? Terry needs dosing advise PMPS 351

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My feeling is that might be a bit high as he dropped to 2.8 (50) with a similar pre shot number before the change to low carb food. From the data we have since the switch 3 units seems to offer more consistency.
 
Thanks Alexi, should Fabienne stick with 3U for the next couple of days? for example if the AMPS tomorrow is the around the same # she should stick to 3U? and if Terry goes lower, like 10mmol (180dg) then she comes online to ask for advise right? This is how we arranged it on the Dutch forum.
Above 252 was 3U (or now it was 3.25U) and everything below she would come online asking for advise. Or would you say that it's better for her to get online every PS moment to ask for advise?
The trick here is to hopefully get Terry more regulated, seeing nicer # within 2 weeks (because then the prozinc bottle will be empty and Fabienne needs to decide to switch to Lantus or stick with Prozinc) otherwise she will consider to switch to Lantus (again not saying that that's a bad thing) but we want to try and stick to Prozinc because he's already been on caninsulin for a short period and Prozinc is also not a long period of time yet..
I believe his body still needs to adjust to Prozinc but maybe the way he's been dosed is not the right way.
So the more eyes on Terry the better don't you think?o_O
 
I think if the numbers are shootable then I would say yes to your plan and stay with a consistent dose. Some +2 or +3 numbers would be helpful as well.
 
+2 and +3 at AM or PM? or both? because at AM she can't test it, she's at work then.. Only maybe in the weekends.
 
one or the other - maybe evening time as I can't do daytime tests when I am at work either but we need to see if he is rising or falling in the hours after the insulin.
 
I looks like the dose is jumping around a lot. Terry might do better if his insulin dose was kept the same for a few days or a week. Terry 's system might be confused with the dose jumping up and down so much.
 
3.0 units seems to give some yellows and blues but too long a duration - ie., PMPS that required a large dose decrease. I've been told that this usually means the dose is a bit too high. Would it be worth trying 2.8 units (measured on a U100 syringe) or 2.75 units (estimated on a U40 syringe with half units) for several days (5 - 7?) with no changes and just ignore the odd black or red? If Terry is a cat who needs time to adjust to external insulin, he might be better off with some dose stability for now. Just a thought ...
 
That's sounds good Kris! Good tip!
I will shot 2.75 ( u40) this night if he's shootable. But if he continues the same ( weird) pattern he could be in not shootable scores this evening. From wich score on should I shoot the 2.75? Higher than...?
 
Hi Fabienne,
I'm not sure what to say about when you should shoot 2.75 u. I haven't enough experience with dosing yet. There are others on this board who do. What I did was look at Terry's SS to see what dose he was at when the yellows and blues showed up through the day and gave you a PMPS that was low and needed a dose reduction. The two things we have to do with our diabetic kitties are:

1. look closely for patterns on the SS - whether a dose is too high or too low;

2. learn over time and with experience what dose to give at what BG number - this is more difficult.

To add to the difficulty, some cats do well with doses that change frequently in response to BG numbers and others are better if a dose is held several days. Some cats are regulated quickly in the early days when the owner is aggressive in responding to each PS with a dose suited to that number. Some cats need to get an "acceptable but maybe not ideal" dose that is held for some time. You find out which type of cat you have when you start giving insulin. The jumpy cats might become more predictable when they are regulated. I'm not there yet with my cat. o_O
 
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Hello! :) welcome to the forums both of you!

It's good to see more yellows happening, so looks like the low carb food and your dosing are working well together. I would say you are well on your way now to getting some really good information as to what dosing will work for
Terry. :)

Hoping it works as well for Terry as it has for Tempest.
 
I don't think I have posted on your thread before, Fabienne. It looks like the insulin is working better, along with the change to wet low carb food. I think I'd stick with the 2.75 for a few cycles. It may be that he needs a little more, but getting the data is always wise. Then you can make better decisions going forward.
 
Sue and Oliver (GA) said:
I don't think I have posted on your thread before, Fabienne. It looks like the insulin is working better, along with the change to wet low carb food. I think I'd stick with the 2.75 for a few cycles. It may be that he needs a little more, but getting the data is always wise. Then you can make better decisions going forward.
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Thank you Sue! Now his amps is 194. I don't think I should shoot 2.75 at that. Because there's no one awake to advice me I've decided to wait and test again later. Maybe he will be shootable then. I hope that's the right decision. We haven't had such a morning score
 
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TempestsMum said:
Hello! :) welcome to the forums both of you!

