2/24 Doodle AMPS 55 +1.5/38 PMPS 39 NO SHOT :(

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This 52 isi not drastically lower than the 60 you shot yesterday; however it IS getting very close to the "no shoot" range. If you do shoot, I would definitley get a +1 and +2 to see where Doodle is heading. I also would be pretty vigilant about testing with him in these lower numbers.

Did you get any tests in last evening? I'm concerned about shooting that 61 without any follow-up tests in case Doodle did drop into reducie or hypo range...
 
No dosing advice from me, but good luck with whatever you decide to do. I do agree with @Amy&TrixieCat if you are going to go ahead and shoot you probably want to get some extra tests throughout the cycle to make sure Doodle surfs and doesn't go too low.
 
I'd be a bit hesitant about shooting that #, also. Good call on waiting and retesting to see if Doodle's # comes up. IF you do decide to shoot, then definitely get some extra testing in to be sure that Doodle doesn't drop too hard and/or too fast. Keep up the excellent work! :D
 
52 was at 10:30, 53 was at 11. 30 minutes later.

if he did get to a # under 40 last night (i could not wake up, i tried) that's why i'm trying to get his shot time earlier but not this stalling i'm back to 11am/pm) I would be giving 2.75u now, right? so should I just try that?
 
Technically, if you don't actually catch the reduction, it hasn't been earned. But, if you are more comfortable shooting a reduced dose, that is certainly fine. It could be a one-shoot deal (a "BCS", Big Chicken S*** shot), or you could try the reduction and see if it holds.
 
other than the actual #38 he looks fine. He got up from laying down and came to eat. I just gave him FF I didn't really want to spike his blood sugar too much or should I?
 
Absolutely HC food, and/or karo if you have any on hand. retest in 20 minutes. I'm still at work, but will try to check in.
 
also, don't overfeed....just enough to bump up his numbers. You want him to stay hungry in case you need to keep feeding, plus you don't want a scarf-n-barf on your hands.
 
Looks like you did give HC, that is correct at 38 you do want to give HC, but not in large quantities maybe a teaspoon and then retest 15-20 minutes later.
 
I would test him again in half an hour. If he's still above 50 then, then maybe test again in an hour - but no longer than that.

Ultimately, you want to see three non-food influenced tests in a row that are above 50 before you start backing off testing.
 
Can the HC bring his BG up and not just spike it? I'm nervous for the +6 that's "supposed" to be the lowest (although it doesn't seem to be with him)
 
If you just give it in small quantities, in theory, it should just bring him up without spiking.

However, right now, the main concern is that he be safe.

Yep, every cat does have a different nadir - and that nadir can change within an individual cat, too. As Sienne always says, the nadir is a moving target. Trix almost always nadired at +2, then surfed for most of the day. ECID, so unfortunately the idea of a consistent +6 nadir is somewhat of a myth.....
 
Can someone look at his #'s and tell me thoughts on what to give him tonight as a dose? The last time he got this low was last sept. and he stopped eating. I was then not comfortable giving insulin so i stopped for a few days and that really messed him up. I don't want to stop but I'm not sure giving him 2.75u again tonight is a good idea?
 
Where are you in the cycle now? The last number posted in Doodle's SS is +6 - is that where you're at now, or are you further along?
 
No dosing advice from me, but maybe a bit of Food for Thought, wouldn't there still be a shed that was to be depleted during this AM cycle? And then might it be okay to go with 2.75 for the PM dose. I don't really know, but I am interested to know what the experts recommend. I will be watching and learning right with you.
 
I'm actually going into +7 right now. I missed +6 and kind of figured I didn't have to keep testing?

I never understood the whole "shed" concept so I'm glad you mentioned that.
 
You're seeing great progress in the past week, Jennifer, so I'd be reluctant to back away on the dose too much. Technically, you wouldn't even reduce tonight because you just reduced this morning, but I think it's ok to reduce because of the 30's.

