Keep skipping shots because of normal numbers, then super high overnight?

I am so confused with dosing my cat. She was recently diagnosed and I am really struggling with her insulin shots vs. her blood glucose. We started on 1u which was too high, then went down to .75u which I thought was working well, but maybe we should stick to .5u? But recently we have had to skip shots because she is below 150 (double checked with a manual monitor). Her numbers were normal the other morning, so we skipped her shot, she was normal the whole day but slowly creeped up to 200s, so we gave her her pm shot, then high numbers overnight for some reason, normal am shot, but then her numbers were very normal all day so we skipped her pm shot since it was too low, and she shot way way up overnight last night! Now once again she is too low for her pm shot and I know I can't give her the insulin because she will go hypo overnight, but I really don't want to keep skipping doses and her to keep yo-yoing like this. We are also struggling to get enough calories into her, since she is a light eater and is used to dry food instead of the gourmet wet food we switched her to. Can someone please give me some advice?

Her amps number is 163, so we have to skip her shot again this morning agh!

Hi, have you read through these stickies? You'll get more detailed advice soon on where you should be with dosing but I will say you haven't stuck with your doses long enough. You were right to drop the 1U dose when you got a hypo number of course, but after that you should have held that lowered dose for 5-7 days per TR protocol for starting Lantus.

Lantus is a depot insulin, there's more detail in the link below but basically it means it forms a deposit of slow releasing insulin when you inject, but it can take a good few days to build up. So when you start giving insulin you need to give time for that deposit to build up. It can also take time for that depot to be used up so sometimes reductions or skipped doses don't show immediate effect.

Sticky - Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Sticky - What is the Insulin Depot?

Some of those high numbers could also be bounces, which can be frustrating but just something you have to wait out. This can be a real game of patience.

I suspect there are a few things going on.

Lantus is an insulin that likes consistency. Unless a dose reduction is indicated, which with TR means the blood glucose reading is below 50, you hold the dose. With TR, doses are held for 3 days/6 cycles unless a reduction is warranted. Nutmeg's numbers have not been in a dose reduction range. If you make frequent changes to the dose without allowing it to stabilize, there's a high likelihood that you'll end up with wonky numbers.

Bounces occur if the numbers drop low, drop fast, or drop into a range your cat's system is no longer used to. When this happens, the liver and pancreas release a stored form of glucose along with counterregulatory hormones which cause the numbers to spike. The elevated level can last up to 3 days. Nutmeg has some bouncing going on!!

If you get a pre-shot number you don't feel that you can shoot, you have three options:

• You can not feed your cat and stall. Wait 15 - 20 min and retest. Have numbers risen sufficient for you to be comfortable shooting. If not, you can continue to stall.
• You can shoot a reduced dose.
• You can skip

If you stall, your next shot is due 12 hours after you gave an injection. The maximum stall time is 2 hours. Depending on your schedule, stalling may not be feasible. You also have to move the shot time back in relatively small increments.

Most new members are not comfortable shooting low numbers. It's an acquired skill. You've shot 150. Where would you feel comfortable shooting?