? 5/2 Sebastian AMPS 173 +5 62 +6 48 +7 68 +11.75 45 PM+0 47 +0.25 52 +2 70 +4 53 +6 43

Justin & Sebastian said:
179@+3. I'm thinking I'll be increasing his dose by .25 tonight since we haven't had a green nadir in 6 cycles.
Click to expand...
I just wanted to bring this up from yesterday. I think you are not understanding what nadir is.
Nadir is simply the lowest number in the cycle, it might happen often happen at +6 for a lot of lantus kitties, but it can occur at any time, and can and will change.
So bearing this in mind your statement that Sebastien hasn't seen a green nadir, is not correct.
He had a nadir of 71 on 4/30 that happened to be at PS /+12 though I suspect that he may have actually gone lower earlier in that cycle, as the next test seemed to suggest that he was on his way up.
On 5/1 his nadir on that am cycle was 81 which also happened to be at PS.

With that in mind, I'm not sure I would have taken the dose up without first getting a couple of tests late in the PM cycle, I'm just a little suspicious that he may be hiding some lower greens later on in the pm cycle.

So having taken the dose up, I would certainly be a little cautious and follow up any falling numbers particularly in the pm cycle.

Glad the appy has picked up, and no vomit is always a good sign.
 
Guess I didn't understand. I re-read the TR guidelines and specifically said to not pay too much attention to the PS numbers and go more off what the low point was during the day. 3.5 didn't seem like enough since we were seeing a lot of yellows that we weren't seeing at 4.

48@+3, 40@+4, 62@+5. Blood ketones: lo.

Been kind of a rough morning, he threw up all his breakfast, ate more, then threw that up also. He got into the bathroom last night and ate toilet paper, which he threw up right before eating, so I don't know if his stomach was still upset from that or it was the new food. Gave him a cerenia around +3 and then syringe fed him some food which he's kept down. Not really sure what's up with his numbers. Don't know if the low numbers right now are just from him not having enough food in him early enough or if 3.75 is too much. It doesn't seem like it would be too much since 3.5 was giving some pretty high numbers. But looks like it's rising now so we'll see what happens and if I can get him to eat a little more.
 
48@+6. He's eating some more on his own. Not going to give him HC and check him again in an hour and see where he's at.

I just don't understand how 3.5 has him in the 150-250 range the majority of the time and then 3.75 has him bottoming out and riding around the 50s
 
I think I would take him back to the 3.5, 40 is pretty low.

Justin & Sebastian said:
I just don't understand how 3.5 has him in the 150-250 range the majority of the time and then 3.75 has him bottoming out and riding around the 50s
Click to expand...
I think he may have been seeing some green in the pm cycles after you've gone to bed.
That 71 the other morning looked like he was on the way up already.
To be honest I wasn't surprised by this mornings numbers, which I recommended vigilance.
Justin & Sebastian said:
Been kind of a rough morning, he threw up all his breakfast, ate more, then threw that up also. He got into the bathroom last night and ate toilet paper, which he threw up right before eating, so I don't know if his stomach was still upset from that or it was the new food.
Click to expand...
I'm sorry it's been a rough morning.:bighug::bighug::bighug:
 
Justin & Sebastian said:
I re-read the TR guidelines and specifically said to not pay too much attention to the PS numbers and go more off what the low point was during the day.
Click to expand...
I think you are misunderstanding.
I'm guessing you are refering to this point in the TR guidelines
Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

In Sebastian's case his AMPS was his nadir from the 4/30 pm shot and pmps was his nadir from his 5/1 am shot. What that statement is particularly referring to is that we look at the low point of the cycle (nadir/ at whatever time that happens) to make dosing decisions, we don't want to take the dose up if kitty is getting nadirs that are acceptable but PS are in the red. Some cats can have a nadir at +3 of 60 and then bounce right up to black by PS, CG can sometimes be tempted to take the dose up when they get a very high PS but this would be inappropriate or even dangerous, if kitty is seeing lower numbers earlier in the cycle.
But sometimes the nadir can be very late in the cycle, it happens, and this definitely happened in May 1st with Sebastian, he nadired at PMPS/or +12 with that 83, please not the 124@+6 was NOT his nadir in that cycle, that is, it was not the low point in that cycle.

Justin & Sebastian said:
68@+7
Click to expand...
I'm glad he came back up.



 
Hey Justin, glad that Gill caught that. Sometimes kitties PS numbers are the nadir. Bubba used to be a late nadir cat with his lowest numbers at the AMPS and the PMPS on his first rodeo on Lantus. Those numbers were his nadir.

I agree, I would decrease back to 3.5.
 
@Justin & Sebastian , I can't see your spreadsheet because I am at work, so I can't verify that 45 is not a typo, but PLEASE do not shoot 45. Can you stall, get another test in about 20 minutes to see where you are at. It is most definitely not recommended to give any insulin under 50, I appreciate the past DKA which I know needs to be considered, but you would be better to shoot late with a safe number, IMHO.
 
You must log in or register to reply here.
Back
Top