Nadirs ranging from 77 to 390

Hi everyone,

I’m on day 4 of 1.25 units. Lions nadirs are (so far) ranging from 77 to 390. Is this at all normal?

 

Yes. Unfortunately, this wide range of nadir numbers is normal. Not to worry! It is called bouncing. I will quote someone who explained it far better than I can.

"Cats come here with their bodies fully convinced that 524 is the perfect and normal level their blood glucose should be and we have to, essentially, desensitize them to lower and lower numbers and retrain them to what is normal. It fits with all the bouncing from lower numbers that aren't really that low, but much lower than what is perceived at the time by their body to be normal. Bounces typically lessen the more time they spend in lower numbers."

And from the Lantus sticky:

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

 

Hi, thank you so much for your response! I just wanted to confirm I am on the right path. It appears Lion is stabilizing out a bit. I did such a poor job before my “starting over” phase, I just wanted to confirm I am on the right path!

Thank you!

 

You are doing great. You are unbelievably lucky that you have the Libre to help ease you into this.

I will say one thing. I know you were on the fence regarding TR or SLGS. If you decided to stick with SLGS, you reduce the dose .25 units if you get a number under 90. So on the 6th, you would have reduced his PM dose to 1 unit.
That being said, if you have the Libre running and working, you have monitoring in the bag, and you could do TR if you wished.
I think your primary concern was shooting at low numbers with TR?, but I assure you, you will be safe and in good hands here if it comes to Lion having a low PS number.
Just something to think about.

 

Hello!

Today we replace the Libre for the first time. Hopefully I can put it in a new spot that still doesn’t allow him to get to it. Any lower and I think he can lick it, any higher may be his neck!

This is probably illegal but I’m sort of doing a bit of both protocols right now : ) I just reduced him after 5 days. I just want to see some stability before moving to the next dose (it may not be a full 7 days).

I work a crazy job and there will be many times I won’t be able to post on the board and wait for help with a dose.

I’m going to take it day by day. The help I get here is tremendously helpful, and as we get to lower numbers (I hope!) I know everyone will help me figure it out overall. : )


P.S. When to reduce the dose on TR is a bit confusing to me. If 90 is the number for SLGS, what is the number for TR?

 

Reducing the dose: Lantus

The TR Protocol is an aggressive method in itself. The modified version of the protocol is slightly more aggressive. Let's keep all our kitties in the Lantus, Basaglar, & Levemir ISG safe by taking reductions when appropriate.

• If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit.
• Alternatively, attempt a reduction when the cat regularly has its lowest BGs in the normal range of a non-diabetic healthy cat (50 - 80 mg/dL) while staying under 100 mg/dl overall for at least one week.
• Copied from the dosing method
• @Lion