2/9 Silver AMPS 176 +3=256 +6=241 +9=205 PMPS 209 +1=247 +5=176

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Elizabeth B said:
I know this might not be a popular recommendation; but if you continue to see him nadir this late in the cycle - or possibly not at all, it might be worthwhile to pull his fructosamine. Now, there is a lot of debate regarding the value of that test when doing home testing, but when there is ambiguity in the data, that overall reading could help you identify whether an increase, decrease, or hold is in order.

It seems there is no discernible curve and if he wouldn't throw those weird greens every once in a while, one might believe an increase was in order. (He has yet to really nadir in the month of February, regardless of history, the most current data might say not enough insulin.) However, if he's caught in a cycle of chronic rebound and periodic drops, a decrease is in order. (On 1/20 there is a potential bounce and that pattern is repeated 1/22, 1/26, 1/30. Chronic rebound could, in theory, last this long and he could even be hiding drops throughout non-testing times OR he could be in the "flats.") Conflicting strategies and differing risk.

This is a long shot, but do you think absorption could be an issue? Do you rotate injection sites? Or could we note where the injection was given and maybe identify an absorption pattern? (you may have talked about it in the past, but it's sometimes difficult to review history in this format.) I'm just trying to think of anything we could eliminate.
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Not sure I understand any of that. Don’t have $ for a vet visit. Vet doesn’t even know he’s diabetic. I think I just haven’t caught nadir due to work. Im doing an 18 hr curve today. I think he needs more insulin although we are heading in the right direction and numbers are trending downwards.
 
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Elizabeth B said:
Actually, that's a popular misconception. Nadir corresponds with insulin peak. When a curve is normal, nadir is absolutely the lowest point in the day; however, when you find abnormal curves or lack of insulin effectiveness, it's not the case.
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I don’t believe the insulin is ineffective. I am following the instructions in SLGS.
 
Out of the tests you’ve been able to get, the 124 & 119 are good numbers on SLGS. I also suspect he’s made it to green. If it were me with your schedule I’d hold this dose based on the above numbers. Hopefully he’ll come down more today.
 
Tracey&Jones said:
@Elizabeth B - so are you thinking that due to possible absorption issues that is why we are seeing "a reverse or non" curves so to speak? Which would explain the odd low number being thrown out. However, he is generally going down in numbers overall, or is this just due to a higher dosing?

Even if a curve is normal, are you saying the nadir is always typically in the middle some where for Lantus? Like the 4-8 hour mark?


Just trying to flesh out the idea in my head and get what you are trying to tell Juliet. I can take this off line if you feel I am hijacking your thread Juliet.
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I think the discussion is not relevant in Silver’s case. If there were absorption issues we would not see the trend downwards that we are seeing. No more reds or pinks. Far more blues and yellows. You can’t say there is not a curve. I haven’t done a curve in two weeks. This discussion is not helpful and causes confusion. I’m going to continue doing what I am doing and following SLGS as differing advice confuses me. I need written instructions and am grateful we have that in the two protocols.
 
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Doodles & Karen said:
Out of the tests you’ve been able to get, the 124 & 119 are good numbers on SLGS. I also suspect he’s made it to green. If it were me with your schedule I’d hold this dose based on the above numbers. Hopefully he’ll come down more today.
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I’ve been watching for green but not seen any. Doing an 18 hr curve today and a 12 hr curve tomorrow. Increasing or decreasing per SLGS guidelines after the curve.

@Tracey&Jones that’s not correct re Lantus always nadiring at around +7 or 8. I’ve seen a few on here say their cats nadirs are late at +11.
 
Tracey&Jones said:
@Juliet - was trying to confirm Elizabeth's thoughts on what she wrote. Not referencing Silver or any other members results. Took topic offline as you requested.
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Thanks. Was confusing me. Had no clue what she was trying to say and didn’t look like it fitted his situation. The discussion WAS referring to Silver:

Tracey&Jones said:
@Elizabeth B - so are you thinking that due to possible absorption issues that is why we are seeing "a reverse or non" curves so to speak? Which would explain the odd low number being thrown out. However, he is generally going down in numbers overall, or is this just due to a higher dosing?
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@Tracey&Jones
@Elizabeth B
Tracey&Jones said:
@Juliet - was trying to confirm Elizabeth's thoughts on what she wrote. Not referencing Silver or any other members results. Took topic offline as you requested.
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I understand Juliet not wanting the discussion in her daily thread and I respect her for saying so, but perhaps a better idea is to open a discussion thread on the subject here in the L & L ISG. That way everyone can ask questions and/or offer input if they wish. Taking the discussion offline won't benefit the group and makes it unavailable for peer review.
Thanks much! :)
 
On his way down. Doing his usual. Up after food and a gradual heading down to a nice blue PMPS. Seems like a good curve to me albeit I would rather he didnt spike so much after meals.
 
Doodles & Karen said:
Out of the tests you’ve been able to get, the 124 & 119 are good numbers on SLGS. I also suspect he’s made it to green. If it were me with your schedule I’d hold this dose based on the above numbers. Hopefully he’ll come down more today.
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I was thinking of holding the dose until I saw him not really going down. For some reason his preshots are his lowest numbers in the cycle. Someone else said that their cat did that too.
 
Question on feeding. Usually Silver can only have three meals a day due to work schedule and unable to leave food out.

But on weekends and days off how would it affect his curve (I’m doing an 18 hr curve today) if I gave him a mid day snack? He’s asking for it and I want to give him some. Will it spike his PMPS given that he does spike high after food?
 
If you feed him differently on the weekend, you won't have an accurate idea of where his numbers go on the weekdays. The food will change things up. I hope that makes sense.
 
carfurby said:
If you feed him differently on the weekend, you won't have an accurate idea of where his numbers go on the weekdays. The food will change things up. I hope that makes sense.
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Yes it does thanks. I couldn’t resist the face tho and gave him some food at + 9.5. Blue AMPS and, at 205 at +9.5 - would 100% be a blue PMPS as well so I fed anyway. Looks like he hasn’t been hitting greens during the day but up into yellows and down for the preshots. Will do more testing tomorrow but am increasing him by 0.25u tonight per the SLGS guidelines. I think we are close to the dose that will bring him back down the dosing ladder but not quite there yet.
 
carfurby said:
They are hard to resist. Good luck with the new dose. I think you're right and you are getting close to that dose.
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So he did jump with the food but not too much. 209 at PMPS after having had food. I moved injection site after today's stuff in my condo and wished I hadnt let that affect my judgement as it ended up being a bit of a fur shot. Scruff is the place where I am sure it goes in. Am sure its better absorbed there than not at all because I missed. Gotta learn to ignore some of what is said here.

Am going to grab an unusual +1 and +3 tonight to get some of the missing picture filled out a bit.
 
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I never worried about absorption and just give Furball the shot where it works for her and me. You have to find what works for you and Silver.
 
carfurby said:
I never worried about absorption and just give Furball the shot where it works for her and me. You have to find what works for you and Silver.
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So I think I’ve figured out what’s going on with him. Today all those yellows are the food hike trying to come down but later in the day when I gave him food at +9.5 it made for a higher preshot but less of a food hike with his smaller meal at PMPS. Also his +5 lower due to less of a food hike. Which does advocate for smaller meals throughout the day because it’s a better curve. However in my case due to the fact I can’t feed many meals during the week, I’m going to have lower preshots and higher during the day. Which is a good thing I think as it will keep him safe when I’m at work. I’ll just be faced with lower and lower preshots which may get scary to shoot.

But knowing he’s going up a good 100pts with his meal should be okay? That’s my logic anyways.
 
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