? Holding dose at 0.75 till bounce resolves?

Hi

Previous thread: https://www.felinediabetes.com/FDMB/threads/day-3-of-lantus-low-pmps.239974/

Lily's on day 5 of 0.75iu and is having a very bouncy time. She was at 142 AMPS. I fed and shot intending to try a curve today but at +1 she was at 355. She may have had a late nadir but if not then she was even lower overnight and my worry is if I increase the dose as scheduled she may have a hypo overnight. My instinct is to hold until she settles on 0.75 and I can see what it is actually doing, and to give her a chance to get used to a lower BG and stop her body panicking, but as I have been doing this for all of a month I'm not sure I get to have an instinct. It feels like months.

Liz

 

It is possible that Lily went lower than her AMPS last night - impossible to say without tests. She is indeed bouncing today, so a curve would not give you the data you need.

Bouncing is inevitable and will stop eventually as Lily's liver gets used to lower numbers. That means getting her to dose where she can see normal numbers.

 

Thanks Bhooma.

She seems to have been constantly bouncing for several days so I gather there's little point in testing too much. I'll get another one to see if she's going down again a while after breakfast.

If I keep increasing the dose presumably the drops will be bigger and a bounce even more likely? My concern is that once she eventually runs out of resources to fuel the bounces she could well end up dangerously low and that then even with a reduction there would be days of very low BG until the depot depletes.

 

Hi Liz, she is clearly bouncing today, so I would spare her the pokes. I would get a +2 in each cycle and if it is lower than PS, I would try to get additional tests later in the cycle. Sometimes a +4, others a +5 or a +6 etc. The idea is to see how low she goes on the dose and also to understand where her nadir is - nadirs can and do move around though!

Ignore the bounces. They will reduce with time. Some cats flatten out amazingly fast. Some, like by Bandit, will probably bounce forever (or that's what it feels like! ). You need to only pay attention to how low the dose is taking her and keep increasing till she sees normal numbers which is 50 to 100 on a human meter. You avoid danger by increasing in small increments of 0.25U and testing enough to know how low the dose is taking her.

 

Thanks Bhooma, very reassuring to know that she won't necessarily exhibit a nadir lower than her current one when she stops bouncing. And nice for both of us to know I don't have to keep stabbing her if she's soaring. I'll try to get her at nadir - she's started doing an excellent telltale squinty face when her BG comes down, which could come in useful!

 

No need to test her at "nadir" time today, she's on her way up from however low she went last night. Many (most?) cats like to go lower at night. Since we determine how to change the dose by those lows, it's really important to get a second test in at night. Maybe one just before you go to bed.

No worry. Some cats bounce for years. It took Neko a year to stop bouncing up to the reds. Your goal is also to get her used to normal blood sugar numbers, so she stops bouncing.