0.6 units too little; 0.7 too much. What now?

[Melissa and Celle]

After settling into a very high flat curve at 0.6 units we went up to 0.7, but now we seem to be bouncing again. A rise today from +6.5h = 212 to +8h = 331, and now 399 at +10h. Ugh.

The higher dose doesn't seem much worse than the lower, although I might change my mind when I see her PMPS. But so far the highs aren't any higher, and at least we're getting her below 300 for part of the day now. I'm not sure though what I can do now. Neither dose is getting us acceptable control (even with our fairly low standards given how hard we've been working at this). Have any other cats just not been able to get Levemir to work for them? Could she just need more time at 0.7?

 

[Blue]

I am not understanding your measurement of dose; what syringes are you using to get a 0.7?
Also, I am not see that the current dose is too much; rather, it is still too low because a BG of 212 is far from too low.

 

[Melissa and Celle]

I am not understanding your measurement of dose; what syringes are you using to get a 0.7?

They have just half unit markings. I line the plunger up with the bottom of the 0.5 unit mark rather than with the top. Not sure exactly what this is, but that's what I call "0.7 units"

Also, I am not see that the current dose is too much; rather, it is still too low because a BG of 212 is far from too low.

Right, but the higher the dose, the more she swings from low to high rather than lowering her whole curve. She was all the way into the 500s with my prior attempt to get her low down enough.

 

[pamela and tigger]

Also, I am not see that the current dose is too much; rather, it is still too low because a BG of 212 is far from too low.

Right, but the higher the dose, the more she swings from low to high rather than lowering her whole curve. She was all the way into the 500s with my prior attempt to get her low down enough.

Melissa, I still don't see any bounce here, and I agree with Gayle in that the dose is still too low.

Go back over the Tilly Guidelines I posted for you in your last thread and see if that helps. I still think you need to slowly go up the dosing scale. I think you have been on the 0.7 units long enough now.

 

[Vicky & Gandalf (GA) & Murrlin]

Yeah, today's cycle is pretty indicative of not quite enough insulin, she got some response to it, but it was not enough insulin to hold the blood glucose down long enough. If you can manage .9U, that's not too large of an increase.

Since lowering the dose stopped the 500s, you've essentially started over with a dose low enough to not overfill the shed. By this point the .7U is not enough to keep her out of the 400s, so a small increase is needed before you're going to see results. I know it's hard to tell how this is different from what too much insulin was doing, but it is. I'm also looking at all her recent cycles, which continue to be in the 300s. All indicative of not enough insulin.