Help with very high and low numbers

[hellolucy]

Lucy's AMPS number this morning was 160. We halved her insulin dose as she is not eating much and are waiting for her to use the litter box and test for ketones. They were negative 2 days ago.

The main point of this post is needing some help figuring out Lucy's recent numbers as they have been bouncing really, really high and low. I can tell it's a bounce, but am unsure if she needs more or less insulin? I am scared of not giving her enough, she has been hospitalized a couple of times for pancreatitis, most recently in January for a week and required a feeding tube She has a vet appointment coming up but it's not for a week and a half.

I entered in all of her recent numbers in to a new spreadsheet as we fell out of recording them for a while.

Any help is greatly appreciated, I am starting to lose it worrying about the direction this is going.

 

[Sienne and Gabby (GA)]

A couple of basic questions... What exactly are you feeding Lucy? I realize you've been managing her FD for some time but, not all "wet foods" are created equal and I want to be sure that what you're feeding your kitty is low carb.

I'm glad to hear that you have a vet visit scheduled. One of the things that can throw numbers off is any source of inflammation or infection. For many cats, the need for a dental or a UTI can throw them out of remission. Make sure your vet checks to see if Lucy has any dental problems going on.

As a rule, reducing the dose because of a bounce is not effective. All it means is that you're going to have to get the dose back up to where it was. You end up losing time at what could be a good dose. With Lantus, when you make changes to the dose, it has an effect on the depot. Any change in dose can take the depot up to 3 days to recover. Thus, it's no surprise when you dropped the dose at the PM shot on 9/3 that you saw a big bounce by the time of the AMPS the next day. The drop into the 100s caused the bounce and giving less insulin caused numbers to skyrocket and they stayed elevated until the PM cycle on 9/6.

The other factor with dosing is that you want to base the dose on the lowest number in the cycle and not on the pre-shot numbers. (The exception is if the pre-shot number is too low to shoot. I would shoot any number above 50. You may now be that comfortable with shooting that low.)

What I would suggest is that you go back to basics. You having indicated which dosing strategy you're following. This is a link to the dosing methods sticky. Whether you follow Start Low Go Slow or Tight Regulation, stick to the guidelines. Just as an example, we typically make changes in dose by 0.25u amounts. Increasing the dose by more raises the potential that you fly past what could be a good dose for your cat.