? Totally lost

ok i dont know what to do here. His preshot numbers totally stink. Had been slowly increasing, got a bounce, and still awful.

Due for a shot now and i literally have no idea what to do. Is this too mich insulin? How can his preshots now be comparable or even worse than his prshots when he was on less insulin?

Its like less insulin isnt enough, and any increases are too much. Why do i keep hitting this wall of resistance!?

 

Hi Jen,

If I was looking at this SS as just some anonymous SS with no worried owner attached to it, I'd say that there's still some bouncing going on from the blues a couple of days ago. The dose was upped from 3.2 to 3.4 u in the PM on 10/09, yellow and blue appeared next day and then a retreat into mostly pink. A non-bounce response to that small dose increase would have given more yellows and blues because the results of 10/10 prove that it was effective in lowering BG. A flattening of numbers in the pinks says bounce to me.

In addition to this - and just to make it more complicated - kitty can get "stuck" in higher numbers after a bounce. This is something I've dealt with for months on end with Teasel. There are tons of examples on his SS if you want to have a look. What's worked for Teasel is to shift him out of this 'insulin complacency" with a tiny dose increase. It's almost as though his body is (metaphorically) dozing off and I have to give it a poke to wake it up. Make sense?

Now, I'm not sure that's what Mr. B. needs but he does show some similarity to Teasel in this way. Let's see what Sue and the others think;
@Sue and Oliver (GA)

 

I agree with Kris. I really do think you're still seeing some bouncing. You could certainly try a little dose increase to see if that would jolt him back into gear. It's worked for Teasel...no way to know if it would work for you for sure. This is one of those you hold the syringe things. What do you think?

 

mmm he does look like Teasel, yes. I would increase the dose a little as you've been keeping it steady long enough looking at your SS.
Sometimes a little increase can break the cycle.

 

It looks to me like you're using U100 syringes, Jen, based on your 0.2 and 0.4 u dose increments. If so, you could try a tiny dose increase by eyeballing half way between the mark you use for 3.4 u and what you'd use for 3.6 u. This would be close (enough) to 3.5 u for the purpose of testing out a dose change. Try this dose, see what happens for a cycle or two. If you get a same day response of lower BG with this small increase, it's a clue that either he needs a slightly higher dose or that he was "stuck" in pink. If this tiny increase has no effect, then an increase to 3.6 u might help. Start with the very small increase first. As frustrating as it is, it's this experimentation that fleshes out the picture over time. Not what you want to hear, I know ...

 

I think a tiny increase is fine. This weekend, can you get a curve? I know it is discouraging to see pink preshots, but there is no way to know what is really going on with some numbers in the middle. There are the two blues in the middle of the cycle on 10/10 and yes, the next few cycles could be bounces (especially the flat one right after) but we are just guessing about the last two.

Would it help to figure you will increase- when needed - on the weekends, after getting several mid cycle numbers or a curve and just leave the week numbers as they are and not worry about them? (I am assuming you can't get numbers during the week.) Any cycle you could during the week will help flesh out the picture and would mean dose changes during the week too. It's a slower process than someone like Kris who can get data during the day and often night, but it has worked for people who work during the day and maybe won't stress you out so much.

Look at Maggie's spreadsheet. (Maggie's bounce a Rama) Kelley was worried about the pre shot numbers. Yesterday she was able to work from home and get a curve. Maggie dropped into the greens and had good numbers all day, and then bounced for pre shot. If you look at just her preshots yesterday, they were high. But actually she is doing quite well. She is a perfect example of why just looking at preshots doesn't give you the whole picture.

Any data helps. Some people give a shot and then leave the house a hour or so later and get a number as they go out the door. Some people get a number as they come in the door before the pm shot. Some people get a number before bed or when they wake up at night (for other reasons....). All data helps you see how your cat is using the insulin and how to help it work more efficicently.

 

Great advice about getting most of your dose investigation done on the weekends if that works better for you. I'm retired so I'm able to go at this every day. I understand how very difficult it is if you're out of the house all day during weekdays.

 

Yes, I would be (even more) lost with Maggie if I didn't have any mid cycle numbers. If you just saw her preshots you'd think she doesn't get any insulin at all! But she actually does stay in pretty good numbers throughout the day. It's just those last couple of hours that she comes back up.

 

Sorry i'm just catching up on my responses now. I was such a mess today. I started new thread can you please look? http://www.felinediabetes.com/FDMB/threads/how-much-to-dose-with-lower-preshot.166645/ sorry i should have just added that on to this thread.