Should we try going down instead of up?

[Simon'sMommy]

Since Simon has never had a dose below 2u, what if we try going down to 1.5 tomorrow instead of going up to 2.75? Maybe his starting dose was too high and he bounces all of the time? I don't know. I just know that his insulin seems not to last the full 12 hours and because we are not home during the day to check, Lantus is probably not a good idea (or Levemir) plus my vet likes ProZinc anyway. So, what if we think outside of the box and go backward for a day or two?

I know Robin suggested trying that a while ago and he did well on 2.25 in the beginning so I did not do it. I did shoot 2.0 after starting on 2.25 for a couple of shots because he had low yellow and a blue amps. But, he ended up going way up in the 400's when I did that.

I am totally at a loss. Either up or down tomorrow cause I know this dose is not working cause he is always in pink at amps and pmps and usually a few hours before his pre shot tests too.

Thoughts? Comments? I am open to all suggestions! confused_cat

 

[Sue and Oliver (GA)]

I wish I could be sure what the best dose would be, Joyce. His numbers are pretty good, with blue and even green nadirs but yes, he is up in the pinks by preshot. My gut says he needs a little more, not less. He isn't bouncing from deep lows to red and pinks and he isn't high and flat, both of which suggest too much insulin.

Does he eat midcyle? That might flatten out the curve and get those preshots lower. You can use an automatic feeder to help with that.

Other than that, two choices - up or down. If you can monitor this weekend, maybe try .25 more and see what happens. Or try a smaller dose and see what happens. (if you do that, be sure to check for ketones). Be ready to monitor and also have that higher carb food around. I am, like Robin, a little nervous with your green nadir today. It certainly could be that he didn't eat, but if you increase and he doesn't eat, he could go too low. Is he eating tonight?

Your ss starts at 2 units. Is that where your vet started or did you start at one unit? If you started at one unit and increased by .5 or less before you started testing at home, it is less likely that he needs to go down. If your vet started at 2 units, it is a possibility.

I wish I had the answer, Joyce, but this is truly a process of changing things and testing and changing again.

 

[BJM]

For some cats, ProZinc has a somewhat steep drop and wears off quickly. It did in Spitzer, who had other issues.

From 330 to 65 is a 265 point drop today. I don't think increasing is a good idea unless you feed the curve - ie give medium carb around +3 to slow the drop and keep it from going so low. This means you need to be sure he'll eat and keep it down properly, so if he has any problems with appetite, vomiting, or diarrhea, don't do it.

 

[Simon'sMommy]

Simon ate well tonight and ended up at 154 at nadir (which is generally +5 for him) and that is what is happening. He RARELY gets in the green unless he has a day he doesn't eat well. Tonight he ate like a little piggy and his nadir was blue. This morning, he just did not eat well and he went a little lower. The lowest he EVER tested was 61 and he climbed back up right away and that was a few weeks ago.

Sue, the vet started Simon at 2 units which is why I thought maybe trying a lower dose might be beneficial, but I think you are right and my gut tells me he needs more insulin too. His cycle suggests an increase according to all that I read on here, even with his few lower tests because they are not all that often and he ALWAYS climbs back up.

As for feeding the curve, Simon is easy to entice with food. No problem, especially when we are here. He just hates to eat alone and always has. If you are sitting there talking to him, he will chow every time. He has no other health problems except diabetes. Other than that, he is healthy as a horse the vet said.

Tomorrow I will increase.