Urgent Dosing Advice Needed

Nancy S

Nancy S

Member
@FrostD, @JanetNJ
Usually when I post I am frantic about KittyLous super high numbers and awful spreadsheet. We have switches from Basaglar to Prozinc and did a reset. We are now up to 4.5 U twice per day and in the past few days we have moved off the black numbers and the past 24 hours have been amazing (in my mind).
The only things different this week are she had a curve done at the vet 4 days ago. He upped the dose to 4.5 U twice daily, he attached a Libre to her (which i spot check the low numbers, in disbelief, with my Alpha Track 2) and he gave her a Covenia shot because she has the stubborn small rodent ulcer on her upper lip and also has a couple of bad teeth.
Last night her numbers did a rapid dive into double digits and I was starting to worry about a hypo. There are no emergency vets in my city on Monday or Tuesday nights and the next nearest one is two hours away. I cannot have her go hypo. Since numbers in this low range are so new to me, I have no idea how low she is capable of going and 4.5 U is a pretty substantial dose. She did tend to have wild swings in past months. This is the first time she hasnt gone low and then swung up into the 500's , 600's and 700's afterward. She has been relatively stable for 24 hours.
Any idea what is going on? What is a safe dose to shoot tonight? I dont want to lose the momentum but I dont want a severe hypo either.
Please advise. This group and its members have been instrumental with your help!
 
I’m sure Melissa or Janet will be around to offer some advice, but I just wanted to point out that she did earn a reduction last night by going on under 90 on SLGS.
 
She may still bounce yet, so don't be surprised

New dose per guidelines is 4.25U. it's possible that convenia shot helped with the infection and is lowering BGs. Could also be some glucose toxicity breaking.

At this point, I would:
- Give 4.25U if preshot is 300s or higher
- Give 3.75-4U if 200-299
-- Give 2U if 150-199 (this seems unlikely given last test)

It's a balancing act - you don't want to get too "spooked" and drastically reduce the dose and lose the progress she's making, but also don't want too high of a dose. Normally I'd say "advice assumes you can stay around to monitor and intervene" BUT that's the case no matter what you do - something is happening and need to keep a close eye on her no matter what you choose to do
 
And any time she goes under 90, reduce the next shot by 0.25U. if she goes drastically under 90 then it may warrant a larger reduction.
 
FrostD said:
She may still bounce yet, so don't be surprised

New dose per guidelines is 4.25U. it's possible that convenia shot helped with the infection and is lowering BGs. Could also be some glucose toxicity breaking.

At this point, I would:
- Give 4.25U if preshot is 300s or higher
- Give 3.75-4U if 200-299
-- Give 2U if 150-199 (this seems unlikely given last test)

It's a balancing act - you don't want to get too "spooked" and drastically reduce the dose and lose the progress she's making, but also don't want too high of a dose. Normally I'd say "advice assumes you can stay around to monitor and intervene" BUT that's the case no matter what you do - something is happening and need to keep a close eye on her no matter what you choose to do
Click to expand...
 
I didnt get these posts before shot time. I didnt feel right about shooting 4.5U. In my limited wisdom I shot a “heavy” 4U. I hope I dont mess up any forward momentum she has going on. She sleeps on her “bed” on a twin mattress next to my bed. She cant jump up on a bed anymore but she can still navigate jumping up on this mattress.
 
I dont know if it was because I only shot 4 U last PMPS, instead of 4.5, but KittyLou was over 500 (max reading on the Libre) all night and was 697 at this mornings AMPS (AlphaTrak2). She came down decently today, despite the bad night. I just HATE the swings. So does the vet. The cat probably hates them too. Why does she have them? is it the dose? Some underlying disease process that we can't find?
 
Hey body just isn't used to the low numbers, or huge drops. The dry, higher carb food also doesn't help, but I know that was discussed before.

When does she get her meals? I apologize if we've asked before. We usually recommend two larger meals around preshot time, and in KittyLou's case another snack around +1 to start. It helps slow the drops a bit. Anytime you see a large drop, it's a good idea to see if she'll eat a little snack
 
FrostD said:
Hey body just isn't used to the low numbers, or huge drops. The dry, higher carb food also doesn't help, but I know that was discussed before.

When does she get her meals? I apologize if we've asked before. We usually recommend two larger meals around preshot time, and in KittyLou's case another snack around +1 to start. It helps slow the drops a bit. Anytime you see a large drop, it's a good idea to see if she'll eat a little snack
Click to expand...
KittyLou free feeds. She eats right after her morning shot. She free feeds and visits the food bowl 2 or 3 more times before the PM shot. I would she eats about 1 Tablespoon of food each time and probably a little more at the AM feeding. I measure her food —2/3 cup in a 24 hour period.
She has always been a boring eater. Doesnt like variety or change.
 
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