12/20 Sam Siam AMPS 495 Dose advice?

Hi ya'll. Hopefully I did this correct today & you can see my link below to yesterday's condo. Sam was quite high again this morning but just waiting till things clear from his system. Tomorrow I will be off work and will do my best to get a good curve on him. Hopefully this will help to treat him further. Will update later when I get home.

Ok, so I'm home and want to say thanks for the responses and thanks to Julie (?...memory is bad) for suggesting editing the subject line. Any other opinions or suggestions out there? Want to make sure everything clears from him before increasing but don't want to wait too long either. Thank you all!!

Thx for your patience Marjorie! ;-)

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=59000

Re: 12/20/11 Sam Siam amps 495

You need a solid 3 days minimum, and up to 5 days, at the same dose, to have a stable Lantus shed.

You just went to 1 unit and have 6 cycles with that; it could take 10 cycles, ie, 2 more days, to get an accurate picture from a curve.

Re: 12/20/11 Sam Siam amps 495

Hi, Donna,
I'm a newbie, too. You've come to the right place to learn about Sam Siam's FD, and you can expect to have all the help you need from the kind and knowledgeable people on this board. Welcome!

Re: 12/20/11 Sam Siam amps 495

Just to clarify & get opinions. I have had Sam on 1.0 since Sunday morning, which would make tonight the 6th cycle, except that I don't think his Sun morn shot really went in (fur shot) which would make tomorrow during the day his 6th. I will be home tomorrow so can do a curve but won't be home part of the day Thursday so will be able to get extra tests in but not a full curve. How long should I wait till I up it to 1.25? Want to wait it out as long as I should but really wondering if he may need that extra .25. Whaday'all think?

Actually, now that I think about it, maybe I should wait till Friday to do a complete curve so it will give me more of an accurate idea of what he is running on Lantus 1.0. I just hate to test him so many times a day until he is regulated, plus his strips haven't arrived yet and we are using a lot of my hubby's & don't want him to run out. He tests a lot during the day. I am really trying to follow what you all are telling me even though it is soooo hard to see his numbers so high for so long.

Re: 12/20/11 Sam Siam amps 495

Hi Donna,

From looking at your spreadsheet, on 12/17 the +5 reading of 186 was the last time kitty had a low reading. You can see the bounce after that with the high numbers in the 500s. It takes up to 72 hours to clear a bounce, which would be tomorrow.

I would give it a couple more days at 1.0 units before thinking about changing the dose. You don't' want to up the dose too fast or you can set kitty up for a nosedive due to the increase.

Here is also the guidelines for adjusting the dose from the sticky in this forum called Lantus & Levemir - Tight Regulation Protocol

"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. < ----- You are here

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.


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.


Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

If an attempted reduction fails, go right back up to the last good dose.

Try to go from 0.25u to 0.1u before stopping insulin completely.

Click to expand...

Re: 12/20/11 Sam Siam amps 495

i agree with cathy & BJM about holding the dose right now. actually, i don't really think you'd be considered in the initial starting phase, but rather in the "increasing the dose" part of what cathy quoted above. sam siam was already on lantus from the beginning of this spreadsheet, right? so even though the dose was changing, it hasn't been below 1.0 unit on this spreadsheet. i'd think the shed that corresponds in size to a 1.0 unit dose is already there.

the reason i think you should hold is that i think sam siam is bouncing from the 186 2 days ago. the standard answer is that it can take up to 72 hours for a bounce to clear. some cats clear faster, i think at the beginning it took punkin a little bit longer. what will tell us that the bounce has cleared is that you should see some blue numbers again. if you haven't seen them by tomorrow night, i might increase then. if it looks like the numbers are coming down a bit, but it's not obvious that the bounce has cleared i might wait another day to see. but i would definitely give it the full 3 days to see what happens. i would not increase before tomorrow night.

it will help get opinions on this so you can make a decision if you edit your subject line (first post of this thread) and add "dose advice?" or "increase dose?" or something like that to your subject line. that let's people know you're looking for advice and not just reporting.

but through it all, don't get discouraged. this is truly just part of it. we go with a dose and then wait to see what it does. after a while you'll be able to read his spreadsheet and it will get easier! :YMHUG:

eta - i wouldn't worry about doing a full curve. i try to catch a +3 to see if punkin's going up or down, and again +5 or +6ish to see because that's usually his lowest point. once i see it's starting to go up i stop testing until the next preshot. just catch tests when you can. personally, i've never done every 2 hours. the most i've ever done is 3 hour intervals unless i have a reason to test more.

Re: 12/20/11 Sam Siam amps 495

Donna, I agree with the others about holding for a couple of more cycles. You definitely do not want Sam to dive too fast. I try to do tests when I can and rarely get ones every two hours. Like Julie said, once you figure out when Sam goes lowest, then you can try to always test around that time. I usually test in the AM, at Simon's +6, his PMPS and before I go to bed. If I can't get home from work, I don't test at the +6. I leave food in an automatic feeder so I can make sure he gets food during the day if I'm not there. that way, if his bg goes lower, he will have food to keep him stable until I get home from work. Of course, it is important to get as much data as possible, but don't stress about it. It is great that Sam can use your husband's strips but you definitely don't want him to run out and not have any for himself. You are doing a fabulous job with Sam!

Re: 12/20/11 Dose advice??

Donna....

You can just leave your subject as it was and add "dose advice" to the end of it so everyone knows your kitty. So it would look like:

12/20 Sam Siam AMPS 495 Dose advice?

Thanks!!!

Re: 12/20/11 Dose advice??

um, red face here. today was 72 hours. oy! i need to work on counting to 3 again! :lol: you wouldn't know i'm in a 3rd grade classroom - perhaps i can switch to preschool and brush up a bit!

so you're good to increase in the morning. i'm sure you'd like to see some lower numbers, so i'd go ahead.

No worries Julie!! :lol: :lol: :lol: Math is definitely not my thing...like AT ALL!! Are you a 3rd grade teacher? I work with ESL students (English second language). HATE it when they ask me to help with math! Gotta luv ya!

I'm glad Julie caught the number of days/hours. I sat there scratching my head and counting and re-counting!! Good luck with the dosecrease.

Welcome to LL, I don't think we've been to your condo yet. This is the best place you never want to be!
Thank goodness Liz, Zener's other bean, is an engineer because I am math impaired and who knows what sort of dosing I would sort out on my own! :lol: Paws crossed with the dosecrease. :YMHUG: