Hermione's Dosing Rollercoaster pt4

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ShipsCat

ShipsCat

Member Since 2016
The other thread was getting long so I figured it's time for a new one.

I've been fighting a cold so I didn't get as many tests in as I would have liked. I didn't even turn on my computer since I'm feeling awful and Nutter is feeling good enough to totter around the house and get stuck in strange places because he can't turn around or back up without falling over. Fortunately he doesn't panic or get upset, he just makes these really sad quiet meows until I find him and get him unstuck. I let him out of the room I was keeping him in because being isolated WAS making him upset and even if I let his best buddy in with him he just yowled. Poor old dude!

Here are Hermione's recent numbers, which are as disappointing as Nutter's recovery is encouraging :(

10/20
520 AMPS, 1u given
591 PMPS, skinny 1.25u given, just below the 1.25 mark

10/21
608 AMPS, 1.25u given - negative for ketones.
 
ShipsCat said:
The other thread was getting long so I figured it's time for a new one.

I've been fighting a cold so I didn't get as many tests in as I would have liked. I didn't even turn on my computer since I'm feeling awful and Nutter is feeling good enough to totter around the house and get stuck in strange places because he can't turn around or back up without falling over. Fortunately he doesn't panic or get upset, he just makes these really sad quiet meows until I find him and get him unstuck. I let him out of the room I was keeping him in because being isolated WAS making him upset and even if I let his best buddy in with him he just yowled. Poor old dude!

Here are Hermione's recent numbers, which are as disappointing as Nutter's recovery is encouraging :(

10/20
520 AMPS, 1u given
591 PMPS, skinny 1.25u given, just below the 1.25 mark

10/21
608 AMPS, 1.25u given - negative for ketones.
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Poor Nutter! Your description of him getting stuck was heart-wrenching. I'm glad he's feeling better though.

I see what you mean about Hermione's numbers - very puzzling. You have lots of data which is great . If I look at your SS for a very general "overview", it seems that the more recent blues and yellows are associated with doses in the 1 - 2 u range. Your recent lower doses have left you in black/red/pink territory for many cycles which makes me think they're too low. I see that you've often responded to an AM/PMPS with a dose tweak. Hermione is a very volatile girl, much like my guy. My approach is to try to keep dosing as stable as possible and any changes are miniscule - and Teasel still overreacts. I wonder whether selecting some "OK" dose and keeping it for several days might break you out of the blacks. Of course you'd have to respond if she dropped too low. Just a thought based on my experience with a jumpy kitty.
 
Yeah, it's pretty sad when he gets stuck. But he really doesn't get upset about it, more like he's puzzled. And he's never actually wedged in anywhere, it's things like walking behind the toilet and not being able to make the turn at the tub. He's doing much better today though, he can make slow turns without falling. It was really terrifying when he first came down with this - I was sure he'd had a stroke.

Thanks for the encouragement & suggestions! I'm trying not to be frustrated right now, but it's hard when we were doing so well ;)

505 @ +4
480 for PMPS, 1.25u given. Hopefully we're getting closer & that's not just strip variance!
 
259 @ +9!

Kris, looks like your eye for data is right! I was watching a hockey game with Hermione on my lap so I didn't get a nadir test. Nutter has been doing really well, and I'm less congested so hopefully things will keep trending in a positive direction.
 
279 for AMPS!

I gave her a little reduction to 1u. I'll get a test before I go to bed and have extra alarm clocks set so I don't sleep through nadir!
 
ShipsCat said:
259 @ +9!

Kris, looks like your eye for data is right! I was watching a hockey game with Hermione on my lap so I didn't get a nadir test. Nutter has been doing really well, and I'm less congested so hopefully things will keep trending in a positive direction.
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I'm thrilled for you and Hermione, Kimi! If she's like Teasel, she can get "stuck" in high numbers and loses responsiveness to a dose that might have worked previously. A dose increase can give her the nudge she needs. I always have to be aware of this with Teasel.:):) !
 
I am with Kris. She needs small increases. It'all be interesting to see if one unit is enough today - good data to have.

Are you considering U100s? It looks like she will need tiny increases/decreases like Teasel. U100s and the conversion chart would make that easier.
 
I'm with Sue on the U100s, Kimi. You'd have a ton more fractional doses to work with along with "fats" and "skinnies".
 
