Dosing advice needed, Forever stuck in the 200's

[MizzKitty]

Hey everyone, I finally got around to getting a chart made for Cookie. As you can see Im having a hard time keeping her in the 100's. You can pretty much copy and paste this two weeks data for how its been since her dx 5 months ago. My guess is her body is too used to anything lower than the 200's, and keeps bouncing when I get her into the blues. Any advice is appreciated by those more experienced than I.

A part of me wants to try keeping on her on one flavor of food as well, so the data is more controlled. But I feel bad giving her the same thing day in and day out. All food flavors are the ones listed in the food chart with the lowest carbs, the friskie's classics.

Cookie's sheet is in my signature. Thank you so much for any advice.

 

[Bobbie And Bubba]

Hey Cookie's Human, ( sorry, I don't know your name), I think you hit the nail on the head :

My guess is her body is too used to anything lower than the 200's, and keeps bouncing when I get her into the blues. Any advice is appreciated by those more experienced than I.

The bouncing is frustrating for sure, but all a part of this diabetic dance. And if you follow the protocol for raising the dose, she will get there. Have you decided whether you want to follow Tight Regulation(TR) or Start Low Go Slow method ( SLGS) ? You are testing enough to follow TR and you will be able to get her into lower numbers faster doing TR. The sooner she gets used to being in more lower numbers, the bouncing gets less. Also TR has a higher remission rate than the SLGS

Since she gave you the a green nadir yesterday AM cycle, you will hold the dose and give the bounce 6 cycles or 3 days to clear. If she hasn't made her way back to a green number 6 cycles later, then you would increase to 1.75U

As far as the flavors of food, it's not necessary to limit her flavors. As long as the flavors are about the same amount of carbs the data is pretty controlled. I would limit her to fish no more than once a week .

I noticed on her SS that you have switched up the dose some. Lantus craves consistency and it's important to hold the dose according to the protocol. When you raise the dose and the lower and then raise, the depot gets disturbed and you won't know what a dose is doing for her. You only want to lower the dose if she goes below 50 then she would earn a reduction. So, I would hold this dose now unless she does not make it back into the greens in 6 cycles from yesterday AM cycle.

 

[MizzKitty]

Hey Cookie's Human, ( sorry, I don't know your name), I think you hit the nail on the head

The bouncing is frustrating for sure, but all a part of this diabetic dance. And if you follow the protocol for raising the dose, she will get there. Have you decided whether you want to follow Tight Regulation(TR) or Start Low Go Slow method ( SLGS) ? You are testing enough to follow TR and you will be able to get her into lower numbers faster doing TR. The sooner she gets used to being in more lower numbers, the bouncing gets less. Also TR has a higher remission rate than the SLGS

Since she gave you the a green nadir yesterday AM cycle, you will hold the dose and give the bounce 6 cycles or 3 days to clear. If she hasn't made her way back to a green number 6 cycles later, then you would increase to 1.75U

As far as the flavors of food, it's not necessary to limit her flavors. As long as the flavors are about the same amount of carbs the data is pretty controlled. I would limit her to fish no more than once a week .

I noticed on her SS that you have switched up the dose some. Lantus craves consistency and it's important to hold the dose according to the protocol. When you raise the dose and the lower and then raise, the depot gets disturbed and you won't know what a dose is doing for her. You only want to lower the dose if she goes below 50 then she would earn a reduction. So, I would hold this dose now unless she does not make it back into the greens in 6 cycles from yesterday AM cycle.

Thank you so much for your thoughts! I honestly haven't even considered raising the dose because I'm so hyper paranoid about a hypo episode, so that's something to take in haha. Thanks for the advice about not jumping around on the dosing, Ill be sure to stick to my 1.5 guns then!

I was leaning more towards slgs, as I prefer not to test so often. I just worry and want to know what Cookie's numbers are all the time while I experiment. Once I get consistent numbers for her where she can be healthy, I planned on only testing at pre-shot. Testing as often as I do also causes me to burn through test strips faster than I can afford them sadly. They are cheap for Relion I know, but I dont make much money haha.

But yes, thank you so much. Ill keep this advice and see how she does on a consistent 1.5u!

 

[Wendy&Neko]

If you want to follow SLGS, it would help us to help you if you put SLGS in your signature. And that 85 yesterday would mean Cookie earned a dose reduction down to 1.25 units per SLGS.

As for testing just at preshots, that doesn't give you a very good idea how low she's going in between *****. If you hadn't tested yesterday mid day, you wouldn't have seen those green numbers. We determine how to change doses based mostly on the nadir, or how low the dose is taking the cat. Unfortunately, cats don't like to be predictable.

 

[MizzKitty]

If you want to follow SLGS, it would help us to help you if you put SLGS in your signature. And that 85 yesterday would mean Cookie earned a dose reduction down to 1.25 units per SLGS.

As for testing just at preshots, that doesn't give you a very good idea how low she's going in between *****. If you hadn't tested yesterday mid day, you wouldn't have seen those green numbers. We determine how to change doses based mostly on the nadir, or how low the dose is taking the cat. Unfortunately, cats don't like to be predictable.

All super useful info, thank you! And very true, I do want to know what her lows are. I guess what I mean is that once she gets a month of consistency (if that's even possible haha) I can mostly test twice a day, with random curves done maybe 1 or 2 days out of the week, rather than 5-6 tests every single day. Hope that makes sense!

Darn, back down to 1.25u? Is it too late for take-backs? Maybe Ill say TR then for now since I'm practically doing enough testing for it anyhow. I want her numbers down pronto!

 

[Bobbie And Bubba]

Darn, back down to 1.25u? Is it too late for take-backs? Maybe Ill say TR then for now since I'm practically doing enough testing for it anyhow. I want her numbers down pronto

I am glad that you shot the 1.5 again. Personally, I would do the TR to get her in better numbers pronto. And you are all ready testing enough for TR. Can you add TR to your signature so when you need dosing help, peeps will know how to guide you.

 

[MizzKitty]

I am glad that you shot the 1.5 again. Personally, I would do the TR to get her in better numbers pronto. And you are all ready testing enough for TR. Can you add TR to your signature so when you need dosing help, peeps will know how to guide you.

Done and Done, TR added and TR it is!

Thanks again for the input guys, will see how she does, and will test cookie again when I come back from the store! She just tested 208 @ +3.5