PM Dosing Advise??

[Tuxedo Mom]

Previous threads :

http://www.felinediabetes.com/FDMB/posts/1392040/ Sunday

http://www.felinediabetes.com/FDMB/posts/1392926/ Tuesday

Tuxie's numbers yesterday were pretty flat even with 2 days of returning to 4.75 units. Today he seems to be having a much more active cycle and his nadir seems to be coming later. The +10 hr reading was actually done at +9.5 but I don't know how to add notes to his spreadsheet.

So considering how active he has been today should I keep the same dose of 4.75 or drop it to 4.5? Or try a fat 4.5?? These doses or somewhere in between seem to be where he starts to get active. After 4 months of only minor changes it is both exciting and scary to see him so active.

Any advise would be appreciated...thanks in advance!

 

[julie & punkin (ga)]

It looks like he's clearing a bounce today with the constant drop all day long. He may be lower at shot time, so you may have to think about what you want to do if he is.

If you're following Tight Reg, you would only reduce his dose if he falls below 68AT. Until then you either hold the dose or increase the dose. Personally, I definitely wouldn't reduce his dose. He's pretty high overall and you don't want to back away from a dose that's finally getting him into better numbers. Remember the idea with Tight Reg is to get all his blood sugar into normal numbers - and of course we don't have an exact range for AT, but assuming that it's roughly 30% higher than human glucometers, where normal is 50-120, the range on an AT would be roughly 68-160ish.

Have you done any reading on what happens when you shoot the full dose into normal numbers? Lantus and LEvemir ar at their best at holding blood sugar flat when they're used in the normal range. Here's a couple of things for you to read - you may need them for tonight!

shooting low - Charlie
shootling a dropping number - post #6 in this link

If you're available to monitor, and you have strips and supplies, shooting low can change the entire range of blood sugar for a cat.

 

[Tuxedo Mom]

Thanks for the reply Julie.

I am available to test into the night if need be and I have lots of strips and a hypo kit.

I would really like to see Tuxie's numbers in a lower range overall so if shooting low might help then I am willing to go with it. The AT meter actually reads fairly accurate at the low numbers..and higher at the high numbers..sort of a paradox. The literature that comes with the AT calls 3.6 (65) a low blood glucose for adult cats and dogs and will not read anything lower than 1.1 (20) which will cause hypo syndrome..although I would be panicking well before that number

They also call anything higher than 13.9 (250) high blood glucose.

From readings I have done over the months the AT is probably more accurate in the low numbers than a human meter, but not in the high numbers.

 

[julie & punkin (ga)]

For the most part, we don't try to compare between the meters. Because all of our documents are in human glucometer numbers, and most people use them for that reason and because the strips are a fraction of the cost, we just go with those readings. It's comparing apples to oranges when our docs are in the human readings. We did have one member, Amy, do a side by side comparison of the AT - I'm not sure where that is, though. If i remember correctly, she consistently had 30% difference. She may have been using the AT rather than the AT2 - I think the AT2 came out later.

I should've also given you the sticky on Shooting Low Numbers. It gives you options for what to do if you think it's too low to shoot.

 

[Tuxedo Mom]

Well it looks like I didn't have to worry about shooting his regular dose. His numbers are back up again..not as high as he has been but still higher than I hoped after the better numbers this morning. So tomorrow I will increase his dose another .25 unit. and see if that helps. As his vet even says Tuxie does not follow the "normal" guidelines for treatment.

 

[Wendy&Neko]

As his vet even says Tuxie does not follow the "normal" guidelines for treatment.

There's a lot of that going around here. That's why we say ECID - each cat is different, and know thy cat.

Good luck with the increase. Sometimes a little bit more juice will also help get those high numbers down and make a flatter cycle over all. With Neko, if she's at a dose where she's holding nadirs in the 70's, then she doesn't bounce as much.

 

[Tuxedo Mom]

Thank you. Well at least I can go to bed and get my "regular" 4 hours or if I am lucky 5 hours of sleep tonight.

Tomorrow is another day so we will see what it brings. Have a good night!!