? 9/19 Chino|AMPS=209|6 hrs of green/carbs|PMPS=179

Yesterday...

Yikes! I'm glad I reduced the dose last night, but I'm afraid today might still be a repeat of yesterday. He already dropped by 105 mg/dL from +3 to +4. I guess he really likes the high-carb cat food! Next check at +5.

 

Chino, my man, you need to slow down.

I hope he levels out for you so you can focus on work!

 

The +4 meal slowed him down, but not by much...

AMPS = 209 (1st meal LC 2%)
[2nd cycle on 11 units of Levemir]
+3 = 291
+4 = 186 (2nd meal LC 2%)
+5 = 115 (3 tsp MC 14%)

If that doesn't slow him down, he'll be at 45 or below in an hour. Next check at +5.5.

 

Gravy is delicious, but smooth surfing is pretty wonderful too! Slide on down and surf safely Chino

 

AMPS = 209 (1st meal LC 2%)
[2nd cycle on 11 units of Levemir]
+3 = 291
+4 = 186 (2nd meal LC 2%)
+5 = 115 (3 tsp MC 14%)
+5.5 = 96 (same)

That slowed him down from ~70 mg/dL/hr to ~40 mg/dL/hr. I gave another 3 tsp and will retest at +6. If he's at 85 or above, I'll give another 1-2 tsp and test again an hour later.

 

AMPS = 209 (1st meal LC 2%)
[2nd cycle on 11 units of Levemir]
+3 = 291
+4 = 186 (2nd meal LC 2%)
+5 = 115 (3 tsp MC 14%)
+5.5 = 96 (same)
+6 = 88 (2 tsp same)

Success! Like I said yesterday, I'm very aware that cats don't keep dropping at the same rate, but as long as this strategy continues to work for me, I'm going to keep using it. This is how I determine when I need to test again so I can catch him before he goes too low, and how I evaluate how effective the intervention was so I can determine if I need to give something higher carb or not. Next check at +7.

 

AMPS = 209 (1st meal LC 2%)
[2nd cycle on 11 units of Levemir]
+3 = 291
+4 = 186 (2nd meal LC 2%)
+5 = 115 (3 tsp MC 14%)
+5.5 = 96 (same)
+6 = 88 (2 tsp same)
+7 = 73 (3 tsp MC 15%, mostly gravy)

+7.5 is when he started rising again yesterday and the day before, so I hope this is the last time I have to give carbs today. It's a definite improvement that I was able to keep him afloat with MC instead of HC.

 

Hopefully he'll flatten out even more soon. Nice and easy now Chino.

 

Easy on the gravy now. You don't want to give as many carbs towards the back part of the cycle if you can prevent it. This is where he bottomed out yesterday.

It already looks like Chino doesn't dive as much on Lev as he did on Lantus.

 

AMPS = 209 (1st meal LC 2%)
[2nd cycle on 11 units of Levemir]
+3 = 291
+4 = 186 (2nd meal LC 2%)
+5 = 115 (3 tsp MC 14%)
+5.5 = 96 (same)
+6 = 88 (2 tsp same)
+7 = 73 (3 tsp MC 15%, mostly gravy)
+8 = 64 (same + 3 dry treats)

One thing I love about his response to Levemir so far (and I'm hoping this doesn't change) is that he's going lower during the day than at night, though if the depot stabilizes and I'm still having to give him MC/HC every hour for several hours at a time just to keep him out of the danger zone, I'm going to reduce the dose again. I won't be at home Thursday or Friday morning.

 

What finally drove me to try Levemir was Neko's insistance on going low at night and bouncing during the day. Lev helped, though not always. What it really helped though was with the flatness. I found I could go longer between tests. At certain points of the cycle I could even go three hours between tests if she was green. Made for much better sleep.

 

AMPS = 209 (1st meal LC 2%)
[2nd cycle on 11 units of Levemir]
+3 = 291
+4 = 186 (2nd meal LC 2%)
+5 = 115 (3 tsp MC 14%)
+5.5 = 96 (same)
+6 = 88 (2 tsp same)
+7 = 73 (3 tsp MC 15%, mostly gravy)
+8 = 64 (same + 3 dry treats)
+9 = 65 (freeze-dried treats)

This is brutal on his ears... If we have to do this again tomorrow morning, I think I'm going to do a drain-the-depot dose tomorrow night and decrease again. If I have to take it back up on Saturday, so be it, but I want to make sure he's safe while I'm out on Thursday and Friday mornings.

 

After 2 hours without carbs, he's at 62 (+10). I'm REALLY not looking forward to shooting a full 11 units with a BG in the 50s or 60s. Even if it rises to blue or yellow before the onset of the next dose, that doesn't give him a lot of room to safely drop before he hits green again, and I don't want to be up all night feeding MC/HC just to do it again tomorrow morning on no sleep. So if his PMPS is green, I might do a BCS of 9 units, then give 11 again tomorrow morning to see if he'll surf. If he needs constant testing/feeding again, I'll reduce the dose, then reevaluate after Friday.

I know some people won't agree with this, but here's the bottom line: I'm running out of time to see what happens when the depot fills/Lantus depot drains. I'm only able to monitor closely for 3 more cycles, so I'd rather reduce proactively while there's time to see how far a lower dose will drop him. I reduced without a drain-the-depot dose last time, which could be why today followed the same pattern. If a drain-the-depot dose can help keep him safe on the same dose tomorrow, I can use that strategy to keep him safe on Wednesday/Thursday. And if it doesn't, then draining the depot AND reducing the dose might be my last resort.

 

I've only ever given a drain-the-depot dose twice before, and both times, I've regretted it. Chino always bounced on Lantus. For that reason, I didn't give one when I reduced the dose last night, but I'm just blown away by how different this is. He's not bouncing on Levemir! I don't know if that's because the dose is too high or because that's just how he responds to Levemir... but I hope it's the second one.

PMPS was 179, so I gave 9 units to drain the depot. I hope he does better tomorrow morning on 11 units. If not, then he'll get a temporary reduction for Thursday and Friday - the same thing I'd do if I were leaving him with a sitter who couldn't test during the cycle. While I won't be gone all day, I have to leave before the onset and might not be able to get back before +6 or +7.

Question: If he responds the same way to 11 units tomorrow as he did today, what would you suggest as a "sitter" dose? 10 units? 9.5?

 

70% of his Lantus dose would've been 10.5u. ( typical starting dose when switching).. You certainly want a dose to shoot consistently ( at least 6 cycles, no R) to let the depot stabilize. I might try 10u. Hopefully the 9u will drain enough so you both can get a little break and he'll be safe for the few days you're out. Just my 2 cents which is worth a 1/2 a penny