AT 1/26 PMPS112, .5u, +1/109, +2/73 LOW #s Pls Help!

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Its the depot, the build up of Lantus crystals under the skin.

The effects of the 1.0 and 0.75 unit doses will wear off over 3-5 days. And with Lolly racing down the scale, skipping a dose or only giving a token 0.25 dose may help the depot left over empty out faster.
 
We ALL do that at first!

The first time China went too low, I knew to give her some Karo, honey or syrup, but didn't know how much, so I dumped about a cup full into a bowl and gave it to her...She loved it!

Needless to say, she went up...and up....and up....LOL

Found out later it was supposed to be a drop or two!
 
So Martha,,you have learned something. You didnt give too much food per se'...but all of this kind of stuff is nothing but good information for you. You now know if you give her HC food w/ gravy it will bump her up a decent amount. It is not that you are NEVER supposed to give food and gravy, you just start with a little gravy first 'cause that where all the carbs are and you get the most amount of mileage with the least amount of volume to keep them hungry so they will continue eating if you need to feed the curve up. If however you fed a little gravy and number was not rising still at next retest, and you did it again, you may at some point increase amounts, add food with it, or even some karo drops into it. In this case, she probably could have used some LC, but by doing the HC you kept her from going lower and this earning another reduction. This is not a bad thing since this was only your first cycle at this dose and hasn't had a chance to even settle. Like Chris said, this can just be depot action yet from the .75. I would think unless she drops below 68 tonight or you have trouble keeping her form doing so unless feeding her HC over and over, then you stick at the .50 and see how it goes.
You would wait then for the next time she drops below 68 to reduce again to .25.

You are still getting a little extra mileage still leftover from her previous dose of .75. And on top of that her little pancreas might even be starting to sputter.
My Hank only needed a little jump start with insulin before his pancreas started to kick in. It was great but I have to say I was almost as nervous getting him off as when we got on. He was diet controlled after that and maintained remission the rest of his life. Check out our SS if you like. We were down to a drop pretty quickly.
 
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Good job handling those numbers tonight Martha. As BJ says, the depot can affect 4-6 cycles after a reduction, depending on the size of the dose. The .5U dose should still be her dose. If she's low in the morning and you can't be around and are worried, it would be OK to skip in the AM and resume at night. Doing a skip, or even a temporary smaller dose dose help reduce the depot.
 
This is amazing stuff. Also, even though there is a very evidence based protocol, there are so many factors it would take a supercomputer to compute them, So it's somewhat trial by error, isn't it? Though only within the protocol. I looked a Hank's chart, wow, it was one month to OTJ. An amazing boy -- I am so very sorry for your loss. We never stop missing them. Lolly's been with me 12 years, and I thought this sounded like her best bet. My vet thought it might take 6 months though.

If I skip, though, won;t there be a bounce? Am I better off trying a really low dose, .25? Then tomorrow night, I have to go to sleep by 10pm. Her dose will be at 7:45 by then, so I'd only get a +1 and a+2. Am I safe sleeping through the night? (so I can earn money for more test strips ;-)

I wish there was some way I could thank you and everyone else who has stayed with me through the night.
 
On the other hand if I skip am, I can SLEEP. But then bg's higher at PMPS, so the evening cycle isn't really conclusive right? It wouldn't be until the next day's cycle that I'd see a "clean" i.e., no depot, no skip high bgs. Does this sound right?
 
A bounce happens when the glucose drops fast and/or lower than usual for the cat. Compensatory hormones release stored glucose which bumps up the levels. This is different from the glucose increase which happens if you miss a shot or give too little insulin.

If she's at a shootable number in the morning, I'd be inclined to go with the 0.25 units just to keep the glucose from going completely uncontrolled, and still allowing the depot to drain some more.

Its about time for a +5, yes? And update the spreadsheet? Thanks.
 
She's 81 at +5. This is lower than I've measured her at +5, but do you agree +5 is pretty near her nadir? at least pm

The AT range is 70 - 160, so she's low. I'm trying to learn - wait and do a 5.5 and 6? Or call it safe since it's the nadir.
 
I'd feed another couple teaspoons of medium carb to carry her through.

The nadir can move around. Looking at the spreadsheet, she's had nadirs from +5 to +7 hours post shot.
 
It's not so much trial and error it's every cat is different (ECID)..and every day is different. Just because she reacts to .50 a certain way one day it may not be the same the next...she could have eaten more/less, played more/less, not be feeling well, stressed (construction noises, fight with other pet, trip to vet..) and so on. Its not like you take one cat, put in X and get the same thing out each time.
There is a protocol but then also nuances and strategies that come from tricks you have tried, or seen others try. For some cats feeding at specific times, certain % of carbs or such as that is critical to keep their cats from bouncing. That is why the group is your best bet...because at some point someone in the collective has been there, done that, or seen it and knows some things to suggest or try.

