10/4 Billie PMPS 327

Hello!!

Yesterday: viewtopic.php?f=9&t=126377

Billie is doing pretty well! She had two coughing fits this morning, but that is less than she was having, and she was overdue for a pred dose when it happened - she got her first dose at the vet's at 3pm yesterday and I gave the second dose at 7am or +1 today. I want to start giving it at +2 or +3 but gave it early since she was coughing.

I'm wondering about a dose increase. Since starting the pred/based on last night's cycle and today's AM cycle, it looks like her numbers are trending up. She did hit green on this dose, but that was 5 cycles ago and I don't think she's still bouncing from it.

So, I'm wondering if the dose increase from 1.25 to 1.5 sounds like a reasonable idea. Also, if her numbers still continue to trend up, I'm wondering if I can be a bit more aggressive with the dose increases - increasing every 4 cycles for example, or increasing by 0.5u if her numbers look really bad? I'm hoping that won't be an issue, and I guess I can cross that bridge if I get to it. I just don't want her BG to get out of control. Any advice is much appreciated!!

I hope everyone is having a nice day. Sending vines to all cats and beans needing vines.

Re: 10/4 Billie AMPS 356 +5 215 dosecrease?

Morning Deanna! At least it's still morning in AZ :lol:

I'm glad she is coughing a bit less. I was wondering if you would mind putting on her SS when she gets pred so we know as we give advice that she's on it and we can see how it affects her BG.

It looks like she might be trying to clear the bounce so let's see how this cycle plays out; it's the fourth cycle of the bounce.

Normally, for a new member, we would suggest they allow the bounce to clear before they increase. But for an experienced member like you who tests, if she does not come down into blue during the day cycle, you could increase as long as you watch her because she might zoom down on you as the bounce clears with extra insulin on board. It is possible that the green you saw the other day, even though it was four cycles since the reduction, could have been the depot from the 1.5u dose. If her depot was really full at the 1.5u, it could affect several subsequent cycles.

If she stays in yellow today and you decide you want to increase back to 1.5u, you can also choose to raise it tomorrow so you don't have to deal with possible low numbers tonight like you might if she clears the bounce and you had increased the dose.

Just to be clear for any lurkers or new members, for a failed reduction, you'd go back to the last good dose but the last good dose for Billie got her to 40 so normally, for a failed reduction, I'd just suggest Deanna fatten the 1.25u. The difference here is that we have a new variable.....a steroid....which frequently will raise the BG. And we also have an experienced CG who monitors closely.

eta: on larger increases (.5u) or increasing every four cycles, I think we need to wait and see what she does. Those are both very aggressive and I'm not seeing the need for that right now. But, once she's been on the pred a bit, if the current scenario changes, we have some options.

Re: 10/4 Billie AMPS 356 +5 215 dosecrease?

Marje, thank you so much for the detailed response!! It was super helpful!

Yes, I will definitely keep her SS updated with the pred dosing. Based on today's cycle, it looks like she's asking for the increase, but I'm sticking with the 1.25 tonight just to be safe and will increase tomorrow. I think she could use a bit of a poke break tonight anyway. She has been getting more annoyed with me at poke time lately! I got 2 ketone tests today, and they were both negative.

I hadn't thought about the possibility of those greens a couple days ago coming from the 1.5 depot. That's interesting. I assume her depot was pretty darn full considering the quick drop to 40, so maybe there was some influence there.

I will wait and see how things go with this increase, and hopefully it will do the trick. Thank you again!! :smile:

You're welcome. Good luck with the increase.