Re: 12/28 Cobb AMPS 396 +3 405 +5 357 +8 324 PMPS 246 QUESTI
YAY! clearing in a day! that's great. we want him to get used to better numbers.
I think tonight, I'd get a test right before you go to bed (i'm assuming +3ish, maybe?) and decide by that. If he's still over 200, sleep all night and check him in the morning. If he's under 200, then do some number counting to see how many points per hour he might be dropping and plan to recheck him again if he's headed down very quickly. If you're up with Matty anyway and you want to check him, go for it. But i think if he makes it to +3 and is still over 200, you could go to bed and sleep. you must need it.
the only danger to him is under 50. so we want to make sure someone is monitoring him to keep him above 50. I don't think he's at a risk of that yet, but that is what we are always looking for. Everything above 50 is fine and will just be information -gathering for us to help us make dose decisions. if he surfs in the 200's again this evening, I'd be looking toward the protocol and thinking perhaps the dose should be held for a total of 6 cycles instead of 4, just to see if he'll settle in and repeat a cycle again. if he sucks up the insulin and acts like he didn't even have any, increasing BGs back up and staying there, then we have to keep going up.
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
In the morning, if he's anything over 150, you can probably go ahead and shoot the same dose. I'm not a fan of stalling and really, most of that is for a newbie's comfort zone. Experienced people will shoot preshot numbers in the 50's or 60's, but he's been such a question mark that wouldn't be a great idea for you at this point. the big thing is that we want him to not be dropping dramatically when you shoot. when people stall, don't feed, and retest in 30 minutes, that lets them know the insulin is waning and the BGs are beginning to rise on their own. It's more for information gathering than any other reason.
I'm not sure how clear this is, so ask any questions. I'm running out for birthday dinner for my DH right now, but will be back in an hour or so and will check back in.