9/27 Ivy Amps 358, +3 157, +6 79, +8 71(Libre), +10 102 Contour/41 Libre, PMPS 49 Libre, +2 193

Staci & Ivy

Staci & Ivy

Very Active Member
https://www.felinediabetes.com/FDMB...2-pmps-151-1-117-2-198-late-drop-dose.281956/
Good afternoon,
Ivy had a more stable night last night on a 1/2 unit (half dose) of Lantus at pmps.
I thought it might be a tactic to reduce the depot a bit from higher doses which she earned reductions in the last few days and was dropping at pmps and then first half of pm cycle.

I gave full dose of 2.5 U this am.
She began today amps in pink numbers on her Libre monitor.
By +6 she dropped to 79 & +7 she’s at 77 on Libre, (so numbers are actually higher on handheld device).

I assume her depot from 3 cycles ago is still influencing her dropping numbers. Does that sound correct?

FYI, If she drops to 40s or under on Libre, we ear prick to see what her numbers are on Contour meter, as that’s where she’s been dropping, to earn reductions this week.

I’m concerned again about her late cycle drop to lower PMPS numbers, a trend she’s been having this past week. After those pmps drops, she continues to drop so low she earns a reduction.

If I see her dropping lower again at pmps is there a suggested plan to give her dose so I don’t push her into earning another reduction again?

I know I can not feed and stall, but she usually just continues to drop, not rise.
Thank you.
@Angela & Cleo @tiffmaxee
 
The larger depot can influence 4-6 cycles after a reduction. The half dose BCS last night would shorten that time frame. Her dose for tonight (4th cycle after last 2.75) should be 2.5 units, unless she gets up to some funny business later this cycle.
 
Wendy&Neko said:
The larger depot can influence 4-6 cycles after a reduction. The half dose BCS last night would shorten that time frame. Her dose for tonight (4th cycle after last 2.75) should be 2.5 units, unless she gets up to some funny business later this cycle.
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That’s what I thought. If she’s dropping fast and lower like last night again, would it be awful if I had to do another BCS dose again (hoping not to have to do that, but don’t want another reduction again because of the damned larger depot influence.)?
 
I'm not fond of BCS doses for smaller doses/depots like Ivy's. Besides interrupting the depot (again), it means you have no idea whether 2.5 units has now become too much insulin. Most of the larger depot should be gone now.
 
Wendy&Neko said:
I'm not fond of BCS doses for smaller doses/depots like Ivy's. Besides interrupting the depot (again), it means you have no idea whether 2.5 units has now become too much insulin. Most of the larger depot should be gone now.
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Hoping she comes up before pmps. Thanks, Wendy.
 
Wendy&Neko said:
The larger depot can influence 4-6 cycles after a reduction. The half dose BCS last night would shorten that time frame. Her dose for tonight (4th cycle after last 2.75) should be 2.5 units, unless she gets up to some funny business later this cycle.
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Well she’s just dropped to 48 on Libre. So she is in a mission to keep dropping. looks like she’s headed lower and if so I will ear prick.
I’m thinking another BCS in 2 hours If still low at her pmps. I’m reading the tea leaves and her patterns and it’s not good.

It must still be the larger depot??? Do you think?
 
Staci & Ivy said:
Well she’s just dropped to 48 on Libre. So she is in a mission to keep dropping. looks like she’s headed lower and if so I will ear prick.
I’m thinking another BCS in 2 hours If still low at her pmps. I’m reading the tea leaves and her patterns and it’s not good.

It must still be the larger depot??? Do you think?
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*She them dropped to 102 on Contour (41 on Libre). This is quite low for Ivy at +10.

I fed her a teaspoon of her 12.5% lamb 25 minutes ago, but still dropped.
Should I give her another snack now even though she’s 1.5 hours from dinner and shot time? @Wendy&Neko
 
+11 78 on Libre.

It doesn’t look like Ivy will come up much higher if at all in 30 minutes when I am due to feed and shoot.
Need Help with what to shoot?

My gut tells me 1/2 dose BCS again (as last night) of 1.25 units.
This will be the lowest I have shot on SLGS. :nailbiting:

Any suggestions?
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Oh wow Staci, I'm sorry Ivy is giving you tough decisions! I wish I could give advice. Just here to tell you that you're doing great for her. :bighug:
 
Remember with SLGS you can shoot any number of 90. And also that you're not shooting the BG now, you're shooting the BG at onset.
It looks like she's having a late nadir which, imho, is a great time to shoot low to stay low. I would shoot the full 2.5 dose as Wendy suggested in posts 2 and 4 above.
Can you get a reading with the handheld?
 
