Please Help

[MissMolly]

Previous conversation http://www.felinediabetes.com/FDMB/threads/dosing-advice-please.192623/#post-2150838

I'm at a total loss as to what is going on with Molly. She was giving me some really good numbers this Christmas past and also just a bit ago. But here lately her numbers have started to climb by quite a bit

Am I giving her to much? Should I increase her dose?

Perhaps a trip to the vet is in order to see if there's not something else going on with her.

Hopefully a fresh set of eyes can see what I'm failing to see.

 

[Sienne and Gabby (GA)]

I have a couple of observations...

Back-to-back chances in dose can result in wonky numbers. For example, on 3/22, you changed Molly's dose for one cycle. Given that Lantus is a depot insulin, adjusting the dose for one cycle, disrupts the depot.

I'd also give some thought to how long you're holding a dose. You held the 3.25u dose for most of March. If you are following TR, you evaluate whether the dose is bringing Molly's nadirs into normal range (50 - 120) and if not, increase accordingly after 3 days if numbers are above 200 and after 5 days if the numbers are below 200. Holding the dose for too long can make it harder to get numbers to come down without a good deal of bouncing.

You may need to consider using food to steer the curve given that Molly is dropping into good numbers overnight. I suspect some of what you're seeing is her bouncing around after the numbers in the 60s in the PM cycle. The lower numbers make increasing the dose chancy but, on the whole, I suspect that Molly needs a bit more insulin.

I hope this helps!

 

[MissMolly]

Sure does help

It was the evening lows that made me hold of on increasing her. I shouldn't be such a whimp we've been doing this for a long enough time that I can pretty much just look at her and know what number I will see when I test her. Hate those pinks and I hate that she probably feels pretty bad having all these ups and downs herself. I'll give her a increase in this evenings dose to see if we can't start seeing some better numbers with her. I don't think I'll ever stop doubting myself when it comes to her care.

Thanks so much for your help.