10/01/19 Luna Pmps 119, +2 65, +3 52, +4 79, +5 101

[K8&Luna]

Hi,

I'm not used to shooting low numbers and have been trying to get more regulated, but numbers kept dropping after pm shot, whereas they were stable after am shot. I fed some dry food purina dm, and it looks like numbers are coming up.... how long do I need to keep testing? No symptoms. This is so hard, I'm not sure how to tell how she reacts to insulin, it seems different every day.

See link for more history http://www.felinediabetes.com/FDMB/threads/slgs-dosing.219906/

 

[Chris & China (GA)]

how long do I need to keep testing?

Until it's been at least 2 hours since the last time you intervened with anything high or medium carb. If she can continue to go up and get to above 60 and you haven't had to feed anything HC/MC you can probably call it a night.

This is so hard, I'm not sure how to tell how she reacts to insulin, it seems different every day.

That's because you keep changing the dose. Lantus craves consistency and should be given at the same dose both AM and PM.

Lantus dosing is based on the nadir (the lowest point in the cycle), not the Pre-shot. By changing the dose like you've been doing, you never give the depot a chance to settle, so you get wonky numbers.

Since you've been giving such varying amounts, it's really hard to say where you should go next.

How about dropping back to 1.5 and holding that dose for at least 3 days (unless she drops below 50) and then let's see where she's at?

ETA....most cats go lower at night

 

[AmandaE]

Hi Kate!

Typically the rule of thumb is that you want a rest every hour until you have two hours of tests that are rising without food intervention. What time did you feed the DM? Try getting a test in at +5 to see if Luna is coming up without food. Then grab one more at +6. If she was rising without food intervention then you should be ok to stop. If she starts going down you’ll have to feed some MC or HC and repeat. I hope it’s not a Pyjama party night

 

[K8&Luna]

Until it's been at least 2 hours since the last time you intervened with anything high or medium carb. If she can continue to go up and get to above 60 and you haven't had to feed anything HC/MC you can probably call it a night.



That's because you keep changing the dose. Lantus craves consistency and should be given at the same dose both AM and PM.

Lantus dosing is based on the nadir (the lowest point in the cycle), not the Pre-shot. By changing the dose like you've been doing, you never give the depot a chance to settle, so you get wonky numbers.

Since you've been giving such varying amounts, it's really hard to say where you should go next.

How about dropping back to 1.5 and holding that dose for at least 3 days (unless she drops below 50) and then let's see where she's at?

ETA....most cats go lower at night

Ok, so i gave the mc dry food at +2, so, now it's +4 and so she should be ok since her number went up?

Also, i thought she was needing an increase because we never got blue numbers, but when I tried it, i got some low ps numbers, so when I get those, I'm not sure what to do if I can't stall or stay home. So, I usually reduce dose a bit, then try to get back on track. What is the reasoning behind dropping back to 1.5, when usual has been 2.5? Only this one low episode?
And if i do that, how do i know when to increase, when i can only do curves once a week?
Thanks for your help.

 

[K8&Luna]

Hi Kate!

Typically the rule of thumb is that you want a rest every hour until you have two hours of tests that are rising without food intervention. What time did you feed the DM? Try getting a test in at +5 to see if Luna is coming up without food. Then grab one more at +6. If she was rising without food intervention then you should be ok to stop. If she starts going down you’ll have to feed some MC or HC and repeat. I hope it’s not a Pyjama party night

Thanks for your help. I fed the mc at +2, +3 was even lower, then +4 started to come up. I just did a +5 and we're at 101, so I'm thinking it's ok? It's 1:20am here, and I have to be up at 6am :s.

 

[Chris & China (GA)]

What is the reasoning behind dropping back to 1.5, when usual has been 2.5? Only this one low episode?

No....the idea is to find a dose that you can give both AM and PM.....You've been changing the dose so often that there's really no way to know what's going on with her.

By dropping back to 1.5 and holding that dose for at least 3 days, we'll have a much clearer picture of what's really going on without (hopefully) having her drop too low. If we need to go up, we'll know more in 3 days at the same dose.

In just the past week, you've given everything from 1.00 unit to 2.75 units so the depot that slowly releases insulin into the bloodstream isn't giving a consistent amount