Good questions!
KarenAmelia said:
Any rate, there is conflicting info out there, some of it on articles on this site. I read about rebound in the linked article and it said to reduce dose by 25%. Since my syringes don't have .5 unit markings, I thought just barely shaving the whole unit would serve.
"Rebound" is a controversial subject and people have lots of opinions about whether it even exists in cats. Here, we follow a
Tight Regulation Protocol. There is no need to do "rebound checks" when following this protocol because we already know the dose is ok - we increased to it methodically, and we are testing enough to know what the dose is doing. In your case, you haven't been exactly following the TR protocol (which is ok, you didn't know about it so how could you follow it?). Because of the low blue Terra saw on 1.5 units, we would have increased to 1.75 rather than 2.0 units. Still, you're not far off and Terra's should be fine for now. I don't see a reason to reduce at this time, though she might need a reduction soon. That is why we're encouraging you to check her in the PM cycle too, though.
Also, on my one day where I did a real curve (1/8) , the nadir was at +7. That timing agrees with the Lantus curve that someone posted on this site, so I figured that in general the nadir will happen around +7. In that case, is it worth doing a reading at +3? Doesn't seem too likely that this reading will tell me much, according to the curve and according to the numbers I have gotten so far.
I love getting +3 tests because they can give you a good idea of how the rest of the cycle will go. Usually +2 is about the same as the preshot, and +3 is a little lower because the insulin has started to work. If the +2 or +3 are much lower than the preshot, then you know you need to pay attention to the rest of the cycle because she might be on a mission to drop low. If the +3 is about the same or higher than the preshot, then you can rest easier. As you start to collect more +2 and +3's, you'll start to see what Terra's patterns are, and then you'll know when she is differing from those patterns. Make sense?
I totally agree that you have to take care of yourself too. That is a big reason why I always tried to get a bedtime test, even if it is only +3. Then you know she'll be ok (or if she is dropping too much, you can feed her some carbs and bring her up so she'll surf safely).
So I'll just hold at 2.0 units of Lantus for the next couple of days and keep testing midpoints as well as +8, when I can.
Sounds good to me.
Question: when you reduce the dose because of the low numbers at nadir, but the endpoint numbers are still high, what about instead feeding the cat an hour before the usual nadir, so as to bring the numbers up? That would improve the low BG and still allow you to control the high points.
It's nice to see some thinking going on! There are some people here who have found that their cats respond better with different feeding schedules. It takes some experimentation to figure out what works best for your cat. Usually I suggest keeping it simple to start with, but if simple doesn't work for your cat then we can brainstorm what to try next.
