Seems like Chester is bouncing down

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MaryB & Chester

MaryB & Chester

Member Since 2012
Chester's numbers have been odd lately. For a while we were on 2.75 units of Lantus, twice a day and holding in the 200-300s. I did a couple of curves in that time to see if we needed to increase the dose, but he was getting down to a nice low 70-80. Anything higher would probably have sent him too low. We've never managed to get him stabilized to greens
Then about a month ago, he started throwing lows at shot time, as in he'd have a significant high in the morning so he'd get a shot, but by dinner time he'd be below my shot comfort threshold. After about a week of this, I started lowering his dose. I'd have one or two cycles of stable looking numbers, then I'd get the same pattern. As the dose got lower, I increased my low shot comfort zone. I'm still getting morning highs and evening lows.

I've been assuming that the morning highs were because he didn't get a shot in the evening so he'd be up, then he'd get the shot in the morning and it would take him a bit too low so no shot in the evening, then he'd go high...
We've been watching him throughout the day and he seems to be quite fine. I'd like my DH to get some day tests, but he's not very cooperative with "unneccessary extra tests".
All this bouncing can't be good for him, but I really don't know what to do. He still seems very healthy - active and playing and eating heartily.

We're going to be boarding him this next weekend and I wish I knew what dose to tell the kitty hotel! i have to make SURE that they know to test him every single shot...Bouncy boy...
Does it look like his dose is too low or too high?
 
can't really tell without any mid cycle tests. The black may be an indication of him dropping too low at night but might not be. He could also be going dangerously. And some cats don't show hypo symptoms until they are seizing and brain damage is occurring. My Bailey looked fine until I realized his snooze was a coma.

Can you at least get a before bed test say 2-3 hours after PM test/shot? That would give you a bit more data even if DH won't do it during the day. Or tests at weekends?

Wendy
 
I'm thinking his dose is too high and he bounces after going low, then is way high in the morning.

As an experiment, try dropping it 0.25 units.

And definitely get some mid-cycle tests around +5 to +6.
 
Where's the information about going off the juice? Is there a link or a sticky?
I don't think we're anywhere near that yet, but we might be heading that way. I'd like to be prepared.
 
I would drop that dose down big time. Try .25 of a unit. It would be best if you can give the same amount for each and every shot, and dont skip if you can help it. Remember that it will take 3 or more days for you to really be able to see what it is doing for him. Right now, its not going well, so if the .25 isnt enough you can easily dial it up a bit.

And yes, you need more tests. Mid Cycle at the least, as well as pre shot
 
MaryB & Chester said:
Where's the information about going off the juice? Is there a link or a sticky?
I don't think we're anywhere near that yet, but we might be heading that way. I'd like to be prepared.
Click to expand...

Well, we have OTJ trial instructions. Are they what you mean?

Chester needs to be down to BG readings all in the normal range (40-130 mg/dL) AND the dose should have gone down from the current dose to 0.25U and then 0.1U before you are ready for that step.
•Try to go from 0.25u to 0.1u before stopping insulin completely.
Click to expand...

We realize you probably work during the day, so those mid-cycle daytime tests during the week are impossible to get. What would be really helpful, is if you could consistently get at least one more test in the evening, what we call the "one last test before you head off to bed" test. That test would give us an idea how low Chester is dropping.

It certainly does seem like Chester is dropping low in the PM cycle. Only way to know for sure, is for a test or 2 in the evenings.
 
At the moment I have him down to 1.5U to see what that does to his cycle. I know we're nowhere near going OTJ yet, but he might be headed that way. It would be nice...
We did get a test today at lunch, where he gave us a 212 after a morning 476. I'll see where he's at tonight and I'll try to get a bedtime test or two in.
We're going out of town this weekend, unfortunately. I'm going to double-emphasize that he's on 1.5U with a test before every shot. I really hope they listen. They are very good with him, but he always comes home a little off his feed. I wish that he traveled better, or that there were more (inexpensive) options for "special needs" boarding.
 
Thanks for getting that mid day test today. It shows us that Chester can drop a couple of hundred points on his dose.

Let's hope the numbers keep improving.

Keeping our paws crossed he does well while being boarded this coming weekend.
 
That two hundred point drop potential has been part of the problem getting Chester regulated (which we've never quite managed).
 
MaryB & Chester said:
That two hundred point drop potential has been part of the problem getting Chester regulated (which we've never quite managed).
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Yes, but those drops do show you that Chester is responding to the insulin. Maybe not the way you'd like to see, with nice smooth curves, but he is responding.

Well, as cats get better regulated and their bodies adjust to the lower numbers, the drops aren't as steep as what you are seeing right now. Some kitties are champion bouncers, and Chester looks like another one of them.

I'm still getting morning highs and evening lows.

I've been assuming that the morning highs were because he didn't get a shot in the evening so he'd be up, then he'd get the shot in the morning and it would take him a bit too low so no shot in the evening, then he'd go high...
Click to expand...
Yes, skipping the shot like you had been doing was at least part of the reason for the morning high numbers.

It looks like the dose may be too high, but since Lantus insulin dose adjustments are made based on the nadir, we can't be sure of that.

Did you get a chance to test any more in yesterdays PM cycle?
 
I was going to, but then I got tired and plain forgot to test before his bedtime feeding.
We're going to get another lunch number, and I'll try for an evening number as well. He got about 1.75 this morning (I was aiming for 1.5 and drew up a little extra).

Just wondering...if we can get this new dose tweaked out so we have a clue where he's at, do you think that Levemir might be a better option than Lantus? I've been reading that it can be a better insulin for bouncy cats, and Chester has been a bounce master. For a while, he was doing well with the 2.75U, getting down to the 100 somethings at the nadir, but still bouncing back up to 400 by shot time.
Then this new phase started.
*sigh*
 
I don't have any Levimir experience, so can't really say if Chester would do better on that insulin or not. I do know it has a much later nadir than the Lantus does, so most people learn to shoot on low pre-shot numbers when they are using Levimir.

When does your current vial/pen of Lantus run out? Maybe think about a switch to Levimir then?

Chester is doing ok on the Lantus. I just have this feeling he's dropping really low at night and may have "earned" a couple of dose reductions. We say that anytime a cat drops <50 mg/dL on a human glucometer, that they have earned a dose reduction.

Looking forward to seeing some other tests for Chester. That evening one has me especially curious.
 
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