4/3 Honey AMPS 330, +6 313, +8.5 272, PMPS 278

http://www.felinediabetes.com/FDMB/threads/4-2-honey-amps-366-4-353-6-5-355-pmps-364-3-284.212717/

 

Honey, pink is not your color. A nice blue maybe would look better on you.

 

Maybe you and Olive can hold a net so we can get her out of the darn trees!

 

I think it would be better if she climbed down on her own. I don't think we can trust Olive to hold the net.

 

In keeping with the spirit of peer review on the FDMB, I'm replying to Julie's PM on the open board:

Technically, the cycle count starts over after a missed shot (PM 3/29). You stalled a half hour and she was 203. Not sure why you didn't shoot the 203?

On the surface and given the data you've collected, increasing to 1 unit bid looks just fine. However, here's the 64,000 dollar question: What would have happened had you shot the 203 with 0.75u?

The effects of Lantus are cumulative. When there's the ability to monitor, lower preshot numbers are a gift. It's what you want to happen because of the cumulative nature of Lantus. It's an opportunity to create a shift in a positive direction. That opportunity was missed because of the skipped shot.

Because of that skipped shot, this is the 4.5 consecutive day at 0.75 unit. Since you're following SLGS, you'll want to hold the dose for 7 consecutive days before making any adjustment. Let's hope the opportunity to shoot a little lower comes around soon!

About curves at the end of a week when following SLGS...
Historically, those who *usually* choose to follow the SLGS approach do not test often and/or consistently.

However, the whole idea behind performing a curve is to learn how low the current dose is dropping kitty. Those who test often and/or consistently may have found that information making a curve a moot point. I like how you reached out to someone with a little bit more experience for advice. In time it won't be necessary, but it's a good idea for now.

You mentioned her ears being sore...
Are you using a folded tissue to exert firm pressure with your fingertips after poking? Cream or ointment or coconut oil? Are you hitting the edge of the ear? There's an awful lot of talk about hitting the "sweet spot", but truth be told, you can poke anywhere around the edge of the entire ear. That way you're not always poking in the same spot.

Unsolicited advice...
Two things jump out at me when looking at Honey's spreadsheet:

• The absence of either +2 OR before bed spot checks every night - While not mandatory, they're valuable data points.
• Start preparing yourself mentally and emotionally to shoot on lower preshot numbers by gradually lowering your "no shoot number". At this point, you shouldn't have any trouble shooting preshot numbers 200 or greater.

Just because I'm sharing in hopes of giving you a few more tools...
The +1s, +2s, +10s, and +11s are what we call the "forgotten" spot checks.
ECID, but generally speaking:

• +1s will teach you how much a food spike Honey gets after eating (if any - not all cats do).
• +2s (with Lantus), +3s or +4s (with Levemir) will usually give you an idea of when onset occurs.
• +10s and/or +11s will tell you if kitty numbers are on the rise and how quickly they're rising going into the next shot time. If they're on the rise, it'll make you feel more comfortable about shooting a lower than usual preshot number because you know her numbers on on the way up. Conversely, if her numbers are dropping going into shot time, it might give you pause for thought. Eventually, learn to shoot a dropping number, but it won't be until you have a little more experience under your belt.

Hope this all makes sense. I know this is more than you were asking. Give yourself time to absorb.
Ask any questions you might have.

 

I can keep the .75 dose a couple of more days, I thought 10 cycles after skipped dose would be enough to have depot filled. I did not shoot that 203 because no one was on at that time that could provide guidance, I looked at the stickies and it said option was to skip and I did not feel safe doing anything else. I could not stall any longer because her shot schedule was already several hours off. My vet wanted me to check in this week and she will likely recommend increasing to 1 unit, that is why I was checking now also, I will wait a couple of more days before contacting vet, I would like to know increasing to 1 unit is the right thing to do before vet recommends it.

Her ear problem arose from her jerking 2 or 3 times recently as I had the lancet in her ear (not normal for her) this jerking resulted in several spots that have minor trauma to the soft tissue. I think now she is resisting being poked due to these sore areas. It will be fine in time. I have plenty of stuff for ears and am alternating between triple antibiotic and Halo salve. I have some 30 gauge lancets which I have switched to yesterday which I am hoping will help also.

 

Ah, ok. Over time and accumulating more data, you'll learn to shoot lower preshot numbers... as low as 90. This is why I mentioned to begin preparing yourself emotionally and mentally to gradually lower your no shot number. Baby steps is ok.

Right now, we don't know how low the 0.75u dose can drop Honey. If you shot the 162... or the rise to 203 thirty minutes later instead of skipping the shot, would Honey's BG numbers have risen OR dropped? That's what you want to find out by holding the dose for the full week (14 consecutive cycles) per SLGS... before increasing the dose.

I hope Honey's poor ears heal quickly...

 

[QUOTE="Julie and Honey, post: 2357726, member: 25982
Her ear problem arose from her jerking 2 or 3 times recently as I had the lancet in her ear (not normal for her) this jerking resulted in several spots that have minor trauma to the soft tissue. I think now she is resisting being poked due to these sore areas. It will be fine in time. I have plenty of stuff for ears and am alternating between triple antibiotic and Halo salve. I have some 30 gauge lancets which I have switched to yesterday which I am hoping will help also.[/QUOTE]
Are you using the lancet free-hand? If so, you may find that using a lancet device will be easier on her ears. It gives a very fast earstick and immediately pulls back. It is virtually impossible for the lancet to remain in the ear.

 

Are you using the lancet free-hand? If so, you may find that using a lancet device will be easier on her ears. It gives a very fast earstick and immediately pulls back. It is virtually impossible for the lancet to remain in the ear.[/QUOTE]
I use the holder but do it freehand, too hard to get the right spot otherwise and she does not like the click anyway. Freehand has been working for several months just fine, just a few days ago she pulled away and it hurt her ear, I think she will be fine in a few days.