06/14 Kiki's Charlie AMPS 75 Should I lower the dose?

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Kiki's Charlie

Kiki's Charlie

Member Since 2014
Charlie had a good 'low' day yesterday. This morning very low numbers (AMPS 75, fed, waited 45 mins, 2nd AMPS 99). Two questions: At what number is it safe to shoot? Can I reduce the dose with 0.25? (See yesterday's thread too). It's nice to see those greens and blues but also nerve wracking :/
Kiki
 
For me, the main thing when I see a low pre shot number is "will I be home to monitor?" I nearly always am, so I shoot low and make
sure I do a +2 check and then a +5, +6, until I get the low point (nadir) and then monitor a few more times near the end of that cycle.

Normally, they say you drop a dose if you get 3 different readings in the 40's (2.2 to 2.7 in your units), or if you get one reading in the 30's (1.6 to 2.17)
then you drop the dose by 0.25. So based on that and your spreadsheet, you didn't need to drop the dose yet. But it's your call. You have to be
comfortable. You can always go back up if the numbers don't stay down.

I hope that helps.
 
I meant to add that stalling is a good move when you're not comfortable. In your case, you got a higher number which is what you'd expect
at the start of a new cycle.
 
One thing to remember when you're stalling is to not feed. You want the number to be rising on it's own, not a food influenced number because the food carbs can wear off quickly.
 
Hi Janet - thanks! I'm struggling a bit to get my head around the idea of shooting low numbers since logically it seems like it will make the cat crash... but that isn't the case... I'm learning!
By the way, checked out Dimitri's SS - looks pretty amazing that you managed to get him off insulin in such a short time! What's your secret??

Kiki
 
As Janet pointed out, you need to consider a few factors when thinking about shooting low:
  • Will you be home to monitor?
  • Do you have supplies (i.e., strips and HC) if needed?
  • Are you data ready? (See the sticky on Shooting & Handling Low Numbers)

In most cases, we don't suggest that you shoot low if you see a 50 and your pre-shot numbers have previously been in the 300s. Many people aren't comfortable with shooting low in that situation. However, if you've been seeing a lot of blue pre-shots, it may make sense to shoot lower. When you do, you want to get early tests so if numbers are dropping, you catch the situation early and can intervene.

You're right -- even thought it's counterintuitive, shooting low doesn't mean that numbers will plummet. I have a kitty who likes to nose dive. Those dived don't necessarily happen when I shoot low numbers.
 
Normally, they say you drop a dose if you get 3 different readings in the 40's (2.2 to 2.7 in your units), or if you get one reading in the 30's (1.6 to 2.17) then you drop the dose by 0.25.
Click to expand...
Just to clarify. If a kitty has been diabetic for over one year, then we recommend reducing the dose by 0.25 if you get a test below 40. For a cat that has been diabetic for less than a year, we recommend reducing the dose, if you get a test below 50.
 
Thanks for all the tips! So the conclusion is that I probably lowered the dose too early since I didn't have that low numbers (they felt low to me though, it was also the first time that she had such low numbers for a longer time)... I'll see how she does the coming days!
Kiki
 
If you're home to test and have supplies, I think depending upon how her numbers go today, I would go back to her regular dose tonight. We call a one time reduced dose a BCS dose, and it is used sometimes when we are scared or have to leave the kitty and can't be there to monitor.

Her numbers were just starting to look really good on the 1.50 dose. Nice healing numbers, and more consistant.

It's up to you.
 
As for Dimitri, I didn't do anything to get him off the insulin so fast the first time, it was all him and his pancreas. As of 2 days ago however, he is back on insulin, but he's already responding very well. So hopefully he won't be on it too long. As they say here a lot, "Every Cat Is Different." And that is the truth! I hope everything goes well for Charlie.
 
Charlie's looking great!

it's ok to give a one time reduced dose if you are nervous or not going to be around to monitor. I agree with Dyana that i'd go back to 1.5 tonight and hold it there until you catch a number under 50. The goal of Tight Regulation is to get all the BGs between 50 and 120. The opportunity to shoot low is a gift! Now that you've shot a 130 and a 110 you've got some experience. Try shooting something under 100. Often shooting low will reduce the entire blood sugar range and flatten out everything.

If you looked at Dimitri's spreadsheet, did you notice the preshot numbers and what happened to the rest of the cycle when Janet shot a green preshot? It is very counter-intuitive that if you shoot a low number the cat will drop less than if you shoot a high number, but that's how Lantus works best. Yesterday and today you're already seeing that effect at work. Kinda cool, eh?
 
Hi Julie, thanks! I did already shoot 1,25 tonight... I would like to try it for a few days. The low numbers are quite difficult for me to handle since I'm also very busy with my work. But of course I want to do what is best for Charlie...
Kiki
 
I think I want to get Dimitri a shirt that says "Shoot Low to Stay Low," cause that's our mantra. :-D
 
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