2/15 Buddha

[Donna & Buddha]

Well, after last Sunday's bg plunge to 50 at +3 and +4, I cut back drastically on Buddha's insulin, going from 2u to 1u, bid. Big mistake. His bg was high, and he was saturating the kitty litter, an all around unhappy kitty. So by midweek, we were back to 2u. The last couple of days have seen yellow amps and I've decreased the dose by .1u and .2u. Buddha's been a happy cat the past few days and litter wetness seems back to normal.

Buddha was at 220 this morning, and I shot him with 1.8u. This morning from +3 to +4, his bg once again was in the upper 40s. I kept cool this time, fed him only his normal 1/2 more can of fancy feast. 1/2 hour later (+3.5) bg dropped from 49 to 46 and he ate another 1/2 can. At +4, he was at 91.

I don't understand why we have such an early and low nadir. Guess I should have cut back further to 1.4u or 1.6u this morning. Or should I wait for bg to go higher before I shoot the normal amount? Or do I feed a higher carb food at lower numbers and keep time of shot and amount of insulin constant?

If his bg is HI tonight is it safe to shoot 2.1u, which worked to lower it a couple of days ago? Or do bg's in the 40s require a dose decrease no matter the ps bg?

 

[Ele & Blackie (GA)]

I wish I could help. I think the early and low nadir usually means you have some overlap from the previous shot, but I'm not sure. I agree that the 1.8 this morning was probably a little too much. I'm wondering if you can come up with a sliding scale to help you determine what to shoot. I hope others will answer soon and give you more insight.

 

[Gator & H (GA)]

My input is this. Ideally you would like to find a dose that Budda is sensitive to, that will just get PS that are approximately the same then you can up the dose just ever so slightly - maybe by 0.1u or even "0.05u" to bring him back down slowly rather than expecting to find a dose straight off that's going to put him into the zone you would like him in.

You are obviously not waiting multiple cycles for a dose to settle which can be OK if you want to try sliding scale. If SS is not your objective then you may want to be waiting for things to settle for at least 3 and up to 8 cycles. But if you do SS then IMHO an important lesson to learn is to not overreact when they run high. It's a tough sensibility to learn. And then if you do SS it's important to learn to back off when they start going down from PS to PS quickly [but not over react here either]. The way I go about SS is to then finally develop a small range of doses [usually less than 0.5u range] that I can control the ups and downs with. You would eventually develop a small range of doses that As long as you can find that dose that brings them back down slowly then you are golden.

What is your current strategy or how would you describe you current strategy?

And also if you are experiencing rebound/panicky liver like it looks you are, then I've been of the mind to identify that rebound in H by testing for 3 or 4 hours in a row when it is generally happening to identify it.

I'm sorry if I'm not much up you you guys and your sitch. I hope I'm not messing up any other advice that you guys have gotten.

 

[Terri and Lucy]

Hi Donna,

The problem you're having is why so many people choose to use a sliding scale. You might want to try a 3-tiered scale. For example: over 300, shoot 2.0; 250 to 300, shoot 1.8; under 250, shoot 1.6. Then you adjust the scale based on your test data.

 

[Joanna & Bix (GA)]

When you get those PSs in the low 200s, I would probably experiment with lowering the dose a hair further. Bix did well with 0.1u reductions, but it looks like that's not quite enough reduction for Buddha. One minus of waiting for a higher PS is then you lose the nice overlap that you have going, and are looking at the next cycle potentially being a big drop from a high #.

If you can stay with a 12/12 schedule and find the in-between doses that work best for him, I think you may find the #s get steadier on their own. If the PSs were under 150 my suggestions would be different, but it would be nice if you can go ahead and shoot on the ones in the 200s before he zooms up from there.

It's frustrating I know to figure out what works, but you are at least seeing some good #s here & there, and you are a pro it looks like at dealing with the unexpected lows! With Bix, I tried 16 different things on low PSs (no doubt to the frustration of those following along and giving me suggestions ) before I got to what worked. It's confusing and scary when it doesn't work, but when it comes together and you find that you know exactly (more or less) what to do to keep things going smoothly, it is a sweet reward!!! Til things change again and you are back to clueless... ah, feline diabetes. :lol:

The good news is that as you try different things and get more data, you are seeing the bracket of what doses are too low, what is too high, what works well on higher vs. lower PSs, etc. and at some point (soon hopefully, for your sanity's sake! ) you may find it gets more predictable & easier to work with, as you hone in on what works best.

Keep up the good work!