Dose opinions. What happened??

[Sofia]

So, we were doing 1.5 units Lantus, but I believed he was bouncing so I reduced to 1.25… nothing really changed much. Three days ago his amps was black, two days ago out of the blue amps much lower than usual, then all through night and yesterday we had surprisingly nice (for us) numbers. Out of nowhere again at lunch time 400+.
Trying to understand this, is really draining. I was so hopeful that something had miraculously clicked into place and we were on a good run.
Can someone have a look at tell me what you think please??
Should I stick to 1.25 units? ( I did only give 1 unit due to much lower than usual amps number)
Any advice welcome

Thor's Spreadsheet

 

[tiffmaxee]

You dint reduce if he bounces. You reduce if the BG is under 90. He will bounce if he’s in the 100’s or lower right now until he gets used to more normal BG. Stick with 1.25.
From the sticky on the SLGS method look:

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

 

[Sofia]

You dint reduce if he bounces. You reduce if the BG is under 90. He will bounce if he’s in the 100’s or lower right now until he gets used to more normal BG. Stick with 1.25.
From the sticky on the SLGS method look:

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], do lengthen the waiting time between dose increases. If you decide to change another factor (e.g., diet or other medications), don't increase the insulin dose until the other change is complete (but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change).

Thank you! I think I understand. I’ll stick to 1.25units, and I guess wait it out, his body might be getting now used to a new BG… It needs a whole lot of patience and it feels like it’s been forever already watching his bg go up and down all over the place.​

 

[Chris & China (GA)]

Here's another opinion.

I don't see but 1 test (103) back on Aug 2 that was below 149 in all the cycles he's been on 1.25.

While Elise is totally right about not reducing due to bouncing, I think you could go up to 1.5U

You held 1.25 from July 20 to Aug 8 and just got that one "between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L)". That's 40 cycles on 1.25

Holding a dose longer than 14 cycles that's not getting nadirs between 90-149 can lead to glucose toxicity setting in (basically, his body gets used to being in those higher numbers even through he's getting insulin) and you can end up needing to go up even higher to break through that toxicity.

 

[Sofia]

Here's another opinion.

I don't see but 1 test (103) back on Aug 2 that was below 149 in all the cycles he's been on 1.25.

While Elise is totally right about not reducing due to bouncing, I think you could go up to 1.5U

You held 1.25 from July 20 to Aug 8 and just got that one "between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L)". That's 40 cycles on 1.25

Holding a dose longer than 14 cycles that's not getting nadirs between 90-149 can lead to glucose toxicity setting in (basically, his body gets used to being in those higher numbers even through he's getting insulin) and you can end up needing to go up even higher to break through that toxicity.

Thanks for this information! You think I should increase to 1.5units, expect him to bounce, but stick it out and hopefully his numbers will improve? He was on 1.5, the vet told me to double from 1 to 2 units but I felt uneasy with that so went to 1.5 instead, then was led to believe he was bouncing and needed to decrease, thus the getting stuck on 1.25 units.