Dosing advice

RRaptor

RRaptor

Member
Olivia likes to do funny things when I'm paying too much attention. PMPS is 145, lower than its been all day. I know I need to shoot, so I'm stalling now. What should I shoot?
 
Rachel said:
Sorry we were all not here earlier! Looks like she stayed in safe numbers. Lovely greens!
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Yes, nice greens! I wonder if it was that or if she maybe got a little too low when I was sleeping because quite the bounce @AMPS 410
 
Lovely cycle last night. You might keep the 2 u dose today to see how she does. I like to focus on lows in a non-bounce cycle to judge a dose. Bounce-inflated PSs aren't reliable dosing guides.
 
Here's something I wrote about bouncing a long time ago:

Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:
  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
 
Yes, she was in the greens a few cycles ago and didn't bounce, but did a few cycles before that. I shot 2u today to be safe since I'm not home before +10
 
RRaptor said:
@Djamila @Kris & Teasel @Rachel if any of you would be kind enough to help, probably going to need some dosing advice in the AM, we've had an interesting night!

Link to hypo post
http://www.felinediabetes.com/FDMB/threads/44-at-4.203541/
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Hi RRaptor. Just saw this out on the main forum. So glad to see she’s coming back up, and it seems like you handled it very well with gentle steering. Well done!

I know that the lime earns her a dose reduction though I hope one of The Three Gurus can help guide you with how much. She’ll likely be high for AMPS (though hopefully not too bad since you didn’t have to hyper-carb her back up), so a dose reduction will seem counterintuitive. Lemme do a little searching, and I’ll post back if I can find something that may be helpful to you.

Edit: I searched “reduction” + “lime,” and everything points to a reduction by 0.25u, but hopefully someone will confirm/correct that before you shoot tomorrow!
 
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Jenna Josie said:
Hi RRaptor. Just saw this out on the main forum. So glad to see she’s coming back up, and it seems like you handled it very well with gentle steering. Well done!

I know that the lime earns her a dose reduction though I hope one of The Three Gurus can help guide you with how much. She’ll likely be high for AMPS (though hopefully not too bad since you didn’t have to hyper-carb her back up), so a dose reduction will seem counterintuitive. Lemme do a little searching, and I’ll post back if I can find something that may be helpful to you.
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Hopefully not too high, we're at almost 100 at +6 so I'm going to sleep. Don't stay up late on my account, I was hoping just to catch someone when they wake up, and certainly I appreciate you looking into things. Four cycles ago I shot a reduced 2 on a similar number and I think that was probably a good call.
 
Well ack!!! I definitely didn't see that one coming. I'm so glad you were testing and caught that low number..especially since it was fairly early in the cycle!

Reviewing your sheet, my suggestion is going to be dropping back to 2 probably. Yeah she is probably going to be high this morning, but remember that high isn't a real number. It's a bounce. Therefore, though it DOES seem counterintuitive, we usually do reduce after a lime green like that. GREAT job steering her with low carb food! That's the best way to do it if you can, since it keeps them from skyrocketing even further!
 
Well, I'm the worst. It's 2.5 hours post usual t/f/s time and I'm just waking after staying up and multiple visual checks through the night. I'm sure everyone is hungry and ready for the day.
 
Rachel said:
Well ack!!! I definitely didn't see that one coming. I'm so glad you were testing and caught that low number..especially since it was fairly early in the cycle!

Reviewing your sheet, my suggestion is going to be dropping back to 2 probably. Yeah she is probably going to be high this morning, but remember that high isn't a real number. It's a bounce. Therefore, though it DOES seem counterintuitive, we usually do reduce after a lime green like that. GREAT job steering her with low carb food! That's the best way to do it if you can, since it keeps them from skyrocketing even further!
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368 AMPS and in good spirits, even though I was late. I'll take it and shoot 2u
 
Ohhh! Well it happens. I'm sure after last night, you were pretty exhausted. You may need to adjust your shot time some tonight to move your way back to your normal shot time. Shooting late this morning is one thing (and a pretty good number for a late preshot and a bounce!) but you don't want to shoot at +9.5...that's pretty early. :)
 
Rachel said:
Ohhh! Well it happens. I'm sure after last night, you were pretty exhausted. You may need to adjust your shot time some tonight to move your way back to your normal shot time. Shooting late this morning is one thing (and a pretty good number for a late preshot and a bounce!) but you don't want to shoot at +9.5...that's pretty early. :)
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Oh, of course. I usually adjust by the half hour. I'll adjust back 30-45 minutes each shot this weekend so we're in a good place Monday morning.
 
