? 07/28 Tommy AMPS 200, PMPS 400; High PM BG, need advise

As you have no tests taken during the cycles it is hard to say what is happening. But I think Tommy has most likely dropped low during the am cycle today and is now bouncing up high from that drop. I would not recommend an increase until we can see what is happening during the cycles. Lantus dosing is based on the nadir or lowest point in the cycle. Are you able to get any tests in during any of the cycles either am or pm cycles? Which meter are you using.? You need to choose one and stick to it, ithereiwse it will drive you crazy.

From the Basics:
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
 
As you have no tests taken during the cycles it is hard to say what is happening. But I think Tommy has most likely dropped low during the am cycle today and is now bouncing up high from that drop. I would not recommend an increase until we can see what is happening during the cycles. Lantus dosing is based on the nadir or lowest point in the cycle. Are you able to get any tests in during any of the cycles either am or pm cycles? Which meter are you using.? You need to choose one and stick to it, ithereiwse it will drive you crazy.

From the Basics:
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
Сurrently we are using RelionPremierClassic. Backchecked it against RelionMicro (older model) but the BG difference was ~60 in 2 measurements. Panicked, decided to order NovaMaxPro to run another comparison. Glucose meters do drive a bit crazy giving such a wide offsets in measurements. will have to stick to one as advised.
Plan to do within the cycle tests this weekend as "tiffmaxee" recommended in the yesterday's post.
 
Yesterday you said you might be able to get a +6 or +8 today. I guess that wasn't possible? Those spot checks mid cycle will provide the answers to why the higher numbers tonight. Can you get even a +2 or +3 test before bed each night? That will also provide clues as to how this dose is doing. At present, the data says either the dose is too high, or too low.
 
Yesterday you said you might be able to get a +6 or +8 today. I guess that wasn't possible? Those spot checks mid cycle will provide the answers to why the higher numbers tonight. Can you get even a +2 or +3 test before bed each night? That will also provide clues as to how this dose is doing. At present, the data says either the dose is too high, or too low.
Gotten tied up at work missing +6/8. Will do it over the weekend for sure. Thank you for your guidance
 
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