5/17 Duriel AMPS90, +9 101, +10 228, PMPS 307

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Durielle

Durielle

Member Since 2012
http://felinediabetes.com/FDMB//viewtopic.php?f=9&t=95457

Yay! Durie's AMPS is 90. Will recheck at +2 for info. I will be away between +3 and +7... but I think she'll be okay during that time as her nadir 'seems' to come late in the cycle.

EDIT: As of AM+2 Durie got a 70. Is this reason for concern? I will be away from +3 to +7... but will stay if she needs to be monitored.

EDIT: As of AM+3 she got 65... starting to get a little concerned. Will stay home and keep testing. Very glad I brought down her dose to .5u a few days ago. But unclear as to why it's dropping, when nadir on Lantus is 'supposed' to be mid-cycle... Durie's nadir seems to come very late.

EDIT: 61 at AM+4. To prevent a hypo, I will feed her a little bit of her regular food and retest in 1hr.

EDIT: 63 at AM+5. This is the most 'normal' blood sugar day she's probably had in quite some time. Will keep monitoring.

EDIT: 35 at AM+6. No symptoms of hypo. Fed full normal portion, with a teaspoon of maple syrup added to food. Retested after 20 minutes, got 42. Retested again after 20 minutes and got 39. Fed another teaspoon of maple syrup with oral syringe.

EDIT: Waited 20 minutes got 67 at nearly +8. Back in the normal range. What a day!

EDIT: 101 at nearly +9
 
Re: 5/17 Duriel AMPS90, +2 70, +3 65

If I were you, Jorge, I would stay home too.

Given she peaks late and had a 94 at PS, and has continued to fall, it may have been that her last shot still was having residual effect.

I have to run, but hopefully someone here can give you a link to information about slowing a too-low drop. Some may recommend a simple sugar if she gets too low, but I suggest using a medium or high carb canned for for that purpose. If she gets into the 40s before +6 and you aren't getting responses here, please consider moving over to the Health Forum.
 
Re: 5/17 Duriel AMPS90, +2 70, +3 65, +4 61

I think your plan is good -- try LC food first since numbers are still in a good range and see if that slows things down. If numbers are still heading down, you can give some medium or high carb food. Here's the link, in case you need it, on handling low numbers.

I don't know that I would definitely conclude that Duriel has a late nadir. The nadir can change from cycle to cycle. At this point, you don't have very many spot checks to help you figure out where the nadir typically falls. Likewise, based on the information on your SS, I don't think nadirs were going too low and that a dose reduction was warranted -- at least based on the tight regulation protocol. I suspect you're not yet comfortable with lower numbers. It's a process not just for your kitty but for you, as well, to get comfortable with those green numbers. Let's see what this dose does for Duriel.
 
She was doing so well for the last few days. Don't really know why she went so low today... I shoot at the same time every day, with very exact amounts so no overlap/double dose was possible. Perhaps she's getting too high a dose, even at only .5u? She spent about 1.5 hrs today below 65... now, of-course, her levels are high because of the 2tsp of syrup and the extra food. Strongly considering reducing her dose as of tomorrow am shot, to a hair under .5 but not quite .25units. Thanks everyone for your info and support. Will only test around +5 tonight. Can't keep testing this much.
 
Cats are unpredictable, even when we shoot exactly the same amount at exactly the same time. Sometimes the pancreas sputters a bit, and helps out by producing a little more insulin sometimes, and that in addition to what you shoot brings the BGs down more. When Durie's BGs are in a healthier range, there is a better change the pancreas has a chance to start recovering and you can see changing numbers like this. As much as we'd like to find a pattern, it's hard to predict!

You don't need to do anything more than a +5 ... Durie is giving you a bounce from those low numbers, so get a little sleep!
 
Lisa & Leo said:
Cats are unpredictable, even when we shoot exactly the same amount at exactly the same time. Sometimes the pancreas sputters a bit, and helps out by producing a little more insulin sometimes, and that in addition to what you shoot brings the BGs down more. When Durie's BGs are in a healthier range, there is a better change the pancreas has a chance to start recovering and you can see changing numbers like this. As much as we'd like to find a pattern, it's hard to predict!
Click to expand...

Interesting... so next time her pre-shot is below 100, my instinct is to lower her dose a tiny bit (just a hair less, not down by a full .25u). Would that make sense?
 
Some people are conservative and will not shoot insulin on a double digit pre-shot. For example, I would not shoot my diabetic at less than maybe 130, and that was only after I had a couple years of logging history on him. (He was insulin dependent for 4.5 years. We were using Levemir, which is similar in action to the Lantus you use with Duriel.)

But if you choose to shoot at a low pre-shot, you should at least make sure you are shooting into a rising, pre-food BG number. That is, don't feed and retest maybe 30 minutes later to make sure Duriel's BG numbers are not still falling. My feeling is that making sure that the number is safe to shoot at full dose is a better strategy than shooting a lower dose into a potentially unsafe number.

You will get different opinions.
 
Venita has good advice for shooting low, like the sticky says. If you have a lower number, you need to make sure the numbers are on the rise before shooting, by stalling (no food) and then retesting 30-ish minutes later. Sometimes you could be stalling for a couple hours if you really want to shoot rather than skip.

Some people like Venita have selected a number that they won't shoot below such as 130 or 200. That gives you a safety margin so you don't have to worry as much about going low, and won't use as many strips spot checking. On the other hand, a kitty's glucose values will be overall higher and chance of remission likely lower since the pancreas isn't in normal ranges as long. It's a trade-off. Some people work and just can't shoot a full dose on some days. Some people follow the "Relaxed" protocol or it's also called the Go Slow protocol - it is similar to the tight regulation that we do here, but it is less aggressive when to shoot and when to skip shots. You might want to look at that protocol here. It's really just a modification rather than a whole new protocol.
 
tompytomp said:
Lisa & Leo said:
Cats are unpredictable, even when we shoot exactly the same amount at exactly the same time. Sometimes the pancreas sputters a bit, and helps out by producing a little more insulin sometimes, and that in addition to what you shoot brings the BGs down more. When Durie's BGs are in a healthier range, there is a better change the pancreas has a chance to start recovering and you can see changing numbers like this. As much as we'd like to find a pattern, it's hard to predict!
Click to expand...

Interesting... so next time her pre-shot is below 100, my instinct is to lower her dose a tiny bit (just a hair less, not down by a full .25u). Would that make sense?
Click to expand...

Well, you can't make that a general rule, like Venita said. It's really all about where kitty is in the rolling cycle. A 100 could be heading to a 300 or it could be dropping to a 50, and without data you don't know. Every person is different - I nearly always shot a 100 but I was very aggressive. Some will never shoot a 100. It takes experience to make some judgement calls.

I can shoot a lower dose, but you don't want to make a habit of that because Lantus is longer-lasting than one cycle. Some will "spill over" into the next cycle, so when you test pre-shot, there may still be insulin in there doing it's job, which is why that number may still be falling. You should be consistent in the dosing. *Occasionally* people will shoot a lower dose due to lower #'s, personal obligations, etc., but it's really more important that you stick to a dose that you can consistently shoot.

I hope that helps.
 
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