Reduced dose again to 0.7

[Melissa and Celle]

We got a reading at +6.25 last night = 196, then AMPS = 484 this morning. We reduced the dose from 0.85 to 0.7. Too soon given that we had only been at 0.85 since Sunday? She's been remarkably consistent all week, so I lost hope that more time at that dose would help. I'm also worried about cutting back right before we turn things over to the sitter (Saturday PM). She doesn't do well in the 500s, and I'm afraid that's where she'll go if we're wrong about the dose being too high.

 

[Vicky & Gandalf (GA) & Murrlin]

My advice is to stay with what's working - the dose reduction has helped, but she's still swinging (going from lows to highs) so reducing to .7U was great! If you can prepare syringes ahead of time at .7U for the sitter it would probably be OK over the period they have to do this for you. As long as you are going lower I don't think you will see 500s again.

No, it was not too soon to lower dose again. The pattern of swinging will possibly continue 'cause it's still very wide between lows and highs. Remember, the idea is to keep the levels more even - that is when Levemir works and probably why they call it "leve(l)mir!" and what you saw with the 100s preshot, then the 400s at next preshot is a strong indicator of too much insulin still.

Here's a spreadsheet to look at. https://spreadsheets.google.com/pub?key=pxGL7AcHbfFGP98wDVWTrYw&output=html This is Sheila's Beau, who went off insulin on Levemir after 2 YEARS on Vetsulin (which is thankfully no longer made) in 3 months, yes 3 months. 'Cause Sheila was on her game and realized that even .5U was too much.

It's not as obviously with Celle, but you can see all the spotty pinks in July yet he was getting double digit BGs too. The trouble with a dose too high is the lows may not be as low as you would think - Beau's dose was lower than Celle's when he was swinging and he wasn't swinging very much, but since he was going lower than Celle is, the percentage swing is probably about the same.

Then scroll slowly down to about mid August when she started reducing the dose. It is obvious as she reduced the pinks went away and he began leveling off.

It's very counter-intuitive that such a small dose can make level blood glucose happen, but it does. That's why I scream and yell when I see members such as yourself come to the board on such high doses as even 4U sometimes. There is one right now on Lantus that is doing the same thing. That spreadsheet is here: https://spreadsheets.google.com/spr...GI5SFNKUGpwUm5MbFIwODBTZFkxaWc&hl=en_US#gid=0 Look kind of familiar? Even on 2U he's dramatically swinging.

I need to try to get a library of spreadsheets as examples of this phenomenon. It is such because it just boggles people's minds that so little insulin works! Our society now is all "more, more, more" and that does not work in the world of feline diabetes sometimes.
So it's hard to break that mindset.

Hope this helped illustrate what's happening.

 

[Melissa and Celle]

Thank you Vicky! This is hard to do without someone experienced to hold my hand along the way.

Eventually I'm going to put all of my Lantus data in a spreadsheet. We were up to 5 units before backing down to 3 and then giving up. So even though I'm not happy with so many readings in the 400's, I can't believe that we're getting any control at all on under 1 unit Levemir.

 

[Vicky & Gandalf (GA) & Murrlin]

Thank you Vicky! This is hard to do without someone experienced to hold my hand along the way.

Eventually I'm going to put all of my Lantus data in a spreadsheet. We were up to 5 units before backing down to 3 and then giving up. So even though I'm not happy with so many readings in the 400's, I can't believe that we're getting any control at all on under 1 unit Levemir.

Remarkable isn't it? Lantus is a good insulin too and probably would have done the same thing if the dose had been lowered, but we've seen what tiny amounts of Lev can do here so I have a lot of faith in it.

Again I just have to thank you for having the wherewithall to trust people on the internet :shock: When so many places tell you the internet is a jungle to be wary of and all that, FDMB is pretty much a place you can trust.

Just so you know though - we don't do any hand holding here! You're the one with the syringe and by golly you are making the right decisions. Hope everything goes well for the sitter over the weekend. Will you be home in the evenings? I get nervous when people go out of town, 'cause we've had some stories of people coming back to disasters when someone else has cared for their pet. I hope that doesn't scare you, it sounded like your pet sitter has been doing sitting for a while and you're comfortable with her, so that's good.

Also, I am wondering if you've been able to get any ketone tests on Celle? If you see any signs of lethargy or inappetence it would be a really good idea to try to test for ketones and do not hesitate to run her to the vet if she exhibits behavior changes like that and you can't get a test. Ketones are treatable in the early stages before it explodes to DKA but you have to catch it quick.

Have a good weekend!