Pete asked me a few questions in a PM and I’m posting it all here for transparency.
No, I’m referring to holding a dose. Again, because the shots are cumulative due to the depot, what might have been a stabilized depot can quickly become overfull meaning the BG will drop. Since you have no data (not your fault), you don’t know how low that dose took him. If we don’t know how low a dose is taking a kitty, we don’t increase the dose.
Wendy said, "There is no reason to assume a drop of 100. With Lantus, a lower preshot typically meana a lot flatter cycle. Even if he did drop to 50, that is still safe, though on the edge. Besides which, he hasn't gone below 130 on this dose, so not likely he'd dive down to 50." Before that she said, "He's breaking a bounce, see how he dropped down from 400 overnight. That can mean later nadirs." How do you know that "a lower preshot typically means a lot flatter cycle", instead of the effect of insulin kicking-in late?
You’ve misunderstood what Wendy was saying. If he starts at 100, he’s already broken the bounce. And while, as she said, he might drop to 50 or 40, he’s going to have more like a regular Lantus cycle than like a bounce clearing cycle which are very, very active and the dives are steeper because there is “more room” for the BG to dive. If you have a lower PS, on Lantus, the insulin didn’t kick in that late. It onsets around +2 with Lantus and while ECID and you might see a bit later of onset, it won’t be at +6 or +7. Lantus doesn’t work that way. Or a lower PS can be due to a bounce-breaking cycle. Also keep in mind that Lantus can give a second dip. A second dip is when the BG has come down during the cycle, then gone back up a bit and then drops again at PS but it doesn’t drop lower than the earlier nadir.
If so, why is he bouncing 14 cycles in?
A cat can easily bounce the entire time it’s on a dose even if it’s on that dose a month. Bouncing stops when the liver becomes more accustomed to lower numbers but some cats never stop bouncing, some bounce for years and then decide to flatten out. You can help a bit with bouncing by controlling the drops with food so the curve flattens a bit but that doesn’t mean he will totally quit bouncing.
I take it here, you're referring to increasing the dose, not holding it. At this time Stache had completed fourteen cycles. Normally, a curve should stabilize well before that, correct?Marje and Gracie said:
No, I’m referring to holding a dose. Again, because the shots are cumulative due to the depot, what might have been a stabilized depot can quickly become overfull meaning the BG will drop. Since you have no data (not your fault), you don’t know how low that dose took him. If we don’t know how low a dose is taking a kitty, we don’t increase the dose.
Wendy said, "There is no reason to assume a drop of 100. With Lantus, a lower preshot typically meana a lot flatter cycle. Even if he did drop to 50, that is still safe, though on the edge. Besides which, he hasn't gone below 130 on this dose, so not likely he'd dive down to 50." Before that she said, "He's breaking a bounce, see how he dropped down from 400 overnight. That can mean later nadirs." How do you know that "a lower preshot typically means a lot flatter cycle", instead of the effect of insulin kicking-in late?
You’ve misunderstood what Wendy was saying. If he starts at 100, he’s already broken the bounce. And while, as she said, he might drop to 50 or 40, he’s going to have more like a regular Lantus cycle than like a bounce clearing cycle which are very, very active and the dives are steeper because there is “more room” for the BG to dive. If you have a lower PS, on Lantus, the insulin didn’t kick in that late. It onsets around +2 with Lantus and while ECID and you might see a bit later of onset, it won’t be at +6 or +7. Lantus doesn’t work that way. Or a lower PS can be due to a bounce-breaking cycle. Also keep in mind that Lantus can give a second dip. A second dip is when the BG has come down during the cycle, then gone back up a bit and then drops again at PS but it doesn’t drop lower than the earlier nadir.
If so, why is he bouncing 14 cycles in?
A cat can easily bounce the entire time it’s on a dose even if it’s on that dose a month. Bouncing stops when the liver becomes more accustomed to lower numbers but some cats never stop bouncing, some bounce for years and then decide to flatten out. You can help a bit with bouncing by controlling the drops with food so the curve flattens a bit but that doesn’t mean he will totally quit bouncing.
) I also handed out more than one treat. Anyway, tomorrow's another day, I guess...