Curve yesterday, upped dose, now what?

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123joan

123joan

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Lucy's numbers have been consistently high, nadirs in high 200s, our vet wanted me to do a curve yesterday.

After going over the numbers, he suggested upping her dose to from 1.0 units to 2.0 units, I asked about doing 1.5 and thought that was a good idea.

At +6 last night she was 215.

This morning she is 156, now I do not know what to do. I'll call vet this morning, but of course it's Saturday and probably won't be able to speak with him.

I don't want to go wacky way off on the schedule again, that wreaked havoc on us.

If she is above 200 an hour or so after she's eaten, is it ok to give her a smaller dose? For example 0.5? Or should I wait till tonite?
 
When our sugar babies test lower than normal, wait 20 minutes to test again without feeding. Just so you know next time. :smile:

I'd give 1u since the 1.5u is lasting too long. Are you still using u40 syringes? It's hard to eye ball smaller doses (between 1 and 1.5u) but it can be done. Take a syringe and see if you can count off, and mark, syringe plunger widths. When I was still using u40 syringes, I could count off 5 plunger widths (so each mark was .2u). I could then dose in .2 increments, using my marked syringe as a guide.

If possible, you may want to get u100 syringes and use the conversion chart. :-D Sure makes it easier for my poor, old eyes! :lol:
 
I have the u100 syringes. Off to shoot 1 unit right now. I have more questions, will let loose later!
 
I can't get computer time today. Couldn't talk with vet today.

She shot up to 405 at 8:30, about 15 hours since her last evening shot. I gave her one unit, then at +7 she is 181. If I get a reading over 200 at PMPS do you think I should go back down to 1? Or 1.2? What guideline should I use? I am using the U-100 syringes. I think this is too complicated to answer in an email. Obviously there isn't a magic number.

Lucy Lucy Lucy!

I can't talk with our vet until Monday.
 
Not, it is not too complicated for an email You are doing fine, Joan. Lucy is just changing the steps to this dance every few bars and it makes it hard to follow. (sugar dance makes a nice analogy for FD)

Let's get some input before you consider this, but how about a scale? It's flexible and so not set in stone, but it might give you some idea of what to consider shooting.

150-200. Wait 20 minutes without feeding to be sure she is rising. If over 200 in 20 minutes, .6 if you can monitor, . 4 if you can't. If still under 200 , but clearly rising to the 170+ range, .4 units if you can monitor If still in the 150 range, skip unless you can mess up your schedule by waiting 2 hours.

200 - 250 .6
250 - 300. 1
300 - 350. 1.4
350+ 1.6

I tend to be more conservative than either Carl or Teresa so let's get their tweaking first. But maybe it would give you a few cycles without anognizing over the dose?

It is so easy to get wrapped up in the numbers, Joan. Is Lucy feeling good? Eating, playing enjoying kitty life? She is in decent numbers and really close to the renal threshold.

Your vet was on the right track with the increase. 1.4 might have been perfect.
 
Fab insight: a few cycles without agonizing over the dose. This scale will settle me down. I have been going back thru previous posts, trying to apply the past to what is going on today, and tearing my hair out! My family is very patient.

She is acting great! Loves her FF, occasional canned tuna treats, comes running (well, actually waddle/saunters, she is 13 years old) when she hears the monitor beep, lolls in the sun, and hangs out in her special carboard boxes. I used to think she would begin to run and hide when the monitor comes out, but it's the opposite. I'm lucky in that respect.
I don't know what you mean by really close to the renal threshold.
Thank you again, everyone.
 
renal threshold -
the blood glucose concentration at which the kidneys start to excrete glucose into the urine.
Usually between 220-250.

Stole this from Carl. So below those numbers the kidneys are not having to work so hard and they can "rest". The first goal is to get them below the renal threshold part of the time.
 
LOL, you didn't steal it from me....I borrowed it from someplace!

I like the scale Sue came up with.

Carl
 
I like the scale, too....but with the clear understanding not to shoot a bounce.

A bounce? :dizcat

If Lucy is dipping during nadir to nice, low numbers, and then her PS is high...that very well could be a bounce. When bounces happen, shooting higher amounts of insulin keeps the yo-yo numbers going instead of calming them down. If lucy dips nice and low around nadir, keep the dose the same. Let her body get used to those lovely lower numbers. :-D

The problem is knowing if it's a bounce or not if no nadir numbers. ohmygod_smile For me, if the PS is higher than normal, I'd err thinking it was a bounce.
 
Teresa has a good point. Maybe an easy way to think of it is that if you get a low nadir ( maybe under 60 for now?) and then a high preshot, skip the scale and ask for advice. If things are going along fine with normal nadirs and normal preshots, go with the scale.

But always ask for help if you are unsure.
 
Now more confused than ever.
Click to expand...

Oh Joan, I hate it when the beans get confused. :cry: Try to take this in small portions. If you have questions, just ask them one at a time. "We" can tend to overload people with too much info at one time. If one or more of us has caused confusion, ask for help in understanding as many times as it takes. If there's one thing we are it's "patient". We had to put on the patience pants lots of times, especially any of us who has been here for any length of time. We love questions. :smile:

Carl
 
Joan, you're doing fantastic! You ask questions, and you're trying to understand the dance steps for this ever changing sugar dance. Trust me, once you feel you have a handle on things, something will change! ohmygod_smile I think it's our cats' way of reminding us they are the ones in charge. :lol: We just keep plugging along, asking each other questions. :-D

I apologize if I added to the confusion. :YMHUG:

A good way to look at it...if Lucy has a higher than normal PS, like Carl and Sue said, just post and ask. :smile: Questions are good. :-D
 
Thank you for the encouraging words. I keep waiting for the lightbulb moment.

I keep thinking there must be some collective eye rolling going on, WHEN IS SHE GOING TO GET IT?

We love questions.
Click to expand...

I seem to have an endless supply.

And when something goes wacky (which seems to be every 36 hours) I will be here.

Sun's just coming up, we are going to have a beautiful day today.
 
Wacky = ECID (Each Cat Is Different).

We understand wacky...well, maybe not understand but we've been there and done that! haha_smiley
 
Three things I have learned-
There's no such thing as "never"
There's no such thing as "always".
And there's no such thing as "normal" when it comes to feline diabetes.

Carl
 
Carl & Bob said:
Three things I have learned-
There's no such thing as "never"
There's no such thing as "always".
And there's no such thing as "normal" when it comes to feline diabetes.
Click to expand...

Carl - I'm posting this on my fridge... you guys are really a God send to those of us doing the dance marathon - I feel like Jane Fonda in They Shoot Horses Don't they but it's more like They Shoot Cats Don't they... with insulin????
 
damn, I KNEW I should have copyrighted that!
:lol:
Carl
 
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