? 05/03 Benny AMPS 499...+10 80 PMPS 209 dose question

Discussion in 'Lantus / Levemir / Biosimilars' started by Ben&Squirrel, May 3, 2022.

  1. Ben&Squirrel

    Ben&Squirrel Member

    Joined:
    Mar 18, 2022
    https://felinediabetes.com/FDMB/threads/4-2-benny-amps-454-pmps-498.262779/#post-2945186

    Yet another dose question. Ben had a dose increase this morning to 1.0u. He went from 499 to 80 to 209 in one day. He ate a little in the afternoon, so unfortunately I can't say whether the nadir would have gone any lower.

    His nadir was 80. Does this mean he should get a reduction...back to where he was yesterday?

    I'm thinking about this part of the SLGS instructions: "A4.4. There's no hard and fast rule, but if you don't have data on how your cat responds to insulin, here are some general guidelines.
    • Below 150 mg/dl (8.3 mmol/L), don't give insulin."
    I am not sure how he will respond to the insulin, given how his nadir is not consistent in range or time. He responded so strongly to the increase that I fear what he would do when I am asleep.

    However, just not giving insulin after a single dose increase seems like a recipe for a bounce?

    Ideas, @tiffmaxee @Bandit's Mom ?
     
  2. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Yes, he’s earned a reduction by falling under 90. He is bouncing from the 80 bg.
     
  3. Ben&Squirrel

    Ben&Squirrel Member

    Joined:
    Mar 18, 2022
    So, down to .75 tonight, or lower?
     
  4. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Reductions are always .25. Back to .75.
     
  5. Ben&Squirrel

    Ben&Squirrel Member

    Joined:
    Mar 18, 2022
    Done. The 1u was fun while it lasted. :facepalm: Go back to it again in the morning, or stay at .75 for 7 days? Thank you once again!
     
  6. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Stay at .75 for 7 days.
     
  7. Bandit's Mom

    Bandit's Mom Well-Known Member

    Joined:
    Oct 18, 2019
    Just for future reference, bounce breaking cycles have greater donward momentum and later nadirs. You want to slow him down by feeding a little food. Not sure if you fed him, but a little food at +7 and +8 and even +9 would have been good. The idea is to keep them at a good dose as long as you can by intervening with food.
     
  8. Ben&Squirrel

    Ben&Squirrel Member

    Joined:
    Mar 18, 2022
    I did feed him a little at +7 but wasn't sure I should have. He was hungry! So if I can keep him above the danger zone with food, it can keep him on the full dose of insulin? This makes total sense now; I wasn't sure it was okay to feed him with the snacks he has been getting. Will try to manage him more with food when he is dropping!
     
    Bandit's Mom likes this.

Share This Page