Dose reduction without losing good numbers

teresazu

teresazu

Member Since 2020
Cleo has earned multiple dose reductions in a short period of time. I don't want to cut back too much and lose the ground she's gained. This is the most low numbers she's had, with the least "HI's" and I want to keep heading in the right direction. It's difficult though with the way she has these sudden drops, which then cause a bounce! but at least her bounces seem to take less time to clear now
 
Hi!
Helping to bump your post for others to see it. It looks like Cleo has a colorful spreadsheet!

On SLGS, if Cleo is earning the reductions, I personally think you should take them. The dose is based more on where it takes your kitty at the lowest (Nadir - wherever that may be), rather than where Cleo bounces to. I think it's good that the bounces are clearing faster and I can empathize with how bizarre it is when they drop so fast, so suddenly.

I heard a really great explanation of the sugar dance between the liver and pancreas... I wish I could articulate it as well. @Sue and Luci. Eventually, the liver doesn't create bounces as severe, often or long in duration and hopefully more regulation and "normalcy" (whatever that means :smuggrin:) is the result. But...cats are living creatures and every day inside their little bodies is a little different. What works one day/month/week may not work on another

Sometimes reductions can fail to produce the results we are looking for and the dose needs to be increased again - but only time at a new dose can tell.

I'm not sure if that was particularly helpful, but wish you and Cleo well :) Others may have some additional thoughts to share.
 
Would you be willing to try TR for a while?

If she's on all low carb pate and you can test (looks like you do already) then why not switch to TR?

You could increase/decrease more frequently based on the numbers after only 3 days.

After looking over your SS, the dose was held for too long earlier...then after that it appears that you change it frequently - although I'm not sure why..from no shot on 8/27 to 1.5 and then an odd 1.75 on 8/29 and then back to 1.5 and then on 9/1 1 unit.

That type of dosing isn't good with Lantus...wonky doses will cause wonky numbers. Lantus loves consistency; consistently shooting 12 hours apart every day, twice a day; consistently giving the same dose unless you have a preshot number below 90 (on SLGS) OR below 50 on TR...

So, how about it? Try TR for a while; don't change the dosage amount; shoot consistently for at least 3 days before changing the dose (of course there's always a chance that she earns a reduction - by dropping under 50 x 3 OR under 40 x 1 - on TR only)...

The bouncing will level out after a while...but first she needs your help because she can't tell time and she can't help get the dosage loaded into the syringe...
 
With Lantus being a depot insulin, you might also be getting some carryover from the old dose on the first few cycles of the new reduced dose.

I'm wondering about feeding times, out of curiosity. Aside from preshot meals, do you have a set 'snack' schedule as well?
 
I think some of the inconsistent dosing is not helping. You are shooting a different dose in the AM and the PM. That means the depot doesn't really have a chance to get established. With the dosing methods we use here - shooting the same dose AM and PM is best, unless she earns a reduction. Which she did today with that 55. When she earns a reduction, that means reducing both the AM and PM dose.

The link to your last post here, for continuity: https://www.felinediabetes.com/FDMB/threads/shoot-or-no-shoot-under-150.234224/
 
teresazu said:
Cleo has earned multiple dose reductions in a short period of time. I don't want to cut back too much and lose the ground she's gained. This is the most low numbers she's had, with the least "HI's" and I want to keep heading in the right direction. It's difficult though with the way she has these sudden drops, which then cause a bounce! but at least her bounces seem to take less time to clear now
Click to expand...

One last thing - if you could PLEASE begin your next post with the proper title it would be very helpful; This is the formatting that's recommended and encouraged:

9/5 Cleo AMPS ### - Dosing question or whatever you want to say.

THANK YOU!

Here's the info on how/why we ask this of you:

https://www.felinediabetes.com/FDMB/threads/6-26-psa-please-read.231511/

We have many new members and more joining every day. The subject lines have gotten out of “conformity” making it sometimes difficult to triage and see who needs help first. To that end, we’ve added sections on the specific manner in which to entitle your daily condo. In the last several months, some titles have long text entries and almost little to no data. Please be sure the title is started:

Date Kitty’s Name BGs using the detailed example in the linked post above. Flipping any of this data around makes it difficult for those helping to quickly scan the column and see who needs help first. The year is not needed.

We'll be looking foward to seeing your new post soon :)
 
I agree with Wendy and Sue. Giving different doses at AM and PM does not permit the depot to stabilize. It can often result in wonky numbers.

@thebigfuzz -- Tanya, in most cases you do not want to take back-to-back dose reductions. Because of the depot and the carryover between doses, there can be instances where a kitty earns a dose reduction and the numbers drop again during the next cycle. The 2nd drop in numbers is likely due to the carryover from the previous dose since the depot hasn't had a chance to catch up.
 
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