On the advice of the vet we've only been doing BG curves every 2 weeks and then adjusting after telephone consult with vet. N
I disagree with the way the vet is monitoring Siri. (but at least he is getting you to test the BSL, which is a big plus). Curves taking once every two weeks do not tell you much. BSLs change from cycle to cycle. Some cycles are active cycles where the BSL dips down into good numbers and some cycles don't move much and the BSL doesn't dip down much at all. If you test during a cycle that is not doing much you are only getting part of the picture.
We recommend you test every day.....before EVERY insulin shot to ensure it is safe to give the insulin and then sometime during the cycle at @4 or @6 to see how low the insulin is taking Siri.
I would recommend you set up our spreadsheet and document all the numbers in it. That way we can help you
www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Vet has determined the increases, amounts and timing...so far a 1 unit increase each time.
In my opinion increasing the dose by one unit each time based on one curve with no other testing is not safe.
Is there a way to tell we've past optimal mark (fructosomine or ketones tests)???
Fructosamine and ketone testing will not tell you if you have gone past the best dose. The only way to tell is to be testing each day at preshot and during the cycle, to see how low the cycle takes Siri. If you look at other peoples SS you will see what I mean. Some cycles will not move a lot and others will. Siri could also be bouncing....ie dropping low and then bouncing high from the low numbers. If you are doing a 2nd weekly cycle when this happens, you will only see high numbers.
Fructosamine tests only tell you the average of what has happened over the last few weeks with the BSLs. Not if they have been high, low or in the middle. Ketone tests tell you if there are ketones in the urine, which is a condition which needs vet attention. So neither test can tell you if you have gone past the best dose.
Next call is this Thursday 21Mar.
I would definitely NOT increase the insulin until you are testing each cycle to see that Siri is not dropping low and bouncing high.
One more question for tonight...I'm using 3/10ml syringes and filling to the 5 mark (first 5 lines). I understand that to be 5 units...is that correct? If so, I'm not sure how I can consistently get .5 or .25 on this syringe. Based on the Lantus forum and the stickies over there (THANKS..very helpful) Siri's nadir #s still seem to indicate an increase. How can I tell if we've overshot and 5 units is too much?
Yes you are using the correct syringes and up to the 5 mark is 5 units.
There are 1/2 unit syringes available in the US at Walmart and many other places. I live in Australia and only had access to 1 unit syringes like you have at the moment. I used to eyeball 0.25 and 0.5 unit amounts for several years. I used a magnifying glass to make it easier. If I were you I would try and get some 1/2 unit marked syringes. Make sure they are the 0.3ml U 100 syringes.
With testing during the PM cycle always get a preshot test and then get a before bed test. If the before bed test is lower than the PM preshot then you probably have an active cycle so need to set the alarm and test a few hours later.
Keep asking questions. it is a steep learning curve in the beginning...and I know it can be hard to go against vet advice. But a lot of vets do not know a lot about feline diabetes. It is not the same as canine diabetes which they know more about. Siri is your top priority and keeping her safe is the most important thing.
Started with the AMPS at 214, followed by 5 units and just took +6 at 143. Will test again PMPS and before bed. These are certainly better #s, however, they don't reflect incredibly low BG that would indicate hypoglycemia (a crash). Is it possible to have a less exaggerated 'drop and bounce' where the overall numbers stay higher? Also to clarify...Bron's reply seems to indicate that some cycles create more results than others? Is that an accurate description? Is that a result of the insulin depot, overlap, both/neither??? Definitely want to lower Siri's overall curve into the 100s and below without creating a crash and/or bounce situation.