Re: 6/9 Mali AMPS Hi
Robert
Jill, one of our most experienced members who has used lantus and lev, had a chance to look at Mali's SS. She believes we need to get back to the basics with Mali.
Frequently with spot checks, the caregiver (CG) is able to see the onset, nadir, and duration. These are important concepts that we each need to know about our own kitty as ECID. We know when an insulin "might" onset....for lantus...about +2; levemir...about +4. Nadir? Lantus....we start by looking at +6; levemir....+8/+9. But our kitties don't read the info on the insulins and so not only do we see different curves from different cats but sometimes our own cat's onset, nadir, and duration change.
Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
Peak/Nadir - the lowest point in the cycle
Duration - the length of time insulin continues to lower blood glucose
I was really hoping we could find out some of this for Mali by getting different spot checks but we're just not getting the data to tell what she is doing. To be quite frank,we don't know right now if she needs a dose increase or not. So let's hold off on increasing the dose and do an "assignment".
You will need to do a little more investigative work which means a bit more testing. Today might be a great day as Mali looks like she is clearing her bounce. It's too late to get an onset for the a.m. cycle but how about getting a +10 today so we can see where she went since +8? Then tonight, let's get a +3. If she is down at +3, let's plan to get more tests. How many? Depends on how low she is. If she's in yellow, retest in two hours. I will be up and online tonight and if you post her numbers in the subject line, I can keep an eye on it and help you decide.
Keep in mind that it takes 72 hours for a bounce to clear but even while she's bouncing, we still need data because maybe Mali doesn't take that long to clear....but we need to know. I think going forward, keep in mind that any time you get a number that is more than 20% meter variance lower than the one before and its the first drop you see in the cycle, you should be testing again sooner rather than later. I don't mean you have to test every single hour in the cycle if you get a lower number each time. However, we need to have an idea of what she is doing, right? (Caveat: there might be a cycle or so that she is coming down into green and you will need to test more often).
Don't be shy about posting and asking for help on when to test next. On 6/2 when you got a 92 in the a.m. cycle, you could have posted and asked when to test again. There are ALOT of experienced members here who can help with that until you get a feel for it.
Let me give you an example. If you look at Gracie's SS on the P.M. cycle of 5/28. Her +2 was 190 and +5 was 128. I have no idea how fast she was dropping. Did she onset at +4 and drop 70 in an hour....believe me, she is more than capable. So I tested at +5 which told me she likely came down a little slower than I thought and flattened out. So keep in mind that if you see a 60 mg/dL drop over three hours, that doesn't necessarily mean she dropped an even 20 mg/dL over that time. She could have done it all in one hour.
Look at other SSs and see if you see any patterns. Sometimes it's easier to see on someone else's SS before you see it on your own cat's SS. (Don't let yourself get overwhelmed with how much some of us test....some of us are very data driven....you don't have to be with strategic testing to figure out her onset, nadir, duration).
How does that sound?
