4/30 Missy amps 133, +3 - 149 , +5 -124 pmps 94, +3 - 86

[DanaB]

I'm looking for an opinion if this dose might be too high... she seems to be reverse curving

Should I drop to 0.25?? I'm doing TR but I have noticed it usually takes 5 days for her to settle. She doesnt seem to settle into a dose for long.
But seems to always dance around the 0.5 dose. I use calipers and have tried just dropping or raising 1/8 of a unit (skinny&fat#s).

 

[tiffmaxee]

As a long term diabetic diagnosed in 2014 she needs to be in the 40-49 range on three different cycles to earn a reduction or drop under 40. You are reducing with a single drop. I would increase the dose a full .25.

 

[DanaB]

As a long term diabetic diagnosed in 2014 she needs to be in the 40-49 range on three different cycles to earn a reduction or drop under 40. You are reducing with a single drop. I would increase the dose a full .25.

Yes... she dropped to 40 at +4 2 weeks ago on this dose then i gave HC. I was also often giving her more carbs to make sure she didnt drop too low mid cycle. I didnt want to drop it too quickly even though her numbers were low becasue she tends to take 5 days to settle... so intead i used food to try to balance and hold a little longer. You can see around line 70-80 last time i didnt hold long enough before the reductions then she just ends up bouncing all over.
This is the first time she is reverse curving. Ive seen people say its common when the dose is too high. So i though maybe she needed a reduction.

 

[Katherine&Ruby]

This is the first time she is reverse curving. Ive seen people say its common when the dose is too high. So i though maybe she needed a reduction.

I've seen this repeated in other feline diabetes groups, but here on the FDMB whenever numbers start going up it's always recommended to give more insulin rather than reduce. Here are the TR guidelines for increasing doses from the Dosing sticky:

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.
• Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
• Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.

 

[DanaB]

I've seen this repeated in other feline diabetes groups, but here on the FDMB whenever numbers start going up it's always recommended to give more insulin rather than reduce. Here are the TR guidelines for increasing doses from the Dosing sticky:

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.
• Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
• Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.

Yes. I understand that. What i mean by her numbers are going up is that instead of dropping by +3 like she usually does she is up at +3 or still climbing which is not normal for the way SHE usually curves.
Last time she did this she suddenly dropped... but someone randomly mentioned that her curve looked like i needed to drop her dose. So now here i am again wondering if im missing something. I will hold until day 5 before i raise just to make sure.
Thank you.

 

[Wendy&Neko]

Inverted curves can mean too little, as well as too much insulin. The former can be from bouncing. Nice downward cycle tonight and yesterday AM, both of which caused bounces.

 

[DanaB]

Inverted curves can mean too little, as well as too much insulin. The former can be from bouncing. Nice downward cycle tonight and yesterday AM, both of which caused bounces.

She just dances around this number. Now today again she has a different curve. I know if i go up to a 0.75 dose she will likely drop below 50 with in a week. Im ok to handle it, and im at the point where i give MC food early in the cycle to prevent it when i see it coming. But then she bounces.
I guess i was kinda thinking maybe im looking at it wrong and when she started curving a bit different at a skinny0.5 and 0.5 maybe i should have dropped the dose more. Right now her numbers are ok so im not too worried. I just wish there was a dose where she was a little more regulated.
I'll probably hold here and i suspect she will drop below 50 tonight. But I'll hold the dose as long as possible until 3 under 50 or 1 under 40. Then maybe i'll try dropping the full 0.25 again. Technically it will be the lowest shes been since ive recalibrated doses with the calipers.

Thank you.