Looks like Teasel and Hermione may be sugar siblings ;)

The 1u wasn't quite enough, or possibly she's bouncing. I'll do a curve today. I'll be ordering u100s on Monday since it's pretty obvious she's going to be a tiny changes only girl. There is a limit with what I can do even with caliper measurements on the u40s.

417 @ +3
381 @ +7 (Hermione was asleep on my legs! I know she's feeling great when she snuggles with me)
551 for PMPS, 1.25u given
 
ShipsCat said:
Looks like Teasel and Hermione may be sugar siblings ;)

The 1u wasn't quite enough, or possibly she's bouncing. I'll do a curve today. I'll be ordering u100s on Monday since it's pretty obvious she's going to be a tiny changes only girl. There is a limit with what I can do even with caliper measurements on the u40s.

417 @ +3
381 @ +7 (Hermione was asleep on my legs! I know she's feeling great when she snuggles with me)
551 for PMPS, 1.25u given
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A 0.1 u increase in dose brought Teasel from AMPS of 479 to a +5 of 157. How's that for a reaction?! And a 0.1 u change would be impossible with a U40 syringe.
 
Yes, I definitely think that's the kind of tiny change Hermione needs right now. And she didn't want me to do a curve today, she spent the day cuddled up with me except when she let me cook & eat dinner. I hate to disrupt our snuggle time, especially since it means she's feeling good. I know I shouldn't let her keep me from testing her appropriately, but I've been so stressed with Nutter and me being sick I just wanted to let her sleep on me while I watched tv :p

475 @ +5 (when I made dinner)
513 for AMPS, 1.25u given

Nutter is almost back to normal! He still has a head tilt, which my vet warned me might be permanent, and if he shakes his head or tries to move too fast he's still wobbly. But it's an amazing improvement from just a few days ago when I thought he had a stroke.
 
ShipsCat said:
Yes, I definitely think that's the kind of tiny change Hermione needs right now. And she didn't want me to do a curve today, she spent the day cuddled up with me except when she let me cook & eat dinner. I hate to disrupt our snuggle time, especially since it means she's feeling good. I know I shouldn't let her keep me from testing her appropriately, but I've been so stressed with Nutter and me being sick I just wanted to let her sleep on me while I watched tv :p

475 @ +5 (when I made dinner)
513 for AMPS, 1.25u given

Nutter is almost back to normal! He still has a head tilt, which my vet warned me might be permanent, and if he shakes his head or tries to move too fast he's still wobbly. But it's an amazing improvement from just a few days ago when I thought he had a stroke.
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You'll get there with Hermione, Kimi. Some of us have kitties who want to teach us as much as possible while they're at it. :) I'm glad that Nutter is so much better. I could just picture the old boy stuck behind the toilet calling for you to come and rescue him.
 
Hermione is doing better today!

485 @ +5
385 for PMPS. I gave 1.25u since she wasn't liking the bigger reduction.

Oh, and here's Nutter today on his favorite dog bed. The rolled up towel is so he has something to lean on until he gets his balance all the way back. He'll go lay next to it all by himself.
20161023_134702_zpskkkt7bpw.jpg
 
Thanks, gang! I'm fortunate to have an equine medicine background as well as being very comfortable with needles, blood, etc, so once I understand what to do I'm diligent about doing it. I'm also very lucky that my cats are generally good patients ;)

AMPS was 501, I gave her 1.25u then fell asleep without setting my alarm so no mid-cycle numbers
PMPS was 441, 1.5u given.

I'm still on vacation from work, so I decided to be a little adventurous and give her a slight increase.
 
The increase worked, although a bit too well. I'm looking forward to my u100 syringes now, since it looks like her ideal dose right now falls between 1.25 & 1.5u.

373 @ +4
232 @ +8
187 for AMPS!
198 after 20 min stall, AT strip instead of FS
209 after 40 min total stall on AT strip

I gave 1u based on the % of dose instead of just looking at the dose number. She seems to react poorly to large dose changes, and even though the last time she was given 1u on a yellow she had a big bounce mid-cycle it also set up the run of beautiful blues. I just didn't feel brave enough to give more than 1u. Fingers crossed it works out!
 
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Welcome to the world of nanodosing, Kimi! :) You'll like the options you have with the U100s. I see you use those $$$ AT strips for critical times like I do. I'm more comfortable with the FS strips in my AT meter now, given that I know they always read higher and I've worked out an approximate % higher when I open a new vial of AT strips and do a few same drop comparisons. I'd break the bank if I used only AT strips!
 
Yes, what they charge for AT strips is criminal. I work out the best code for each new bottle of FS strips compared to an AT strip on the same blood drop - fortunately Hermione is very patient! But I still don't trust them in the blue range.

541 for PMPS 1.5u given.

I swear I did a nadir test this morning but there's nothing in my paper log. I'm testing my cat in my dreams! :p
 
I also expected the bounce. What I didn't expect is this +8 number!

99 @ +8! I double checked it with an AT strip.

She was cuddling with me for +6 again, but I didn't expect her to be in the greens! She didn't act like she was low, just snuggly and full of purrs. My u100 syringes can't get here soon enough. She sure seems to want to be somewhere between 1.25u & 1.5u right now.
 
86 for AMPS on AT strip!!

Hermione really does like messing with us, doesn't she?!

Going by what was suggested last time she held nice low numbers (and because she's pestering me for food) I'm going to give her a partial meal & test again in a few hours.
 
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183 @ +3 with no shot and half a can of FF given at AMPS!

If I had u100 syringes I could give her a tiny dose. But since I don't have them yet I'm skipping. It's well past my bedtime, and I don't want to be asleep if she gets really low :(
 
So she needs insulin but would like somewhere in the 1-1.25 unit range. Looks like the 1.5 was a little too much, even for a black.

I like your idea of giving a dose a tiny dose in the 180s, but the U100s would be nice, and you do need to sleep :p At least she is giving you some good numbers!
 
It's crazy how reactive she is now! I would have loved to give her a microdose this morning but I knew I'd fall asleep and didn't want to be snoozing if she had a crisis.

497 for PMPS, I let one drop out from 1.5u so hopefully she won't be too low to shoot in the morning. My u100s should be here tomorrow!
 
109 for AMPS, checked on AT strip. Repeating yesterday's protocol and giving her a little food. I'll check her before I go to sleep again.

I'm really looking forward to the u100 syringes. This is driving me batty!
ALL the patience pants, ALL the time. ALL OF THE TIME! :p
 
194 @ +3

Again too late for me to give her insulin with a u40 syringe. Although letting out a drop seemed to help a little with the extra long duration.
 
Yes, that's what we did last time, Sue. I meant to give her PM shot early today but had to clean poop out of her tail. Long haired kitties can be so much fun! I also didn't get my u100 syringes in today's mail, so I reduced her dose to 1.25u.

501 @ PMPS, 1.25 given.
 
Yup! Although they're very close on my syringes. I got the smallest u100 dose I found at ADW with 1/2 unit marks (3/10cc) but maybe I overlooked a smaller one.
 
ShipsCat said:
Yup! Although they're very close on my syringes. I got the smallest u100 dose I found at ADW with 1/2 unit marks (3/10cc) but maybe I overlooked a smaller one.
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No, what you got were the ones I use, Kimi. The half unit marks allow 0.2, 0.4, etc. dosing. I eyeball halfway between those half unit unit marks when I want to try 0.1, 0.3, etc. dosing. And to split it even finer, I nudge the plunger just up to or just beyond a mark to get the "fats" and "skinnies" that I call the 0.05, 0.15, 0.25 etc. doses. Some people do this by letting out a drop or two. I can manage it with my reading glasses (!) and holding the syringe up to a bright desk lamp. Where there's a will, there's a way. :)
 
I already need my reading glasses to draw insulin anyway - my arms aren't long enough :p I'm glad I didn't overlook a better size syringe too. This dose seems to be working well, although she seems a bit high for PS numbers. Hopefully she'll smooth out a bit once she's used to the dose.

450 @ PMPS, 1.4u given.
 
Like those blues, don't like those blacks and reds...

Wonder if a curve would help us see when she starts up and if there are lower numbers in the cycle somewhere?
 
I need to do a curve, but this weekend has been really crazy for me. It so confusing that .1u change can make her swing so wildly.

414 @ PMPS .4u again.
 
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