oregano 8/29 numbers dropping regardless of dose adjustment +9 115, +10 94

wade

wade

Member
weird goings on and hoping someone can give me some clarity on this.
i moved oregano up to 3 units 2x daily because she was staying consistently high on the 2.75 2x. (300's)

on 8/25 pm we started on 3, then held that dose through both doses on 8/26 and half way through 8/27. she earned a reduction down to 2.75 by pm dose on 8/27, then on 8/28 she was between 150 and 200 when it was pm shot time so i gave her 1/2 her 2.75 dose, which was 1.375.

then for am shot on 8.29 (today) she was under 150, so no insulin at all. and today she has been going low all day--dropped below 90 twice thus far, and drops fast. we continue to give her a little food to help keep it from crashing, and it will bump her up to the mid to high 100's, then she comes barreling down again.

i am at a bit of a loss. no dose this morning, and half a dose last night and still she's keeps coming down. have y'all seen this before?

thanks,

oregano and wade
 
Tim & Pookey said:
Hey Wade, glad you made it over.

Those are nice numbers today! Have you read about the Insulin Depot? Maybe you're seeing the effects of the 2.75 and 3 unit doses from the last couple days?
Click to expand...
i am familiar with it and have read the stickies on it. maybe you're right. not sure, but its some seriously fast dropping and i don't know how active i should be in countering it. or maybe i just let it ride until she gets closer to 50, then intervene? this is new territory for us.
 
wade said:
i am familiar with it and have read the stickies on it. maybe you're right. not sure, but its some seriously fast dropping and i don't know how active i should be in countering it. or maybe i just let it ride until she gets closer to 50, then intervene? this is new territory for us.
Click to expand...
That sounds like a good plan. If it were me, I wouldn't be intervening any more during this cycle (unless she gets a bit lower, 50s). You're pretty late in the cycle and with the skip this morning you don't want her to go sky high tonight either. Hopefully she comes up a smidge so you can shoot tonight.
 
Tim & Pookey said:
That sounds like a good plan. If it were me, I wouldn't be intervening any more during this cycle (unless she gets a bit lower, 50s). You're pretty late in the cycle and with the skip this morning you don't want her to go sky high tonight either. Hopefully she comes up a smidge so you can shoot tonight.
Click to expand...
ok. we will take it that way then and hope she does not drop too quickly.
 
wade said:
i am familiar with it and have read the stickies on it. maybe you're right. not sure, but its some seriously fast dropping and i don't know how active i should be in countering it. or maybe i just let it ride until she gets closer to 50, then intervene? this is new territory for us.
Click to expand...
Hi Wade. So glad to see you and Oregano!
If you’re following SLGS, you don’t want her dropping under 90 (the 50 threshold is for TR)
Are you still giving sub q fluids?
Do you notice any issues with the Libre and doing fluids?
I’ve read you should do fluids on the opposite side of the body as the Libre sits since fluids can cause issues with the readings.

How old is the Libre? (New or end of cycle?)
Just asking a lot of questions to try to help troubleshoot here ❤️‍🩹
 
Staci & Ivy said:
Hi Wade. So glad to see you and Oregano!
If you’re following SLGS, you don’t want her dropping under 90 (the 50 threshold is for TR)
Are you still giving sub q fluids?
Do you notice any issues with the Libre and doing fluids?
I’ve read you should do fluids on the opposite side of the body as the Libre sits since fluids can cause issues with the readings.

How old is the Libre? (New or end of cycle?)
Just asking a lot of questions to try to help troubleshoot here ❤️‍🩹
Click to expand...
this libre sensor is on day 11 of 14, so 3 more days left before it will have to be changed.
we do the sub-q fluids every other day. so they were done yesterday. haven't had an issue but they do seem to flush the glucose out of her system a little additional and i do think that plus the increase to 3 units is alot of what caused the lower readings yesterday. i am surprised that we are struggling with lower numbers now though, after half a dose last night and zero dose this morning.


we are following SLGS and her monitor's alarm just went off to signal under 90. she was at 78. so i gave her a little HC soft food and gravy to see if i could nudge her back up.

it looks like we may have to skip tonight's dose too.
 
gave a little food and she went up to 165. 15 minutes later her alarm went off and she was at 88. she's never dropped this fast or this consistently.

just scanned her again and the libre is not giving a reading, of course. it loves that move when we really need a reading. so will check again in 14 minutes and likely take her to the vet. something unusual is happening with her. no insulin this am, half dose last night--she really shouldn't be dropping like this.
 
