? 8/19 Ivy AMPS 363,+4 96 (Libre),+5.5 162(Contour)+6 166, +9 330 Pmps 400,+5 141 Increase?

[Staci & Ivy]

https://felinediabetes.com/FDMB/thr...-5-164-night-drops-ideas.280581/#post-3095573
Is it safe to increase dose tomorrow am cycle given today’s bounce break action? Please See below for details:

Pink start today 363. (On Libre) after yesterday spent in pink and yellow with a dip at pmps into blue.
Breaking yet another bounce this am by + 2.
Fed small snacks at +1, +2, +2.5, +3 to try to slow the drops.
Snacks are regular diet MC lamb and 15% FF mc gravy lovers, 1 tsp.

Thinking about a dose increase to see if we can get more green bgs.
Just never know when is safe to increase, since she bounces/breaks bounces so often and I never know when she will break the next bounce. Many times she doesn’t begin her drop until +2 or so, which is after I’ve already given her the insulin dose.

I don’t want to increase during a breaking downward cycle.
Suggestions are quite welcome.
Happy weekend to all.

 

[Staci & Ivy]

Updates: Continue to drop lower. We are at +5.5. Tested on Contour meter with ear prick. 162 contour reading (71 on Libre).
Feeding mc lamb, regular diet to surf and try to keep from dropping too low.

 

[Staci & Ivy]

And at +8 she’s now at 235 (Libre). Not too high, considering a relatively lower drop for her.
I guess she will bounce up some more before she breaks the next bounce.
Not sure when is safe to increase her dose yet with all the bounces.
Any suggestions?

 

[Staci & Ivy]

After days drop, We have bounced to 400 now around +11. Any advice on an increase and when it’s safe to do it would be appreciated. Thank you
@Angela & Cleo @Bandit's Mom @tiffmaxee

 

[Angela & Cleo]

Hi Stacy, It looks like Ivy had a calmer cycle today . With those upper green BGs, I'd hold the dose and see if she can get the BGs in the same/similar range again after this bounce clears.

 

[Staci & Ivy]

Hi Stacy, It looks like Ivy had a calmer cycle today . With those upper green BGs, I'd hold the dose and see if she can get the BGs in the same/similar range again after this bounce clears.

So how long do you think I should hold the dose then? A few days If no more upper green? (She bounces then clears pretty constantly.)

 

[Angela & Cleo]

So how long do you think I should hold the dose then? A few days If no more upper green? (She bounces then clears pretty constantly.)

I just realized that you're using both LIbre and Contour. I may retract my prior statement if you are basing your dosing decisions on the Libre or the Contour?

 

[Staci & Ivy]

I just realized that you're using both LIbre and Contour. I may retract my prior statement if you are basing your dosing decisions on the Libre or the Contour?

I use the Libre to see what’s going on overall. (She’s too tough to ear prick many times a day)
Then if she drops low, I double check with the Contour to make dosing decisions.
Does that help or change your answer?

 

[Angela & Cleo]

Does that help or change your answer?

Good question . I have to ask then (no judgment) if you're using the Contour for dosing, why bother with the Libre? Is she too difficult to get 4-6 manual BG tests a day? Maybe even less manual testing since you're following SLGS.
For example, last night's PM cycle, I would have stopped testing at +2 or +3 with a manual meter, left out some food and went to bed since Ivy was bouncing.

I digress, others may disagree but if using the Libre readings, then I would hold the dose 3 days, 6 cycles. If I were going by the Contour reading, I would increase tomorrow morning.

 

[Staci & Ivy]

Good question . I have to ask then (no judgment) if you're using the Contour for dosing, why bother with the Libre? Is she too difficult to get 4-6 manual BG tests a day? Maybe even less manual testing since you're following SLGS.
For example, last night's PM cycle, I would have stopped testing at +2 or +3 with a manual meter, left out some food and went to bed since Ivy was bouncing.

I digress, others may disagree but if using the Libre readings, then I would hold the dose 3 days, 6 cycles. If I were going by the Contour reading, I would increase tomorrow morning.

