previously After a day of relatively high numbers Jerry decided that he liked the blues/greens again last night. This morning's BG was 109 which is low for him. I stalled 20 minutes (with two very vocal and hungry cats in my face) but his BG didn't budge in fact it was 101. I decided therefore to just give a token dose of 0.50 IU rather than skip a dose altogether. I'll be here today to monitor him and see how he goes.
Yep, I was surprised after his numbers yesterday. I little nervous though. He was relatively high last night so went to bed, had a horrible dream of him having a hypo event and got up to test... glad I did. He'd dropped quite a bit. We'll see what today brings.
Well he seems to have gotten fed up with surfing and is now in the pink... don't know if this is a bounce from last night, this mornings lower numbers or the token dose...but he's earned a reduction from last night so his Pm dose will be 1.25 right??
I want to encourage you to start thinking about shooting progressively lower numbers. Jerry's numbers generally look pretty good when you stick with a dose. If he throws you a lower than expected pre-shot number, you get nervous and either skip or shoot a reduced dose. Numbers then spike upward. 4/15 is a good example. Once you got Jerry back to his usual dose, he headed back to good numbers. By avoiding shooting in the lower ranges, Jerry is going to continue to see numbers in the 300s or higher. I know the idea of shooting low is scary. Most people assume that if you shoot low, numbers will drop like a rock. While that's possible, it's not usually the case. The typical Lantus curve is flat. The mantra with Lantus is "Shoot low to stay low." What I encourage people to think about is what is the next most comfortable lower number you think you can sum up the courage to shoot? It should be a day when you're around to monitor and have strips and HC food on hand. Another consideration is that Jerry may have a late nadir. It's a bit challenging to piece together whether that's the case since he is clearing bounces relatively quickly and his clearing a bounce may influence when the nadir occurs. It's something to keep in mind since a kitty with a late nadir will have a low point around shot times.
Yes, but if he is pink at PMPS you can shoot through the bounce (giving the same dose one time with high numbers before reducing) and take the reduction tomorrow morning.
Thank you for this Sienne, you are of course correct I get very nervous. I'll have to summons my nerve and just do it. Next time I'll do better and just shoot. I test enough to catch a low BG and correct. It's just that he usually drops at +2 and that's in the back of my mind.
Thanks Carla. Hopefully tomorrow will be better. Wasn't too too bad today but he did climb to higher numbers later in the day. As Sienne advised I need to get my nerves under control and shoot anyway. Still something I struggle with.
I was initially afraid to shoot under 200, so I would stall 30 minutes or so and then shoot after BG came up some. After doing this several times, I finally shot a preshot in the 160s (in the morning when I was home) everything turned out ok. Not to discount your concerns, since Jerry is going lower at +2, I would think that is a valid concern, hoping you get more specific advice relevant to shooting a lower preshot in relation to a lower +2 for Jerry.
Thanks Julie. I checked the slgs protocol and it did say lower than 150 don't give insulin. Since I've chickened out before and skipped a dose and seen terrible numbers as a result I thought a token dose would be a better option... his numbers of yesterday told me he could have handled more. It's just when I compare his preshot and +2 there is usually a large drop and it puts my nerves on edge. I'll just have to put my big girl pants on next time, take a deep breath and shoot. Its tough.
@Jerry dutchboy Deirdre - Take a look at Gabby's SS. She had an early nadir and drops could begin at +1 or +2. I put notes in the comments section regarding when I would be giving her carbs to steer the curve. It will be helpful to have more of an idea as to whether Jerry has a late nadir vs and early nadir. The PM cycle on 4/18 suggests a late nadir vs. the AM cycle on 4/16 which looks more like an early(ish) nadir. I'll have to go back and look but I think the recommendation to not shoot if PS is below 150 is directed to someone who is new to managing their cat's FD. You are likely to see members suggesting that with either dosing method, if you aren't sure what to do when confronted with a low PS value, post and ask for input. While it's primarily directed at TR, there's also information on shooting lower numbers in the Becoming Data Ready sticky.
Sienne, thank you. I looked at Gabby's sheet and understand what you mean however Jerry's drops from AMPS to +2 are nearly always large (sometimes almost 50%). I understand that the drop on a lower AMPS BG may not be that large as was the case on 4/10. This is what makes be so nervous. I will, at some point in this process, have to rally the courage to try it otherwise I won't be doing him any favors. I really appreciate other eyes on his spreadsheet, sometimes I can't see the wood for the trees and don't always see the pattern. I know from previous experiences that he reacts quite quickly to HC food and LOVES gravy so I know I can control with food. Again thanks for taking the time to look his ss over and advise.
If +2 is particularly low on a regular basis, seems that should be taken into consideration as many cats do nothing at +2. Some people may be available to feed and test if shooting in a similar situation, but that may not always apply in your case. People always say ECID, so if that is the case, they should be looked at that way, at least that is my take on it. In some cases owners are different too, and in the end it is good to get input, but as they also say it’s your cat and you are the one holding the needle. Sorry, I am not much help
@Julie and Honey - You are correct, at least most of the time. A drop from PS to +2 or +3 can signal a busy cycle. However, you need to know if what you're seeing is an early onset versus a late nadir If a cat's nadir is quite late in the cycle, you may see low numbers at PS. Numbers may start to rise shortly thereafter. Likewise, a bounce may be breaking. These are different scenarios. Of course, given that a kitty's nadir can change makes all of this challenging to sort out.
Julie, all input is helpful. I really do appreciate all input to help me make the best decisions for Jerry. I take it all onboard and it helps me understand more.. Sometimes I think I am getting it and other times I'm lost. He has come a very long way since we started this journey and all of the advice, encouragement and hand holding I've been given here from community members has been invaluable. Its all nuggets of information that help me determine the best course of action for my Jerry boy.
