? 5/26 Ivy, Dose increase, AMPS 271, 298 +1, 353 +2, 335 +3, 394 +4, 301 +5

[Staci & Ivy]

https://www.felinediabetes.com/FDMB...-255-2-249-3-313-4-305-5.277809/#post-3073716
Ivy got an increased dose this AM, up to 3.75 units Lantus. As expected, she’s already running high from the increase.

Past few days she’s been in pink and yellow. However, in early evening she is dropping to Blue for several hours, around 107-130 on the Libre. (I did not cross check on hand held meter because she didn’t drop super low, which I will do if she drops anywhere near 50 ).
In the early evenings she drops quickly, within 1/2 hour to 1 hour past her meal and shot. Seems to be super sensitive to the insulin I guess with an early nadir??? (Sound right??)
She bounces a bit but continues to drop until around +4. Then things calm down.

I’m giving AM & PM +2 & +4 snack, each are 1 oz lc food, to try method to maintain glucose levels, slow bounces.

Does this seem to be a good protocol so we can get a gague of how the deuce is working without my intervening too much with food?

Thank you.

 

[Wendy&Neko]

I'm glad you increased. With TR, you only hold doses with blue nadirs for 6-10 cycles. I tended towards 10 for lower blues, less for higher blues.

Those early cycle nadirs can also be looked at as really late nadirs. When Neko was on Lantus, I did spot nadirs at +13 occasionally, especially for bounce breaking cycles when nadirs tend to be later. PM of 5/9 is a classic example of that. As could have been last night. Ivy's patterns on insulin will become clearer when she's on a better dose and not bouncing as much.

 

[Staci & Ivy]

I'm glad you increased. With TR, you only hold doses with blue nadirs for 6-10 cycles. I tended towards 10 for lower blues, less for higher blues.

Those early cycle nadirs can also be looked at as really late nadirs. When Neko was on Lantus, I did spot nadirs at +13 occasionally, especially for bounce breaking cycles when nadirs tend to be later. PM of 5/9 is a classic example of that. As could have been last night. Ivy's patterns on insulin will become clearer when she's on a better dose and not bouncing as much.

@Wendy&Neko Ivy tends to do that early cycle dip for the first few 3-4 hours pretty regularly (am and pm). Does it make sense for me to be feeding her a small snack once an hour during that time to slow a drop? Or am I interfering with what the dose is trying to do?
Also, what did you mean by PM of 5/9? (Lost me)
Thanks!!

 

[Wendy&Neko]

Also, what did you mean by PM of 5/9?

Look at the PM cycle of May 9th, going into the AM cycle of May 10th. She started high 300's, and kept going down all cycle. That's a bounce breaking cycle, which can have downward momentum. That downward motion kept going into the first part of the May 10th AM cycle.

If you want to feed a little LC to slow her down, that's OK. You'd like to flatten her out, and if you can prevent fast drops with feeding the cycle, that can help. More info in this post: Using Food to Manipulate the Curve

 

[Staci & Ivy]

Look at the PM cycle of May 9th, going into the AM cycle of May 10th. She started high 300's, and kept going down all cycle. That's a bounce breaking cycle, which can have downward momentum. That downward motion kept going into the first part of the May 10th AM cycle.

If you want to feed a little LC to slow her down, that's OK. You'd like to flatten her out, and if you can prevent fast drops with feeding the cycle, that can help. More info in this post: Using Food to Manipulate the Curve

Hi @Wendy&Neko
Thanks for this information. So on this new dose as of yesterday, …more complications:
**so we had a new wrinkle early this morning.
Ivy tried to jump up on the bed and got caught in the footboard and broke her leg. She’s at the hospital right now getting sedated and a splint and then they will have to do surgery sometime this coming week.
** On the way to the hospital, her glucose was dropping fast and she ended up somewhere just under 50 on the libre device. (I couldn’t check on glucometer on the way there)
(could the trauma of the leg break cause more of a drop?? The hospital thought, if anything, it would raise her glucose)

When the hospital tested her (ear prick) she had bounced to in the 200s.
*I did not give insulin this morning before I took her to the hospital at their direction, nor did I feed her.
She injured herself right before I was getting ready to test feed and shoot.

I should have her back later today and hopefully can get her to eat and get insulin into her. I’m not sure what I should shoot.
They recommend reducing her insulin to the last dose, so I’m wondering if I should take .25 unit reduction this evening and until I get her stable with the leg and upcoming surgery. Last thing I need is a hypo going on.
It seems that around 4 o’clock this morning she started dropping steeply, another bounce breaking cycle??? Do you think that was what was happening?

This sharp drop this early am was after yesterday all day and last night being in early pm pink and then eventually going yellow overnight.
it’s a nightmare and I’m crying.