? Theodore +9 477, increasing numbers today

I'm reluctant to have you increase early, if we don't know what he's doing in the night time cycles. When following SLGS, you hold the dose for 7 days before evaluating it and deciding if you can increase. With TR, you can increase sooner, but it's with more testing so that you know what he's doing in all those cycles, and allows you to increase safely. You get second tests in the night cycle, but only +1 tests on this dose. That's not enough for us to know what's happening on the PM cycle with 3.25 units. Is it possible to get a +2? That's more telling of what is happening at night. A +1 is typically still food influenced, and the insulin will not have onset yet. Technically, you also haven't gotten a PMPS test for the last 5 nights, only a AM+11.
 
Wendy&Neko said:
I'm reluctant to have you increase early, if we don't know what he's doing in the night time cycles. When following SLGS, you hold the dose for 7 days before evaluating it and deciding if you can increase. With TR, you can increase sooner, but it's with more testing so that you know what he's doing in all those cycles, and allows you to increase safely. You get second tests in the night cycle, but only +1 tests on this dose. That's not enough for us to know what's happening on the PM cycle with 3.25 units. Is it possible to get a +2? That's more telling of what is happening at night. A +1 is typically still food influenced, and the insulin will not have onset yet. Technically, you also haven't gotten a PMPS test for the last 5 nights, only a AM+11.
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Thank you, will try to get some readings tonight.
 
Wendy&Neko said:
I'm reluctant to have you increase early, if we don't know what he's doing in the night time cycles. When following SLGS, you hold the dose for 7 days before evaluating it and deciding if you can increase. With TR, you can increase sooner, but it's with more testing so that you know what he's doing in all those cycles, and allows you to increase safely. You get second tests in the night cycle, but only +1 tests on this dose. That's not enough for us to know what's happening on the PM cycle with 3.25 units. Is it possible to get a +2? That's more telling of what is happening at night. A +1 is typically still food influenced, and the insulin will not have onset yet. Technically, you also haven't gotten a PMPS test for the last 5 nights, only a AM+11.
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@Wendy&Neko so his +3 just took now (10 mins early is 13.3 or 239.4, haven’t had a chance to update the SS since I’m in bed but I guess that’s a big drop?
 
Yes, that's a big drop. It depends on the cat, but anything over 20% of the PS test might be a big drop. If you can't test later, make sure he has food out to keep himself safe.
 
@Wendy&Neko Is his dose too high then if he's dropping so fast? I read the previous post about cheaper options for acro but I am not sure my vet will agree to getting blood for me. Do you think there's enough possibility where it's worth it to test? I just can't justify spending $1,000 on bloodwork right now as it's been a tough year with a lot of spending as he was just in emerg twice a few months ago and that was close to $7k. First time was because he got backed up (took away dry food) and second time was the following day that visit caused him to go DKA
 
NadineTheodore said:
Is his dose too high then if he's dropping so fast?
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No. His dose is too high if you see a number under 90 when following SLGS for dosing. Some cats like to drop fast at the beginning of the cycle. All we can do is try to slow him down with food. More details here: Using Food to Manipulate the Curve

You can always wait on acro/IAA testing if you want. However, track record here is that if you can treat it, the sooner the better. It might be worth asking the vet what he/she thinks might be in play and what sort of infection they are looking at. Neko had many urine cultures done, each one negative, all costing $$$. So I'm sort of biased against them unless there are signs there is a UTI brewing. Has the vet had a good look inside his mouth for possible dental issues?
 
Well he only has 2-3 teeth left but I can certainly ask her to take a look. Is there something I should ask for? He had almost full dental extraction done December 2021
 
Wendy&Neko said:
I'd get the vet to look at the remaining teeth and the gums. Infection/inflammation can also be a source of insulin resistance.
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He is getting seen this Tuesday :) Booked him in for a check in and blood sample, will go from there what I do, might see if I can get a bundle discount of some sort. Ha. ;)

Also I don't know how his numbers always surprise me. All morning and early afternoon he had horrible numbers, just check now at 6PM and he's at 20!:eek: I know that's still high but makes no sense. He sure likes to keep me on edge. Last year all I could think about is if he pooped that day now it's his glucose lol. Definitely the centre of my world:D
 
@Wendy&Neko Sorry to bother you again, last night he tested 15.5, I was worried to do 3.25 because he can dip over 10 points in the past with 3.25 units, it wouldn't' have been enough time to get a response here so I did 1.5U, this was probably too low. What should I do in this situation? he is 25.7 this morning.
 
Sorry for being late getting back to you. I wasn't home at the time you posted. Please start a new post each day that you post. Conventions for post title, listed here POSTING GUIDELINES PLEASE READ make it much easier to follow your current situation. We have a large number of kitties on this forum and we find the conventions help us help you easier. Also following conventions means someone else might be able to help.

As for dose, we don't change dose based on preshot values, but rather nadirs. He hasn't gone below 90 on this dose so his dose remains the same. You have enough experience now to shoot lower numbers, and have shot full dose on a preshot of 173 previously. The thing about Lantus (and Levemir) is that the cycles are typically flatter, the lower the preshot. Even if he had dipped 10 (180) points from the preshot of 15.5 (279), he still would have been in safe numbers and wouldn't have earned a reduction in dose.
 
Lesson learned for next time. One reduced dose should be OK, pretend it was a partial fur shot.
 
Wendy&Neko said:
Lesson learned for next time. One reduced dose should be OK, pretend it was a partial fur shot.
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Thank you!! Wendy sorry to bother you on this post, my 7 days is up tomorrow but I do have my niece's bday. I need to do a curve before I can increase correct? I was thinking of doing the curve Monday then assuming I will have to increase, do you think that is too late? I noticed on my other notes he was gaining weight (up to 14.8 lbs - august 7) but dropped it after his dose was reduced. Even on 3 units still not really gaining. He's down to 13.8 lbs. He's active and eating well just I would like to build up his weight again. He's a larger cat in general. He looked good at 15 lbs + although I prefer him at 16lbs...his heaviest was 20lbs which I know was not healthy.
 
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