? 8/23 Ivy amps 400, +6 198, +9 166, +11.25 88 Libre, pmps 122, +3 145,+9 292

Staci & Ivy

Staci & Ivy

Member Since 2022
https://www.felinediabetes.com/FDMB...2-pmps-241-1-400-pm-dose.280749/#post-3096902

Reduced dose today to 2.5 u after dropping low yesterday (on an increased dose).

I’m still trying to figure out if I gave an appropriate increase on Tuesday.

I have a question for
@Wendy&Neko
Wendy, you said to me yesterday : “With SLGS, you would increase if all the nadirs were above 149 on a human meter.”

Based on “all nadirs above 149” I would have to say yes, they were above 149. So it appears I was ok to give the increase.
**However, she couldn’t handle the increase by dropping to 78 yesterday on the 3rd dose after NDW high bgs & bounce.

So how do we make any progress?
Do I go in between the 2 doses next time I increase a dose (give a fat 2.5 u dose?)
We still don’t seem to have a good dose for her where she’s getting consistent numbers under 149 but when I increase her, she drops too low.
How do I make progress and get the bounces under control more if I can’t get her nadirs under 149 all the time on a dose?
 
+10 dropping 139 (Libre).
Will check if drops very low with Contour meter.
Hope she doesn’t drop too low for her pm dose in 2 hours. A very late drop today.
I guess she’s breaking last night’s bounce and the larger depot in effect from the decrease last night?
@tiffmaxee @Angela & Cleo
 
Two hours at the end of a cycle is a long time in FD. See where she is at PMPS. With SLGS you can shoot a BG of 90.
 
Ivy seems to be having a late nadir now, it is +11 right now and she’s around 124 on the libre. She’s dropped slowly all day and now she’s dropping fast.

I have to be prepared what to do in one hour which is feed/dose time.
Is it recommended that I give insulin since she’s dropping fast now?
She looks like she’s coming off a bounce from last night and has a higher Depot from a lowered dose yesterday from dropping low yesterday.

I just fed her a tsp of her regular food and 1/2 tsp FF mc 15%, which is my go to if she’s dropping fast and I want to try to slow her down a little bit. That usually works for maybe 20 to 30 minutes to slow her down.
She’s not carb sensitive
Thanks.

@Angela & Cleo @tiffmaxee @Wendy&Neko

This is her day today:
upload_2023-8-23_17-3-13.jpeg
 

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Staci & Ivy said:
https://www.felinediabetes.com/FDMB...2-pmps-241-1-400-pm-dose.280749/#post-3096902

Reduced dose today to 2.5 u after dropping low yesterday (on an increased dose).

I’m still trying to figure out if I gave an appropriate increase on Tuesday.

I have a question for
@Wendy&Neko
Wendy, you said to me yesterday : “With SLGS, you would increase if all the nadirs were above 149 on a human meter.”

Based on “all nadirs above 149” I would have to say yes, they were above 149. So it appears I was ok to give the increase.
**However, she couldn’t handle the increase by dropping to 78 yesterday on the 3rd dose after NDW high bgs & bounce.

So how do we make any progress?
Do I go in between the 2 doses next time I increase a dose (give a fat 2.5 u dose?)
We still don’t seem to have a good dose for her where she’s getting consistent numbers under 149 but when I increase her, she drops too low.
How do I make progress and get the bounces under control more if I can’t get her nadirs under 149 all the time on a dose?
Click to expand...
Angela & Cleo said:
Two hours at the end of a cycle is a long time in FD. See where she is at PMPS. With SLGS you can shoot a BG of 90.
Click to expand...
I’m 45 minutes from feed shoot now. And she’s been dropping still. I fed her a little carbs (see my post a few min ago.)
My main concern is that she’s got this extra momentum from the dose I took her down from yesterday and this late Nadir going on right now.
Does it seem safe that I should be able to dose her if she’s not under 90? @Angela & Cleo
 
Staci & Ivy said:
it is +11 right now and she’s around 124 on the libre. She’s dropped slowly all day and now she’s dropping fast.
Click to expand...
+10 139
+11 124
This is not a fast drop. It's within the 20% meter variance per Libre.

