Too Much? Too Little?

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SugarFreeLucy

SugarFreeLucy

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Hi again!

I'm back again with another question...I am wondering if there is a way to tell if the dose I am giving Lucy is too high? or maybe too low?

Here's a rundown of the last couple days (I have been a bad cat mommy and not updated her SS...all info is recorded, just hasn't made it to the SS yet!)

After a couple days of Lucy bouncing from the 100s way up to the 300s between AMPS and PMPS, and me only shooting her once a day (2.5u). I reduced her dose to 1u and was comfortable shooting BID....merrily along we go!

Two full days of her having great green numbers at all test times, including nadir and before bedtime! Then comes the third morning....poof! right back up to over 250! Ugh! Is there a way that I would know if the 1u is too much or too little? Or is it more of a try and reduce and see what numbers come up?

She is eating canned (petsmart brand and ff) only and loves it! She is a bit of a hoover, so leaving food out didn't turn out well...she is the proud new owner of an automated feeder!

Thanks for all the advice we have been given so far! Lucy has put back on a bit of the weight she has lost and generally seems to be feeling better!

Val
 
We call that a bounce - when a cat's body is adjusted to being in high numbers for a long time, it goes into panic mode when the numbers drop, even if they are still within normal range. The cats body reacts to the "low" numbers by dumping a bunch of stored sugar into the bloodstream to help prevent hypoglycemia, which can significantly raise blood sugar hours after the "low" number. It can take up to 3 days to clear a bounce. That combined with the lack of insulin in the morning calls for a high PMPS.

Scooter has been in the blue-green for the past 3 weeks and he still bounces. He hit 34 (yikes!!) yesterday at his nadir, and by his evening PMPS he was at 230 and he was in the 200's until this afternoon.
 
So you've got about 5-6 days of no dry food, right?

You may still have too high a dose.

Or, her pancreas may be kicking in intermittently, resulting in a dose that could be ok or too high, depending. (don't you just love consistency!) In that event, you may need to cut back a smidge on the regular dose to give you some room for that to happen without going too low.

Please either update the spreadsheet or put the recent day or two's numbers here as AMPS, +!, +6, etc. so we can see them. We'll get a better feel for what is happening.
 
OK, Lucy's SS has been updated!

She has not had dry food at all since April 6th! Strictly eating FF and PetSmart brand (no grain, no veggies) low carb foods!

I was wondering if the dose was still too high.....how do I know that? Or is it just a situation where I would have to lower her dose and see what her numbers are?

We are not home at all during the day next week as both of us are on day shift, so I am reluctant to try any thing that would put her at risk of hypo since nobody will be home between hours +2 and +9 after her am shot.

Input, thoughts and your expertise are welcomed!

Thanks a bunch,
Val and Lucy
 
I still think she is bouncing.... but you might need to reduce the dose so you can shoot 12:12 consistently. Skipping shots is obviously not working well for her... Lantus likes consistency.

Normally in TR protocol you would only reduce if she tested lower than 50 but maybe someone else will have some insight on what to do with your dose.
 
Ok, I have been able to shoot 1u consistently 12/12 for the last 6 days....still stuck in the yellow and pinks! Today we had some blue numbers, which made me quite happy! :-D

I am wondering how I can tell if she is still bouncing? I know I don't have a great deal of data this weekend, it was a busy one for me!

If anyone has any info or thougths about bouncing etc would love the input / reassurance!
 
Can't help with dose but I didn't realize the Petsmart brand (Great Choice) had higher carb content than Friskies in many cases. I agree Lucy's bouncing...like a pretty little ball!

HUGS!
 
You're doing great!

As you collect data on your cat, you will learn when it is safe to shoot at lower numbers bit by bit. Generally, we recommend new users not shoot if @ 200 or lower, so keep an eye on her tonight and maybe test her before you go to bed, since you shot a US value of 140 (7.8ish). You'll probably be OK, but you don't have a lot of mid-cycle data, so you can't be sure. If at +4 you are below 100, I'd stay up until you were certain she didn't go too low. And maybe get your hypo kit ready, just to be prepared. Folks on the Tight Regulation forum are present almost all hours of the day.

With everything updated, a spreadsheet, low carb canned food on board, and a consistent insulin schedule and dose, you are ready to start posting to a Lantus forum and getting feedback from regular users of your insulin. There are 2 - Tight Regulation and "Relaxed" Lantus. Both forums will find it important to have glucose tests - always before shooting, and periodic curves help determine dose.

If you are hoping to have a diet-controlled diabetic, you want the first one. It is more rigorous as there is a very specific protocol for testing and adjusting the Lantus dose.
If you have a complex cat (ex, several other health problems that affect insulin and glucose, erratic appetite, weird responses to everything), or a really whacky schedule that didn't let you shoot every 12 hours, you may do better in the "Relaxed" forum, but it is less likely that you'll discontinue insulin. Not impossible, just less likely.

How to tell if you have the correct dose is based on Lantus's nadir, or lowest point in the cycle, not on the pre-shot numbers (which are starting to look decent!). This roughly 5-7 hours after the shot.

If you can manage the time, do a curve. This is when you take glucose measurements every 2 hours from the pre-shot to the next pre-shot.
 
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