Bumped up dosage, no change

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Shell

Shell

Member Since 2022
I've bumped up to 1 unit and it's only one point lower half way through the cycle. Yesterday at 6+ it was 346 and today it's 345 at 6+. He's tended to do better previously on 1.5 to 1.75.

If not for the stellar numbers he was having over 10 days ago, he was actually almost at 2 units in the days before.

Would it be best to remain at 1 unit for a certain amount of time, or should it increase based on his higher dosage history?

I may confirm with the Vet. Previously it was recommended by the Vet that it be a little higher than 1 (like 1.5 or 1.7) by the Vet. But I had concerns based on readings I had with a human meter. Anything over 1.75 seems to really reduce it quickly and I was very scared. Then I come to find out his readings were actually okay because I've been using a human meter. Very frustrating. However, I am glad I understand that now.
 
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I would hold the dose for 7 days as per the SLGS dosing method. Can you get some tests during the PM cycles? Pumpkin could be dropping lower over night as we have no way of knowing unless some tests are being done. If this is happening, he could be bouncing from lower numbers and this could be why you are seeing the higher numbers.
If the BG drops below 90 you need to reduce the dose back to the previous dose.
 
I don't know if you've had a chance to read the sticky notes at the top of the Lantus board. Lantus is a depot type of insulin. Unlike most other types of insulin, it's unlikely that you will see an immediate response to changes in a dose. It takes several cycles or even days for the depot to stabilize whenever you increase or decrease the dose. It's not a surprise that you're not seeing an immediate response to increasing your cat's insulin.

It would also be helpful if you are able to get at least one test during the PM cycle. There's no way to know how your kitty is responding at night without those data. His numbers may be lower and without any tests, you won't know.
 
Sienne and Gabby (GA) said:
I don't know if you've had a chance to read the sticky notes at the top of the Lantus board. Lantus is a depot type of insulin. Unlike most other types of insulin, it's unlikely that you will see an immediate response to changes in a dose. It takes several cycles or even days for the depot to stabilize whenever you increase or decrease the dose. It's not a surprise that you're not seeing an immediate response to increasing your cat's insulin.

It would also be helpful if you are able to get at least one test during the PM cycle. There's no way to know how your kitty is responding at night without those data. His numbers may be lower and without any tests, you won't know.
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Thank you. One detail I've left out is that he went in the 60s on a human meter. At that time he was taking 1 unit. So he was cut back to .75. At that point, numbers in the mid-cycle were also nowhere near as high as they are now. If anything they were in the hundreds. He's a heavy kitty. And, has previously been on 1.75 more often than not.

I can't get PM cycles in the middle of the night, though.

What I do know is that he is usually highest in the morning when we wake up. And, lowest in the evening after dinner. That's all I know for certain.
 
Sienne and Gabby (GA) said:
I don't know if you've had a chance to read the sticky notes at the top of the Lantus board. Lantus is a depot type of insulin. Unlike most other types of insulin, it's unlikely that you will see an immediate response to changes in a dose. It takes several cycles or even days for the depot to stabilize whenever you increase or decrease the dose. It's not a surprise that you're not seeing an immediate response to increasing your cat's insulin.
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Thank you. Always learning. I'll check the stickys after we do our nightly dinner and dose. That is fascinating because I read a few paragraphs so far.

I suppose I will hold the dose. However, it is so very tempting to raise because I'm used to having him at 1.75 - 1.5 anyhow. I feel so discouraged I could literally have a good cry after learning that this whole time, I didn't know that a human meter will register lower than a pet meter. So, I was trying to avoid what was actually good numbers (above 50). I thought 80 was the action number. And would become very concerned when it went below 100. But, I think I like my human meter.
 
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What are the chances of getting a "before bed" test every night? It's not necessary to get a test in the middle of the night -- well, in most cases. If you can get a +2 or a +3 during the PM cycle, it should tell you if Shell's numbers are dropping to the degree you need to monitor. If either of those tests are considerably lower than your pre-shot, it can be a signal that numbers are heading down since the +2 or +3 is typically around where your pre-shot test number falls.

Did you give Shell a shot last night? You didn't enter the dose on your spreadsheet.

Let me clarify. All of our dosing information is based on human meter readings. With SLGS, you reduce the dose if numbers drop below 90. If your cat's numbers are not in a normal range after a week, you raise the dose. You do not want to be aggressive about raising the dose if you are still feeding Shell dry food.
 
