? +11 at 70 , never seen before, unsure about dosage

Hi FD family

Raja is showing 70 at +11. (tested twice)
I wasnt home to monitor his day activities. Not sure whether he went very low or not.
Going to measure again in 15 mins to get his pre shot number

Should i shoot the full dosage of 6 or give him a reduction ?

thanks so much

arman

 

I don't think I can really offer advice, but I can ask questions! I've been following your story at a distance but my memory is terrible. I can't tell from your spreadsheet if you are still using a pet meter or if you've switched to a human meter.

If a pet meter, 70 is very close to the "high carb now" cutoff of 68, I'd be nervous about shooting 6.0U. Has anything changed recently (food, behavior?).

The next reading will be useful, hopefully it will show that he's on the rise!

 

I'm not sure how Lantus dosing works. A BG reading of 70 seems pretty low to me. Hopefully someone with more experience will be able to help you. I don't think I would be comfortable shooting at that low number.

 

I am using a Human Meter. Havent switched my chart yet but it shows when i switched, Nothing drastic has changed in terms of diet .

 

now at 102 at his PMPS. Should I consider a reduction ? He just ate his food

 

I would give his full dose if you can monitor tonight and have plenty of strips and high carb food. You've haven't seen anything under 50 so we can't assume he went there.

 

Since you already fed him, it's too late to stall to see if he is coming up on his own (i.e., without food influence). Whichever protocol you are following (TR or Go Slow), he hasn't yet earned a reduction. I would agree with Wendy. Watch him carefully.

 

waited 15 mins after his shot time and it was 128.

As nothing was out of the ordinary in terms of diet , and having some understanding of his numbers I can be pretty sure he went down in the 30s or 40s during the daytime.
I decided to give him a reduction of .5 . Now with the weekend I will be able to monitor him more.

Hopefully this was the right decision

 

He did come up, from 70->102, before the food (I think).

More data will be helpful!

It is exciting that he is starting to go even as low as 70.

 

Have you switched to the Start Low Go Slow method? I though you were following TR. It'll help us help you if you put SLGS or TR in your signature.

 

Just read this now..
you are right..maybe we cant assume he went there.
I worry the lack of day time data and when i extrapolate the night time data into day along with the few day time data, I get a feeling that he might have dipped low today.

And tonight I wont have time to monitor him for too long. I had an incredibly long busy week and I am exhausted ;(

Also not sure why i chose a .5 reduction versus .25 . I assume thats what the protocol calls for
Maybe because i really need to have some worry free sleep.......

 

The bean's well-being is important, too.

 

Over 5 units total dose, we typically make changes by .5 units at a time. Though I have done .25U increases at that size dose to just tweak it.

Rest well tonight, you can always go back to 6 units tomorrow morning when you are refreshed and can monitor more closely.

 

no i didnt switch. I stayed longer on certain dosage due to him seeing lower numbers for the first time and in some cases fur shots which made me continue the whole cycle.
Is there any area where you see something that i should have followed ?

 

The reason I asked if you changed dosing methods is that you reduced without seeing under 50. That plus you don't have the dosing method in your signature so I wasn't 100% sure. It's hard for me to remember what each caregiver is doing for dosing. With greens on the spreadsheet, I too would hold the dose longer, especially now that you've seen that 70.

 

yeah you are right. What does one do when they are not exactly sure how low the cat went as they were not there to collect data ? Should they take an educated guess from previous data ?

 

No, we wait until we see the proof that the cat went under the reduction point. It's just too hard to guess what really happened.

 

Isnt that risky as I might not be there to get the data. Do you think the risk outweighs the benefit ?
I worry that he might have hypo numbers while I am at work

 

Do you have an autofeeder? Check out the Sticky Note on Doing TR With a Full Time Job for other tips. Leaving food is your main tool for keeping him safe.

 

Raja rarely gets up to eat food from his usual spot. Only to drink water. Six months ago he was a grazer . Now he just eats when given

 

Can you put dishes of food within a couple feet of where he sleeps? How was he today when you saw that 70? Some cats get a little more food motivated in lower numbers than they are used to.

 

I'm new on Lantus so I don't have advice but I had to comment and tell you he is amazing! What a handsome guy!

 

he had a good appetite. but maybe he has a bot of constipation. His poop looks hard and his belly a little tight.
He knows where the food is. I leave food beside him where he sleeps. He rarely eats. Only when I take the dish and put it close to him. BTW these are all new habits from the last three months.

 

Maybe he needs a vet check-up?

 

If you're concerned that Raja's constipated, add (additional) water to his food. It's a good habit to get into since FD is hard on the kidneys and water is good for the kidneys. You can also add some oil or butter to his food. If that doesn't seem to help, there are other options.

Throughout Gabby's FD, I worked full time. I never took reductions unless I had test data that informed me that she "earned" a reduction.

It's great you were able to get a +11 test yesterday. What you saw was a rise in the numbers between the +11 and PMPS. Since the numbers were on the way up, it would have been fine to shoot your regular dose (if you're following TR). It helps to keep in mind that by shot time, you're well past the most active period for the previous shot -- hence the numbers are rising. You'll also be giving a meal which raises numbers further until Lantus onset occurs. Of course, having data when you run into a situation like this will give you a means of informing your decision the next time this occurs.

Regarding your question about whether the risk of shooting low vs reducing, the difficulty is that you need data. Some cats are prone to "double dips." They may have a nadir that's very safe and then numbers start to rise. By late in the cycle, numbers drop again. There really isn't an explanation for why this happens but it does. It's why you can't assume that numbers were even lower earlier in the cycle.