? 4/18 TR Jenks AMPS 71 +5.5 56 +8 57 PMPS 60 +4 66 +6.5 66

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AZJenks

Member Since 2014
4/17

I'm a little worse for wear today after last night. At PMPS+9.5, when he was 56, I gave him 8% turkey & gibs, 2.5tbsp of 21% gravy with a little karo, and some dry treats so I could get a little sleep before AMPS.

He was 71 at AMPS. That was the most inflation I got out of all of that food, which tells me it was a smart thing to do at the time. Realizing that was an inflated number, I gave him a BCS dose of 2.0U (which is slightly less than 50% of his current dose of 4.25U). Fed him, then went back to bed for a few hours. As you can see, the depot is still having an effect because we're down in the 50s again, even after a 9% food and treat feeding at +5.5.

So what the heck do I do for PMPS?

If I give a full dose, it's likely going to be a rocky night. I don't think he's going to leave the 50s today without some food intervention.

Do I take another reduction in the regular dose? This too is iffy because we don't know how much of a lasting depot effect there will be, and we don't know how far off from a new dose sweet spot we are, so even 4.0U may still be too much for his body.

Do I give another BCS dose? This would give the depot more time to drain, probably let me go to bed early, but carries the attendant risk of letting the numbers get away from us if he runs out of gas early in the night.

I just want him to be safe, and for me not to be exhausted to the point where I'm no help for him. I'm honestly not sure what the right course of action is.

Thoughts? What are the pros and cons of each option? Any others I haven't considered?
 
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How tired are you? You must be exhausted. Remember that you have to take care of you so you can take care of Jenks. If you were to do another reduced dose tonight, he will get back on track quickly enough. I don't think that letting him drift up to blue for a while will abort Jenk's mission. Usually you can feel the effects of a depot for 4-6 cycles after a reduction. Doing the BCS does speed that up.
 
Thanks @Wendy&Neko! I'm pretty beat today, but I'll do whatever it takes (including lack of sleep) to make sure Jenks is ok. From the sounds of it, it's going to be another day of just letting the numbers decide what course of action we take.

I had no idea a depot could affect readings for up to 3 days. That explains a lot, and must be why Jenks powered through his last BCS and stayed on track without a hiccup. He must be working with a pretty stout depot that requires more than one cycle at a reduced dose to dissipate.

If he's heading into PMPS tonight and is still in the 50s, I may strongly consider doing a BCS dose again, getting some sleep, and then getting back on track tomorrow.
 
Often when kitties are on a roll, they barely notice a reduced dose or even a skip. Getting some sleep tonight will recharge your batteries for his next adventure. If you have to give any more HC this cycle, and he stays stubbornly low, that probably indicates his depot is still full to bursting.
 
There's only one example to go on but last time you gave the BCS it didn't seem to hit until the 4th cycle following and then he was quickly back on track. If numbers are still low I don't see any harm to giving another BCS tonight, it would be interesting to see how that affects the cycles but Im not sure it will guarantee you sleep, he's got a fairly good sized depot going on. If you need guaranteed sleep I think you'll have to skip - it would be interesting to see what he does about that too. Perhaps a bit of a science experiment tonight ;) When does OH return?
 
Ok, the blood glucose train rolled into the PMPS station at a respectable non-carbed 60. That means he held mid-to-high 50s for a good portion of the day with the AM BCS dose. No emergencies today, yay!

60 is still low for a 4.25U dose with the specter of the remaining depot still lurking in the background. So, with me needing sleep without any surprises tonight, I decided to give a BCS dose tonight too. Unless something out of the ordinary happens in the meantime, we'll probably return to a normal dose in the morning.
 
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Wow all those green numbers! Good luck with Jenks and get some sleep.
Couple newbie questions: What does BCS and OH mean?
 
+4 and things are nice and calm and steady at 66. What a relief.

Hi there @ewalker405 and thanks for stopping by with your words of support! Wishing you and Wrigley (what a cutie!) all the best on your journey!

I've been using "OH" to mean Jenks' "Other Human".

As for "BCS dose," I have to admit, I had no idea what that acronym stood for either! :woot: Remember that Lantus is a depot insulin, which means that the body uses a portion of a dose and stores the rest in a "spare tank" that it draws from over time. Sometimes there's too much in this "spare tank," and in conjunction with whatever regular dose is given, that can lead to very active cycles and a series of low, hard-to-control numbers. One technique to interrupt a series of low numbers like that is to give a one-time reduced dose in place of the regular dose (for example, instead of getting 4.25U this morning at shot time, Jenks got 2.0U). That's the BCS dose. It's typically 1/2 to 2/3 of the regular dose, and it's purpose is to give that "spare tank" time to empty so there's not so much insulin available to the body. Functionally, the body would then draw on the reserves in that "spare tank" to make up for the lesser amount of insulin given in the shot. In theory, that should let the blood glucose readings recover a bit.

It appears that Jenks' "spare tank" had more insulin in it than one BCS shot could manage. So that's why he got a second one today, rather than returning to his regular dose.

I'm sure there are other reasons to give a BCS dose, but I was introduced to the whole concept a week ago, so that's the extent of my understanding :)
 
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Still cruising at 66 as of midcycle. He must be hiding one heck of a depot somewhere.

zzzzzzzzzzzz
 
Often when kitties are on a roll, they barely notice a reduced dose or even a skip.

I think this is really important. Jenks is on a mission these days. You're giving significantly reduced shots and not even seeing a blip. In this situation, I would err on the side of too-little insulin if you can't monitor. Sometimes cats coming down the dosing scale move fast and furious - sometimes needing reductions of more than 0.25u or 0.5u. You'll have to follow Jenks' lead in this dance.
 
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