Lee lu pmps 71 - don't shoot right?

Given Lee's last hypo episode, I'm going to refrain from a shot altogether tonight. 71 is too low to even shoot a reduced dose. Will feed her normal, maybe even toss in a small amt of gravy rich food. Thoughts?

Maybe I'll test her right before we feed

 

Hi Amanda
if she were mine, i would skip tonight. since she is again below 90, you need to reduce the dose even more i think. tomorrow i would do .5 twice a day and is it possible at all to get some mid cycle tests in? i suspect she is going much lower at her nadir and dose changes are based on the nadir. If her pre shot is this low, then she def needs to go down in dose to keep her safe. i am sure others will chime in and advise you on dosing, but if no one else answers tonight, def skip to be safe . try to get those mid cycles so we can see if she needs even less insulin than 1 ok
maybe she will be higher when you test before feeding so we can see.

 

i would wait for the more experienced to advise you on dosing. she's looking good.

 

Nadine asked one of us to come over to chime in here.

I agree it was fine for you to skip the shot tonight. However, I would not lower the dose any more at this time. (BTW, it's really helpful if you keep the SS updated so we'd have a better idea of his numbers today).

When a kitty on lantus or levemir earns a reduction from a higher dose like Lee Lu did, the depot from that higher dose can affect up to six subsequent cycles with lower numbers. Most cats, we'd likely see the depot affect about four cycles and so you don't want to jump into another reduction too fast. The caveat to that is if she went into the 30s again on the third or fourth cycle following the reduction, I'd reduce again. Does that make sense?

My best advice to you is to not reduce the dose again yet unless you get a number below 50 at a preshot or during a cycle.

Enjoy some sleep tonight

 

thanks Marje so much for checking in. i learned something new too. even lowering the dose needs to settle for a few days unless, as you said they go below 50. thanks very much for your help

 

Actually, dose reductions don't need to "settle" as increases do.

The depot for the L insulins, especially if it is full enough to get kitty into the 30s, just takes time to deplete. During that time, it can still drop the BG low. As an example, if my Gracie's dose is enough that she gets into the 30s and I reduce her, I have to hold the reduced dose for 4-6 cycles because her depot can affect her numbers that long.

Sometimes it doesn't and the reduction fails. For a failed reduction, you want to get right on it and take the dose back to the last good dose, remembering that the last good dose is not the one that got them in the 30s. So if you reduce, the kitty bounces, the bounce clears and kitty is not back in low blue/green, don't wait. Take the dose back up and that might mean just fattening it.

 

ok. i see. that def helps me to understand it. thanks.
and thanks Amanda. sorry i advised to reduce right away again. i'm learning alot from your condo. thanks

 

Nadine....you don't need to apologize. We all continue to learn...even if we've been here a while. It's great that you are helping and learning

 

Thank you all! I went wtih my gut, and your advise, and did not shoot her at all last night. I re-tested her at PMPS + 2 and was presented with 128, which made me feel better that she wasn't decreasing more, so off to bed I went. All went well last night, no issues. This morning's AMPS is 230, which makes sense given she hasn't had insulin in 24 hours and her last two doses were 1u.

So... I'll start a new thread (why are they called condos?) with this morning's AMPS and my thoughts on dose.

Thanks again! I'll try to get a couple reads mid cycle today.

Marje - thanks for checking in over here. I updated her SS this morning, I was posting from my phone last night

ETA - I'm sure you all have done this... I accidentally stabbed myself with the lancet last night, so I tested myself - got a nice even 100! Never tested my BG before, so that was funny :lol:

 

Probably because its where the posts 'live' for the day.

 

oh yes i have stabbed myself with the lancet AND......ummmmm the insulin needle. LOL

 

Me too. Its part of why I like shorter needles, They bend less ... and can't stab you as deeply!

 

Amanda

You're welcome!

I always like to take the opportunity to offer some lessons where we can.

While it was ok to skip last night, some another option (for the future) would have been to stall without feeding, retest, and shoot the 1u when she was on the rise. I'm not sure if the 128 at +2 was food influenced or not. It's always best to be as consistent as possible with shooting, as long as it is safe to do so. I think if you had stalled without feeding and she was on the way up, you could have shot late which also acts like a dose reduction.

Any time you are faced with a similar situation and there is no one in Relaxed, please please feel free to post on the TR board and ask for help. One of us will gladly come over to your Relaxed condo and help you and even stay with you if you shoot until we know everything is just fine and she's on the way up.

:lol: :lol: Yes I've stuck myself with the lancets and the syringes more times than I care to think about (mostly lancets). Shame on me but I don't even wash my finger off unless I'm bleeding a ton :lol: :lol: :lol: