Buddy update

[Marci and Buddy]

Just wanted to check in since it's been awhile--Buddy is doing better since dose
increase-mostly blue, some green, some pink. Rebound still a problem.
Wishing everyone a happy healthy New Year.

 

[Vicky & Gandalf (GA) & Murrlin]

Hi Marcy,

I'm not aware of what the reason is for so many early shots, but I see some are as early as 4 hours. That's really too much, unless the dose prior to the earlier shot AND the earlier shot are reduced. I think this is why you are seeing so many pinks and reds, although you are getting good nadirs sometimes.

Can I help you with scheduling? I see you are doing thins and fats on the doses, but I don't think the change is enough. As high as his dose is, you should probably be making the change in dose for an earlier shot in .25Us. So if his dose is normally 1.75U, then the reduced shots would be 1.5U.

That is for scheduling purposes only. I think it would even out his cycles better. If you know your schedule in advance, like which days you need to do earlier shots and which later shots, I can set it up for you so you know when to give how much. Just tell me what hours you would be giving the shots. Although I have to tell you, even on reduced dose, earlier by 4 hours is not advised and 3 hours earlier is pushing it. If you can make the prior shot 2 hours early than the next shot 2 hours early to even it out, that would be better.

 

[Marci and Buddy]

Thanks so much for the help on dosing-i will reduce by .25 now-good idea.
As for the scheduling -I mostly work at home, that's not why i give early shots.
i do it because at those times he is at red. I can't bear knowing what it is doing to his body, and to sit and wait 4 more hours while damage is being done is too hard. Do you think its wrong to do that, even if I reduce the shot?

 

[Vicky & Gandalf (GA) & Murrlin]

Thanks so much for the help on dosing-i will reduce by .25 now-good idea.
As for the scheduling -I mostly work at home, that's not why i give early shots.
i do it because at those times he is at red. I can't bear knowing what it is doing to his body, and to sit and wait 4 more hours while damage is being done is too hard. Do you think its wrong to do that, even if I reduce the shot?

Yes because it could very well be what is causing the reds. Levemir likes stability. That's why we encourage people to sit on their hands and not change doses until they can get mid cycle numbers which show how low the dose takes them after it's settled for 4 or 5 days. Giving earlier shots is the same as a dose increase, which could be exactly why you are seeing this rollercoaster going on.

I would stick with 1.5U for at least a week as 1.75U may be too much, not give any shots off-schedule shots other than every 12 hours, no matter what the BG and see how he's doing after 7 days.

What can we do to help you feel better about his BGs? Swinging from greens to reds/pinks is actually just as bad as 400s. A human diabetic will tell you that rapidly changing BG is very uncomfortable feeling. Staying with 1 dose over a period of days given at the same time each day should stop the rollercoaster and help Buddy a lot.

 

[Sheila & Beau GA & Jeddie GA]

I agree with Vicky. He is taking some big swings right now (from 40s to 400s) and that is from too much insulin. Shooting early = dose increase which makes the problem worst - and makes his regulation worse. I think if you want to get rid of 400s you will need to talk yourself out of panicking over them, stick to 1.5u and a 12/12 schedule for at LEAST 5 days - a week would be better.

From all that I have read here, 400s are not causing that much, or any damage in a cat that is seeing regular numbers below 100 and a good 5-6 hours below renal threshold every 12 hours. Cats are more resilient to higher BGs than humans or dogs.

Please, do not shoot early just because you see a higher number. It isn't helping and may, in fact, be causing harm,. It is certainly causing him to feel like crap and it probably is keeping the rebound hormones pumping. I'd be more concerned about that excess cortisol circulating than the actual 400s.

 

[Marci and Buddy]

Ok . I will do exactly that-thank you both very much.