Trinity 10/1 AMPS 396, +4/158 +6/42 +8/34 +10/40 PMPS 37

[JoeyB]

I'm a little confused what is going on here today.

Last Lantus pen went bad showing floaties after sucking air into it somehow while withdrawing insulin. I got another pen 9/27 and have been using that since.

Todays numbers are fantastic, but somewhat lower then I'm used to.

I'm definitely lowering the dose to 1.25u BID after todays numbers, but am most curious why after the 34 reading at AM+8, with honey and HC treats given, she went up for a couple hours, then back down again for the PMPS?

I did mix a couple more drops of honey into her feeding at PMPS, to try and bring her levels back up before I return in a few hours to test and probably give her shot a bit late since I can't stay right now.

Is there something going on here that I'm missing? There is no rush in answers tonight since I'm holding the shot for at least a few hours, but would like to have a better idea what may be causing her levels to be so low, so long after a shot. She usually has a nice curve with an obvious nadir, but that seems to have been lost today.

Thanks for your input and ideas!

 

[Dale 'n' Chip]

Hi Joey,

Glad you got a new pen.

BTW what meter are you using? I thought I read you got testing supplies from Venita, but I was wondering what meter it is as a frame of reference for some of these low numbers.

 

[Dale 'n' Chip]

I suspect you should skip this shot tonight with those numbers.

I'll see if I can find someone more experienced to take a look at this.

At any rate Debbie and Mel should be along in the AM.

 

[Wendy&Neko]

Hi Joey, Dale asked me to pop in and take a look at your condo today. First off, congrats with the reduction, your new dose should be 1.25U. And I agree with Dale, unless Trinity comes up a lot, and I mean well over 100, I'd skip tonight. And you might still have an active night. So unless you have plenty of strips and are willing to monitor, then that's also a reason to skip and then start with 1.25U tomorrow at whatever time you want AMPS to be.

I have one possible explanation for what happened today. You got a new pen and started using in on the PM of 9/27. That new pen was more potent, so it was like a dose increase for Trinity. After 6 cycles of that new pen (which was today), her depot for the new dose (pen) was full so you started seeing those lower numbers.

A question for you, you got a 41 on both 9/17 and 9/19. Why didn't you reduce then?

As for why the cycle looks different. I'll often find if Neko starts higher, her nadir is later. Today's cycle looks a lot like the one Trinity did on 9/10.

 

[JoeyB]

Hi Joey,

Glad you got a new pen.

BTW what meter are you using? I thought I read you got testing supplies from Venita, but I was wondering what meter it is as a frame of reference for some of these low numbers.

The meter I'm using is and Arkray, pretty much a unbranded Relion Confirm. The results have always been pretty good. I frequently test myself as a control along with the control fluid that came with it.

 

[JoeyB]

Hi Joey, Dale asked me to pop in and take a look at your condo today. First off, congrats with the reduction, your new dose should be 1.25U. And I agree with Dale, unless Trinity comes up a lot, and I mean well over 100, I'd skip tonight. And you might still have an active night. So unless you have plenty of strips and are willing to monitor, then that's also a reason to skip and then start with 1.25U tomorrow at whatever time you want AMPS to be.

I have one possible explanation for what happened today. You got a new pen and started using in on the PM of 9/27. That new pen was more potent, so it was like a dose increase for Trinity. After 6 cycles of that new pen (which was today), her depot for the new dose (pen) was full so you started seeing those lower numbers.

A question for you, you got a 41 on both 9/17 and 9/19. Why didn't you reduce then?

As for why the cycle looks different. I'll often find if Neko starts higher, her nadir is later. Today's cycle looks a lot like the one Trinity did on 9/10.

Considering the bounce that is likely to come from these lower numbers, I'm going to put her next shot off until the morning so I can keep her on schedule. I've only got 5 test strips left, and have to work early so can't stay up all night. 1.25u is the new dosage, yupyup.

The explanation you gave was what I was suspecting myself. I knew it would happen 3-4 days after the new pen, but wasn't expecting it to be quite so low as it tried to go.

As far as the denial of the reductions on the earlier dates, I put it off since there were still wildly variable periods around the same time where she was spiking over 400. Which is oddly familiar if you look at PMPS 9/29 and AMPS 9/30 to this most recent dive. I'm still going with the reduction this time because Trinity needs some stability in her numbers, and this new pen should help that out.

Thanks much for the insights, it brings that extra measure of peace of mind to what's going on with Trinity!

 

[Dale 'n' Chip]

The meter I'm using is and Arkray, pretty much a unbranded Relion Confirm. The results have always been pretty good. I frequently test myself as a control along with the control fluid that came with it.

That's a good meter. I have the branded Confirm. It does normally read lower than my other meters below 50, so that's just why I was wondering.

I agree with Wendy that the new pen may have something to do with what you are seeing. And the old pen may have been getting wonky before you spotted the floaties, so that might have contributed to some of those numbers.

What I keep seeing is how well she responds and it has look of cats that go OTJ. So that why I think it's good to keep up with this right now and go "by the book" as far as protocol.

 

[Wendy&Neko]

I also use the branded Confirm. Good call on the skip tonight given your time constraints.

One thing to be kept in mind with Lantus, is that you change doses based on the nadirs. As much as you hate the high numbers, you have to listen to what the nadirs are telling you and ignore the preshots. I have an extremely bouncy cat, so I can sympathize. As Trinity comes down the dosing ladder, there should be a point where her liver gets it and she stops the crazy bouncing.

 

[JoeyB]

I also use the branded Confirm. Good call on the skip tonight given your time constraints.

One thing to be kept in mind with Lantus, is that you change doses based on the nadirs. As much as you hate the high numbers, you have to listen to what the nadirs are telling you and ignore the preshots. I have an extremely bouncy cat, so I can sympathize. As Trinity comes down the dosing ladder, there should be a point where her liver gets it and she stops the crazy bouncing.

Aaaaaand of course I can't sleep knowing there's test results from Trinity to be had over the next couple hours before I'm actually relaxed enough to sleep.

Trinity's PMPS +3 shot to 289, and as before in this situation, I went ahead and gave her 1u, not wanting her without any shot at all, but comfortable enough with the lower dose considering the high number that is probably still rising.

She's eaten well tonight too. Gave her some Salmon FF, lower carbs, and of course one of both her and Nubi's favorites. Figured the super low carb might help her not bounce to much, which is what I fully expect her to do. ECID...and mine is a chaotic mess at times.

I'll keep an eye on the nadirs a bit more in the future as well. I remember reading that before, but with everything else I read during the same time it's hit or miss with remembering all of it.

That's why I keep coming back here to fill in all the little nooks and crannies of my overall knowledge!

 

[Dale 'n' Chip]

...I'll keep an eye on the nadirs a bit more in the future as well. I remember reading that before, but with everything else I read during the same time it's hit or miss with remembering all of it.

That's why with Lantus we want those mid-cycle spot checks, so we know the nadir.

But still great to see her holding this much green at this point in the process. :mrgreen:

 

[MommaOfMuse]

Sorry I didn't see this last night but to answer you're question of why she went up and then back down again. What happened is very simple the sugar in the honey and the treats wore off before the insulin did.

Going forward the next time you get a low reading like that you need to keep testing every 30 minutes and keep feeding her up until you have 3 rising reading. You got lucky yesterday that she didn't drop any lower. High numbers kill over time but too low numbers can kill very quickly.

Mel, Maxwell, Autumn and The Fur Gang