? 6/12 Max- How long does it take to clear a bounce? High PS #s and lows are still 400+ on 0.25U

[Rebecca & Max (GA)]

Max bounced in the wee hours of 6/9. I lowered his Lantus dose from 0.5U to 0.25U on advice from here, and 24 hours later he got one and a half cycles in the blue! The next cycle he started to rise, but he dropped into the high 300s during the night. Now he's back to high PS (400s or >500) and only dropping below the mid 400's at nadir (390 +6 AMPS; 371 +5 PMPS). Do I keep holding the 0.25U dose?

After yesterday's carb scare, I went back and rechecked all Max's food using the ME numbers. I was happy to find almost all the foods he's been eating are lower in carbs than I had thought. All cans and packets have been relabeled (range from 0% to 6%), but how can I use that information to help with BG levels? If he's high at PS, feed as low carb as possible, etc?

 

[Wendy&Neko]

Here's the link to your previous post here: http://www.felinediabetes.com/FDMB/...es-already-high-catinfo-said-it-was-5.230830/ We ask that you include those links so it's easy to go back and see what happened before. I particularly wanted to easily go back and see the reference to lowering the dose. If you are following TR, he did not earn a reduction. You lowered the dose because you thought he was overdosed.

To answer the question on bounces, it can take up to six cycles to clear the bounce. Hopefully that means today. If you don't see green today, that's proof the reduction was premature and you can increase back to 0.5 units.

I didn't vary carb % for meals based on preshots, I instead just went for consistency. If over time you find he really dives big at onset, you can play with feeding to slow down the dives. Here are a few posts you might want to look at in regards to food:

• Using Food to Manipulate the Curve
• Feeding Low Carb vs Lower Carb Foods
• Carb sensitivity - thoughts

 

[Rebecca & Max (GA)]

Sorry about not including a link, I was unaware, but I will make sure to do that when I reference another post. Here is the one about the advice for his bounce (which I think you looked at from your comments).
http://www.felinediabetes.com/FDMB/threads/6-9-max-stalling-and-need-help.230722/

The reason why I dropped him was that with SLGS anything under 90 earned a reduction. If I was TR, then I wouldn't have because he didn't drop under 50, but the FB group telling me he was overdosed freaked me out (it wasn't fully confirmed here, but the mention of an earned drop sort of cemented that idea in my head). The depot was mentioned here too, and I'm still trying to fully understand that as well. It feels as if I'm in a foreign country and know some of the language, but don't know the slang or nuances of the people who live there if that makes sense?
I wasn't sure TR was for me, so I decided to stick with SLGS. I honestly am trying to absorb as much as I can as a newbie (don't shoot under 200; anything under 90 earns a reduction, etc.), but every time I think I have it, it seems as if my decision is wrong, and then Max suffers. I was stuck in anther Zoom meeting until noon when he needed his shot, so my daughter tested and fed him, then I stayed with the 0.25U for his AM shoot and will bump him up to 0.5U tonight if there are no greens (highly doubt it if there will be).

Thank you for your advice and for the links. I will definitely be looking them over in a little bit!

 

[Wendy&Neko]

OK, good to know on the SLGS. When I first posted today, I thought your signature said trying TR. By the way, I agree with the many others posting June 9th that the FB group was wrong, he was not overdosed - if you were following TR. The 1 unit depot had been long gone by the time he went under 90 on 0.5 units.

Since you have now decided on SLGS again, you hold this dose for a week before deciding if you should increase. Unless he goes under 90 again. The suggestion to increase was because I thought you were still trying TR. So 4 more days on this same dose.

Our guidance to new people changes as they get more experience and data. With the luxury of the Libre, you are able to gather a lot more data than most new people can.

 

[Rebecca & Max (GA)]

OK, good to know on the SLGS. When I first posted today, I thought your signature said trying TR. By the way, I agree with the many others posting June 9th that the FB group was wrong, he was not overdosed - if you were following TR. The 1 unit depot had been long gone by the time he went under 90 on 0.5 units.

Since you have now decided on SLGS again, you hold this dose for a week before deciding if you should increase. Unless he goes under 90 again. The suggestion to increase was because I thought you were still trying TR. So 4 more days on this same dose.

Our guidance to new people changes as they get more experience and data. With the luxury of the Libre, you are able to gather a lot more data than most new people can.

How long can he safely stay so high? He’s dropped to 479 and I will keep a watch on him today. I have not used the ketostix as yet, but am wondering if I should try and test him the next time he uses the litter box. My fear of KDA is the same as hypo. I don not want to hurt my cat.
And I honestly do not know which method would be ‘best’ for us! I think partly is that I don’t fully understand the differences in the dose changes (aside from when to change a dose or NS), and ‘tight’ makes me feel as if I must do exactly x, y, & z at precise moments and my fear is missing something. Gah that sounds so horrid! I have read both methods, and I fell in line with SLGS because that’s what our vet said he does...but he’s also okay with blind dosing, so you know, maybe NOT the best thing? I now feel like I made a mistake by dropping him, but back then it felt right and got pulled into this false sense of hope- ‘oh, look, he’s now all blue and he’s doing great so that was the right thing to do and now all is well!’ HA! ((Insert face palm))
I know that you all cannot tell me what to do, but I feel like I’m floundering and flip flopping between the two methods...and Max is the one suffering. I honestly do not want to see his at these high numbers for another four days! I can tell he’s not feeling good. He finally pooped in the house yesterday, but I can tell he’s constipated. He’s now on 1/8 tsp Miralax 1x/day but going up to 2x/day tonight. He used to poop only outside but since getting the Libre, I haven’t let him roam (and by that meaning sleep outside in his few spots in our yard- he doesn’t wander off except maybe to sleep under the bushes right next door). I feel like the new mother who sits and watches her newborn to make sure s/he is breathing (yes, did that too for a bit with my 3). I know I need to step back, and breathe, but I’m in control of his health, so to speak, and I don’t feel like I’m doing it right.

 

[Wendy&Neko]

Yes, I would test daily for ketones while he is in high numbers. Not all cats get ketones for high numbers, testing is the only way to know.

The choice of which dosing method is one that only you can decide. The method must fit your lifestyle, comfort level, and goals for Max. And yes, you must learn to use bounce cycles to step away from being a helicopter mom. We all get it, it just means you care.