As the queen of the chicken shot, I say welcome to the realm!

It’s all a big experiment, and you have to take care of you too, after all. Are you going to get a before bed test? I’ve recently found it very useful to look at what happened with past low PS reductions when trying to decide what to do with the next one(s).
 
Jenna Josie said:
As the queen of the chicken shot, I say welcome to the realm!

It’s all a big experiment, and you have to take care of you too, after all. Are you going to get a before bed test? I’ve recently found it very useful to look at what happened with past low PS reductions when trying to decide what to do with the next one(s).
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Honestly, I thought about just shooting 1 so I could sleep and hopefully be able to move shot time back to the usual time. I'll get a before bed. I'm happy to see these blues, but I need to sleep, too!
 
I am wondering if she went low today. Yesterday she had a lovely “normal” curve, and if that happened today, too, she maybe got into the greens and was on her way back up, it’s just that it didn’t get so high since she was (possibly) at a lower than typical nadir.

If so, than maybe a bounce + a lower shot tonight will probably mean she’ll be just fine to shoot the normal dose at your usual AM shot time.
 
Jenna Josie said:
I am wondering if she went low today. Yesterday she had a lovely “normal” curve, and if that happened today, too, she maybe got into the greens and was on her way back up, it’s just that it didn’t get so high since she was (possibly) at a lower than typical nadir.
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It was a nice curve yesterday and we started at a bounce, pink to yellow to blue. Hopefully today was yellow to blue to dark greens. I hope I won't regret shooting low, but you're right that it may help get back to regular shot time.
 
I'm not sure why Olivia has high PS right now. Sunday's cycle was great. My thoughts are that there are a handful of possibilities.

1) she hasn't cleared the late shots from the weekend.

2) she's eating just before I wake up, but I know yesterday there were 2 hours of fasting PMPS.

3) bouncing?

I can't imagine she needs a higher dose after the hypo and seeing how she's going low and coasting mid- cycle. Thoughts?
 
I'd stay at 2 u for a bit longer because of those greens recently. Olivia is a bouncy girl and that makes it extra challenging to judge a dose because she can spend quite a bit of time in bounce-inflated numbers. My guy is an Olympic level bouncer too so I know how confusing it is. It's best to avoid too frequent dose changes in bouncers and they WILL surprise you with the odd low nadir cycle in among the multicoloured cycles. If you don't see any more green after another 4 cycles or so, maybe try 2.25 u. It's also true for bouncers that a dose that gave you a lime green in the past might not when you try it again (I'm referring to the evening of Sept. 21st).
 
Kris & Teasel said:
I'd stay at 2 u for a bit longer because of those greens recently. Olivia is a bouncy girl and that makes it extra challenging to judge a dose because she can spend quite a bit of time in bounce-inflated numbers. My guy is an Olympic level bouncer too so I know how confusing it is. It's best to avoid too frequent dose changes in bouncers and they WILL surprise you with the odd low nadir cycle in among the multicoloured cycles. If you don't see any more green after another 4 cycles or so, maybe try 2.25 u. It's also true for bouncers that a dose that gave you a lime green in the past might not when you try it again (I'm referring to the evening of Sept. 21st).
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Thanks Kris! Tonight's PMPS was a much more tolerable 257; I'm sure because I asked a question this morning. I'll stick it out with 2u for now.
 
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Looks like you did what we call a skinny dose this morning. That seems like a good call given the numbers last night.
 
Djamila said:
Looks like you did what we call a skinny dose this morning. That seems like a good call given the numbers last night.
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Yes, I felt like a little less was best but didn't want to shoot too little. She seems really hungry this evening, so we'll see how things are PMPS.
 
Tonight's +4 is 173, with likely pizza on board. Glad not to worry tonight, but disappointed numbers may be artificially inflated.
 
Did he sneak a bit of pizza when no one was looking? :p Mine do that if I leave it on a low table in a room and walk away....
 
Rachel said:
Did he sneak a bit of pizza when no one was looking? :p
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Yes, our kitchen is rather closed off and a couple of pieces were left on the counter. I walked in to find them scattered with cheese and toppings missing as she walked out. Could have been the civvies, too.
 
Oh, she also really wants potato chips, but those are usually more well hidden.
 
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