? 8/2 Chandler - DOSE REDUCTION HELP - AMPS 192; +2 153; +7.5 77; PMPS 102; +3 58; +3.5 59; +4 74

Discussion in 'Lantus / Levemir / Biosimilars' started by Ashley & Chandler, Aug 2, 2020.

  1. Ashley & Chandler

    Ashley & Chandler Member

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    May 27, 2020
    Have been trying to post this since ~12:45AM (EST), but kept getting a server error...

    So the other day he had an AMPS reading of 41, so I panicked & posted on here, but I was skeptical because of the food he had been given the night before, so I tested him again 10 min later & he was at 185 & then 196 10 min later, so with some discussion on my post we concluded a likely bad test strip.

    He had been running a bit high the past day or so & his PMPS last night was 195, so I gave him the usual 5.5U dose (around 7pm) & then I had to leave. Got back home to test at the +5.5 mark & it read 49 - due to the bad strip previously, I tested again (only like 3 min later though) & it read 50, so I’m pretty sure it was accurate this time.

    Since it was right on the cusp of the limit for earning a reduction, I was wondering what to do for his AM dose, but since the forum was down I was not able to seek advice before this morning.

    I thought he would probably be high this morning because I was more panicked since I couldn’t get advice & gave him more than just 1-2 tsp of HC food, but he was only at 192 this morning.

    I did do a 0.25 reduction for the AM shot & gave him 5.25. I was wondering though since I have increased by 0.5 at a time if I should have also decreased by 0.5?

    As can be seen in his SS, he tends to go lower later in AM cycles & was just at 77 at +7.5. Wondering what I should do with the PM dose - keep the reduced 5.25 or reduce to 5?
     
  2. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
    Tagging @Wendy&Neko since Chandler is a higher dose cat.
     
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  3. Ashley & Chandler

    Ashley & Chandler Member

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    May 27, 2020
  4. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    With TR, and kitties that are considered long term diabetics (over a year since diagnosis), a reduction is earned when they go under 40. Some people with cats that don't hold reductions well, go to a method of three times under 50 on three separate days (or once under 40) . Since Chandler was diagnosed in Feb last year, he is considered a long term diabetic. Last night would be considered the second time under 50 on 5.5 units. So tonight would be back to 5.5 units.

    Has Chandler ever been tested for any of the conditions that need a higher dose, such as IAA (insulin auto antibodies) or acromegaly. If so, and the positive for either, I might change my dosing suggestions.
     
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  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
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  6. Ashley & Chandler

    Ashley & Chandler Member

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    May 27, 2020
    Okay, I read about the 40 as well but wasn’t sure how long was considered long term. Even with the minor reduction he has done ok today but I will go back to 5.5 tonight then. So if it goes below 40 once or one more time below 50 then he would get a reduction?

    No, he has not been tested for either of those.
     
  7. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    Yes. That’s correct.
     
  8. Ashley & Chandler

    Ashley & Chandler Member

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    May 27, 2020
    Since I had gone up by from 4-5 by 0.5 at a time, would I reduce by the whole 0.5 or still just 0.25?

    Gave him the full 5.5 tonight & he was just at 58 at +3 (PMPS 102).

    @Wendy&Neko
     
  9. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013
    I think you should reduce by .50. Hoping Wendy replies. I’d check again in about 30 minutes.
     
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  10. Ashley & Chandler

    Ashley & Chandler Member

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    May 27, 2020
    Just checked again at +3.5 & it is 59
     
  11. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I’d feed a little low carb and check again in 30-45.
     
  12. Ashley & Chandler

    Ashley & Chandler Member

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    May 27, 2020
    Sorry, just saw this - haven’t fed anymore yet but just tested again at +4 & it was 74
     
  13. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    That’s good. Don’t feed and get one more test but looks looks good.
     
  14. Wendy&Neko

    Wendy&Neko Senior Member Moderator

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    Feb 28, 2012
    Over 5.0 units total dose, you can make 0.5 unit changes. Though you can do smaller changes if you want to tweak what is already a fairly good dose.
     
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  15. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I’m confused. Why did you go back to 5.5? A reduction was earned to either 5.25 or 5.5. That’s not just for one cycle.
     
  16. Ashley & Chandler

    Ashley & Chandler Member

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    May 27, 2020
    I was going based off of this post from @Wendy&Neko:

    Since he is considered long term, based on the numbers I have, he has not gone under 50 3 times or below 40 once, so he did not actually earn a reduction. I had given him the 5.25 based on the one time below/at 50 which was the other night when I was unable to post on the forum, so could not get the advice given yesterday - if I had been able to post & received Wendy's advice, I would have stuck with 5.5 yesterday morning.
     
  17. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    You are correct. I missed the long term part. :p
     
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  18. Ashley & Chandler

    Ashley & Chandler Member

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    May 27, 2020
    hahaha :D
     
  19. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I did three times under with Max before a year because he didn’t hold reductions. It helped regulate him.
     
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