Results of Boo's first curve

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Wendy and Boo (GA)

Wendy and Boo (GA)

Member Since 2009
Hmmmm. I like the fact his curve is flat and no numbers were in the 400's but I have no idea what to do with his dose. He did peak late the day before with a respectable 112 but didn't see anything close to that yesterday. I wanted to check more last night, but fell asleep :YMSIGH:

Should I give the 1.25 a more time?

Thanks everyone and have a nice Monday!
 
Wendy, these are the hardest types of curves/numbers to figure out. It's obvious that his dose needs changing, but which way? In my experience here, conventional wisdom is to raise the dose, but those numbers look almost like the definition of rebound on a long acting insulin. Here is my source (petdiabeteswiki) quoted:
A typical rebound pattern, most often seen with long-acting insulins, is a high, flat, unresponsive blood sugar over a period of days. Sometimes, often when raising dosage, this high flat curve will be punctuated by sudden drops to very low values, (with possible hypoglycemic events) followed by a fast return to high unresponsive numbers. (It's the sudden dip that distinguishes this pattern from inadequate insulin, but it doesn't always happen.)
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http://petdiabetes.wikia.com/wiki/Somogyi_rebound

While that 112 is not a "very low" number it was sudden and he did immediately climb back to the 300s and stay there.

If this is rebound, and you raise the dose, his numbers will probably get worse (they won't get better except maybe the second day's numbers, in my experience with Beau), but the drops may become more definitive (Beau dropped to the 30s). However, if you decrease the dose enough the numbers will get better.

If it is NOT rebound the numbers should get at least a little better on a dose increase and worse on a dose decrease.

At this point my gut is saying he is rebounding and his dose may be between .25u and .5u, but your decision is to make a call on the risks of "going the wrong way". I know its really confusing right now. Things to consider are ketones if the dose is reduced and that was the wrong move versus potentially very low numbers if you increase and THAT was the wrong move. Do you leave food down during the day, or can he be fed a snack between +4 and +6? Beau always had food available and they are usually pretty good about eating as their BG drops below 40 or so.

What I think I would do for one of my cats with these numbers is drop to .25u, let that settle 3-5 days, test for ketones, get spot checks as I can and then do another curve. But I have not had any hint of ketones with either of these guys and they both eat well.
 
Wendy and Boo said:
Hmmmm. I like the fact his curve is flat and no numbers were in the 400's but I have no idea what to do with his dose. He did peak late the day before with a respectable 112 but didn't see anything close to that yesterday. I wanted to check more last night, but fell asleep :YMSIGH:

Should I give the 1.25 a more time?

Thanks everyone and have a nice Monday!
Click to expand...

Well I have the benefit of seeing the +7 today and it is nice to see him in the 200's once again so this dose seems to be settling. So I would shoot 1.25 again tonight, get some spot checks and then see about increasing slightly tomorrow to 1.5 keeping in mind what Sheila said about the numbers possibly getting worse as you raise the dose. I hope that isn't the case and as you climb the dosing ladder his numbers will get better. :) We'll see.
 
I responded earlier today--don't know where it went. Missing posts seem to happen a lot. Bottom line of that response was that I would raise the dose. You've given the 1.25 units more than enough time to settle and even with today's 275 peak, it's no where close to good enough. But you also know that I am more aggressive than others so take that into account. :)

Terri
 
Thanks everyone for your input. I really appreciate it. I shot 1.25 tonight and I'll shoot 1.5 starting tomorrow. I'll leave FF out for him to eat during the day in case he drops too low. I'll be with him through +3 in the morning and will be home by +9 to check on him.

-Wendy
 
I would raise, but not to 1.5...I am microdose queen, though....I'd go with somewhere in between, hold for 5 days and curve again.

In any case, remember you may not see results immediately of the raise- like tomorrow while you are waiting and watvhing...it may be a few cycles and surprise you. ;-)
 
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