dosing advice

Heather and Gizmo

Heather and Gizmo

Member
Can I get someone's help with dosing advice for Gizmo? I don't know if this evening was an early bounce or the am insulin dose just lasted longer. Should I expect that his numbers will go lower and at what time should I do his next BG reading? Should I go up to 2.75u tomorrow morning? Is this just a reaction to some overlapping due to the daylight savings time? I tried to do at least the last three cycles early in preparation for the time change. I know I should have probably done more than that but my work time didn't really allow for it so I had to wait until Friday evening and Saturday. Any advice would be greatly appreciated.
 
This is a tough one Heather. I have to admit...I'm not sure. First, I don't think he's likely to go too low tonight. That pink is an indication that you're safe if you want to go to bed. If you just stay up late, you could certainly get another test in, but it isn't necessary.

As for dosing. I'm really flummoxed by the numbers you've been getting. You got some pretty low numbers on this dose a few times, but you've been running higher numbers lately. And your PMPS is almost always yellow...while AMPS is reds and pinks. Remember I have no way of knowing, but my hunch/guess is that he might be running lower during the day. Not dangerously low necessarily, but low. The reasoning for this is that you've tested him at +4 twice in the last few days and then he ended up having an even lower PMPS than that. Not super significantly low, but still lower. Then he jumps up into those higher numbers at night a lot of the time...making me think he's bouncing. So it's like he goes into lower numbers during the day (maybe his insulin is lasting a little long) and then he jumps up at night, causing the higher AMPs...etc. However, he wasn't doing that before. So yes, it's possible that the daylight savings time adjustment caused a little wonkiness. My tendency is to push the dose up some, but those recent lower numbers make me nervous to do that...thus this long, rambling explanation of my thought process AS I think it out! :p

So here's the options.
A. You go up to 2.75. You'd want to test frequently to be sure you didn't start hitting too low numbers again.
B. You stick with 2.5 for a few more cycles. You'd want to get some tests in to be sure that we knew what was going on. Any chance of getting some later daytime tests in? With work I know that can be hard/impossible, but I wanted to ask.

I think, if he was mine, I'd choose B for now. Stick with it, try to get some later daytime tests if at all possible, and see if the DST adjustment made the difference. Let him settle into it basically. If no change, increase to 2.75...maybe Tuesday daytime?

Anyone else have thoughts? This is a tough one to me!
 
I am off tomorrow so I can get some later daytime test in. I usually get more during the weekend but I wanted to give his ears a little break. He will still just lay there, but when I go to grab his ears he pulls them back and away from me, so I taking his hint and giving them a little break and trying to choose wise times to get at least one reading in between the AMPS and the PMPS readings. Any suggestions on the best times to test him to get the best reading for him. I know each cat is different and each cycle is probably different, so your best guess would be great. I think I am going to go with Option B and see if things settle down from the daylight savings time, since his numbers were pretty low before I started changing the times on him.
 
Anything between +7 and +10 would be great. I totally get giving his ears a little break, and I think it's great that you are listening to him and letting him make some decisions. Too often, we don't really listen to our cats, I think. :)

Since you're off tomorrow (well today now...) I'd probably get a +3 or +4 and then get something after +7. Maybe like a +4 and a +8? That way you can still give his ears a break, but get a general idea of what his curve might look like during the daytime.

As for his ears, just one or two thoughts. Do you press firmly on the spot that you poke for a few seconds afterwards? That helps prevent any bruising. And do you use anything on his ears? I used to use neosporin gel (not cream) with pain relief. I don't know if it really did much, but it made me feel better. :)
 
Good morning Rachel. I am not sure if you are still on or not, but I could use some advice this morning. I did his AMPS reading and 6:30 am and it was 165. I did a second reading to be sure and it was 164. I have stalled for an hour to see if his numbers are going up or down. I just did another reading an hour later and it is 156. I know that that is not much different than 165, but it is still going down. I am pretty sure I am supposed to give a reduced dose but I don't know what that would be. Should I give 2.25? Any suggestions?
 
Sorry. I forgot to thank you for all of you advice last night and this morning. I usually have better manners than that. I really do appreciate it. My mind was off in another place as you can imagine. I do use a cotton round to press firmly on his ear after the reading. I use Vaseline or Neosporin. Lately I have been adding some warm water to a prescription bottle hoping the warmth will help soothe his ear and stimulate the blood. It does help stimulate the blood and I don't have to rub it before poking it, but he does not like anything against his ears right now. They do not look bruised or irritated. I think he just wants a break. He is such a trooper though. He just lays there, even when I have to poke him a couple of times to get some blood.
 
Thank you Lisa and Rachel. I am doing a curve today since I am home. HIs numbers have been kind of flat. Which I am okay with when they are in the 100's and not the 300's, but I don't know what I should do for the evening dose. I guess we will see what the +9 and PMPS reading give me. Thanks again for your help.
 
Lol. I know. Instead of a smile it is more of a grin or a smirk. I am wondering if I should gave went back up to the 2.5 u. His +2 reading is 269 or is his morning insulin just lasting longer. I will get up later and do a +5 and see how his BG readings are doing. Any suggestions on the morning dose? I will be back at work tomorrow and don't want to chance a hypo.
 
I don't think you're in danger of a hypo in your current dose range. And whether to go with 2.25 or 2.5 will depend on the +5 tonight and the AMPS.
 
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