Re: 8/2 Gobnait -1 79 AMPS 62 +1 46 +3 83 +4 76
sienne/gabby did an awesome job of putting things in perspective. thank you, sienne!
mj, let's talk a little bit about what's going on...
remember yesterday i mentioned a reduction of 0.25u may not be enough of a reduction, but the only way to know was to test, test, test.
most of us start at a lower dose and systematically work our kitty up the dosing scale in increments of 0.25u or 0.5 unit. your vet started gobnait at a higher dose which brought gobnait's numbers down quickly... which is one way to approach controlling a diabetic cat. initially, slightly over dosing a cat will often push them into remission quickly. however, this method does carry an increased risk of hypoglycemia and more often than not will result in kitty racing down the dosing scale rapidly.
a given --- lantus is a depot insulin, meaning one dose builds upon the next... the action is cumulative. the effects of a single dose can affect what happens over the next 3 days.
another given --- a change in diet from high carb dry food to a high protein - low carb diet *can* result in a decreased need for insulin. i say *can* because a diet change may or may not a kitty's numbers. every cat is different (ECID).
and yet another given --- the difference between using a human meter versus a meter calibrated for feline use may be approximately 30 points
in the lower range. a personal note: i've been using freestyle meters for the last 5 years. i've found the difference between
freestyle meters and the alphatrak meter to be less than the 30 points
in the low range that Dr. Rand has suggested in her tight regulation protocol.
because the effects of lantus are cumulative, the drop to 46 @ +1 *could be* the result of the residual effects of the
insulin depot/shed (leftover action of the insulin) OR it could be an indication the dose remains too high.
we don't know which it is.
there's also the *possibility* the higher doses of insulin you've been giving gobnait combined with the recent diet change has
greatly diminished his need for insulin.
so, what to do?
you have a few options and your decision may be based on your availability to monitor.
- you can drop the dose to 1u bid to essentially "start over". pros: starting over could give you some peace of mind when you're not available to monitor. working up the dosing scale is easier and less scary than racing down the dosing scale. cons: you *may* lose some of the progress you've made.
- you could continue with 2.25u bid and monitor like crazy. pros: you won't lose any progress made to date. cons: close monitoring will be required to keep gobnait safe.
- you could take another reduction by dropping the dose to 2u bid. pros: offering a lesser dose could help to keep gobnait from diving again. cons: you *could* have to take the dose up again.
as far as what dose to shoot tonight...
if i were in your shoes, i'd see how the rest of the cycle goes before making any decisions. with the exception of that dive at +1 requiring the need for a higher carb food to bump the numbers up, so far the cycle is looking good (that may change as the cycle goes on). remember, the effects of the higher dose (2.5u) are still in play today. as the insulin depot/shed empties, it's possible the 2.25u dose will be fine. again, frequent testing is the only way to know for sure.
another option is to skip the shot tonight in order to drain the insulin depot/shed even faster. skipping the shot tonight and getting some spot checks would allow you (and us) to reassess gobnait's dose.
frequent monitoring is the key in keeping gobnait safe. since you're working outside the home you may be a whole lot better off dropping the dose, but it's your decision to make. safety is always the number one priority.
hope this helps...
