Hi— vet said not to give insulin if BG is < 200. Yesterday— BG dipped to under 40– no symptoms. This morning at 379 and tonight at 173. I think I should give shot— maybe at 2.75. Spreadsheet is updated. Any advice appreciated. Thanks
40 is really low on AT2. Most certainly that earns a reduction, regardless of whether you are following Tight Regulation protocol or the Start Low Go Slow method. Please take a moment to review this sticky, as people's advice will depend on which you choose to follow. http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/ At this point we know 3u is too much insulin, as evidenced by that 40 on AT2 meter. Can you stall and not feed for 20-30 minutes from this 178 (per your SS) and retest to see if the numbers are coming back up?. He appears to have been coming down all day so you may be in for a bounce breaking cycle tonight, which requires more testing. If you shoot 2.75u tonight, can you continue to test and monitor? Do you have plenty of test strips and higher carb food if you need to intervene?
Here is you last post for continuity http://www.felinediabetes.com/FDMB/threads/decrease-dose.220989/#post-2467123 ETA: I see from your SS you shot 2 units. Please keep in mind that due to the nature of Lantus as a depot insulin, this means that the larger 3u he has been on will likely affect this cycle and up to 6 cycles. Also, as a suggestion, please keep in mind that with Lantus we make dose decisions primarily based on how low the dose is taking the kitty, not preshot numbers. I would suggest getting a +1 and +2 minimum tonight, and see how the cycle is going. Please post if you need help, okay?
Thank you. I gave him the 2 units about 30 minutes after he ate ( and before I read your initial post)— his BG increased by 1 point. When you say six cycles— does that mean 3 days? I’ll test him as you recommended. I’m in good shape with strips and HC food if need be. As you can see, his numbers have typically been high — would love to get him stabilized!
Yes, exactly. Ideally you would like to find a dose that works both a.m. and p.m. Since Lantus really likes consistency. You've had to adjust some shots when you got lower preshots, which is completely understandable, but throws the depot off. I think @Sienne and Gabby (GA) recently mentioned how important those before bed tests can be, and I'll second that. Many times if I hadn't caught the lower numbers at night with my kitty, all I would see are the higher preshots or daytime highs. It would have suggested an increase was required, not a decrease. You are lucky that Walter showed you today he was done with 3u for the time being I'll stay on for a few hours yet, so please post the next few tests, and either myself or others can help if you need it.
I'm glad Christie can stick around and I agree with what she's said. What your spreadsheet (SS) is suggesting to me is that Walter has likely been seeing some lower numbers mid-cycle. Today is a great example of you're catching some blue and green numbers. When a kitty that's used to spending time in high numbers drops, and in this case drops quickly into lower numbers, the liver and pancreas interpret this as an emergency and go into panic mode. This causes a release of a stored form of glucose and counter-regulatory hormones. This thing cause numbers to skyrocket. That's why you've been seeing such high numbers at pre-shot. Anything you can do to get more spot checks during both the AM and PM cycles will help to see patterns and to figure out just how low numbers are dipping. I'd also encourage you to read over the sticky on dosing methods. We tend to raise doses in smaller units that 1.0u. Having a strategy for how you're dosing will help with being consistent.
Thank you! This all makes sense and I really appreciate the time from all of you for helping me out. I’m going to do one more reading tonight before I go to sleep and then will also get a reading or two early in the morning. I work during the week so it’s impossible to get numbers during the day until I get home which is usually around 6:30.
I peeked at Walter's spreadsheet, his +1 of 255 may be related to having eaten his meal (we call that a food bump), so yes, just in case, if you can test one more time before bed, maybe around +3, if the number is the same or higher, you likely won't be seeing any crazy shenanigans tonight .
What a yucky bounce this morning , but he seems to be recovering nicely this evening . It would be good if you can maintain the 2.5u for a few cycles so we can see what the dose can do. And a wee gentle reminder, have a peek at the dosing methods that Sienne shared with you in post #7. For what it is worth, I would have stopped testing after the +2 last night, his bounce had already started by then.
Thanks. Reviewing again now. Ok— will keep him at 2.5 for a while. He’s been a bit low key but I did a ketone test and he seems to be ok on that front. Might just be worn out!
The higher numbers can certainly make them feel under the weather. I hope to see an update tomorrow . If you could start a new post tomorrow, we usually post one a day here because it can get so busy, just put the date, your cat's name and blood test...for example 12-Nov Walter AMPS 738, PMPS 254
The webmaster has no ability to fix a spreadsheet problem. That's on your Google account. Make sure you are logging in via Google, not from the spreadsheet link in your signature.
I’m not having problems entering the data into the spreadsheet —I’m having problems entering the information on this blog.
