Dosing advice needed for Shadow

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Shadowboy

Member Since 2013
Today I got a few more tests. Still not sure what to make of his numbers. Is he high +2 this evening because the insulin hasn't kicked in yet?

With his low at +8 being 194 should I go up to 3 units tomorrow morning? I'm working tomorrow so won't be able to get as many tests.

Feeling a little discouraged tonight =(
 
Since the Alphatrak and the Relion meters give such different numbers, we need some sort of indicator on the SS as to which numbers are from the Alphatrak and which form the Relion.

It makes a big difference in the advice I would give you as to dose changes, what is hypo territory, etc.

You also need to add the Alphatrak to your signature ASAP and put in in large font.

The spreadsheet can be modified to add a second row for the same date for the two different meters. It gets very confusing this way but it can be done. Label one row for the Alphatrak and one row for the Relion.

It would be best to choose one meter only and stick with that one. The Relion has much less expensive test strips and that is the one I would recommend you use consistently on an ongoing basis. You can drive yourself crazy using two different meters.

Based on the BG numbers today and yesterday being from the Alphatrak, I would hold the dose, keep the dose the same 2.75. That is based on the Lantus dosing protocol, which says if the nadir is < 200 with the pet specific meter. Also, I'm advising keeping the dose the same since you are not around tomorrow to test.

Onset for Lantus is usually around +2 and nadir is around +6 (give or take an hour) but ECID. Every Cat Is Different.

On 5/19, was that BG of 55 with the Alphatrak or the Relion? With the Alphatrak, anything under 80 is a hypo. With the Relion, anything under a 50 is a hypo.
 
Can you get a few more tests during the day? I am seeing these high black bounces and wondering what the low number is that is triggering them. I am thinking around +5 and +6. He might just be bouncing off blue but I wonder if he is dropping even lower.

Also I am wondering if you want to post on the lantus tight regulation board? They are very experienced dosing members there and a great sense of community, they will be able to help you more on dose. Many people post on there daily to get questions answered and dose advice.

Wendy
 
I didn't realize there was such a difference between the Alpha Track and other meters.

After today I will be able to get more testing. I'm off for the next 11 or so days!! =)

I'm wondering, if his low is under 200 but he still has really high numbers in the 400-600s at other times during the day, is that ok? Will those high numbers eventually come down?
 
11 days off ! thats nice!! And its good to get some more testing in..

The high numbers are likely because he is bouncing:

When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
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He is bouncing pretty high (into black) so I am trying to find out how low he is going to trigger that. But the idea is that the bouncing goes away over time. So for the next couple of weeks lets keep an eye on him, test a bit more when you see him start to drop down to see if we can catch that low

Wendy
 
Thanks Wendy. The time off is much needed!! =)

Sorry if this is a stupid question, but are there cats who always bounce and never adjust to having lower BGs?
 
Yes, but as long as they spend most of their time in good greens blues and low yellows, and aren't showing clinical signs then is ok.(clinical signs like losing weight peeing a lot etc) but you don't need to worry about that. We need to find out how low he is going.
 
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