I Do Not Like This Roller Coaster!

[bagheerathediabeticcat]

Sigh. Today my blood sugar dropped all the way down to 75. My human has to go to work, so he will not inject me. This means that tonight, it will spike, and we are not happy about it.

As you can see from the spreadsheet, he increased the dose to 6.5 units over the weekend. It was fine but then we saw this drop. We both were happy with the number in the high 100s last night, and we both thought, hey, we finally got it.

But then this number showed up and my human just doesn't feel comfortable shooting me when he will not be around.

Any suggestions on what to do since we know it will spike tonight with no insulin?

I know you suggested I get tested for acro. My human is going to take me to the vet soon and that will be one of the tests he asks they run.

 

[Marje and Gracie]

With a 181 at PMPS last night, he was clearing a bounce from the a.m. cycle, and he likely wemt lower. The 75 might be a rising number.

Honestly, if you aren't going to test at night and manage the curve with food so he doesn't go too low, these spikes and dips will continue. If you want better results, you have to do a bit more to use this insulin as it should be. If you don't understand the action of the insulin, you can't use it to Bagheeras benefit.

I would have gotten a +2 last night and if he was still dropping, I would have fed LC food to let him glide into a nice number above 50.

 

[Sienne and Gabby (GA)]

I agree with Marje's observations.

In addition, I haven't a clue what protocol you're following.

Increasing the dose:

• Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
• After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.
• After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.

Of course, the above instructions presume that you are getting tests at nadir, which you are not getting on a routine basis. Many of us work. If you can't get a test at nadir during the day, then get the tests during evening hours or weekends or days off.

The Tight Regulation Protocol is aggressive with respect to dose. When used properly, it is safe. You are not following the protocol and as a result, you may be putting your cat at risk.

In addition, by holding doses for as long as you are holding them, there is a distinct possibility that glucose toxicity is developing.

How you approach managing Bagheera's diabetes is up to you. To the extent that you are attempting to manage your cat's diabetes in ways that I believe to be unsafe or ill advised, I have a difficult time making suggestions and as a result, I rarely post to your thread. As Marje pointed out and I agree, if you don't understand the action of the insulin you're using, making modifications to a protocol that's based on research only serves to put your cat at risk.

 

[Amy&TrixieCat]

As Marje and Sienne are saying, it is very important to remember that dosing adjustment with Lantus are based on the nadir, not on preshot values. I know it seems counter-intuitive, but that is how Lantus works. We have cats here who have preshot values in the stratosphere, but will basically cliff-dive into very low, potentially dangerous numbers just a few hours after their shot. That is why it is so very important to test throughout the cycle, in addition to preshot testing.

Without knowing what is going on in between shots, well, very bad things - like life-threatening hypos - can happen. And, around here, we don't just worry about our own kitties, we worry about each other's kitties, too. Please very strongly consider adding mid-cycle tests in when you can, and base any dosing decisions on THOSE values, not on preshot values. And, we'd love to see you visit here more frequently, so we can help you iron out your plan for getting off the roller coaster!