please review and advise

[Dunkin in Hawaii]

https://docs.google.com/spreadsheets/d/1ydCtZUdidVYrTvB9dQyAAFTEBsHN_hoksRv5jit1aIM/edit#gid=0

Just cant seem to fine tune the dosage. Looks great then shoots back up into the 400's. Following SLGS guidelines. Just increased dosage by 0.25. Any advice would be great.

 

[Sandy and Black Kitty]

The SLGS. guidelines state-

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

The 2/21 AM cycle saw an 89. The 2/16 AM cycle saw a 48. In each case you increased when a decrease was indicated. You have inadvertently set up a cycle of going low, setting off your cats counter regulatory hormones which results in the extreme highs.

I recommend you follow the guidelines and for safety sake decrease the next time your kitty goes below 90, which may be very soon.

Shooting the same dose consistently, AM and PM, unless you get a signal to decrease is important. Lantus likes consistency. hold the dose for one week and then run a curve to determine if an increase is called for based on the nadir.

When you see a high follow a low, (a bounce) hold steady and give the bounce a chance to clear before evaluating if an increase is called for.

Make sense?

 

[Dunkin in Hawaii]

The SLGS. guidelines state-

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

The 2/21 AM cycle saw an 89. The 2/16 AM cycle saw a 48. In each case you increased when a decrease was indicated. You have inadvertently set up a cycle of going low, setting off your cats counter regulatory hormones which results in the extreme highs.

I recommend you follow the guidelines and for safety sake decrease the next time your kitty goes below 90, which may be very soon.

Shooting the same dose consistently, AM and PM, unless you get a signal to decrease is important. Lantus likes consistency. hold the dose for one week and then run a curve to determine if an increase is called for based on the nadir.

When you see a high follow a low, (a bounce) hold steady and give the bounce a chance to clear before evaluating if an increase is called for.

Make sense?

THANK YOU for reviewing. I don't know why i increased dosage at those times. Made some changes since your response and it looks like things are more consistent now (dont want to jinx it). Please review most recent data when you have some time and I'd appreciate feedback =).

 

[Sandy and Black Kitty]

Looking good

So you now have strung together 5 consecutive cycles at 0.25u. Hold this dose until you have a total of 14 consecutive cycles and then perform either a 12 hour curve (testing every 2 hours) or an 18 hour curve (testing every 3 hours). Once you have done the above evaluate the resulting nadir along with the nadir data obtained in the preceding 14 cycles and determine if the dose should be held or increased based on the ranges outlined in the SLGS method.

It’s very important that while on the way to 14 consecutive cycles of 0.25u, if you see a BG of 90 or lower, that signals a reduction is in order starting with the very next PS.

From 0.25u the next dose down is 0.1u-


Any questions?

Something is off with your ss formatting- there is no color on the PM cycle entries. Also the numbers that signal a reduction is in order should be lime green. I’m tagging our spreadsheet guru, @Marje and Gracie to have a look.

 

[Dunkin in Hawaii]

Looking good

So you now have strung together 5 consecutive cycles at 0.25u. Hold this dose until you have a total of 14 consecutive cycles and then perform either a 12 hour curve (testing every 2 hours) or an 18 hour curve (testing every 3 hours). Once you have done the above evaluate the resulting nadir along with the nadir data obtained in the preceding 14 cycles and determine if the dose should be held or increased based on the ranges outlined in the SLGS method.

It’s very important that while on the way to 14 consecutive cycles of 0.25u, if you see a BG of 90 or lower, that signals a reduction is in order starting with the very next PS.

From 0.25u the next dose down is 0.1u-
View attachment 42912

Any questions?

Something is off with your ss formatting- there is no color on the PM cycle entries. Also the numbers that signal a reduction is in order should be lime green. I’m tagging our spreadsheet guru, @Marje and Gracie to have a look.

THANK YOU again. I don't know how to fix the spreadsheet myself at all. It was sent to me 4 years ago when I started testing.

Looks like I did jinx it....thought it was going well, then got a really high number tonight of 528 . Gave the 0.25 and will test before bedtime tonight. Hoping for a good AM number tomorrow.

 

[Gill & George]

Looks like I did jinx it....thought it was going well, then got a really high number tonight of 528 . Gave the 0.25 and will test before bedtime tonight. Hoping for a good AM number tomorrow.

Hi there that 528 looks like a bounce to me. See how he dropped from yellow to blue n the am cycle, its possible he dipped a little lower, but even that drop of 100pts in 2hrs could have been enough to set up a bounce. So hold fast with the dose even if you are seeing high numbers over the next few cycles. The bounce will clear and you will see a return to lower BG.
Remember, in line with SLGS dosing method, if you see a number below 90 that is your signal to take a reduction on the very next dose.