Shell - if I could make a few additional observations. Please don’t get too hung up on what dose you were used to giving. It’s more important to look at the current dose, and evaluate based on the data you have whether you need to increase or decrease. That means in part understanding how low the dose is taking Pumpkin, and not making dose decisions based on the pre shots. It wasn’t that far back on your SS where you were giving a token dose or a different dose in the pm cycles, and with the dosing methods we follow here, it’s recommended to give the same dose both am and pm cycles. The jumping around with dosing too quickly makes it that much more difficult to actually determine what might be a good dose now. I would have held the 1u for 7 days per SLGS, gotten some more tests in, especially before bed as Sienne mentioned, and determine based on those tests how low the 1u is taking Pumpkin before considering an increase.

Depending on your schedule, you might want to consider changing the shot times, if that can allow you to get a before bed test. I always liked being able to get at least one test in before bed, and certainly a +2 or +3 helps gauge whether the kitty is going to have more of an active cycle.

Try not to be discouraged, we can help you get things back on track.
 
Sienne and Gabby (GA) said:
What are the chances of getting a "before bed" test every night? It's not necessary to get a test in the middle of the night -- well, in most cases. If you can get a +2 or a +3 during the PM cycle, it should tell you if Shell's numbers are dropping to the degree you need to monitor. If either of those tests are considerably lower than your pre-shot, it can be a signal that numbers are heading down since the +2 or +3 is typically around where your pre-shot test number falls.

Did you give Shell a shot last night? You didn't enter the dose on your spreadsheet.

Let me clarify. All of our dosing information is based on human meter readings. With SLGS, you reduce the dose if numbers drop below 90. If your cat's numbers are not in a normal range after a week, you raise the dose. You do not want to be aggressive about raising the dose if you are still feeding Shell dry food.
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Yes, I did. I'm in a central timezone (USA Midwest) he usually get's his shot around 9:00p - 9:30p. I called his doc today also because I want to discuss the unmanageable numbers at this time. That is in addition to using this forum as a valuable tool also. I just want the doctor to know and get their input as well. Because, he was always high enough on 1.5 to 1.75. Always when the dose was raised to 2 it began to fall quickly. Then when I got scared, I found out that my human meter was reading higher than an animal meter, which has really stunned me. Because the numbers I was fearing were actually okay. I'm really sad about this.

But, back to what I am wondering is the reading in the 60's that prompted the .75 doses recently a remnant from the depot insulin dosage of 2 from a few days before? It was reduced because I didn't know human meters read higher until I got scared and someone said he had great readings that day. I feel horrible for my utter lack of knowledge for over a half year now.
 
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Christie & Maverick said:
Shell - if I could make a few additional observations. Please don’t get too hung up on what dose you were used to giving. It’s more important to look at the current dose, and evaluate based on the data you have whether you need to increase or decrease. That means in part understanding how low the dose is taking Pumpkin, and not making dose decisions based on the pre shots. It wasn’t that far back on your SS where you were giving a token dose or a different dose in the pm cycles, and with the dosing methods we follow here, it’s recommended to give the same dose both am and pm cycles. The jumping around with dosing too quickly makes it that much more difficult to actually determine what might be a good dose now. I would have held the 1u for 7 days per SLGS, gotten some more tests in, especially before bed as Sienne mentioned, and determine based on those tests how low the 1u is taking Pumpkin before considering an increase.

Depending on your schedule, you might want to consider changing the shot times, if that can allow you to get a before bed test. I always liked being able to get at least one test in before bed, and certainly a +2 or +3 helps gauge whether the kitty is going to have more of an active cycle.

Try not to be discouraged, we can help you get things back on track.
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Thank you. I've been really upset , but I am pretty resilient. Never the less, I was stressed and did not notice this post. I will try to get a +2 in tonight. Thank you so much~
 
Ummm..... The human meter runs a bit lower than the AlphaTrack. A 50 on a human meter is roughly 68 on an AT or other pet-specific meter. The spread between the two types of meters increases with higher numbers.
 
Sienne and Gabby (GA) said:
Ummm..... The human meter runs a bit lower than the AlphaTrack. A 50 on a human meter is roughly 68 on an AT or other pet-specific meter. The spread between the two types of meters increases with higher numbers.
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Perhaps I will get a pet meter later on. But, to be able to understand the numbers I am trying to reach, Im going to use my human meter. I always wondered why greens were good and now I get it.
 
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