I think one reasonable option would be to give a significantly reduced dose tonight, though, say 1.0u, and then return to the 2.75u in the morning.

The "shed" or "depot" means that the Lantus forms a precipate in the body that is equivalent to the dose. That means a depot at 10u is larger than the depot at 3.0u. When you reduce the dose, the depot will also reduce, so as you go down the dosing scale, the depot will equalize to the size of the new dose, but there is a lag in time for that to happen. Reducing the dose this morning didn't prevent you from having the 38 today, because the 3.0u dose's depot hadn't reduced in size yet.

Think of it as a bit of being time-delayed. The 3.0u dose can still be influencing Doodle's blood sugar for the next 6 cycles - probably less and less as you get farther away from the 3.0u.

This is the reason that if you're having a run of lower numbers and you reduce the dose by 0.25u, you can still have the low numbers continue on into the next cycle. If you want to interrupt a run of low numbers for some reason, like you're exhausted and you must sleep, you have to significantly reduce the dose for one shot.

There's a great explanation of how Lantus & Lev work in the body here. It's worth reading to help you understand it a little better.

You must be pretty excited to have Doodle go all green like this! It's a great sign!
 
Well, I have a few hours to decide about giving 2.75u or 1u for tonight. It's such a catch 22. I feel like if I reduce he's going to jump way back up and screw up the progress, however I did go back and realize that the last time this happened I STOPPED giving insulin all together when there were BG's that clearly were high enough to dose.

He was ok today but kind of more tired that normal. Like how us humans would want to spend a lazy day in bed. He's not super active normally but not as "lazy" either.

He and Mikey are both doing really well right now and every test my heart is racing
 
I wouldn't stop his insulin - even if his pancreas has kicked back into gear, we know that the best chance for a strong remission occurs when you give him all the insulin support he needs, for as long as he needs it, as you reduce his dose all the way to 0.1u.

It's helpful if you update the subject line as the new tests come in so the latest info is available from the main page.

Yes, you have some time to think about what you want to do tonight.
 
if he's high enough to shoot tomorrow morning, I'd definitely go with a significantly reduced dose, Jenn. He's not playing games with this dose - he's definitely done with it!

Are you testing every 20-30 minutes while he's under 50? That's incredibly low for 12 hours later - you may have a late nighter ahead of you! Sending "bring em up" vines to little cheesedoodle!
 
He was 94 this morning. I gave 2.5u which I'm thinking was not reduced enough. I will be sure to test often today
 
That is okay, it is probably just a food spike or just the fact that you skipped last night, you can check again in an hour or two and hopefully he will be coming down. I totally know the feeling.
 
There's nothing about this FD dance that is for the faint of heart, is there? it makes us stronger, that's for sure!

You wouldn't normally reduce twice for low numbers in the same cycle, but i understand completely why you wanted to. I would just suggest watching carefully to see if this reduction to 2.5 is going to be ok or not. If his numbers trend up, ie, if they don't come back into green pretty much immediately, you would call it a failed reduction and go back to 2.75u fairly quickly.

Here's the info on failed reduction. The idea with reductions is that the good numbers that caused the reduction continue after you've reduced. The BGs should not go up after you reduced.

The first 2 posts in this thread talk about failed reductions, and the guidelines on the protocol page say:

  • If an attempted reduction fails, go right back up to the last good dose as soon as you see kitty's numbers trending upwards. You don't have to hold the reduced dose for a certain number of cycles before taking the dose right back up. The guidelines listed under the topic "Increasing the dose" do not apply to a failed reduction.

    Please use common sense in this situation. The "last good dose" is not the dose that just dropped kitty into the 20s or 30s. You want to resume momentum by finding a dose in-between the dose that dropped kitty too low and the reduced dose.
In Doodle's case, it likely wasn't the 2.75u that sent him into the 30's, but the 3.0u dose that was most likely the reason. Still, if you are unnerved by going back to 2.75u, if his BGs trend upward, another option would be that you could go to a skinny 2.75u, something less than what you gave as 2.75u.
 
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