Dose tonight?

[Megan and Bernie]

Hi all!
Bernie’s numbers have been great lately. A couple of days ago, she got down to 72 mg/dL at her nadir, her lowest ever! She didn’t eat a huge breakfast so I thought maybe that was why, so I didn’t immediately reduce her. I didn’t catch her nadir the following day, but she bounced way high for her PMPS, so she got herself her reduction from 2.25u to 2.0u.
This morning, she was her lowest ever AMPS, at 202 mg/dL! (She, however, didn’t eat a lot of dinner last night and only ate half her breakfast). I went ahead and reduced her dose since she was so close to the “200 shoot” cutoff. Her nadir was at 114 mg/dL, which is under the “150 hold” dose... do I keep her at 1.75u tonight or do I bring her back up to 2.0u if she’s at her normal PMPS numbers (since she didn’t technically earn a reduction and it was supposed to be preventative)??
@Deb & Wink

 

[Deb & Wink]

Bernie "earned" that reduction in dose to 2U, since she fell <90 mg/dL.
She has not earned another reduction.
So the dose should still be 2U.

That BG of 202 was high enough for the full 2U dose.
Not understanding why you reduced.
Why?

 

[Megan and Bernie]

Bernie "earned" that reduction in dose to 2U, since she fell <90 mg/dL.
She has not earned another reduction.
So the dose should still be 2U.

That BG of 202 was high enough for the full 2U dose.
Not understanding why you reduced.
Why?

I was trying to avoid another bounce. Her PMPS numbers seem to always be higher when her AMPS numbers are low. Today was her lowest AMPS number ever, followed by her highest PMPS number ever. I gave her the 2 since it was through the roof.

 

[Deb & Wink]

You really can't avoid a bounce, they will happen when they will happen.
Reducing the dose of insulin does not limit the bouncing. Only a cat's body getting used to those lower BG levels will help a bit with the bouncing.

One thing you can do is try to slow down the steep drops at mid-cycle. Feed a bit of food a bit earlier in the cycle, for instance a snack at +2 and or +3. For example, 1 teaspoon of Bernie's regular low carb wet food is a good sized snack.

Then, at mid-cycle if you see that the numbers are dropping a bit low, you can feed a tiny snack, 1 teaspoon or so, to try and keep your cat's BG levels more steady.

Try that, and record what you did over in the Remarks column on the far right side of the SS. That way, you can look back and see what helped. And we can look back too.

 

[Megan and Bernie]

Oo sorry, I got bad with annotating in the comments, she essentially free-feeds currently. She lost a bunch of weight when she got sick, so I offer her food whenever she comes to see me until she gets filled out again. She just broke the 9 pound mark this week (she was 10 pounds before she got sick and dropped at 8).
She has a very particular eating pattern. She eats a massive breakfast (like 1/3 to 1/2 of a 10oz can ) and then demands another snack at her AM +2, then usually naps until somewhere around +5-7, snacks, naps and hangs out with my kids, then gets hungry around +10 (but she doesn’t get food until PMPS). Then, she eats about 1/4 can for dinner, then gets small (1-2Tbsp) snacks every couple of hours up until about +5/6. I put one more snack in her bowl when I go to bed in case she gets hungry overnight and it’s gone about 80% of the time. Rinse, wash, repeat.
She didn’t eat much the day she dropped, which is why I initially thought maybe her sugar dropped and was worried it might’ve been a fluke. She didn’t eat a lot of breakfast this morning either, but has been eating all her nightly meals and snacks no problem.
Thanks for the help!

 

[Deb & Wink]

She didn’t eat much the day she dropped, which is why I initially thought maybe her sugar dropped and was worried it might’ve been a fluke. She didn’t eat a lot of breakfast this morning either, but has been eating all her nightly meals and snacks no problem.

Notes like that, when Bernie isn't eating as well, can be very useful to see.

Food sounds good. Eventually, you'll have to cut back on the amount of food fed. But not until she is back to her ideal weight, or a little bit before that.