for the high dose. Whatever is causing that insulin resistance does not stay static. You have to keep on the increases or you fall even further behind. Yes it's hard leaving a kitty if you can't test. But even if Fa was on a low dose, I would be confident increasing at this point. You have had 12 cycles at this dose and her nadir is no where near between 90 and 149, which is where you would continue to hold the dose. Even with SLGS you could increase tomorrow. SLGS has plenty of room built in for safety.

 

Looks like Fa has pretty flat cycles (not much bouncing) like my Freckles. We are on similar doses except I'm still using Lantus. So how it was explained to me is that even though I'm increasing by .5 u, it is really only an increase of 10%, but when a cat is at 1 u and increase by .25 u they are actually increasing by 40% - that's where I think if one dose increase is going to make a huge impact, it would likely be at the lower dose level - am I computing this correctly @Wendy&Neko?

 

Not quite @Judy and Freckles A 0.25 unit increase is 25% for a 1 unit dose. But a 0.5 unit increase is a 10% increase at 5 units, an even smaller percent at 6 units. And you are correct that a 0.25 units increase at the larger dose is pretty much just like fattening the dose, something we only do if we are on a dose seeing green, and want to tweak it a bit.

 

Thanks Wendy for your patience with us. I thought about future increase and so I think it’s better to do it on Friday night. If I did it this time on Wednesday, I think next time I would still hope to do it Friday night, so I guess I will start it with this time. I have been staying up late recently to try to test till +7 (1am) so I have been quite tired lately. I hope that if I do the increase on Friday night, I then can keep an eye on Fa for the first few cycles. Hopefully she can stablize on the 5th cycle (Sunday night) and I will know the pattern of onset and nadir, then I can relax a bit and sleep earlier on Monday night and Tuesday night with testing maybe only till 11pm (+5). On Wednesday then I can do a curve when i am home. I can then again sleep earlier on Wednesday night and Thursday night.

I feel sorry that this is the best I can do but i need to really ensure I got enough energy for work and caring for Fa in the long term.

Fa got her insulin in the morning 6am so basically I could sleep from 1am to 6am only and if lucky, I could sleep maybe another 30 minutes or 1 hour after insulin is given. It’s been tough.