9/20 PMPS number BG 571. Please advise

Boscosmom

Boscosmom

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Posted on the FB page also. Boscos +2 test after 1unit of PM insulin was 571. I did a second test and it was 521. I've never seen it jump like this. How soon should I test again. Should I be watching him for anything. What do you do with #s in the 500!!! Please advise.
 
500s are awful to see! Look at Jude’s SS; we’ve seen 578 before, and it horrified me. Bosco will come down. What is your strategy for increasing his dosage? I see that he’s on SLGS, and the protocol for increases is as follows:
“After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.
  • 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
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).”

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments-- no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may shoot past the right dose.”

I’m not qualified to give dosing advice, but it seems he’s been on this dose for a week, and should be getting a dose increase. I suggest that you put up your “?” Prefix to draw attention to your post.

@Sienne and Gabby (GA) @tiffmaxee @Bandit's Mom
 
It looks like last night he saw a long stretch of yellows, which is a lot lower than what he's seen for a while. So he bounced. Your action when his +2 at night is so much higher than the preshot? Go to sleep, he's not going into dangerous numbers tonight. Tomorrow is another cycle.

I think you can increase his dose to 1.25 units now, in spite of that fur shot a few nights ago. You are getting enough tests to show he isn't going low on this dose.
 
Like Wendy noted, Bosco bounced! Bounces drive caregivers crazy!! They are not dangerous, though. In fact, a bounce is a bit of a protective response. Your cat's body has gotten used to higher numbers so when he dropped into the yellows, his liver and pancreas panicked and released a stored form of glucose along with counterregulatory hormones that caused the numbers to spike. It can take up to 3 days for a bounce to clear. As Bosco get more comfortable with being back in more normal range numbers, he'll bounce less.
 
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