 

[Marje and Gracie]

THANK YOU again. I don't know how to fix the spreadsheet myself at all. It was sent to me 4 years ago when I started testing.

Looks like I did jinx it....thought it was going well, then got a really high number tonight of 528 . Gave the 0.25 and will test before bedtime tonight. Hoping for a good AM number tomorrow.

There are several issues with it. Once is that we start a new tab every year because it takes too long to scroll down through the years of data.

If you will send me a private message, I’ll fix it for you but I’ll need editing rights first.

 

[Dunkin in Hawaii]

Got home just in time for a +6 test and it was exactly 90... not sure what to do, but Im going to test in 30 min.

 

[Sandy and Black Kitty]

What do you feed (wet?dry?%carbs,amounts and timings) Dunkin?

 

[Dunkin in Hawaii]

FF pate, Stella and Chewy freeze dried raw and occasionally a friskies pate to change it up. Hes a grazer, so maybe 1/3 of a can 4-6 x a day.

 

[Dunkin in Hawaii]

Looking good

So you now have strung together 5 consecutive cycles at 0.25u. Hold this dose until you have a total of 14 consecutive cycles and then perform either a 12 hour curve (testing every 2 hours) or an 18 hour curve (testing every 3 hours). Once you have done the above evaluate the resulting nadir along with the nadir data obtained in the preceding 14 cycles and determine if the dose should be held or increased based on the ranges outlined in the SLGS method.

It’s very important that while on the way to 14 consecutive cycles of 0.25u, if you see a BG of 90 or lower, that signals a reduction is in order starting with the very next PS.

From 0.25u the next dose down is 0.1u-
View attachment 42912

Any questions?

Something is off with your ss formatting- there is no color on the PM cycle entries. Also the numbers that signal a reduction is in order should be lime green. I’m tagging our spreadsheet guru, @Marje and Gracie to have a look.

Aloha! Tonight would have been the 14th cycle (If i counted correctly), and I just got an 89 at +5.5. Going to test again in 30 min. Going to reduce to 0.1 for PM shot. The SS is fixed, and the new version will be in my signature line soon. Any suggestions, comments, bits of advice are always welcomed !

 

[Sandy and Black Kitty]

Aloha! Tonight would have been the 14th cycle (If i counted correctly), and I just got an 89 at +5.5. Going to test again in 30 min. Going to reduce to 0.1 for PM shot. The SS is fixed, and the new version will be in my signature line soon. Any suggestions, comments, bits of advice are always welcomed !

Good catch.
Give the decrease a few cycles so that the depot has a chance to drain and rebalance to the new dose.

Try and get some +5 and +6 tests on the overnights; a +5 one night, a + 6 another etc. I suspect he has been visiting the low lands from time to time on the PM cycles.

 

[Dunkin in Hawaii]

Good catch.
Give the decrease a few cycles so that the depot has a chance to drain and rebalance to the new dose.

Try and get some +5 and +6 tests on the overnights; a +5 one night, a + 6 another etc. I suspect he has been visiting the low lands from time to time on the PM cycles.

Upped the dose due to the higher mid cycle numbers. can you please review and advise? btw, the SS format has been updated. Please let me know if anything needs to be changed.

 

[Dunkin in Hawaii]

Also , he jumped up from 92-193 in an hour today. Is that unusual?

 

[Chris & China (GA)]

Also , he jumped up from 92-193 in an hour today. Is that unusual?

Any time you see a number that just doesn't make sense, it's worth it to test again and be sure. I'm betting that the 92 today was a bad strip and he wasn't that low.

Upped the dose due to the higher mid cycle numbers. can you please review and advise?

On SLGS, you hold the dose for a week, so I'd stick with the .25 (unless he drops below 90) and then do a curve before making another change.

Please try to get at least 1 test on the PM cycle, every cycle.....most cats go lower at night so it's important for his safety. Also, without getting data on the PM cycle, you're missing half the picture of what's going on.

 

[Dunkin in Hawaii]

Thank you ! Will do my best =)

 

[Dunkin in Hawaii]

Any time you see a number that just doesn't make sense, it's worth it to test again and be sure. I'm betting that the 92 today was a bad strip and he wasn't that low.



On SLGS, you hold the dose for a week, so I'd stick with the .25 (unless he drops below 90) and then do a curve before making another change.

Please try to get at least 1 test on the PM cycle, every cycle.....most cats go lower at night so it's important for his safety. Also, without getting data on the PM cycle, you're missing half the picture of what's going on.

Would you mind taking a looksee again please? Thinking I should up the dose to 0.5 on next cycle.