? 8/30 Kirby AMPS 563; +3 585; +6 551; +9 571 ; PMPS 466; +2.75 182(Alphatrak) time to increase dose?

https://www.felinediabetes.com/FDMB...81-2-5-634-3-5-alphatrak.234315/#post-2622236

Hi! Kirby's numbers have been pretty consistently high now for the past 5 cycles. I am wondering if it is time to increase his dose of Lantus. Or... is he still in a bounce?

thank you!

 

The decision of when to increase is based on which dosing method you're using...SLGS or TR?

https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

Have you read them? If you make a decision and post again, someone will tell you...on SLGS usually the dose is held for longer than TR; no dry food in the picture on TR...

 

Which method are you using. TR or SLGS?

 

We cross posted. Lol.

 

Regardless of dosing method, you need to wait long enough for the depot to build before increasing. You'd wait a minimum of six cycles if following TR and seeing yellow nadirs, 7 days if following SLGS. However, with recent DKA, we might throw that out the window should his ketone test show anything. Tonight is cycle six after the greens, so hopefully he'll ditch that bounce tonight or tomorrow.

 

I haven't settled on a method, I just want to get him stable. I just did a blood ketone for the first time, and he has slightly more than a trace of ketones. I talked to my vet and she is not wanting me to bring him in. I am thinking we should increase his dose by .25 to try to get a handle on this. He's been in the 500's all day.

 

This dose took him down to 56. Do not increase. Did you recheck that one though? It could be a bad test or strip. Like Wendy said he hasn’t been on this dose long enough to assess. It was most likely not an accurate test based upon all your other numbers.

 

I'm sorry, I must be confused... when was he 56?

 

I just noticed a typo in my subject line. I fixed it. he has been in the 500's all day

 

I mistyped. You have a 58 at +3. Seems it doesn’t fit with the rest.

 

He was 585 at +3. I'm sorry, I think I had a typo earlier in my subject line. He hasn't been in the 50's today.

 

What number was he in the blood ketone meter?

 

1.3

 

His numbers seem very up and down. I would keep him at his current dose for now. Watch to see if he's spiking after a low number. Bouncing up and down can cause ketones also.

 

Also be aware the dosing protocols on here weren't designed from the AlphaTrak 2. The AlphaTrak 2 generally reads higher than human glucometers.

 

Could you put "1.3 ketones" in the SS notes? It's good to note the levels. Try to get another test later tonight if you can. 1.3 isn't "take him to the vet" territory yet, but you do need to keep on top of things. 2.4 is where we worry. Post on ketones and meters. Try to make sure he has plenty of liquid, adding some to his food. You'll also need to make sure he eats plenty. How is his appetite today? I'm hoping he'll break that bounce tonight. Some cats go higher before they dive down and break the bounce.

2.0 units got him down to 77, and that is without the depot being full. I suspect with a full depot he'd go lower and we don't want him below 68 on the AT. If ketones continue to rise you might have to increase, but you'd have to be ready to intervene with higher carb food.

That's because the dosing methods predated the AT, which is a relatively newly marketed meter. Dr. Jacquie Rand (who co published the TR protocol) recommended 68 as the cutoff point on the AT. At higher numbers, it doesn't matter if the AT reads higher - high is just high.

 

His appetite is good! i will try testing for ketones again before bed. And I'm prepared with high carb food if he needs it

thank you!

 

Thank you. he's staying at his current dose of 1.75