8/11 Martian - PMPS 144 (8.0), +1 108 (6.0), +2 74 (4.1), +3 65 (3.6), +4 65 (3.6), +5 70 (3.9)

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If you are stalling, you don't feed as it will influence the shot.
Can you stall for another 30 mins or will that throw you off schedule too much.....remembering that the next shot is 12 hours from the last.
If you shoot low, are you able to monitor today?
 
This could partially be from not eating but shouldn't be all of it. Looking at his ssheet, if he doesn't come up in that half hour and you MUST shoot, how about shaving some off or even dropping .25 unit off the dose.
 
He's up to 119 (6.6) after 40 minutes. And I'm home today, so I can monitor him. The vet would prefer I skip a shot rather than shave the dose, and I don't want to get too far off schedule, so I might go ahead and shoot now.

I'll keep you posted on what happens.
 
Ok.
I would get a +1and a +2
You can also give him a bit of higher carb food to boost the numbers before onset of the insulin. Not a lot, just a teaspoon or two. Then freeze the rest of the higher carb in ice tray for next time.
 
I've given him some higher carb food. He didn't eat as much breakfast as usual, so that was a very good idea, thanks Bron. I've put the rest in the fridge for now, in case I need it later today.

He's in a bit of a restless mood this morning. Didn't want any of the FOUR food varieties that I put out for breakfast - did the rounds of everybody's bowls, and eventually settled for the one he found least objectionable. Now he's wandering around the house, and heading in the opposite direction to me when I come anywhere near him.

I'm going to wait until +2. I want to give his ears a bit of a rest.
 
There's nothing in the dose column for this morning - did you give the full dose?

The rule of thumb is whenever you shoot a number lower than you've shot before, you get a +1 and a +2 so that you don't have any surprises. Once in a while a kitty will head straight down after the shot, especially if a bounce is clearing, and if Martian does that you want to know about it! After you've shot lower and lower, then you'll be able to predict what he is likely to do, based upon what he's done in the past. But until you get to that point, it's a good idea to always check those lower numbers.

There is a bit of information about shooting low - meaning shooting the full dose into normal numbers. Lantus works better at holding numbers flat in the normal range than it does at bringing high numbers down. When you have time (don't need to do it right now) take a look at the "Where Can I Find?" post and there are 2 things to look for in the second half of the post:

Shooting Low
Tight Regulation Protocol: Myths Debunked (the Shooting a dropping Number part)

When you read through the first one, take the time to expand the explanations, look at the sticky on becoming data-ready, and look at the spreadsheets that are linked, so you can understand things. Then if you have questions, just ask.
 
Thanks @julie & punkin (ga) .
I've fixed the spreadsheet now. I gave him the full dose this morning.

+2: 101 (5.6)
So he's dropping again. I've fed another tsp of high carb, and I think he had a bit more breakfast too.
I'll test again at+3.

I slept really badly last night, so I'm struggling this morning. I think it's going to be a day of napping in between tests. Yay for the alarm on my phone!

I'll have a look at that info when I'm a bit more awake...
 
You probably don't need to feed him any more higher carb unless he goes below 50(2.8) or you are having trouble getting him to eat much.
Normally higher carb is not given unless it is below 50. I just suggested it to boost his numbers up after the shot ready for the onset of insulin as it was quite low. Just keep feeding normal food now and post if it is dropping and you are uncomfortable about it.
Giving us the updates is good:)
You are doing a great job looking after him!

I understand the tiredness you are feeling. Most of us are sleep deprived on one level or another
 
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+3: 86 (4.8)
So still dropping, but not super fast.

The food I gave him isn't super high in carbs, just a bit higher than the usual, and I think he enjoyed having something a bit different.

I have sleep issues at the best of times, and I've got some other stuff going on in my life at the moment, and dealing with Martian's diabetes on top of everything else means that I'm feeling totally wrung out and exhausted.

Oh well, we do what we have to do...
 
That is good you are noting down in the remarks column what you are feeding him. If you know the number of carbs, you can put that down. It is helpful when other have a look.

Sorry you are having other issues going on as well. It always seems to be like that. I long for a boring, nothing happening week, but it never happens. All you can do is your best. I just let the unimportant things slide for a while....there is a huge pile now, on the pile from my 'do later' slide:joyful:

Martian is doing really well, he really is. A lot of kitties don't settle down and give good numbers like Martain is for weeks or months. And you are managing it all like an old pro so take heart from that:bighug:
 
+4.25: 88 (4.9)
Holding steady.
I'll check again at +6.

Thanks Bron.
There are some other important things, which I'm working on dealing with. And LOTS in my do later pile.

Intellectually I know Martian is doing really well, but deep down I don't quite trust it. If it keeps going this way for another week or two, maybe I'll be able to believe in it a bit more :)

In the meantime, he's actually curled up on my lap having purry cuddles :D
 
Yesterday's vet visit

I had a good talk with the vet when I picked up Martian after his curve yesterday. We talked about the TRP and the protocol she is following, as well as home testing.

The vet is all for home testing, so yay. She would prefer I just do the AMPS and PMPS, with the odd spot check, because Martian's ears are looking a bit bruised. This is my aim once I figure out how he is going with the insulin, so that should be OK. Also, I expect there will be less bruising as I get better at testing, especially if I can get a new lancing device. She also loves the idea of the spreadsheet and being able to check in on our progress. She also suggested buying some urine glucose strips and using those to supplement the blood tests, which I am going to look into.

I've attached a copy of the protocol the vet is following. It's from the University of Queensland, and it's pretty similar to the TRP, with a few variations. The weblink that's mentioned doesn't work, and I can't find this version of the protocol on the UQ website.

