1/29 Stu AMPS 423, Dose increasing Question

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Ella & Rusty & Stu(GA)

Ella & Rusty & Stu(GA)

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yesterday: viewtopic.php?p=41474#p41474

Hi Everyone, Stu's numbers are still high, but I'm going to stick with the 1.5 unit dose today and see what happens. I'll get another reading this morning at +3. Stu is behaving normally. Water consumption and urine production seem higher, but both have always been on the high side since he was diagnosed 4 years ago. He was patient this morning while receiving his test. Ears seem OK. I'll post again in mid morning, after the +3 test. Thanks so much for watching and for helping.
Ella
 
Re: 1/29 Stu AMPS 423, +3, 335

Stu was not very cooperative at +3, but we're happy that his BG came down to 335. Onward to +6 in a few hours. Thanks for watching!

Ella
 
Re: 1/29 Stu AMPS 423, +3, 335, +6, 363

Hi again. The +6 reading is higher than the +3. How should I interpret this? Stu ate 1.25 oz. of wet food a little over an hour before the +6 test, so I think that might be a factor. If his +9 and PMPS numbers are high, should I increase the insulin dose to 2 units this evening (it will be the start of the 3rd day at 1.5 units)???
Stu thanks you, as do I,
Ella
 
Re: 1/29 Stu AMPS 423, +3, 335, +6, 363

Hi Ella
You are doing a great job in testing Stu.
Whenever you have a dosing question, edit the first post of the day and add the words Dose advice.
I am not here long enough to give that advice but I will mention the following to you.
Plese reveiew the sticky which talks about filling the shed, and review the protocol again.
According to your ss, tonight will be your 5th cycle at 1.5.
You will get the help here so do not worry.
The Mantra in this group as well is, patience.

Keep up the terrific work taking care of Stu.
 
Re: 1/29 Stu AMPS 423, +3, 335, +6, 363

Hi Ella,

You are doing great! Sounds like Stu is too - getting used to the testing. I too am not one to give advice, but do read the sticky's on protocol and filling the shed. they helped me immensely. patience is the mantra.

You are doing an awesome job caring for Stu - others in the know will be along to help with your dose questions. Do however edit the subject line to include "dose advice" - they find you faster that way.

Keep up the good work! Stu is one lucky kitty to have you for his mama bean!
 
Re: 1/29 Stu AMPS 423, +3, 335, +6, 363

If his +9 and PMPS numbers are high, should I increase the insulin dose to 2 units this evening (it will be the start of the 3rd day at 1.5 units)???
Click to expand...

I would wait it out till u get to ur PMPS number...but yes, do add "dose increasing Q?" to ur first post subject line to catch the attention of others.
 
Thanks to everyone for their advice. At +9 Stu's BG was 412. I expect to see it higher at PMPS. Should I go up to 2 units this evening?? (It will be 48 hours.) Here is the recap of the day:
AMPS 423
+3 335
+6 363
+9 412

Re-reading the protocol and the article on the storage shed, I guess I could go either way: a) keep the dose at 1.5 for another 24 hours and see what happens (to fulfill the 3-day starting-dose suggestion); b) up the dose to 2 units because Stu is staying above 300, because his curves are pretty flat, and because he has been on insulin for 4 years and has never been on a dose lower than 2 units bid (that was his starting dose on PZI Vet in January 2006. His PZI dose had gradually increased to 5 units bid by last October, when PZI Vet became unavailable).

I'll check the message board again after I record the PMPS. Whatever dose I shoot, it should be close to 7 P.M. EST (it is now 4:40 P.M.)

Thank you all. Your help and concern are so much appreciated!

Ella
 
Ella & Stu said:
The +6 reading is higher than the +3. How should I interpret this? Stu ate 1.25 oz. of wet food a little over an hour before the +6 test, so I think that might be a factor.
Click to expand...
Food may be a factor. The difference may also be meter variance -- there can be as much as a 20% variation in numbers if you tested twice in a row. It may also be that Stu's numbers are rising. We don't yet know where his nadir is and nadirs can change, they are not always at the same place in the cycle.

Ella & Stu said:
If his +9 and PMPS numbers are high, should I increase the insulin dose to 2 units this evening (it will be the start of the 3rd day at 1.5 units)???
Click to expand...
I would encourage you to hold this dose. It's not yet 6 cycles on this dose. In addition, you are needed to deplete the shed from the 4.0 units where you started. You were seeing some rebound yesterday from the blues and greens resulting from the higher dose.
 
I second Sienne with respect to the 'hold the dose' for now. We are sticklers for the Protocol for many reasons.... one being cat safety. 6 cycles of a dose before considering increasing - sometimes even longer.

Also, when you will be ready to increase the dose (consider info on 1st para), we typically only increase the dose by 0.25U. Only cats in need of agressive dosing because of other medical conditions increase by 0.5U.

Tizon was on PZI too when he started. I wouldn't compare the two insulins.... but that's just me. Consider that you started a entire new chapter when you started with Lantus. It will be easier on your brain.

Hang in there, you are doing well.
 
I know this is frustrating but the sugar dance is a stroll, you can't rush ahead.

It looks as if you have some rebound clearing from lower numbers. You need to hold a dose for at least 6 cycles. As you've dropped from a large dose, it may be worth hoding it one or two cycles longer. The numbers will be your guide.Other thing is that you just don't have the data right now. There's a possibility of a foodspike if eaten and tested within 2 hours. Some kitties are more carb sensitive than others, again in time you will know which one your cat is.

Sienne and Helen are right, you would only increase by .25u, so you don't miss ideal dose.
I know you said he's been on insulin for 4 years. My friends cat was on caninsulin for 3 years at 5u-she didn't know any better, but his numbers were always high (you can guess why), so that isn't to say Stu's ideal dose is as high as this.

What I hope has already been advised is that you get Ketodiastix from the pharmacy and check for keytones ('essentially' a lack of insulin). When looking for ideal dose it's something you should monitor. Just dip in the urine stream.

All gut, your doing great :mrgreen:
 
You're doing great, Ella. I know the high numbers can be very frustrating.

I do think that you should hold the dose through tomorrow (6 cycles), but if you do not see a nadir below 300 then you can increase to 2u (a 0.5u increase). This is what the protocol calls for with nadirs above 300. The first cycle on the 1.5u dose doesn't count IMO as that blue was all from the previous 4u dose.

As per Tilly:

However, if the cat is producing continuously high BGs (nadir always >=300 mg/dl), only hold the dose for 2-3 days before increasing it by 0.5 IU. Alternatively, if the cat is continuously producing moderately elevated BGs (nadir always >=200 mg/dl), increase the dose every 2-3 days by 0.25 IU

See what tomorrow brings once rebound has cleared. It can take up to 72 hours for rebound to pass.
 
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