9/9/13 Jerry AMPS 477 +5 263 Odd night

[HappyCat]

Tried to do his shot at 12 hours past his AM and he had a reading of 115. 13 hours after his AM shot he was at 149. 14 hours after his AM shot he was at 179. Felt comfortable administering his shot at 15 hours after his AM shot with a reading of 271. Good numbers I suppose just at unexpected times for his 1 month into treatment.
Since no one responded to my first post I don't know that anyone will for this. But if anyone has any input as to why he'd start dropping after the 7 hour test I'd love to hear it. Also when the shot gets thrown off on time am I to change his schedule and go 12 hours later I presume? Hope to get some feedback here.

 

[Marje and Gracie]

Sarah

Let me look at his SS and I'll be right back. I. Sorry you didn't get a response earlier. Always feel free to bump up your won condo and put something in the subject line like " need help" after the date, his name, and his BG.

 

[Marje and Gracie]

Jerry is a bouncer. Any time his numbers come down to blue or green, his liver responds by releasing counterregulatory hormones and glucagon which brings the BG back up. The reason he was coming down from +7 to PMPS is because he was "clearing the bounce". When they clear the bounce and the counterregulatory hormones/glucagon dissipate, the BG comes back down. It is at this time that you can see what the dose is doing.

We try to ignore bounce numbers and just focus on the BG when they aren't bouncing. You were right to stall tonight but I don't think you needed to stall so long. If you look in my signature block, you can click on the link for "Dealing with Low Preshots" and print it to have it handy.

When you are stalling, you don't want to feed because you don't want to shoot a food spike. As you recheck, as soon as the numbers start up, shoot because you want to take advantage of the carryover and overlap from one dose to another. If you wait, they shoot up as he is doing now.

I would suggest you stack the stall numbers in the +11 column so it would show "115 @ 12; 149 @ 13; 179 @ 14 and then in the PMPS column put "271 @ +15". Then we know you stalled three hours.

Here is a post to help you with Getting Back on Schedule. I also think if he continues up tonight and is still up at +11 in the morning, you could shoot an hour early to help you get back on schedule.

For example, lets say you shot three hours late tonight and shot at 8 PM. If at 7 am, his numbers are still high, you can shoot at 7 and then have only two hours to make up. You don't want to shoot early more than once a day as shooting early acts like a dose increase.

Questions?

 

[HappyCat]

He is certainly my yo-yo cat!
Thank you for your help. I've been told he's a bouncer but still trying to wrap my head around the bouncing. With very few exceptions he usually starts through the roof, hits his lowest usually at 5 sometimes 6 hours, then starts to climb again quickly. This may be the 3rd time in a month I've dealt with him dropping late from bouncing.
I guess my only question would be are bouncers harder to dose diagnose? We've made multiple changes and I always second guess them since sometimes he's high all day and sometimes he's low all day. In your opinion does he look like he's where he needs to be when he gets good numbers? Thank you very much for the feedback we need all the help we can get!

 

[Marje and Gracie]

Most cats bounce and they bounce until they don't. We are here to help you with his dosing because it can be challenging at first to figure out how to dose around the bounces. One kitty here, Mocha, bounced horribly for 22 months and then stopped and was in remission in three weeks. That was 2.5 years ago and she's doing great off the juice.

IMHO, while he got down into green, he's not doing it regularly. Ideally, each time he clears the bounce, you would want to see him in green. I do teen to be a little more aggressive in dosing so take this with a grain of salt. If he were my cat, I'd probably increase the dose .25u as long as you can continue to monitor as you have been.

Having said that, there is nothing wrong with holding the dose because he nadired in the 70s...very nice. If you want to hold the dose and see if the cumulative nature of Lantus results in progressively more green, that's fine.