I am not sure skipping is best or even necessary. We haven't see her next number but you may be rising and going to bed soon..then wake up with a perfectly shootable number. You may be able to shoot the .50 (really haven't had much of a chance to see what it will do)....OR if you get a pre-shot on the lower side then perhaps you would shoot a reduced dose of .25. If you are not sure post for advice after her AMPS and before you shoot in the morning.
You have not been super low tonight, in reality it has been a very nice curve....as are most of hers. She is like a poster child for how to work the insulin. She is just making it hard for you to keep up.


And thank you for the kind words about Hank, I loved him more than anything and miss him every day. He was my joy. I honestly did not think I could love him more, but our bond grew even deeper caring for him with his diabetes. He was so amazing and I learned so much. He became a kitten again after that and we had nearly 4 more years together (not nearly enough). It was 6 weeks or so before we were officially OTJ, but yes it was fast. Sometimes they only need a little jump start. And changing his diet to all LC canned and mini-meals (easier on their pancreas) made all the difference..he ate like that from then on, we never deviated.
I bet you have that with Lolly too...for all the sleep you are losing now you will only grow closer and love her more from this...it is funny how that happens.
 
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You're doing great Martha!! Remember, we have said you were getting a Baptism by Fire and you're still here and Lolly's doing well!!

If she doesn't have any trouble staying above around 90 tonight and is above 150 in the mornng, I think I'd shoot the .5, but if that would make you too nervous, shoot the .25 CSS instead.

Remember if you need help in the morning to help you make a decision, have something in your Subject line saying something like "HELP.....Please!" get the attention of whoever is around scanning the boards

Surf safely there Lolly and let your mamabean get some rest!
 
Tear:( Martha, how much snow have you gotten so far BTW?...you are pretty close to the bullet, aren't you? Maybe Wed. will end up being a snow day for u too. Hate to tell you it was in 70's here today.

You hanging in there OK?
 
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Because if she can't be home to test tomorrow, I'm not sure she would want to shoot any lower than 150 ...my main concern is unless he bounces really high, she should stall, don't feed, and get some eyes that will watch out for her in the morning before making the decision on how much to shoot and when
 
She's home tomorrow.....they are snowed in. She is supposed to go back to work Wed. Assuming no snow day then too.
 
I've got to sign off for the night.
Time for another test and update the spreadsheet.
 
Taunting me with 70 degrees? That's plain evil ;) it's miserable freezing here- my house does'nt handle 75mph winds very well. But the real snow begins in the morning. I am really torn right now. I have had the flu, still not recovered completely, and I was up monitoring ms, lolly last night. I need to have a long sleep-- if I do skip her dose, which I do not want to, but think I have to, how do I recover ground? I'd really appreciate your help with this, I need to go to sleep for about 10 hrs now. Im going to have to shovel out too, I need rest for that. DH is actually working with the public works crews, so he's gone already.
 
Are we good? Me too.....falling asleep. That last number was not so low and if not nadir then, should be by now or very soon. Martha post in the morning with your AMPS to decide what to shoot if unsure. I'd try not to skip....Hopefully its a totally shootable number,
 
Maybe you can wake up, test, post/get advice, feed, shoot.....then go back to bed for 2 more hours? She would just be near onset..... And you got more zzzz's in?
 
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Hi Martha and Lolly! Just popping in to say good job! Lolly reminds me of Henry--he liked to plummet at PMPS +2 as well and gave me more than a few sleepless nights. The good news is that it was all worth it: after less than a month on Lantus he was OTJ! I am back to sleeping soundly (knock on wood). I also use an AlphaTrak 2, so I can totally relate to your stress about that. It gets so confusing, and you can drive yourself crazy trying to gauge your kitty's progress against others who are using human meters. I started with a human meter, but I switched to the AT because I wanted my vet to give more weight to the values we were getting at home, which were far lower than they got with Henry in his super-stressed state at their office. If I have to do this again (anti-jinx), I plan to use a human meter and only break out the AT for curves to share with the vet. Anyway, hang in there: I suspect you won't be dealing with this for much longer!
 
Oh, I was so torn, but I had to sleep- just had flu,up two nights in a row, I was getting sick again, and I can't catnap. So NS. I got 10+ hours, feel human again, just tested Lolly, She's only 108 at +9.5!!! DH says she ate more than a full 3 0z of FF LC. I can't go through another late night, I have to sleep tonight-- what do I do? She hasn't had any time at all on .5-- not supposed to drop again so soon, I'm scared to shoot anything!

OMG - my husband was changing the ceiling light in the LR, and she climbed to the top of the 6ft ladder and is having a grand old time. She hasn't done that in years.

I'm going to start another post for today.
 
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