Angela & Cleo said:
Remember with SLGS you can shoot any number of 90. And also that you're not shooting the BG now, you're shooting the BG at onset.
It looks like she's having a late nadir which, imho, is a great time to shoot low to stay low. I would shoot the full 2.5 dose as Wendy suggested in posts 2 and 4 above.
Can you get a reading with the handheld?
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She will probably just go lower at onset, that’s my fear, which is what she does when she drops like this.
 
May I ask, what "lower" number are you afraid of? The Libre numbers you crosschecked with the Contour have all been above 50 which is well within the range of normal. Normal is 50-100 on a human meter.
 
Angela & Cleo said:
May I ask, what "lower" number are you afraid of? The Libre numbers you crosschecked with the Contour have all been above 50 which is well within the range of normal. Normal is 50-100 on a human meter.
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I agree about the numbers.

I’m trying to not have another reduction before we see what the 2.5 u dose can do for her.

I guess the larger Depot is still at play and hasn’t yet drained.
I hope by tomorrow that will be cleared. This is the 4th dose after the reduction.

I gave a 1.25 u dose. She was at 49 on Libre. (Which is most likely a little over 100 on a handheld meter.)
I can’t figure out why all the sudden she’s having these very low drops before p.m.PS or late nadirs, as you said.
Or, is it that she still recovering from last week’s sedation issues, and her entire system is completely whacked out.?
 
I would get a check on the Contour with the 49 on the Libre to verify she is in fact over 90. I still double check Cleo's lime BGs from the freestyle lite handheld meter with the AlphaTrak2 pet meter.
The 2.5units this morning may still impact the first half of the cycle even with the reduced dose on 1.25 tonight.

The "very low" numbers are not very low. I wouldn't even consider them low (except the 40s from the Libre which most certainly should always be verified by the handheld). Normal BG range is 50-100 on a human meter.
 
Angela & Cleo said:
I would get a check on the Contour with the 49 on the Libre to verify she is in fact over 90. I still double check Cleo's lime BGs from the freestyle lite handheld meter with the AlphaTrak2 pet meter.
The 2.5units this morning may still impact the first half of the cycle even with the reduced dose on 1.25 tonight.

The "very low" numbers are not very low. I wouldn't even consider them low (except the 40s from the Libre which most certainly should always be verified by the handheld). Normal BG range is 50-100 on a human meter.
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Too late to check the 49. What I see with the Libre is usually, the reading is either in very low 40s or it says Lo” then you have no clue what the heck that means. That’s where I always check with the Contour and I find that she’s under 90 and earned a reduction.
But great idea to check with another meter as @allicatmeow confirmed too!
And thanks for the reminder that the 2.5 unit dose from this morning may impact this evening. She’s come up a little bit, but not too much.
Thanks again for all your help tonight. I appreciate it and I appreciate you.:bighug::bighug::bighug:
 
She went up from 49 to 98 on the Libre, that was quite the jump.

The depot was probably already gone from the larger dose, not sure you needed the 1.25 units to do any more to the 2.75 units depot. Now we'll have to wait several days for the 2.5 unit depot to build, to tell you how that dose is doing. It would have been handy to get a Contour recheck of the 49, to see if she had earned a reduction from the 2.5 unit dose.
 
Wendy&Neko said:
She went up from 49 to 98 on the Libre, that was quite the jump.

The depot was probably already gone from the larger dose, not sure you needed the 1.25 units to do any more to the 2.75 units depot. Now we'll have to wait several days for the 2.5 unit depot to build, to tell you how that dose is doing. It would have been handy to get a Contour recheck of the 49, to see if she had earned a reduction from the 2.5 unit dose.
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Ugh. Thank you Wendy!
She was still dropping as I was trying to figure out what to do at shot time.
I appreciate the information and hope it will help in the future.
:bighug:
 
It's hard to remember everything in the stress of the moment. :bighug::bighug: I tried to always remind myself to take a moment, and take several deep breaths to relax when forced with a tricky decision at preshot. It's always OK to take 15-20 minutes to think about it, without feeding, retest, and ask for help. That won't impact your shot schedule.
 
Wendy&Neko said:
It's hard to remember everything in the stress of the moment. :bighug::bighug: I tried to always remind myself to take a moment, and take several deep breaths to relax when forced with a tricky decision at preshot. It's always OK to take 15-20 minutes to think about it, without feeding, retest, and ask for help. That won't impact your shot schedule.
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It sure is a lot to process and try to make sound decisions. There’s so much on that line.
But good strategies to try to remember! :bighug:
 
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