Re: Nonnie...very low again!!
Good! Please be sure you check again in an hour because karo wears off fast and he could come back down. Please stay on top of his testing today.
Please put his date of dx of diabetes somewhere. I checked his profile and it doesn't really say when he was dx; I'm just assuming it was 2012 or some time before since that is when you joined FDMB and I found your first post. Do you have any SS for 2013?
I understand the SS is not updated but here's what I'm seeing that causes me concern.
--you are doing way too much dose hopping. Lantus likes consistency. We leave them on the same dose unless they earn a reduction (for a long-term diabetic cat like Nonnie, a reduction is earned when they go below 40) or if, after holding the dose the six cycles, it is apparent they need an increase. The increases are then done on a small scale. For most kitties, that means 0.25u; not 1u increases.
--you seem to be dosing on the PS and not the nadir; with lantus, we dose primarily on the nadir. If you get a high PS after they have been low, it's a bounce and you do not want to increase the dose. Examples of what appears to be dosing on the PS are on 3/29 where you dosed 2u in the a.m. and 3u in the p.m. Then you dropped back to 2u the next day; he got down to 47, bounced to the 500s and you increased instead of holding the dose.
--I'm assuming you then dropped him back to 2u because you pulled the dry food?
--After the 42 on 4/3 p.m. cycle, you didn't retest so we don't know if he earned a reduction; has he been below 40 since then?
--I cannot stress enough that when you get low numbers in the 20s, 30s, 40s, you must continue to feed/test in 30 minute increments until you see him rising. You are risking symptomatic hypoglycemia by allowing him to stay at low numbers without working to get him up quickly. The other thing to consider is that while a kitty might not show any symptoms of hypoglycemia in the 20s or 30s, the kitty isn't hooked up to any monitors so we don't really know the effects of the low BG on the brain. Just because they aren't seizing doesn't mean there are not possible other effects that we just aren't clinically seeing.
If he were my cat, I'd drop his dose to 1.75u tonight unless you are not able to do the testing to make sure he comes up from low numbers. If you can't monitor those low numbers closer (because we do have to sleep), I'd drop his dose to 1.5u to keep him safe. With the dry food gone, he might start seeing a quick response to the lantus.