? 10/20 Abby AMPS 139 / +3 50 / +3.5 87 / +5 97 Low drops

Last thread: https://www.felinediabetes.com/FDMB...6-85-pmps-126-2-56-2-5-79-3-85-3-5-87.237166/

Hi, Abby is eating LC food and I'm monitoring her again (and will test in +.5), but I was wondering if I should be doing anything different given last night and today's drop below the take action number on AT2 (which is new on our journey). Her AM/PM PSs are still too high to try testing no insulin (I think), but I'm getting really nervous with her cycle drops since she displays no symptoms of being that low. Even though we are making progress, should I withhold shot tonight to let depot clear? Is the best path to continue to push through this and hope her AM/PM PSs drop? I know take action is 68 on AT, but is there a "really that's too low" number that I should know (it would help lower my stress!!!) Thanks in advance for any wisdom/guidance/etc. and sorry for the questions - I was feeling more confident before the last few days happened!

 

Wow, great job catching that low and kicking into action! 50 mg/dL on the AT2 can definitely be scary, but good, in a way, as well!

I’m still newer to Lantus, but did SLGS with ProZinc (which is not a depot insulin), so some things are similar. At least, the diabetes itself is the same LOL

Hopefully the pros will be on soon and weigh in, but I figured since you have the question up, I’d answer where I could. I checked out your condo from yesterday and your SS.

There could be several things at play here. It looks like as of 10/07, you began testing before every shot (yay!), and started getting more mid-cycle and night numbers (double yay!). One possibility is that your kitty was suddenly dropping lower, but it wasn’t caught. For example, going off your SS, on 10/10/2020, 0.75u brought Abby from 267 mg/dL to 75 mg/dL at her +5, but she was back up to 237 mg/dL by her PMPS. Cycles like this may have been occurring in the late weeks of September and early October as well, but without those mid-cycle numbers, there’s no way of knowing

Another possibility is that her pancreas is slowly healing. Some days, her pancreas may be producing a little more insulin than others (known as a “sputtering pancreas”), and, on those days, the combination of endogenous (kitty-made) insulin and exogenous (shots) insulin may have a more additive and drastic effect on her BGL.

Another possibility is that she is headed towards remission (diet-controlled) *anti-jinx*

As far as dosing goes, I unfortunately have no advice (sorry!). When Bernie was on ProZinc (I know, I know, not the same as Lantus), I was told that back-to-back reductions were okay, but I’m not sure if that holds with the depot insulins. If that’s the case, this morning, her dose should have been reduced (0.25u last night brought her to 56 mg/dL on the AT2, which counts as a reduction under both SLGS [<90 mg/dL] and TR [<68 mg/dL]).

I’ve seen in other posts that some kitties do well with a dose of 0.1u as a stepping-stone between 0.25u and OTJ trials. If it were Bernie, I think I might lean towards that route with her - but I’d also wait until one of the more experienced members confirmed

Again, awesome job handling that 50 mg/dL!

 

Oh, almost forgot! Dosing is always based on nadirs. I believe the PS numbers are the last to go down.

 

Thank you very much @Megan and Bernie. I really appreciate your thorough and thoughtful response and it has definitely helped calm me down (which I know Abby appreciates since I'm not annoying/checking her every 2 seconds). Yes, Abby and I were finally able to come to a common understanding on the testing (or at least that's my interpretation - as she has started feeling better she wasn't hiding as much so I'm not having to drag her out from under the bed to test her, which overall makes it a smoother process and has allowed me to get more data, which will hopefully help in the long run). Don't get me wrong, she still inspects my hands every time I am near her and pretends to want to jump away when she spots testing tools, but I think that's just her being a cat Yes, I'm leaning towards trying to go to .1U and seeing what happens. A week or so, a wonderful moderator said that back to back reductions weren't suggested with Lantus (because the depot needs to stabilize I believe), but I figure with two very low cycles, it may be worth trying and I can always raise her back up to .25U. It's good to know that you believe that PS numbers may be the last to go down - I haven't been able to find info on that so it is reassuring giving her current numbers. Anyways, thanks again for the response - I greatly appreciate it. I love Bernie's photo btw - Bernie looks like she has quite the life

 

You’re so welcome! I wish I was better versed in dosing! I was just thumbing through this info on reductions trying to learn more about when they’re earned, and, if I understand it correctly, yesterday’s second (PM) drop may have also been due to carryover from the first (AM) drop yesterday, in which case, a reduction may not be effective. Sorry, to be wishy-washy, I would hate to give you bad advice

 

Hah, Bernie does this too! Every time I get in our spot, I peek under the bed, and all I see it two little feet just barely within reach, waiting for her food to lure her out LOL

Thanks! Abby looks super comfy too! And fluffy!

 

No problem at all - I welcome and appreciate any and all thoughts/advice. As much as I wish this journey had easy rules to follow, I'm learning every cat is different so there are unfortunately no perfectly clear answers (but it's been so helpful to learn from others and their experience!). Have a great rest of your day! thanks again!