It's good to see more yellows happening, so looks like the low carb food and your dosing are working well together. I would say you are well on your way now to getting some really good information as to what dosing will work for
Terry. :)

Hoping it works as well for Terry as it has for Tempest.
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Thank you! Yess I really hope so! I want him to feel better so much...
 
What a nice surprise this morning. I like that his morning preshots are gradually lowering.

Did you feed between the 194 and the 304? At these levels (304) , it doesn't matter but if you fed and got a 220 for example, it might be food influenced and you might want to skinny up the dose. If you stall, the not feeding part is difficult but important, especially at lower numbers.
 
Sue and Oliver (GA) said:
What a nice surprise this morning. I like that his morning preshots are gradually lowering.

Did you feed between the 194 and the 304? At these levels (304) , it doesn't matter but if you fed and got a 220 for example, it might be food influenced and you might want to skinny up the dose. If you stall, the not feeding part is difficult but important, especially at lower numbers.
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Yes I did. I always feed him (raw food) before testing because he is always very hungry and that influences his Score. After testing he gets the rest of his meal. ( wet food) . So before the second test he already had his whole meal.
 
Try to avoid that if possible. You can always give him a tiny snack and then go take a shower and close the door. :p Being hungry might influence the level a little but not as much as a whole meal might. You want to shoot a 'true number". not food influenced, especially when the numbers lower and start to tighten.
 
I'm going to agree on what Sue is saying here, if you are going to give a shot earlier as from next Sunday you can try to test Terry when you get out of bed and then give him his food. Those numbers will be indeed 'real'
 
Sue and Oliver (GA) said:
Try to avoid that if possible. You can always give him a tiny snack and then go take a shower and close the door. :p Being hungry might influence the level a little but not as much as a whole meal might. You want to shoot a 'true number". not food influenced, especially when the numbers lower and start to tighten.
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I just tested before his meal. Pmps 175.
I think I should wait and test again in 45 min like this morning?
 
He's looking good! Those are some nice preshots. Yep, as Sue said, 20 minutes without food is enough...then go from there.
 
@Sue and Oliver (GA) @Rachel can you please take a look at Terry's spreadsheet? Those +2 and +4 are extremely high comparing to his PMPS. This 'issue' is what Terry does often, he never gets lower in the evening when his pmps is low. What can this be and how can we fix this?
 
It could be his pattern of bouncing. So he doesn't bounce right after the lower nadir, he bounces on the next cycle. I would not have shot higher on that yellow pmps. Remember - just data gathering. In general, the trend is downward.
 
I wonder if it would help to get +2 and +4 each morning for a few days to compare? I see only one +2 in the AM on the SS and there are several +4 values, mostly mid to high-ish yellow, a pink and a red. Terry might have a prolonged food spike if his pancreas isn't working (yet). I also notice that his high evening +2 and +4 values are often preceded by low-ish (blue) mid-day or PS numbers. Could these be early bounces along with food spikes?
 
It's really weird those pmps spikes don't you think?
And if it is a late bounce like you are saying Sue, than that would be hard to dose on...?
He does that really a lot it's doesn't seem like he wants to clear that...
 
I think that's a good idea. If he was 326 at 13.5, he certainly could have been lower at amps. How about - for now - 2.25 for the yellow 200s and 2.5 for the 300s. And the next shot should either be 30/45 minutes later than usual to work back to the schedule. (Shooting at the regular time would be 1.5 hours early). Make sense?
 
Sue and Oliver (GA) said:
I think that's a good idea. If he was 326 at 13.5, he certainly could have been lower at amps. How about - for now - 2.25 for the yellow 200s and 2.5 for the 300s. And the next shot should either be 30/45 minutes later than usual to work back to the schedule. (Shooting at the regular time would be 1.5 hours early). Make sense?
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He was tested normal time 7 am , only his shot should have been 7.30 in stead of 9 am.
Oke thank you for your advise!
This evening I will give him insulin at 8/8.15 pm
 
Gotcha. So the number was right, but the time/shot was off. He was probably higher when he got the insulin. So I would still work to get your schedule back, but not in one cycle.
 
Hi Ruby,
I'm not an expert, except in my own cat's unpredictability, but maybe 2.00 u is a bit low. Maybe try 2.25 u again (fairly conservative) or even 2.50 u (being braver and monitoring) once he's over his upset tummy. I'll certainly defer to the dosing experts. Let's see what they have to say. :)
 
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