? Need help - someone please respond with advice

I haven’t updated spreadsheet (can’t do it from phone). Tooters Amps was 365. Gave 1.5.

Please review previous post.
http://www.felinediabetes.com/FDMB/threads/help-tooters-bs-is-all-over-the-place.211247/

 

Oh! we cross posted I'm sorry I bumped up your old post.

Here is what I wrote (for anyone stopping by)

I'm sorry no one got to you sooner.

I do think it would be good if you can gather some consistent info over the last few days, making sure you keep a note of what dose and when you shot.

When you get a high Preshot number, you don't need to shoot a higher dose. In fact it's better if you shoot a consistent dose unless your kitty earns a reduction, which under slgs is if you catch a number under 90.
On 2/23 you saw an 83 at pmps, that earned Tooters a reduction to 0.75u. You skipped that shot, which was the right decision since you don't shoot below 90 when doing slgs. However when he was high on the amps of 2/24 you then shot 1.5u (though from what you are saying you're not to sure since you haven't been keeping notes) you should have shot 0.75u at that point, tooters was high because you skipped and he 'run out' of insulin (the depot drained) and probably he bounced from seeing green. With lantus we look to how low the dose is getting kitty and we largely ignore the bounces, so there was no need to shoot 1.5, in fact you needed to let that 83 the night before guide your dosing decision, and you should have shot the reduced dose of 0.75u
On 2/24 pm cycle you shot 1u and again he dropped to 83. Now with the inconsistent dosing it can make the numbers a bit wonky, so it makes it hard to know what the right thing to do is.

Being inconsistent with the dosing is likely causing the numbers to be erratic, and not taking a dose reduction when it was earned may be resulting in him dropping low and then bouncing, which is why you are seeing low numbers one minute and then sky high the next.

I would advise you to drop the dose to 0.75u, since that was a reduction that reduction was earned and not taking it, with your limited availability is risky, you run the risk of him dropping really too low.
Also please try and ignore a high PS and just shoot the dose consistently, I know it's hard to see those red numbers.
Looking further back he also earned a reduction on the 0.75u, but you didn't take the reduction then either, and you then instead took the dose up.

How are you for availability over the next few days? are you able to get some midcycle tests in here and there? If you can I think that would be a really good move, because given the missed reductions I am worried that it's possible he's on too much insulin, even if you drop to 0.75u.
With slgs you want to hold the dose for a week, unless they earn a reduction by a drop below 90, at the end of that week you would run a curve and look at the nadirs to help you to decide what to do about the dose.

here is the instructions from the SLGS sticky
Hold the dose for at least a week:

• Unless your cat won’t eat or you suspect hypoglycemia
• Unless your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.

After 1 week at a given dose perform a 12 hour curve, testing every 2 hours OR perform an 18 hour curve, testing every 3 hours. Note: Random spot checks are often helpful to "fill in the blanks" on kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

• If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
• If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
• If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit

If you could post a condo a little more regularly we can perhaps help you with any questions or doubts on dosing you may have. I looked back through the some of the old posts and I know at times you haven't had much response, feel free to tag me by writing @@Gill & George if you need help. Also if you don't get a response you can bump up the post by replying to yourself so that your post goes back up to the list. Sometimes if it is busy and it drops to the bottom it can get missed. Another tip if you have a question and/or need help use the ? prefix from the drop down list, many of us will scan for those as it highlights which members are needing help.

If you have questions please ask.

 

As I see you have shot 1.5u again this morning I would like to add that I think you should try and grab a test early in this cycle. No later than +3. If you can't be around to check on him please make sure he has access to food.

If you find that he is dropping a lot you will need to take some action to keep him safe, I do think 1.5u is likely too much insulin (on slgs he should be now on 0.75u so twice as much as we think he should be getting), and shooting it twice in a row adds to the overall effect it could have on the BG, it could cause his BG to drop sharply.