? 8/18 Post DKA Millie AMPS 404; PMPS 299, +2 244, +4 436. Confused re: dose!

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Sylvia & Millie

Sylvia & Millie

Member Since 2017
My dear post DKA Millie has me a bit confused. When she was on the 1.25 that dose her bg went to 38! Her 1u dose is keeping her higher. Over the next few nights I will be getting more testing to see how low the 1u might be taking her. I am also waiting for my caliper to arrive to insure fine dosing (fat 1u). I posted yesterday and it was suggested that I might consider raising the dose to 1.25 again. Just need to feel comfortable with waiting a few days (to test at night & get a fuller picture); gets the caliper and try a fat 1u; then after those two things depending on how she is, increase back to 1.25u. My concern is, how do I keep her safe on the 1.25 when it brought her to bgs of 38 (will she need to always be monitored which I can't always do)?

I feel like I'm missing something so more feedback would be great!


http://www.felinediabetes.com/FDMB/...trying-to-find-best-dose.182438/#post-2023081
 
Two thoughts:
  1. It's been a week since those lime greens and she's been higher since so perhaps a little glucose toxicity has developed. If that's the case, trying 1.25 u again might yield less dramatic results.
  2. You could try a "fat" 1 u to see if that gets you anywhere - draw up a bit more than 1 u and then expel insulin until the plunger is just touching the bottom (relative to the needle end of the syringe) of the 1 u line.
 
Kris & Teasel said:
Two thoughts:
  1. It's been a week since those lime greens and she's been higher since so perhaps a little glucose toxicity has developed. If that's the case, trying 1.25 u again might yield less dramatic results.
  2. You could try a "fat" 1 u to see if that gets you anywhere - draw up a bit more than 1 u and then expel insulin until the plunger is just touching the bottom (relative to the needle end of the syringe) of the 1 u line.
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Yes, I gave her a fat one today. I agree, haven't seen those good numbers in a while. Not sure if I should do the fat 1units for a few days along with night testing or go straight to an increase due to higher numbers (which could be her bouncing).
 
Hey Sylvia, I understand your concern and it is confusing when a dose takes them too low and then you reduce and it keeps them too high. It's not uncommon for kitties to dance between the same dose a few times. What was too much for her before doesn't necessarily mean it will be too much for her the next time. With the numbers she has been giving you on the 1 unit I would take her back up to 1.25 and monitor her closely. With DKA in the picture, I would be more concerned with another DKA event than I would be a hypo especially because you monitor her so well.

It's possible she went lower the PM cycle of the 15th and bounced again.

JMHO
 
Bobbie And Bubba said:
Hey Sylvia, I understand your concern and it is confusing when a dose takes them too low and then you reduce and it keeps them too high. It's not uncommon for kitties to dance between the same dose a few times. What was too much for her before doesn't necessarily mean it will be too much for her the next time. With the numbers she has been giving you on the 1 unit I would take her back up to 1.25 and monitor her closely. With DKA in the picture, I would be more concerned with another DKA event than I would be a hypo especially because you monitor her so well.

It's possible she went lower the PM cycle of the 15th and bounced again.

JMHO
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Great info regarding what's good at one point may differ at another time. She definitely keeps me guessing. So, I shouldn't bother with campers and fat 1units? I know the DKA is something to avoid. My concern is the 1.25 bringing her low but I'll just have to see. Thank!
 
Sylvia & Millie said:
Great info regarding what's good at one point may differ at another time. She definitely keeps me guessing. So, I shouldn't bother with campers and fat 1units? I know the DKA is something to avoid. My concern is the 1.25 bringing her low but I'll just have to see. Thank!
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I would still get the calipers because they will come in handy for consistency and to fine tune micro doses. I think getting more night time test in would be a good idea especially when she starts off in the low 200's so you can see how low the dose takes her.

When she gave you the 38 it looks like she came up for you nicely. Did she have any hypo symptoms?
 
Bobbie And Bubba said:
I would still get the calipers because they will come in handy for consistency and to fine tune micro doses. I think getting more night time test in would be a good idea especially when she starts off in the low 200's so you can see how low the dose takes her.

When she gave you the 38 it looks like she came up for you nicely. Did she have any hypo symptoms?
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No, thankfully no symptoms. She is just so extreme in her numbers, lol! I will use the calipers for the 1.25u which isn't always easy to get.
 
When you give fat doses, please indicate somby putting something like 1F in the dose entry of the spreadsheet. It helps us to see that data. Speaking of data, I see your signature says TR, but you have been missing half of the night time tests. Her daytime data says she needs an increase, but she could be going lower at night. Neko once did a streak of three months in a row going lower and night (often earning reductions), then bouncing/higher during the day. If I had looked at her daytime data I would have increased instead of the decreases she needed.

I do suspect she needs an increase though. One other thing, on TR, we evaluate a dose after six days. Millie has been on the 1.0 dose too long. I would have called it a failed reduction after six cycles, if you had that night time data.

As for how to keep her safe, how late in the day are you home those days you can't monitor? Can you get a +2 to see if it's going to be an active cycle? Can you leave food out, either in an autofeeder or just out for her to graze on? On the days you see an active cycle coming, you can leave higher carb food out.
 
Wendy&Neko said:
When you give fat doses, please indicate somby putting something like 1F in the dose entry of the spreadsheet. It helps us to see that data. Speaking of data, I see your signature says TR, but you have been missing half of the night time tests. Her daytime data says she needs an increase, but she could be going lower at night. Neko once did a streak of three months in a row going lower and night (often earning reductions), then bouncing/higher during the day. If I had looked at her daytime data I would have increased instead of the decreases she needed.

I do suspect she needs an increase though. One other thing, on TR, we evaluate a dose after six days. Millie has been on the 1.0 dose too long. I would have called it a failed reduction after six cycles, if you had that night time data.

As for how to keep her safe, how late in the day are you home those days you can't monitor? Can you get a +2 to see if it's going to be an active cycle? Can you leave food out, either in an autofeeder or just out for her to graze on? On the days you see an active cycle coming, you can leave higher carb food out.
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OK, I will do note the fat doses. I posted the other day and it did seem like she was bouncing, that's why I didn't increase. But I posted today because I wasn't sure if it was OK to increase without doing more night time testing (in case the day time numbers were due to bouncing).

During the day I can usually get +2.

We were going to increase tonight's dose to 1.25.
 
It's OK to increase while they are bouncing. You just don't want to increase on a cycle they are breaking the bounce because that means extra downward momentum.

I found the calipers really helped, I hope they help you too.
 
Wendy&Neko said:
It's OK to increase while they are bouncing. You just don't want to increase on a cycle they are breaking the bounce because that means extra downward momentum.

I found the calipers really helped, I hope they help you too.
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Yes, they should help with the 1.25!

Thanks so much!
 
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