? 5/22 Phoebe Squeak AMPS 330 +4 312 Time to raise dose? Advice please. Thanks!

[J.J. and Phoebe Squeak]

5/21 Condo
Hi, Phoebe Squeak is not pretty in pink. I feel like based on her spreadsheet she needs a dose between 1U and 1.25U. I just got calipers and I'm up for figuring it out, but I'm a newbie and I wanted to know if this sounds like the right call. Any advice appreciated. Thank you.

 

[Amy&TrixieCat]

In looking at her SS, it looks like a F1.0U wasn't a good dose for her, either. I'm thinking this maybe a failed reduction...since you test frequently enough, I think I'd be inclined to go back to 1.25U and see how she does. With that said, I don't have any caliper experience, so someone else may be able to guide with really micro-tweaking her dose to something between1.0U and 1.25U. Just my two cents...hopefully others will weigh in as well.

 

[J.J. and Phoebe Squeak]

In looking at her SS, it looks like a F1.0U wasn't a good dose for her, either. I'm thinking this maybe a failed reduction...since you test frequently enough, I think I'd be inclined to go back to 1.25U and see how she does. With that said, I don't have any caliper experience, so someone else may be able to guide with really micro-tweaking her dose to something between1.0U and 1.25U. Just my two cents...hopefully others will weigh in as well.

Thank you very much for your advice. I did not yet have the calipers when I tried doing a F1, so I can't be sure the dose was always exactly the same. Thanks for looking at her SS and giving us your 2 cents. It's worth much more!

 

[Jill & Alex (GA)]

In looking at her SS, it looks like a F1.0U wasn't a good dose for her, either. I'm thinking this maybe a failed reduction...since you test frequently enough, I think I'd be inclined to go back to 1.25U and see how she does.

I agree with Amy.
Between frequent testing and the fact that it looks like it's been relatively easy to bring her numbers up I wouldn't hesitate to take the dose back up to 1.25u.

 

[J.J. and Phoebe Squeak]

I agree with Amy.
Between frequent testing and the fact that it looks like it's been relatively easy to bring her numbers up I wouldn't hesitate to take the dose back up to 1.25u.

Thank you very much. I thought since 1.25 sent her hypo twice -- a couple weeks apart -- that it was too high for her. But as you say, I test often and I was able to bring her numbers up quickly with a small amount of HC food. I'll give it a try at 1.25 again thanks to you & Amy and I'll keep a close eye on her.

 

[Jill & Alex (GA)]

Thank you very much. I thought since 1.25 sent her hypo twice -- a couple weeks apart -- that it was too high for her.

You're welcome.

We encourage members using Lantus, Basaglar, and Levemir to differentiate from low numbers vs symptomatic hypoglycemia, when following a tight regulation protocol.

After all, there's a reason for requiring frequent monitoring when following a TR protocol. Reductions aren't taken until kitty drops below 50 mg/dL. It's also suggested reductions aren't taken for long term diabetics until kitty drops below 40 mg/dL once... not to mention the TR protocol we use here on the FDMB recognizes there are some cats that are difficult to regulate and do well when BG numbers greater than 40 mg/dL are held within that range.

Make sense?

 

[J.J. and Phoebe Squeak]

You're welcome.

We encourage members using Lantus, Basaglar, and Levemir to differentiate from low numbers vs symptomatic hypoglycemia, when following a tight regulation protocol.

After all, there's a reason for requiring frequent monitoring when following a TR protocol. Reductions aren't taken until kitty drops below 50 mg/dL. It's also suggested reductions aren't taken for long term diabetics until kitty drops below 40 mg/dL once... not to mention the TR protocol we use here on the FDMB recognizes there are some cats that are difficult to regulate and do well when BG numbers greater than 40 mg/dL are held within that range.

Make sense?

I appreciate your wisdom and I'm still trying to absorb all this new info. I can tell you are an expert, so I hope you don't mind another question -- Based on T.R., what should I do if raising the dose to 1.25 causes her to go below 50 again (on a human meter) but she has no symptoms? Is that when I should try to find a dose between 1U and 1.25U? Thanks again.

 

[Jill & Alex (GA)]

... I can tell you are an expert...

We do not have any experts on the FDMB. Rebecca, the founder and owner of the FDMB wants that very clear. With very few exceptions, we're all laypersons... simply paying it forward.

Based on T.R., what should I do if raising the dose to 1.25 causes her to go below 50 again (on a human meter) but she has no symptoms? Is that when I should try to find a dose between 1U and 1.25U?

At that point you *could* try to find that in-between dose.

However, speaking strictly from experience and looking at Phoebe's spreadsheet, it's usually best to learn how to manipulate the curve with food. Look at her ss on the 1.25u dose. Sure the 1.25u dose dropped her to 67 (AT) and 41 (meter calibrated for humans), but look at the rest of that cycle as well as the other cycles on 1.25u bid. Her BGs fall anywhere from double digits to the 300s.

Our goal is a flat cycle under 100 overall. All too often we've seen failed reductions and then the need to take the dose right back up after a single drop under 50. Personally, I'd rather see kitty "earn" a reduction from maintaining lower BGs with a flatter cycle for a week than to reduce the dose based on a single drop below 50 when the rest of the cycle's numbers remain high.

How to get there? I found the most effective method is to manipulate the curve with food. I've gone into detail in this thread: Using Food to Manipulate the Curve. By incorporating this method you'll raise the curve... which allows you to get more insulin into the cat... which will serve to lower the entire range without letting kitty bottom out.

Check it out. Post any questions you may have. I don't post much any more, but there are several others including, but not limited to @Sienne and Gabby (GA) , @Marje and Gracie , and @Gill & George who are well versed on the subject.

 

[tiffmaxee]

I think you’ve waited long enough and I’d go up as well. I am one that used digital calipers because Max was a bouncer and needed smaller increases and decreases. I also liked them because syringes sometimes vary by a lot as the markings aren't perfect. For a human that doesn’t matter but for a cat it can.

Here’s a video on using calipers made by Marje.


http://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/#post-862835

 

[J.J. and Phoebe Squeak]

I think you’ve waited long enough and I’d go up as well. I am one that used digital calipers because Max was a bouncer and needed smaller increases and decreases. I also liked them because syringes sometimes vary by a lot as the markings aren't perfect. For a human that doesn’t matter but for a cat it can.

Here’s a video on using calipers made by Marje.


http://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/#post-862835

Thank you so much for chiming in and sending the link. I did go up to 1.25 last night, but this morning (Thurs) it was the dreaded FUR SHOT! Ugh! I know she will be off for a few cycles now. Thanks again for your help.

 

[tiffmaxee]

So now you have a little break from extra testing. Take some time for yourself!