1/9 Thumper AMPS 438 +6 479 PMPS 452

I've only posted here once so I hope I'm doing it right.

Thumper was on Pro Zinc for about 8 months & we were getting no where. I switched to Lantus in Dec & at first she was doing great, here lately not so much. I decided to go back up to 1 unit after trying to reduce to .75 after getting a 39 last week. I was going to try to get between .75 & 1 unit but I just can't see that well so tonight I just went with a full unit. Any opinions?

Thanks!

Barbara & Thumper

Hi, Barbara. Glad you stopped back.

What this looks like to me is that Thumper is bouncing. You got that 39 and she bounced. 72 hours later on 1/3, you got a blue nadir and Thumper bounced in response to the low number. 72 hours later, same thing. If it's not completely obvious, it can take up to 72 hours for a bounce to clear.

What's complicating matters is that you fattened Thumper's dose last night before the full 72 hours. Generally, you don't want to raise a dose until the bounce clears. In addition, with Lantus, there's a phenomenon called new dose wonkiness (NDW). When you raise the dose, rather than bringing numbers down they way you'd expect, numbers go up for a cycle or two. That may be a factor in today's numbers.

Thumper is probably bouncing from that 88 on January 6th.
Sometimes bounces can take 3 days, or 6 cycles to clear.
So, normally, we would encourage you to wait out the bounce, for the whole three days, if that's what it takes.
I guess you didn't know, and increased after only two days. I know how hard it is to see those doses. Especially those ones between the marks :roll: I got reading glasses for my first time, just to help me with those doses, and now, I'm more blind and need the ding dang reading glasses to see anything up close with.

welcome to Lantus Land, Barbara!

I would encourage you to monitor the next few cycles. As the others said, we usually try not to increase the dose in a bounce (but I would have been tempted to do the same thing). Just monitor closely in case she decides to drop when the bounce and New Dose Wonkiness (NDW) clears. That might take a few cycles.

Some cats bounce more than others. My Lucy was a bouncer at first and it drove me nuts, but she did eventually stop. Typically the bounces get shallower and shorter as time passes. Thumper had a nadir of 88 on 0.75u. We try to aim to get the nadirs where we want, and then usually the preshots will come down to meet the nadirs, eventually. We can always make some tweaks, but usually once a cat starts getting blue and green, we slow dose increases down to 10 cycles instead of our usual 6, and sometimes we'll wait longer than that if the numbers call for it. I think you're pretty close to a good dose, so we're looking at fine-tuning now. I know it doesn't look like a good dose yet. :roll:

Hi, guys!!!!!!!!


from celi & Bambi-Binks

Hi Celi, I love your pictures! You always make me smile.

Ok guys, I'm following you on the bouncing until the 6th. She typically goes lower when I give her fluids, which is what happened the night of the 5th. She went down to 88 the next day & started bouncing but I don't see where that bounce has ever cleared. I'm not getting the 199 on the evening of the 7th as being that low to cause another bounce. What also puzzles me is that she was doing much better in the beginning, up until that 39 & I lowered the dose, that's what keeps bugging me, like she's not getting enough insulin again. Was the 39 just a bad reading? I never thought to double check it. When I increased last night I just shaved one drop off the 1 unit....honestly I don't know that the .75 was much different, which is way I just gave up & shot 1 unit tonight. The other thing that is in play here is the vial. I started using it on Dec 15th and I know when I first started using it I let go of the plunger & it sucked back up into the pen. That was early on though so I don't know if that would just shorten the life of the pen? Also there is a huge bubble in it but it is still clear. I was having a heck of a time drawing the insulin out at first, it was just dripping into the syringe...very slowly but now it's not doing that. It's pretty different than ProZinc vials so I don't know if I damaged it somehow. I'm going to use a new pen tomorrow. I'm really just puzzled why she doesn't seem to be coming off that last bounce. I'm impatient also & was so happy to see good numbers at first. :YMSIGH:

Going to get a +4 which will probably be my last for the night. I will post it in a minute.

+2 - 489
+4 - 359

Also, as I get later tests in am I still supposed to edit the subject line & add them? Seems like that would get to be too much? Do I delete the beginning numbers?

confused_cat

she might have gone lower than the 199, in fact it's fairly likely that she was lower. We don't really know when her nadir is yet. Some cats bounce off of blue at first too. On top of that, it's common for the numbers to go UP instead of down in the first 3-4 cycles when you increase the dose. She has dropped quite a bit since +2, so hopefully she is on her way back down.

One thing that is very different with Lantus than with Prozinc is that each cycle is affected by the cycles before it, and each cycle affects several cycles after it. Instead of looking at the action in 12 hour cycles, you learn to see patterns in "waves" of several days at a time. It becomes easier the more data you get. To my eye, the 39 seems to fit so I don't think it was a bad reading. Sometimes it just takes them a while to settle in to the lower dose, and sometimes they end up needing to go back up in dose again to get the good numbers back.