Checking In With Fitzel's Numbers

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Shai and The Pirate Fitz (GA)

Member Since 2012
I've been thrilled the last few days/nights because Fitzel's been green numbers with a reduced dose of Lantus at .25u. Then, tonight, she threw a 243. This was a real surprise because she didn't act like there had been a spike in her bg. When she's been in the 200's she gets sluggish. Grumpy. But, she was playing and chasing laser lights this afternoon, so I wasn't expecting the jump. I took her back to the last successful level which was .4u. That's what she received tonight. I'm thinking the reduce dose also drained her shed?

Tomorrow, we're getting windows worked on and all kitties, including Fitzel, will be locked up for the day. I know this will stress her considerably (but better than escaping outside when the workmen go in and out of the house) and I expect to see that stress reflected in her numbers. I'm looking to do another curve on her this weekend as her ears have lots of scabs from my learning curve and they're sore to the touch. I want to give them a bit of time to heal.

This is not an emergency but if anyone has a moment, I'd love to get some feedback on Fitzel's SS.

sending love and light to those who are observing anniversaries of their furrs crossing over - and to those who find themselves here dazed and confused with newbie-ness.
Shai
 
Hi Shai! Fitzel's numbers are looking good, but be careful with these dose increases! The high preshot number could be because she dipped too low in her previous cycle. Sometimes the cat's body releases glucose to combat a low reading. Look at what happened to Fitzel on July 17, the day you did a curve. Her dose was .4 and she dipped to a BG of 46 at +6. Then she came back with a high preshot reading of 339 six hours later. So this preshot number today could have been a reaction to the .25 dose -- maybe it is now too much for her. Without doing daily nadirs (either AM or PM), you don't get a clear picture of what is going on with the current dose. Experts, please correct me if I am wrong on this.

The experts will also advise you not to make dose adjustments on pre-shot readings -- only on the nadir. And even with the nadir reading, you are looking for a pattern (not one BG reading only). So in my (non expert) opinion, you might want to watch Fitzel carefully today since you increased her back up to .4 (from .25) because she may go low on that increase. But listen to the experts on this. They can better guide you.

Otherwise, you are going GREAT!!! So happy to see Fitzel in the (mostly) blue's.

Melanie
:)
 
Hi Melanie - you're right about a lower reading this morning. Fitzel's +11 was 96. I needed to get her bg early as we have workmen today and the kids are locked up. With all the hammering I know it would have been difficult to get a true reading. What would your course of action be with this mornings reading? Any Lantus experienced folks I'd love to hear your opinions. Much thanks.
Shai
 
You need the experts opinion here... whether to shoot anything with a preshot of 96, but I am guessing no. Did you already give her insulin after the +11 reading of 96? If not, hold off until you can get some expert feedback. If you already gave her a shot...then monitor her closely for the next 6 hours or so. After that, hopefully someone will weigh in on what your dose should be (probably go back to the .25 and get some nadir readings -- but I am just guessing. Please wait for the experts on this).

Also, it might help if you change the subject line of your post to: Urgent: Need eyes on whether to shoot (or something similar -- and maybe use the "star" icon above to get attention.

Also, don't forget to update your spreadsheet with your +11 reading.
 
Need some eyes here - Lantus users

I haven't given her any insulin this morning. I was going to give a F0u but am reconsidering. I do plan to get another reading about noon when the workmen go for lunch and thIngs quiet down. I update Fitzel's SS at night after the evening PS. I really appreciate your input Melanie. Thank you.
Shai
 
A couple things--you should never raise the dose based on one high number with Lantus, but if you're not getting mid-cycle checks then it's especially dangerous because you don't know if the high preshot is a result of being BG dropping too low. You need daily mid-cycle checks to determine what's happening. Any time you can test and collect data would be helpful. If you can't stay up or set an alarm to get a 5 or 6 hour test after your PM cycle, can you get some random +1-+4s or +8-+12 tests before bed/after you get up at least? The more data you have, the better you'll be able to safely get Fitzel into remission. Or can you do some more daily tests during the AM cycle? I know many people are going to be hesitant to give dosing advice because of the lack of data. You're not shooting blind, per se, but more like with one eye closed.

Setting an alarm to get those mid-cycle tests may seem like a pain, but you get really used to it after a week or so and it's not so bad. And it's worth it to safely get your cat off insulin, and once you get to remission you only have to test once every week or so, which is way easier than giving shots and testing daily. At .25u, you're very close to remission, and you don't want to lose that. Getting up for 5 minutes to get that test is a small amount of short-term work that will pay off for you and Fitzel huge in the long run. I did it solo working a full time job with a 2 hour commute, a part time job, and going to grad school (which often required a 2 hr commute in the other direction), so believe me, you can make it work. And it made my life infinitely less stressful because not only was I getting the data I needed to get Bandit into remission, I wasn't worrying if he was going hypo because I knew how low he was dropping.
 
Hi Shai! What Julia said above is very important: "you're very close to remission" for Fitzel so you don't want to lose that momentum now. If you can get some mid-cycle checks, Julia and the other experts here can help guide you in your insulin dosing to (hopefully) bring Fitzel into remission soon. And wouldn't that be a wonderful thing!!
 
Yes. Yes. I absolutely agree with both of you (Julie and Melinda). I'm hoping to do a curve this weekend but I do understand you're talking about more numbers on a consistent basis. That's the goal.
Shai
 
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