Dosing advice/guidance

Can anyone take a look at Loki’s spreadsheet and let me know how the numbers are looking or if there’s anything we should be doing differently? He had some low AMPS readings so we gave a reduced dose and then I decided to try splitting the difference and going with 1.25u.

 

@JanetNJ
Thanks Janet

 

Looks like Loki is doing a bit of bouncing from the lower blue numbers. He might be coming off the bounce now.
I’d see how he goes on the 1.25 units.
I see Diane has tagged Janet. She may have some suggestions too.

Are you giving low carb snacks during the cycles as well as the 2 main meals?

 

I don't see anywhere that Loki earned a reduction. The reduction comes by going under 90. I'd go back to 1.5.

 

So I was basing the reduction off of the AMPS readings the last few days (especially the blue) and reducing his 1.5 to 1u. This is where I was unsure because he spikes around +10-12 and his PMPS are way higher so I was thinking it was better to do the 1.25u twice a day rather than the pattern we were getting into with the 1u AM and 1.5u PM for a few days. We can go back up to 1.5u but then his AMPS were low which made me nervous.

I’m going off the ProZinc dosing sticky:
How to handle a lower than normal preshot number when following SLGS:

Until you collect enough data to know how your cat will react, we suggest following the guidelines in the FDMB's FAQ Q4.4:
Q4.4. My cat's pre-shot level was way below the usual value. Should I give the injection?
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.
• Between 150 and 200 (8.3-11.1 mmol/L), you have three options:
  • a.) give nothing
  • b.) give a token dose (10-25% of the usual dose)
  • c.) feed as usual, test in a couple of hours, and make a decision based on that value
• Above 200 (11.1 mmol/L) but below the cat's normal pre-shot value, a reduced dose might be wise.

 

I split his food into 3 portions for AM and PM. He gets 2/3 of a 5.5oz can (2 cans each day) of LC Pate and the other 1/3 split into two feedings at +3-4 and +8 with an ice cube for keeping it cool and adding extra water. This amounts to 2 main meals at 8-8:30 am/pm and two snacks at 11:30-12:00 am/pm and 4:00 am/pm plus he gets a freeze dried chicken piece after a test.

 

@JanetNJ

I guess I’m unsure about holding a dose that causes the AMPS to drop so low and then results in an afternoon bounce. I’m afraid to give him 1.5u in the AM when his BGL is 150-200 because I cannot be home to monitor him until after work. He seems to bounce a lot, even when I hold doses. It makes it difficult to know whether he needs an adjustment or not (for me anyway).

 

You can try 1.25, but if it stays high go back to 1.5. Those blue ps look like you just started a longer duration from the insulin. I'd hate to see you take a step back. What I would suggest with a lower than expected preshot is to stall without feeding for up to an hour and see if the number is going up. If it's going up Than give the full shot. If not than reduce for that shot.

 

Thank you for explaining. I will resume 1.5 for the PM shot tonight and update my little cheat sheet/chart in my spreadsheet.

 

@JanetNJ

One more request:
Can you look at my dosing guidelines tab in my SS and see if it makes sense? I print it out and keep it taped to the bottom of Loki’s box of diabetic supplies for my teenage daughter who helps me with testing and insulin so she knows the plan of his PS reading is lower than normal.

 

Looks good to me. If your stalling and it's going up but still low... Like the preshot was 100 and an hour later it's still only 120... It's risen but i would still reduce quite a bit. If after am hour it's at about almost 200 or 200+ then your good to go, ya know?