On Dwee's spreadsheet there is one instance on Dec 24 (I think) of him hitting his nadir at 9pm which is 4 hours after his PM shot was due. The AM shot was given at 5am and he started to come down around 4pm and kept going down (despite eating his dinner) until 9pm.
That was a bounce breaking cycle.
Look back to the pm cycle on the 27th you see that drop into 70 there he dropped fro 468 to 72 in one cycle, that kind of a drop, and indeed a visit into lower numbers by a cat who is not used to being there is likely to cause a bounce.
This causes the liver to 'panic', resulting in stored glucose being dumped into the bloodstream in an attempt to protect kitty from a perceived low. This state of affairs can last up to 6 cycles, but in many cases a kitty can clear the bounce earlier. As the bounce clears, liver stops panicking and we see a return to pre bounce levels (hopefully), so that 100pt drop between +10 and +11 on the 24th dec signaled the intention to clear a bounce. When bounces clear like that at the end of the cycle yes you can see that nadir later.
Could you have shot? Well technically yes, but only if you were able to be around and check on his BG, and if you were prepared to steer with food to sustain him, you might have had to feed higher LC or MC. The advantage of doing that is that his BG when Lantus onset wouldn't have been through the roof, Lantus works much better when it grabs on to lower numbers, and will more typically yield a nice flat cycle.
When they are clearing a bounce or having a very active cycle, the nadir will often change from where it is normally, I had George nadir as early as +2 and as late as +13, more often than not he was around +5/+6
You might want to read this post by Libby, it talks about shooting falling numbers and shooting when a bounce is clearing, I found it extremely helpful when I was starting out
http://www.felinediabetes.com/FDMB/...combining-merging-protocols-good-idea.111088/
On the evening of Dec 28, he had his PM shot at 5pm and had normal numbers (for him) and then went up again after about 7- 8 hours as usual, but then in the morning of Dec 29, at 5am he had dropped down quite a lot and kept dropping, again despite eating breakfast, until he got to hypo levels at 9am, again 4 hours after his AM shot was due.
I saw that, I wonder if that was real?? seeing as the monitor packed up just after that?? I seem to remember another member using the type of continuous monitor that you are using have issues when it was approaching the end of it's life.
There are some very odd readings at times on his ss with this monitor.
Like on the evening of the 28th all that bobbling about from pink to yellow to blue to yellow to pink to blue to green???? I don't know but it doesn't seem usual. If I had been getting readings like that I would have double checked those readings with a back up meter.
FWIW when the battery was getting low on my regular meter I got some strange readings a LO once and a number in the 500's, as the numbers were not consistent with what was going on at the time I double checked with my spare meter which confirmed my suspicion that something was up with the regular meter. On swapping the battery out for a new one, meter started functioning properly. So is it possible this might be happening at times?
Have you got a back up, regular meter with which to check his BG, so if you are getting a strange reading you could double check??
On closer inspection of the numbers the following might account for these drops beyond +12.
I don't know which, if any protocol you are following, and with a history of tow episodes of DKA, I can understand a reluctance to take down the dose, indeed I would worry about skipping a single dose if my cat was prone to ketones/DKA, but I do notice that on the 22/12 he got into the 30's, if we take the readings at face value that suggests the 1.7u dose was too high and he should have got a reduction. With him bouncing of that you could have held the dose for one cycle (shooting through the bounce) but then really I think he should have had a reduction. But instead, you held on to the dose, then being faced by a rapidly dropping number that you were worried about shooting (understandably), you skip on the pm cycle of the 24/12, the depot drains, you re start with 1.7u, which got him into the 30's, then you take him up after only 4 cycles, granted he was red/pink for most of the time, but you did see a yellow, the depot has settled after the skip, cycle count resets when you skip.......... so I don't know I think you may have taken him up prematurely??? to 2u on the am cycle of the 27th, he's on that for 3 cycles, then you reduce to 1.7 in the pm cycle of 28th (not sure why?), at this point the depot is all over the place because it has not had a chance to stabilise (that is why we usually wait 6 cycles), and moreover is likely over full, what with the failing to take a reduction on the 22nd and taking him up to 2u before the depot has stabilised and you have seen the full effect of the dose, all of the above, may well account for those numbers continuing to drop way past +12, when a kitty is overdosed we can see the numbers continue to drop way past the usual duration.
Please understand that the above narrative is not a criticism, I just wanted to relate to you how I am interpreting the numbers that I am seeing on the ss.
Between the monitor breaking and you getting a new one, did you shoot any insulin? or was he without insulin for a few days?
Is there any reason why you don't use a regular human meter? Do you have difficulties in getting a manual reading?
As for the current dose, I see you are shooting different doses am and pm, usually you would get better results shooting consistently, I'm not sure what you should be shooting but by shooting different doses it's going to be very hard to figure out what is going on because the depot is constantly readjusting and as it increases and decreases in size it will affect the numbers.
I am going to ask some very experienced members, some who have had personal experience with managing cats with DKA to pop round and see if they can give you an assessment and some pointers to help you with Dweezil.
Hang in there
