10/27 Max AMPS 43 - dose decrease? trying freestyle libre

Wendy&Neko said:
What dose did he get yesterday morning and evening? It is missing from the spreadsheet.
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It’s listed on the first line - 2.5. I’m tracking the numbers from the AT meter and the freestyle sensor simultaneously so the first line is the AT reading and the second line is the freestyle.
 
OK, the two lines of data per day is confusing. Most people will combine into one row. Since you are feeding dry food, that means Start Low Go Slow method for dosing. That means reducing if he goes under 90. Do you have any Libre data from the night time cycle? Would be interesting to know Low he really went.
 
Wendy&Neko said:
OK, the two lines of data per day is confusing. Most people will combine into one row. Since you are feeding dry food, that means Start Low Go Slow method for dosing. That means reducing if he goes under 90. Do you have any Libre data from the night time cycle? Would be interesting to know Low he really went.
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it looks like it stopped giving actual numbers below 50 because it just gave me a reading of “LO” this morning.
 

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Wendy&Neko said:
OK, the two lines of data per day is confusing. Most people will combine into one row. Since you are feeding dry food, that means Start Low Go Slow method for dosing. That means reducing if he goes under 90. Do you have any Libre data from the night time cycle? Would be interesting to know Low he really went.
Click to expand...
So I should reduce his dose even though the circumstances (not eating usual amount and vomiting) were out of the ordinary?
 
I don’t see a post for today so I’ll just put my thoughts here. I’m very glad to see you reduced the dose because a 43 on an AT and a “LO” on the FS warrants a reduction for safety.

I know you said you thought he was low yesterday morning because he hadn’t eaten like normal and he vomited during the night but that doesn’t tell the whole story. We can surmise that not eating as much and vomiting can cause the BG to drop (because it does to a certain degree) but cats often go low at night and, with no tests, it’s putting him at great risk. We certainly don’t expect you to be up all night but a +2 and a before bed test would really be helpful in knowing how low he might be going. If he does need a dose increase at some point down the line, you’ll need to know how low the dose is at the current time before you increase safely.

I also understand that you’ve been doing this for 2.5 years. Last year, a member whose kitty was dx in 2010 and was a nice, flat green for quite some time, got a little complacent with testing and came home to find he had had a severe hypo. He didn’t make it. :arghh: While I’m not trying to use scare tactics, I just want you to understand that things change constantly with our diabetic cats. A dose that has looked fine for many, many cycles might suddenly be too little or too much. I encourage you to try and get a few tests in at night in addition to the PMPS. Also, with his history of DKA, I wouldn’t be skipping shots. A 133 on an AT is a safe number to shoot with a full dose. Granted the 43 is not a number any of us would have shot but stalling and letting the BG rise would have allowed you to get some insulin in him.
 
Marje and Gracie said:
I don’t see a post for today so I’ll just put my thoughts here. I’m very glad to see you reduced the dose because a 43 on an AT and a “LO” on the FS warrants a reduction for safety.

I know you said you thought he was low yesterday morning because he hadn’t eaten like normal and he vomited during the night but that doesn’t tell the whole story. We can surmise that not eating as much and vomiting can cause the BG to drop (because it does to a certain degree) but cats often go low at night and, with no tests, it’s putting him at great risk. We certainly don’t expect you to be up all night but a +2 and a before bed test would really be helpful in knowing how low he might be going. If he does need a dose increase at some point down the line, you’ll need to know how low the dose is at the current time before you increase safely.

I also understand that you’ve been doing this for 2.5 years. Last year, a member whose kitty was dx in 2010 and was a nice, flat green for quite some time, got a little complacent with testing and came home to find he had had a severe hypo. He didn’t make it. :arghh: While I’m not trying to use scare tactics, I just want you to understand that things change constantly with our diabetic cats. A dose that has looked fine for many, many cycles might suddenly be too little or too much. I encourage you to try and get a few tests in at night in addition to the PMPS. Also, with his history of DKA, I wouldn’t be skipping shots. A 133 on an AT is a safe number to shoot with a full dose. Granted the 43 is not a number any of us would have shot but stalling and letting the BG rise would have allowed you to get some insulin in him.
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Thanks for the notes. Good to know about the full dose at 133- I was worried he might be extra sensitive to the insulin given that low day, so that’s why I skipped it. I tried stalling at 43 but he took several hours to get back over 100 so I thought that would be too late and didn’t want to get off his normal schedule by too much. I have been testing his blood for ketones.

And I do understand the importance of getting some night time data - that’s the main reason I got the freestyle libre so I could get more data to better regulate and adjust his dose as needed. He’s usually hiding out at night so it’s a bit difficult to get night time tests. I try to do mini curves about once a month on weekends and had plans to do the freestyle every so often too but now I’m not sure given the way he’s responded to it - bummer.
 
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