While a reduction is earned if under 90, you don’t need hc unless in the 50’s. Have you tried mc instead, 10-15% carbs? Hc will raise the bg but when it wears off it can drop again. Remember normal bg is 50-120 so you aren’t seeing unsafe numbers. The depot can effect 4-6 cycles.
 
ok.
tiffmaxee said:
While a reduction is earned if under 90, you don’t need hc unless in the 50’s. Have you tried mc instead, 10-15% carbs? Hc will raise the bg but when it wears off it can drop again. Remember normal bg is 50-120 so you aren’t seeing unsafe numbers. The depot can effect 4-6 cycles.
Click to expand...
it is helpful to keep hearing that. we are not using to seeing anything near 50-100 with her. it just dropped so fast. i reviewed the spreadsheet in light of the 2-3 day depot (4-6 cycles) info and that makes sense. probably going to have to skip tonight (930 is shot time, so one more hour) and then get back into the swing of things tomorrow. not sure how i'm going to go to sleep though if she's in the 70's. i've never done that.
 
Hi Wade and Oregano--you're getting some great advice here, but I wanted to say HELLO! Looks like she's experiencing some good numbers and having a good response to the increase. I know those lower numbers can be nerve wracking, but they are good for Oregano. This situation is one I don't always understand, so...question for @tiffmaxee or anyone else: Oregano hasn't had insulin today and only a 1/2 dose last night. There is no risk of hypo at this point is there? I recognize that the depot is still in play, but do cats have to wait out the depot effect to avoid hypos?
 
The depot + the fluids may indeed be the answer for what you are seeing today. With no insulin this morning, you don't need to be aggressive about the carbs. Also factor in that the Libre tends to read lower in low numbers than a hand held meter. Those high greens may be even higher and in safe territory. The depot can influence 4-6 cycles after a reduction. So do keep an eye on her.

You might consider marking on the spreadsheet remarks column what time you gave fluids, just to see if you can see any pattern in fluids and the numbers afterwards.
 
Mary & Jude said:
Hi Wade and Oregano--you're getting some great advice here, but I wanted to say HELLO! Looks like she's experiencing some good numbers and having a good response to the increase. I know those lower numbers can be nerve wracking, but they are good for Oregano. This situation is one I don't always understand, so...question for @tiffmaxee or anyone else: Oregano hasn't had insulin today and only a 1/2 dose last night. There is no risk of hypo at this point is there? I recognize that the depot is still in play, but do cats have to wait out the depot effect to avoid hypos?
Click to expand...
that is a key question that is keeping me on edge now; are we at risk of hypo? she dropped to 77 a few moments ago and is eating her dinner now, and it seems odd to me that with half a dose last night, and no dose this am or pm, she'd be at risk, but these numbers do keep dropping. are we thinking that she'll just stabilize in the 60's-70's and i don't need to respond with carbs?
 
Wendy&Neko said:
The depot + the fluids may indeed be the answer for what you are seeing today. With no insulin this morning, you don't need to be aggressive about the carbs. Also factor in that the Libre tends to read lower in low numbers than a hand held meter. Those high greens may be even higher and in safe territory. The depot can influence 4-6 cycles after a reduction. So do keep an eye on her.

You might consider marking on the spreadsheet remarks column what time you gave fluids, just to see if you can see any pattern in fluids and the numbers afterwards.
Click to expand...
yep, good idea re the spreadsheet. she gets the fluids every mon, thursday, and saturday now but i think seeing it on the spreadsheet would help. i'm staying up with her tonight. i just don't know what to do when she hits 75 or so. wait it out? give her a little HC food? what's the number where i have to intervene? we live 30 min from the e-vet so i don't want to wait too late if i am going to need to take her in.
 
wade said:
that is a key question that is keeping me on edge now; are we at risk of hypo? she dropped to 77 a few moments ago and is eating her dinner now, and it seems odd to me that with half a dose last night, and no dose this am or pm, she'd be at risk, but these numbers do keep dropping. are we thinking that she'll just stabilize in the 60's-70's and i don't need to respond with carbs?
Click to expand...
77 is still safe—a great bg number for Oregano. No need to carb manipulate that number.
 
Mary & Jude said:
77 is still safe—a great bg number for Oregano. No need to carb manipulate that number.
Click to expand...
Ok. Just scanned her post-supper and she was at 94. Really surprising given no insulin since last night and only a half dose then. We skipped today’s am and pm dose. I’m going to continue to check her every half hour through the night and I guess if she gets below 60 I’ll intervene. She’s full now and likely won’t eat for me so it’ll be caro on the gums and I may need to take her in at that point.


Thank you everyone for your wisdom and time. We appreciate it.
 
She’s not in danger of a hypo since she has not had insulin. It doesn’t last much more than 12 hours. She’s in normal bg which is good for her pancreas. Sometimes when cats hit a breakthrough dose they race down the dosing scale. I’m not saying that’s what is happening but it could happen. You don’t need to stay up and test.
 
You must log in or register to reply here.
Back
Top