11/15 Chloe PMPS 527 +3= 313

If she doesn’t come down today, I would increase to 1.25. Hoping the threat will help. See where’s she’s at at PMPS. It’s a save some strips day. Get a+6-7 if you want. Then take the afternoon off.
 
Bummer about the bounce, although technically she's pretty flat from your AMPS. I do wonder what she might have done yesterday, mid cycle, and especially last night. Once you start seeing blues, getting those spot checks in are really key to seeing what she is doing on the dose. Might be worth holding the 1u, since you are following SLGS, for the additional 4 days, which will also give you a chance to see if she can clear the bounce within that time frame.
 
Christie & Maverick said:
Bummer about the bounce, although technically she's pretty flat from your AMPS. I do wonder what she might have done yesterday, mid cycle, and especially last night. Once you start seeing blues, getting those spot checks in are really key to seeing what she is doing on the dose. Might be worth holding the 1u, since you are following SLGS, for the additional 4 days, which will also give you a chance to see if she can clear the bounce within that time frame.
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Good points. I forgot to check to see SLGS. My mind was on TR. Thanks for catching that.
 
The issue isn’t what happened on October 2nd. It’s irrelevant in terms of what she might do more than a month later. As Christie said you are following SLGS so once a reduction is earned, you wait 7 days before considering an increase. She might be bouncing from yesterday and last night as well. You didn’t get any tests after PMPS last night so for all we know she went down to green and is pink from that. All this to say hold the current dose. Does this make sense?
 
tiffmaxee said:
The issue isn’t what happened on October 2nd. It’s irrelevant in terms of what she might do more than a month later. As Christie said you are following SLGS so once a reduction is earned, you wait 7 days before considering an increase. She might be bouncing from yesterday and last night as well. You didn’t get any tests after PMPS last night so for all we know she went down to green and is pink from that. All this to say hold the current dose. Does this make sense?
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yes, thank you. I'm just baffled that 2 months ago, she was almost in remission when I was using an old vial that had been in the fridge, but not expired. I was told that the vials are only good for 6 months and this one was at least a year old. I don't see how this is irrelevant. As soon as I started the new pen, her BG went up and stayed up. It was the opposite of what I expected.
 
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She’s a long term diabetic. Was she ever in remission before? A cat’s insulin needs change sometimes for no apparent reason. Looking at your ss I’m not seeing that she was almost in remission.
 
tiffmaxee said:
She’s a long term diabetic. Was she ever in remission before? A cat’s insulin needs change sometimes for no apparent reason. Looking at your ss I’m not seeing that she was almost in remission.
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Did you see the results from her lab tests on fructosamine and glucose?
VET glucose 213 (slightly high); fructosamine 292 (normal) on 9/18/2020. The vet even had some hope.
 
No. I did not. I just looked at your ss. So her fructosamine was normal but she got .50 insulin that day.
 
A lot could have happened on November 13 between that AMPS of 192 and that PMPS of 158. For example, did she go down to 30 and was going up at PMPS? Or was she slowly dropping all day and then continued to drop after PMPS? It’s just conjecture at this point because there’s no data. Similarly, a lot could have happened after that PMPS of 158.

Both of those cycles could have set up the bounce to high numbers that you see in the past day or two. Without the data, we don’t know. So we don’t know whether you need to be looking toward a dose increase or a dose decrease.

I’d sit in my hands and wait for the bounce to clear, then be diligent about getting extra tests when you see lower numbers. That will tell you what you need to do with dosing.

Just because you’re not catching low numbers doesn’t mean they’re not happening.
 
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