Glargine_protocol_original (2).jpg

She is happy for me to follow the TRP, with a few caveats:
1. If Martians pre-shot BG is low, she would prefer I skip the dose rather than reduce it.
2. She doesn't want me to change the dose without consulting her (which is fair enough).
3. When we adjust the dose she would like him to be on the new dose for at least a week before we adjust it again (unless something drastic happens).

She is surprised (and pleased) by the BG figures Martian is getting, and positive about his prognosis. So it looks like we're on the same page now and good to go :)
 
+11: 113 (6.3)

Martian has been off his food most of the day, and he threw up at a bit over an hour ago (no food, just some cat grass). He's acting hungry now, but I don't know if he'll eat when I put his dinner down.

If he's still low at his pre-shot (and I think he probably will be), I'm pondering my options.The vet doesn't want me playing with his dose - she would prefer I skip the dose if he's low. So my options are:
1. Don't shoot tonight.
2. Feed normal food, shoot and monitor.
3. If he won't eat the regular food, try some slightly higher carb food, shoot and monitor.

What are your thoughts?
 
If you skip the dose you will start emptying the depot.
The trouble with the vet wanting to have a say in the dose is that they are not open or contactable when you need to decide the am and pm doses . This will be an ongoing problem and having been there I can tell you it is a pain in the proverbial. She is used to people who are not testing.
I think you need to be free to decide what to do. You are not doing it by yourself, you have the help of the forum.
Also it is really important to test mid cycle, every or as often as you can cycle, because that is how you know if the dose is correct, too high, or too low.

With this cycle he has come up a bit so he is rising. Yes, if you give the normal dose and he isn't eating much you can always give him some higher carbs to compensate. The thing with monitoring the numbers is you will always be in charge. If you don't, then you will not know what he is doing. You don't have to test all the time. just one ot two mid cycle. You will get to know his patterns. If you are concerned with the numbers then you can test more.

Also you don't have to tell the vet everytime you are testing. Martian is your cat and you want to keep him safe. If that means testing midcycle then do it, just don't mention it to her.
 
All of that! *sigh*

For tonight, he's had a decent amount of dinner, so I'll go ahead with the shot and check at +1 and +2. I've still got the higher carb food in the fridge from this morning, and honey there if needed.

We've also got way off my preferred timing, so we'll have to work our way back again when I know I'll be home to monitor.
 
You can alter the time by 15 minutes a cycle or 30 minutes once a day either forward or back to get to the schedule you want.
I can't read the protocol you have there very well as it is too small, but it looks like the one my vet has which is a bit old. A lot of vets don't seem to test mid cycle. They just rely on a curve done every so often. The trouble with that is, curves can and do change every day, and if they have a curve done on a day they are having a cycle that is not doing much it can give a false idea of what is really happening.
Martian is being the "ideal" cat really. His numbers are steady and he is not bouncing. If you have a look at many of the other SS you will see numbers are all over the place.
 
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Did you click to open the file?
The protocols that are currently available on the UQ site look closer to the TRP. http://www.uq.edu.au/vetschool/research-centres
But even the one she gave me mentions using the nadir as a guide to changing doses, as well as the pre-shot numbers, so we need to know what it is. Also, with all those lovely, scary low numbers, I feel much happier when I know what's going on during the cycle.

I've been trying to shift the cycle back in 15 minute increments. I was nearly back to my target time again when I had to delay this morning, and this evening added another 15 minutes. Oh well...

I've looked at a few SS. Typical of my little alien to be atypical - at least it's in a positive way :)
 
CarolynE said:
Did you click to open the file?
The protocols that are currently available on the UQ site look closer to the TRP. http://www.uq.edu.au/vetschool/research-centres
But even the one she gave me mentions using the nadir as a guide to changing doses, as well as the pre-shot numbers, so we need to know what it is. Also, with all those lovely, scary low numbers, I feel much happier when I know what's going on during the cycle.

I've been trying to shift the cycle back in 15 minute increments. I was nearly back to my target time again when I had to delay this morning, and this evening added another 15 minutes. Oh well...

I've looked at a few SS. Typical of my little alien to be atypical - at least it's in a positive way :)
Click to expand...

I did click on it and it did open but I have an iPad so it's not very big, but I can see it. I also looked at the site you have above. Even those are from 2006 and 2008. So much changes in 7 years. I noticed one of the papers was co written by Rhett Marshall. He is in a vet practice in Brisbane and when I was having all sorts of problems with Sheba last year, I emailed him and he rang me back and helped me a lot. He was so nice...he encouraged me to shoot low and to have the courage to do it. He is all for home monitoring and testing during the cycle.

The first time Sheba had diabetes, she went into remission in 3 months in 2011. She was diet controlled until Nov 2013 when she got sick. The second time around has been much harder to get her regulated. She still bounces and drops quickly. If I only took her blood sugars at shot time, I would think she was always high and never went low.
 
+1.25 108 (6.0)

He's been making up for not eating during the day (he was eating when I went to do the +1, which is part of the reason it was a bit late), so I think he'll probably surf OK tonight, but I'll still do a couple more checks to make sure.
 
+3.25: 65 (3.6)

I really hope he's rising by the +4...could be a long night otherwise...
At least he's still snacking. His attitude seems to be "You woke me up. Now there must be noms." :)
 
+4: 65 (3.6)

Holding steady at least.
But I suppose I should do a +5...

I could swear I requested no late midweek PJ parties!
 
+5: 70 (3.9)

Heading back up. Yay! Now mama needs some sleep.
I've put out some extra food just in case.
 
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