Dose question

Status
Not open for further replies.
The Nature's Variety is between 0-2% carb depending on which flavour. I rotate between chicken, duck, and lamb.

Sue and Oliver (GA) said:
Yes, I'd bump up to 1.75 if you can eyeball it, or a skinny 2 units (pull up 2 units and let out a couple drops.). It is encouraging that you saw a lower number - we just need to push him a little. Your Natures's Variety is what carb count?
Click to expand...
 
:woot:
image.jpeg
 
Wow. Where did that come from? I hope you can get some tests in today. The 2.5 on the pinks gave you a nice preshot. Then you could have reduced if you got a lower number than usual. Keeping with a higher dose is smart when you continue to see higher levels.
 
I will be home most of the day today so I will run a few tests. Won't be out until this evening.
 
We see this sometimes and I Am not sure why. After a lower cycle, we see a higher one, even with a higher than usual dose for the pre shot. I think it's possible that he went quite low overnight - especially considering the preshot which should have been the rise. That could make this cycle a bounce.

One annoying saying we have: it's just one cycle, just one number. Sometimes a cycle just doesn't make a whole lot of sense. Wait and see what future cycles look like. And remember to celebrate that preshot number!
 
Hard to tell for sure without that midcycle number. Can you get one tonight (set the alarm and get a test at +5-7 hours). I'd assume it's time to raise again by 0.25 but on the chance he is dropping low midcycle and bouncing back up, you need a midcycle number first.
 
I can try. The problem is I take medication at night that knocks me out cold for 10-12 hours. Sometimes I don't hear an alarm, and if I do wake up I'm still not conscious enough to test glucose.

Sue and Oliver (GA) said:
Hard to tell for sure without that midcycle number. Can you get one tonight (set the alarm and get a test at +5-7 hours). I'd assume it's time to raise again by 0.25 but on the chance he is dropping low midcycle and bouncing back up, you need a midcycle number first.
Click to expand...
 
And you can't sneak one in during the day? If no possibility, I guess I'd raise by 0.25 (as his last curve was high and even the two Blues were in safe ranges) and leave out some food, just in case.

If your meds and schedule make midcycle numbers difficult, then try to schedule your possible increases on your days off, when you can monitor. It'll be less stressful for both of you. And try for some out the door and in the door tests to fill out the picture - a test before you leave in the am and right when you get home at night (before food)
 
Here is a message from the vet. I'm still going to test glucose regularly. Any other thoughts on her direction?

"Hey! Thanks for getting us Orion's information. Honestly, I might be reading the excel sheet wrong b/c it is kind of chopped up how we are seeing it on our computers here. It seems like the 2.5 units is what got him below the 200 mark?
But, what I would do, stick with 2 units (not 2.5 units) twice a day for a solid week. I don't think you need to check the glucose, unless you feel like he is sick or not doing well. If he is going to revert (which is what we are all hoping for) he needs to be on a solid dose for a while (at least a week) before changing doses up higher if needed.
Does he seem to be feeling well otherwise and doing good? The reason why I don't want you to stick with 2.5 units when he is at 190 for the blood glucose is that we might have issues when him becoming hypoglycemic when you might not be around. If we have to bump back up to the 2.5 units, let's do it in about 1 week."
 
I think your vet is using a cautious approach which can be fine. I think your cycle today - at least so far - indicates 2.5 might not be a bad dose. (Assuming he starts up and is in shootable range by pmps). The missing piece is the nadir overnight - does that drop low and cause a higher number for amps? Since you can't often catch nadirs, maybe it is too risky for you.

Of course, I disagree completely with your vet on testing. What if he had a low preshot number and you shoot a normal dose? This sugar dance is fluid - levels change. I would make sure the dose I was planning to give each time is a safe dose.

As always, you hold the syringe and get to decide. Two units certainly seems safe. If he stays high and flat, and the nadirs are higher, then you'll know he needs more. If you want to push a little, 2.5 looks reasonable but since you can't catch the nadir often, maybe not. The vet is not at home when you test. You are Orion's best advocate and if you want to be sure he is in safe ranges, that takes testing. MHO.
 
Thank you! I agree with you and disagree with the vet on not testing. Not testing to me feels like pulling the trigger with a blindfold on. This is dangerous! I have no problem paying for test strips and taking the extra 2 minutes required to test especially when it means my cat's safety.

He's been at 2.5 now for 3 days, and I think I will stick with it. The vet sent this message on Monday, and I am just seeing it today He always gets fed right before I go to bed (mainly so he's less of a pest in the morning), so this should help keep his levels safe at night. He's never completely alone for more than 4-6 hours. I'm out cold at night, but my roommate is usually up and about. He also comes home for lunch, so I don't feel like it's too risky staying at the 2.5. I've trained my roommate on low glucose issues. Now if I could just train him to get a reading at night we'd be all set!

Sue and Oliver (GA) said:
I think your vet is using a cautious approach which can be fine. I think your cycle today - at least so far - indicates 2.5 might not be a bad dose. (Assuming he starts up and is in shootable range by pmps). The missing piece is the nadir overnight - does that drop low and cause a higher number for amps? Since you can't often catch nadirs, maybe it is too risky for you.

Of course, I disagree completely with your vet on testing. What if he had a low preshot number and you shoot a normal dose? This sugar dance is fluid - levels change. I would make sure the dose I was planning to give each time is a safe dose.

As always, you hold the syringe and get to decide. Two units certainly seems safe. If he stays high and flat, and the nadirs are higher, then you'll know he needs more. If you want to push a little, 2.5 looks reasonable but since you can't catch the nadir often, maybe not. The vet is not at home when you test. You are Orion's best advocate and if you want to be sure he is in safe ranges, that takes testing. MHO.
Click to expand...
 
He gave me a 68 last night so I withheld insulin. He was 127 when I went to bed. Thank you so much for checking up on him.
 
Glad he's ok! I see he's back up this AM, that's expected with the missed shot. Will you be able to test some today?
 
I'm leaving for work in a few minutes and will be back around 5:30pm. That's the soonest I can test again.
 
Status
Not open for further replies.
Back
Top