3/11 Lily AM 229, 293+3 following 47 on 03.08 Dosage query

Elizabeth20

Elizabeth20

Member Since 2020
Hi

Previously

Lil's had a couple of lows in the last week or so and I've shaved her dose because she is usually high for a few days after a reduction and it makes me uncomfortable and we're getting closer to a dose she can live with I think. She seems to be bouncing today despite not really showing signs at +2.5 last night of heading for a low the way she normally does but I wouldn't put it past her. She's now going out at night but she's more a hunter than a scavenger so I doubt she's eaten anything she shouldn't have. I've referred to new dose wonkiness on reductions before but been told that it only applies on an increase - I assume the scatty numbers she's getting after her reduction is actually a reaction to the low while her system recovers?

My vet has told me yesterday not to reduce her dose without consulting them because there may be other reasons for the dip than needing a lower dose. I was quite happy that she needed a lower dose but now looking at her numbers over 03.07 and 03.08 I'm worried that despite my double pre-breakfast test (113 then 137) she was coming down from a bounce and I shouldn't have shot. I thought she had likely had a low overnight on 03.05 but waited to see evidence of it after the bounce resolved and basically I thought it wasn't worth the risk of her dropping and bouncing again so I reduced the dose.

Roundabout way of asking whether I was right to drop her dose. Given what appears to be a further little bounce today I'm ready to drop her again when it resolves, but is there a better way of managing her shots when she's resolving a bounce to help her stabilise instead of crashing and bouncing for days on end? I feel I'm losing perspective and I always have a crisis of confidence after seeing the vet!

Thanks.

Liz
 
Hi Liz, I'm looking at your message and there's a lot of confusion for me...what is 3.08 dosage? Can you please use measurements for US...

I will look at your SS...
 
Hi Liz - what's your feeding schedule like for Lily? Just wondering if there's opportunity to feed earlier in the cycle to help flatten her out.
 
Ah I see, you're referring to March 8! Sheesh...I've never seen it written like that...some would write 3/8/21, or even 3/8, but the .08 threw me...I'm thinking what is 'decimal' 08???

So forget about the past and focus on your dosing method and recent nadirs!

I see no reason in the past few days to change the dose, if anything I'd be counting the cycles until I could increase.

Also, forget about your vet! I've had so many vets tell me to 'call me when you want to change the dose'...I smile and say 'thank you'...and of course I don't bother calling them. I study the SS, check my dosing method and change the dose accordingly. Trying to listen to you vet is only confusing you...

What I'd really like to see is another test in the middle of the PM cycle to see how low she went. Yes, this may be a bounce, but you won't know that until you get a few more tests...and yes, unfortunately that means setting an alarm and getting up in the middle of the night to get a quick test. It's the only way you'll know how low she's going. Is it possible to get another test during the AM cycle too?

After she went to 173 yesterday at 5+, it would have been a good idea to get another test. Had she reached the end of her cycle? The nadir? We're not sure because there's no test..

So the best way to know what's going on is to fill in the blanks on your SS - try to get an idea of her patterns - when she's going the lowest.

AM and PM readings are the worst ones for figuring dosage. Those measurements are best for preventing hypo as we always always get a pre-shot measurement to make sure that kitty can tolerate a shot - and that's another story...so for now, I see no reason to lower your dosage.
 
JaxBenji said:
Hi Liz - what's your feeding schedule like for Lily? Just wondering if there's opportunity to feed earlier in the cycle to help flatten her out.
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I feed on demand, so she usually eats the most right at the beginning, with three breakfasts then a bit after each test because I've woken her up and more at dinner. I could definitely give her some higher carb food at around +2 to level her off. She doesn't have much of a bump after her normal food although it is about 7% carbs.
 
Elizabeth20 said:
I feed on demand, so she usually eats the most right at the beginning, with three breakfasts then a bit after each test because I've woken her up and more at dinner. I could definitely give her some higher carb food at around +2 to level her off. She doesn't have much of a bump after her normal food although it is about 7% carbs.
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It would be worth trying to get a +2 (and even a +1 on some days) to see what the action is and feed from there. I've given Jax MC very early on (i.e. at +1) to help him through the overlap any overlap between the two doses of lantus + the onset of the new dose - I did this last night and got him to surf the 60s for awhile. Just an example - ECID of course.

If you can slow her drops (flatten her out), that may also help reduce bouncing. just food for thought.
 
Thank you for such a detailed response. Sorry to have been confusing, I'm not used to writing my units or dates in American so I'm clearly not doing it very well!

Sue and Luci said:
I see no reason in the past few days to change the dose, if anything I'd be counting the cycles until I could increase.
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Increase to what? She has had very low numbers at even an eighth of a unit higher. I would have thought the last three days' numbers were pretty bouncy so I've been waiting for her to settle to have a proper look at where she is on 0.75.
 
JaxBenji said:
It would be worth trying to get a +2 (and even a +1 on some days) to see what the action is and feed from there. I've given Jax MC very early on (i.e. at +1) to help him through the overlap any overlap between the two doses of lantus + the onset of the new dose - I did this last night and got him to surf the 60s for awhile. Just an example - ECID of course.

If you can slow her drops (flatten her out), that may also help reduce bouncing. just food for thought.
Click to expand...

Thanks Jax. She does tend to start dropping early if she's going to throw a light green at me, and I've been terrible for realising what time it is when I'm working. I'll have to start setting an alarm for the day never mind the night! Goodness knows what I'll do when I have to go back to the office with no way of knowing what she gets up to at nadir. Fingers crossed I can get her regulated before then.
 
Elizabeth20 said:
Thanks Jax. She does tend to start dropping early if she's going to throw a light green at me, and I've been terrible for realising what time it is when I'm working. I'll have to start setting an alarm for the day never mind the night! Goodness knows what I'll do when I have to go back to the office with no way of knowing what she gets up to at nadir. Fingers crossed I can get her regulated before then.
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While you are home, maybe try to get those +1s or +2s and see if you can steer her with some food. It's a tricky little dance :bighug:
 
I suspect she is dropping lower at night and then is higher at amps. When you see a +2 a lot lower than the PMPS try setting an alarm fir around +5-7 to see.
 
tiffmaxee said:
I suspect she is dropping lower at night and then is higher at amps. When you see a +2 a lot lower than the PMPS try setting an alarm fir around +5-7 to see.
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Hi Tiff

What's the long-term solution to this then? I have been suspecting the same and it is severely tempting to give her a slightly lower dose in the evening so that the combination of shot and depot isn't putting her at risk. The only other option is to give her a lower dose for both morning and evening shots and have her BG higher in the day which I also don't really like. My theory is that the depot would average out as it would only be a slight difference in dose. Unconventional but I don't see how else to avoid getting up at +5 every night which severely affects my functioning and mood.
 
You would not need to do this every night. I would have done a later test for example on 3/5. A reduction might have been earned that night. Do you use an auto feeder? You could set it to go off later in the cycle when the +2 is lower than the PMPS.

Giving different doses for the am and pm doesn’t work well with Lantus at all.
 
She has her shot at 8.30 so I usually test at +3 and if low then I feed, retest, and if she's back up I leave HC and LC food down to see her through (she'll always eat the HC in preference to LC - girl loves gravy!)

I think an auto feeder is the answer to everything - as long as it works. Amazon reviews look like they can be unreliable. Mind you so can I...
 
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