Hello Everyone. I am looking for some dosing advice. I have been giving Gizmo 1.75u the last 5 cycles. This last one was a F1.75u. His nadir was 69 at 5.5, but his PMPS is 420. Should I keep him at the 1.75. I am afraid if I increase to 2 units that it will take him to hypo since his nadir was so low with the F1.75u. I know that I am not supposed to react to one preshot number, that is why I am looking for some guidance from the veterans. Any advice would be appreciated. I don't know if anyone will be able to respond before his insulin is due at 7 pm. If not, I will stick with the 1.75 and then make a decision on the morning dose.
Focus almost solely on the nadir to evaluate a dose and make dosing decisions. The PSs are far less useful in this regard. The red this evening is very likely a rebound from the 69. The 69 is very near the AT meter take action number. If that BG had been below 68 you'd be reducing the dose by 0.25 u.
Thank you Kris. I didn't give a fat 1.75u tonight. It was just 1.75u. Was that the right decision or should I have stuck with the F1.75u?
Oh Gizmo...still showing up with those low PS number, huh? Good call with the reduction this morning.
Thank you. I think I messed up by reacting and increasing him back to 1.75u tonight. I reacted to a cycle full of pink numbers, so now it is at +3 and I am up with hypo numbers. I started him on a new vial tonight as well. I broke the other bottle this morning. Ugh!!! Thank goodness it was not the new one. I just got done feeding him some of his low carb food since his only symptom again is ravenous hunger. I just pray that I will be able to get his numbers up as easily as I have in the past. What do you think I should give for a dose in the a.m? I will not be able to come home during lunch tomorrow so I am worried.
Oh my...Well, the good news is that you're getting to be a pro at this! In general, anytime you get a lime green, you reduce 0.25u (or back to the last safe dose). So I would aim for 1.5u tomorrow, no matter how high the bounce takes him.
Thank you Djamila. Do you think the new vial had something to do with the low number? I am wondering if I should have just stayed at 1.5u. I try to learn from each episode. I pray that I don't have to many more of these lessons to learn. I panicked since his numbers were so flat and in the 300's for the full cycle.
I was just writing you a too long list of possible reasons for the low number! I love that you view these as learning opportunities. The only sight we have around here is hind sight! We try things, we see what happens, and we learn for the next time. First, four cycles ago you gave a token dose. It can take a few cycles after that (or after a skipped dose), for them to get fully up to their regular responses again. So tonight would have possibly been the first "regular" cycle after the token dose (ECID - so some cats can skip a dose and not miss a beat - other cats can take even longer to "recover" from a low dose). Which means that it's possible you would have had decent numbers with the 1.5u tonight. Second, it's a night cycle, and many cats respond more/go lower at night. Third, it's a new vial. Unfortunately the vials do have some variation in effectiveness, so in general the first couple of doses on a new vial we take a little more caution - an extra test or two, or some folks even shave a little off the dose for a new vial (I don't really recommend that, but having had a vial once that was definitely a different power, I can understand why people do it). Now 9 out of 10 times, the new vial will act exactly like the old vial....but once in a while there will be a difference. This may or may not have had anything at all to do with tonight, but figured while I was making a list of possibilities, I'd mention it. Finally.....sometimes these things just happen. Just like for us - some days we have more energy, some days we're hungrier, some days we're tired....bodies are complex, and it could just be one of those things. So it might not have anything to do with any of those ideas above. It might just be because it's Wednesday night and he felt like it. Because cats.
How many cycles should I hold the 1.5u before I react to high numbers? Should I wait another cycle after a cycle with higher numbers to see if it was a fluke?
Ok. First 30 minute test after low carb food is promising. We are at 83 right now. He is a little more tired than usual, but doing okay.
Glad to see he's back up already. Since tonight wasn't a skipped dose, I don't know that you need to wait all that long. I would let him settle through both cycles tomorrow and then see how things look on Friday.
Oh, and maybe go with the fat 1.5 and skinny 1.75 before going all the way to 1.75. Maybe he just likes slower increases.
His next 30 minute testing did not move much. It was 86 which is the same as an 83. I guess I should be happy it didn't go back down. Now to wait an hour to see if he stays up.
