Totally baffled

[monty_dweezil (GA)]

So we haven't been able to test Dweezil's BG since his last monitor came off but he'll have a new one put on in 10 days, however I am CONFUSED.

He has been getting the same dose AM and PM for a month (1.5 units) and the few days just before his last monitor came off on this dose, he was mostly high with some hypo-lows.

So in the past month, he seems to have lost a bit of weight (which we really do NOT want as his natural adult pre-diagnosis weight is 5.8kg and he has for the past 2 years not been really able to get up above 5.4kg even though he has been eating way more than he used to) and is extremely hungry. Otherwise he seems ok. His urine glucose strips mostly show fairly high readings though never any ketones.

Though sometimes he will seem very sleepy, a bit dazed, lethargic and not himself and I think those have been times he's gone too low. He always perks up after food and a few hours. Today his urine glucose reading was negative for any glucose.

So...ignoring much detail, HOW is it possible for him to go too low a few times a week on a dose that would seem to be, in general, not high enough!? If he's losing weight, eating more and his pee is mostly high, his insulin dose is not high enough, but then at times he goes too low. It can't all be bouncing. He doesn't go low often enough for that, and the dose has been steady for a month.

Because he does go low at times, we should reduce the dose. But we can't because mostly he is too high and shows signs of poor control.

So what on earth do we do!?

 

[Marje and Gracie]

Just to be clear, his continuous monitor is a pet meter, correct?

I’m reticent to give dosing advice on numbers that are over two weeks old. Can you hometest him so we can see where he actually is? Are you, then, shooting blind.....not a good idea considering how he dips.

 

[Tricia Cinco(GA) & Harvey]

HOW is it possible for him to go too low a few times a week on a dose that would seem to be, in general, not high enough!?

The high numbers could be due to bouncing in response to dropping low. Without data, we can't be sure. For safety's sake, I would reduce the dose until you can monitor him. Better a day too high than a minute too low.

 

[monty_dweezil (GA)]

We reduce the dose a bit when he seems odd or his pee glucose is low, but we know this is not in any way accurate. But because he's lost a bit of weight over the past month, it really would seem that overall, the dose must be a bit too low. But how can a dose be low if it can sometimes cause the BG to go too low? That's what confuses me.

Can they still be bouncing on the same dose for a whole month? Can they still bounce when that dose was slightly reduced from a previous dose a month ago?

 

[Tricia Cinco(GA) & Harvey]

Can they still be bouncing on the same dose for a whole month? Can they still bounce when that dose was slightly reduced from a previous dose a month ago?

Yes, and yes.

 

[Marje and Gracie]

We reduce the dose a bit when he seems odd or his pee glucose is low, but we know this is not in any way accurate. But because he's lost a bit of weight over the past month, it really would seem that overall, the dose must be a bit too low. But how can a dose be low if it can sometimes cause the BG to go too low? That's what confuses me.

I wouldn’t assume that he is losing weight just because of his BG being too high and the dose too low. Many health issues can cause cats to lose weight. If the BG is going below the reduction threshold, then the dose is not too low. He could be bouncing a lot and the dose coming down and then popping back up. However, if he’s getting below the reduction numbers per the TR protocol (assuming you are doing TR), then the dose is not too low. Does that make sense?

 

[monty_dweezil (GA)]

No way, we can't do TR without the monitor. But yes, that does make sense.

 

[Sienne and Gabby (GA)]

Are you unable to home test without the implanted monitor?