Ok just to clarify.
*Hold the dose 3 days from today, do you mean since she saw some green. (based on Libre)? I did ear poke her to confirm the test at +5.
Libre was 71, Contour was 162.

*And you said based on Contour why would I increase tomorrow? (Just trying to learn)

And yes, she’s way too fractious to poke 4-6 times a day.
I also need to have her allow me to inject her with two needles a day with insulin so that’s two more pokes, and she is a very intolerant of being handled cat.

So it makes my job that much more difficult to try to manage this.
Several pokes every day just won’t work for her, so I’m doing the best I can by using the Libre as a tool.

 

[Angela & Cleo]

Ok just to clarify.
*Hold the dose 3 days from today, do you mean since she saw some green. (based on Libre)? I did ear poke her to confirm the test at +5.
Libre was 71, Contour was 162.

*And you said based on Contour why would I increase tomorrow? (Just trying to learn)

With SLGS (from the sticky), increases are:

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

If you are to go exclusively by Libre readings - I would hold the dose
But if you're using the Contour readings, then the 162 means an increase.

Hoping the above information is what you need to make your decision

And yes, she’s way too fractious

My Cleo is not a lap cat either! I can't cut her nails or even brush her. There is no picking her up. She also has a three pet maximum rule. After the third stroke, she'll swipe with nails out . It took a LOOOONG time and a LOT of patience on my part to get her to trust me to do both the insulin injections and the ear pokes. What worked for me was that she is very food motivated. I used that as my 'training tool' so to speak and acclimated her (and myself) very very slowly to accept the ear tests.

 

[Staci & Ivy]

With SLGS (from the sticky), increases are:

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

If you are to go exclusively by Libre readings - I would hold the dose
But if you're using the Contour readings, then the 162 means an increase.

Hoping the above information is what you need to make your decision


My Cleo is not a lap cat either! I can't cut her nails or even brush her. There is no picking her up. She also has a three pet maximum rule. After the third stroke, she'll swipe with nails out . It took a LOOOONG time and a LOT of patience on my part to get her to trust me to do both the insulin injections and the ear pokes. What worked for me was that she is very food motivated. I used that as my 'training tool' so to speak and acclimated her (and myself) very very slowly to accept the ear tests.

Thank you for that.
I’m confused why 2 different answers based on the 2 testing methods.
Why is one hold the dose and the other is do the increase?

I do understand that the Libre reads lower, that’s why I ear poke when absolutely needed.

And I’m not seeing greens enough on this dose on her SS, so that’s why I was inclined to do the increase.
However, my second concern is trying to figure out when it is safe to give an increase.
I don’t want her to be breaking a bounce in the same cycle to get the increase. (She clears bounces pretty quickly)

And typically she does not start dropping until at least one hour after I have given the shot and that’s when I know we are in a breaking bounce cycle. (After the insulin is given).
So the question is,
1)when do I know it safe to give an increase?
2) do I increase tomorrow or hold the dose?
Thank you!!

 

[Angela & Cleo]

I’m confused why 2 different answers based on the 2 testing methods.

Its two different answers because you're using two different meters. You will have to pick a meter (libre or contour) to determine when its time to increase the dose.

And I’m not seeing greens enough on this dose on her SS, so that’s why I was inclined to do the increase.

You hold the syringe. If Ivy were my cat, I would increase in the morning as long as she was high enough to shoot.

 

[Staci & Ivy]

Its two different answers because you're using two different meters. You will have to pick a meter (libre or contour) to determine when its time to increase the dose.


You hold the syringe. If Ivy were my cat, I would increase in the morning as long as she was high enough to shoot.

Got it. Thanks so very much, Angela! Have a nice evening and hugs to Cleo

 

[Staci & Ivy]

Update for pm cycle: Ivy bounced up through the rest of the am cycle and into early pm cycle. She then began a bounce break at pm + 3 and continued into the evening.
At + 4.5 she’s down to 150 and dropping (from pmps of 400 on Libre.
Looks like a long night ahead.

Not sure if it will be safe to give increase in the morning with all this downward momentum she has from the lower numbers she saw early today.