10/16 Joplin PMPS: 123; +3: 90

I'll probably get a little flack for this, but I decided to give Joplin 1.75 instead of 2 tonight after seeing him at 119 at +9. I just had a feeling he was going to continue on the path downward. A gamble, yes, but it looks like I was right. Will test again before bed in 2 hours to make sure he's not too low.

Cheryl

Well I hope no one would give you flack about keeping your cat safe.

I know you had some reservations about the dose reduction the other night but sometimes things change and Joplin was getting into green on 1.75u before so I would have reduced after those 40s the other night. Sometimes the depot can get ahead of you and it can make for a scary cycle. This post on Reductions might be helpful.

I'm glad you are keeping an eye on this cycle. Even when we shoot a Reduced dose for a cycle, it's smart to keep an eye on the numbers because of the effect of the depot. Typically, the cycle will be the same as if you had shot the full dose and the effect of a reduced dose is more likely seen in the next cycle.

Last thing which is just housekeeping. Could you please link the previous days condo in the current condo so if we need to go back, we can do it without searching. Thanks s million

I hadn't posted the previous day, so that's why I didn't include one....

I feel like he's higher in the morning into day, and lower at nights. I know that Lantus is the type of insulin that builds up in the system, but shouldn't an addition or reduction of .25u be appropriate with am/pm because even though it's about the depot, doesn't the actual amount of insulin at onset have an effect independent of that? Or am I wrong? For instance, he was just 181, and I gave him 2u. I'd rather see him on the lower side with the 2 throughout today, than have him in high numbers and wait to address that with the PM shot....tell me if I'm completely not getting it, but that's what seems logical to me. As always, thanks for your input :smile:

Most cats do run lower at night and go higher in the morning due to the Dawn Phenomenon. The way a typical, active Lantus curve works is shown below:

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

Click to expand...

If you are at a starting higher number in the a.m., the morning cycle is likely to run higher unless your kitty is a diver. As shown above, as the particular shot wears off, numbers rise a bit but sometimes cats will get a second dip and the number will come down.

From the Sticky on the insulin depot:

The result is an extended action. These insulins tend to display a cumulative effect, meaning that what happens in one cycle can affect the next cycle, or even the next several days. This is part of what allows Lantus and Levemir to create those beautiful, flat curves, so it is worthwhile to spend the time to understand the depot.

Click to expand...

So the consistency in dosing and cumulative action of the insulin allows the nice curves. When you change the dose, it can affect subsequent cycles as the depot either drains if you skip or reduce the dose, or it starts to fill additionally if you increase the dose.

It's really up to the cats body as to how their cycles play out. Sometimes the cycles flip flop and they will be high at night and low during the day. There's really not a way to control it unless you want to carb him up at night but I would not suggest that unless you are sick, need the sleep, need to go out, etc. in other words, I wouldn't habitually carb them up because then there is potential for both cycles to be high.

So the actual amount of insulin at onset does not have an independent effect because you are dealing with a depot and each shot you give adds to a cumulative effect. I think one of the hardest concepts to grasp is the depot. I also think it takes reading the sticky on the depot over and over.

On linking, we just link the previous condo even if it was a month prior. It just helps those of us helping you go back and review what was said, done, etc. with all the kitties we have, it would take us forever to find those posts Typically before I make a suggestion, I read back through the previous 3-4 condos and then look at the SS. If I see something on the SS even further back (e.g. A week), I find that condo and read it.

Hope this helps...please let me know if I've confused you further.

Not at all! Thank you...you are a tremendous help, as always. :smile:

You're welcome! Any time you have questions, please let us know....you can bump your own condo to the top but if you have a question, be sure and put the ? Button on because we scan for those. You can also type "question" or something like that in the subject line after his numbers.