Your +11 screenshot shows the arrow pointing to the right. To my recollection when I used a Libre a loooonng time ago (lol), it meant that BG was stable, not rising nor dropping.

I read and reread and reread the dosing stickies constantly even though we've been dancing this sugar dance for over 18 months . https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
It has the answers to your question. Here is what is suggested to do:
If the preshot number is far below usual preshot numbers:
Do you need to stay on schedule? Then skip the shot.
Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
If the preshot number is near kitty's usual preshot numbers:

Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.
​
Unfortunately I won't be around until much later to stay with you but the information above from the sticky should help.
 
Angela & Cleo said:
+10 139
+11 124
This is not a fast drop. It's within the 20% meter variance per Libre.

Your +11 screenshot shows the arrow pointing to the right. To my recollection when I used a Libre a loooonng time ago (lol), it meant that BG was stable, not rising nor dropping.

I read and reread and reread the dosing stickies constantly even though we've been dancing this sugar dance for over 18 months . https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
It has the answers to your question. Here is what is suggested to do:
If the preshot number is far below usual preshot numbers:
Do you need to stay on schedule? Then skip the shot.
Do you have some flexibility with your schedule? Then stalling to wait for the number to rise might be a good option. Don't feed, retest after 30-60 minutes, and decide if the number is shootable.
Repeat until the cat either reaches a number at which you are comfortable shooting, or enough time has passed that skipping the shot is necessary.
If the preshot number is near kitty's usual preshot numbers:

Look at your data to see what numbers you have shot in the past and decide what would be a safe, shootable number for your cat. Don't feed. Stall until kitty reaches the preshot number you've decided on and then shoot.
​
Unfortunately I won't be around until much later to stay with you but the information above from the sticky should help.
Click to expand...
She’s still dropping. But thanks for checking back.
I’ve read the stickies many times.
Guess I will have make the call in half hour.
Many thanks Angela!
 
Angela & Cleo said:
I'm looking at your SS and see that Ivy was really flat from +10-PMPS.
Good job shooting! Maybe next time you'll feel more confident to shoot the full dose :bighug:
Click to expand...
Angela, she was actually dropping several times (and dropped down to 88 on the Libre ) I fed her several times after +10 which I’ve never done before to keep her from going even lower before PMPS.
It may look like she was flat, but she was dropping and I pulled her back up with mc 15%.

And now she’s dropping at just about +2 and I’m feeding tsp of mc 15% again.
Looks like it may be a long night.
 
Here’s a ss if a cat on SLGS that went otj.

https://docs.google.com/spreadsheet...KME2II3aAFcIvvZ4X_sObFccjTxR7Sb-Uj_MA/pubhtml

Lantus kicks in at +2 for many so a drop in bg is normal. While under 90 earns a reduction when following SLGS it is not a dangerous place to be. 50-90 is still normal for a non diabetic cat and that’s where many off insulin register when tested. Every cat is different though. Just because you see a big drop does not mean it will continue and it’s very possible she could level out. Hence surge saying shot low to stay low. I’m not suggesting you lower your reduction point or not follow SLGS. I am just trying to help you see Ivy’s bg numbers are not so scary for many. With time you just might get more comfortable with greens. It’s also quite difficult to find a dose where a bouncy cat will stay all in the 100’s. Just my opinion fwiw.
 
Angela & Cleo said:
Did you check that Libre 88 with a handheld meter? I don't see a +2 on the SS?
Click to expand...
I didn’t double check the 88. I fed her and she bounced up a little.
I just added the +2. She’s dropping and I’m feeding snacks to keep her from diving.
My typical breaking bounce night for hours on end. Feed, feed, feed till she stabilizes hopefully around +4 to +5.
 
tiffmaxee said:
Here’s a ss if a cat on SLGS that went otj.

https://docs.google.com/spreadsheet...KME2II3aAFcIvvZ4X_sObFccjTxR7Sb-Uj_MA/pubhtml

Lantus kicks in at +2 for many so a drop in bg is normal. While under 90 earns a reduction when following SLGS it is not a dangerous place to be. 50-90 is still normal for a non diabetic cat and that’s where many off insulin register when tested. Every cat is different though. Just because you see a big drop does not mean it will continue and it’s very possible she could level out. Hence surge saying shot low to stay low. I’m not suggesting you lower your reduction point or not follow SLGS. I am just trying to help you see Ivy’s bg numbers are not so scary for many. With time you just might get more comfortable with greens. It’s also quite difficult to find a dose where a bouncy cat will stay all in the 100’s. Just my opinion fwiw.
Click to expand...
tiffmaxee said:
Here’s a ss if a cat on SLGS that went otj.

https://docs.google.com/spreadsheet...KME2II3aAFcIvvZ4X_sObFccjTxR7Sb-Uj_MA/pubhtml

Lantus kicks in at +2 for many so a drop in bg is normal. While under 90 earns a reduction when following SLGS it is not a dangerous place to be. 50-90 is still normal for a non diabetic cat and that’s where many off insulin register when tested. Every cat is different though. Just because you see a big drop does not mean it will continue and it’s very possible she could level out. Hence surge saying shot low to stay low. I’m not suggesting you lower your reduction point or not follow SLGS. I am just trying to help you see Ivy’s bg numbers are not so scary for many. With time you just might get more comfortable with greens. It’s also quite difficult to find a dose where a bouncy cat will stay all in the 100’s. Just my opinion fwiw.
Click to expand...
I get what you’re saying Elise. It’s the fast drops as she heads to onset that are so fast and steep.
And she doesn’t level off.
I’ve tried to just let her go on her own without snacks and she keeps diving, very low.
I’m trying to keep her from earning a reduction every day.

I would be fine with green numbers, she just dives so fast into them.
 
I don’t see her diving. I see her gradually coming down and then flat. Then she jumped up at +1. I would have been totally comfortable shooting a full dose tonight.
 
tiffmaxee said:
I don’t see her diving. I see her gradually coming down and then flat. Then she jumped up at +1. I would have been totally comfortable shooting a full dose tonight.
Click to expand...
I fed her several times. Fed at +8,+9 after +10 (which I’ve never done before) to keep her from going even lower before PMPS.
It may look like she was flat, but she was dropping and I pulled her back up with mc 15%.
I guess the SS is a little deceiving since it looks like she was just coasting.
She was dropping at shot time instead of going up as the insulin was wearing off. That was why I shut a reduced dose. I was afraid I’d send her down further :(
 
The more she surfs the sooner she will get used to normal bg. If it is with food great. If it’s without food great. If you can keep her flat with food that’s good. I think you might give more food than is needed and then the bg goes up a lot. Also duration can be more than 12 hours with lantus. Some cats even double dip and come down before shot time although usually not quite as low as nadir but even that is possible.
 
tiffmaxee said:
The more she surfs the sooner she will get used to normal bg. If it is with food great. If it’s without food great. If you can keep her flat with food that’s good. I think you might give more food than is needed and then the bg goes up a lot. Also duration can be more than 12 hours with lantus. Some cats even double dip and come down before shot time although usually not quite as low as nadir but even that is possible.
Click to expand...
I keep try different tactics to get her to just surf. She’s not getting the message :(
I try to give regular hourly snacks for the first several hours through onset to try to keep her from diving, as some have suggested.

If I give some MC 15% to try to make her more flat & keep her from dropping further, the bump lasts about 20 to 40 minutes.
Do you think the bg goes up in general longer than the 20-40 minutes of the food bump?

If she’s dropping fast, her regular food does nothing to hold her steady.
I have tried not given continuous snacks and she still dives.
It’s really hard to know what to do with such a bouncy cat.
I know you’ve been through it.
 
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