Spreadsheet and Numbers check?

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Lauren Cox

Lauren Cox

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Hello everyone! I wanted to check in with everyone and see what you thought of Izzy's spreadsheet and numbers? She's been averaging in the 100-200's during Nadir. Her numbers really did bounce around significantly from February-July. I feel as if they aren't so up and down now. Do you have any input or suggestions? You all have been so helpful during this journey. Have a great night!
 
Before I comment on her dose, her numbers are looking nicer though :), is there any way you can get a before bed test? Usually that's between a +2 and +4 in the evening. It will give us a better idea of where she's going overnight, as most kitties run lower overnight.
I'm thinking she may need another decrease ;)
 
Hi all! I have been doing as instructed. I had a FS (fur shot) and it messed her up a bit. Been bouncing. I am going to wait until tonight even if it gets high this afternoon to give her insulin and get her back on track. She was 100 at regular insulin time last night so anything under 200 i skip her shot of insulin. Then +3 hours later she was 543??? So i gave her a dose and waited until 12 hours later to test her and she is below 200 again this morning. Please advise me if I am doing something wrong. I really think it was that FS that messed things up. Thanks and have a wonderful day. :)
 
It was wise to skip last night. Did you retest that 543? Sometimes it could be a wonky strip, and if you get an unusual number it's a good idea to retest. Either way she probably went high because of the no shot. So you gave her a shot at +3? Just making sure I read that right. Typically you wouldn't want to do that only because it changes the shot schedule. If you're flexible enough to be able to accommodate the new shot times then it wouldn't be too much of a problem. Usually with Prozinc if you get multiple no shots you would back off on the dose so you get suitable numbers to shoot. I'm not comfortable offering dosing advice but I'm sure one of the experts will probably get back to you soon.
 
Case said:
It was wise to skip last night. Did you retest that 543? Sometimes it could be a wonky strip, and if you get an unusual number it's a good idea to retest. Either way she probably went high because of the no shot. So you gave her a shot at +3? Just making sure I read that right. Typically you wouldn't want to do that only because it changes the shot schedule. If you're flexible enough to be able to accommodate the new shot times then it wouldn't be too much of a problem. Usually with Prozinc if you get multiple no shots you would back off on the dose so you get suitable numbers to shoot. I'm not comfortable offering dosing advice but I'm sure one of the experts will probably get back to you soon.
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It is quite possible the strip was wonky! I was shocked it went from 100 to 547 in 3 hours.

Good feedback! I'm leaning towards reducing her shots from .8 to .5 units possibly because she has had a lot of numbers between 100-199 (during insulin time) lately where i wont insulin her then she is super high by morning. I'll hold off a few more days before reducing it and keep trying for the +3 or +4 test before I head to bed each night.
 
Hi Lauren! Izzy's numbers are quite high still, so I wouldn't recommend reducing the dose. Instead, I would suggest that when you do the PS test and it's low, wait 20-30 minutes without feeding, and test again. If the number is rising, but still not high enough, wait another 20-30 minutes and test again. Odds are the number will be high enough at that point that you will be able to give the regular dose. That last hour from +11 to +12 can have a pretty dramatic rise for some cats. So you may be getting those lower numbers just because for whatever reason, she hasn't started that final climb yet. By waiting a bit without food, you hopefully won't need to skip those shots.

Of course if you stall and she doesn't rise, then you would skip. If Izzy is anything like Sam, it's pretty hard to do the stall because he's begging and I'm a softie. Rachel told me to leave the house and go for a walk during the stall times. It's really not that hard on him - he just fusses because I'm there. It's much harder on me to hear him meow at me! So leaving the house turned out to be the trick that got me through the 20 minute wait! Plus, it got me a bit of extra exercise! :)
 
Hi Lauren - There is still some bouncing, but it doesn't look terrible. It does look like you've skipped a number of shots because of blue pre-shot numbers. A couple of things to consider: when you get a number under 200, stall for 20 minutes without feeding and then retest. If the number is rising and getting closer to 200, you can give the shot. Skipping shots contributes to the bouncing, so the more consistent you can be the better. Using the stall technique can help you be consistent. You can stall in 20 minute increments for up to an hour. Second, schedule a day when you can do a curve to get a picture of what Izzy's BG is doing in the middle of the cycle. I'm guessing you work long hours since there aren't any mid-cycle numbers during the day. Doing a curve on a day off will help to see if she is needing more or less insulin at this point. We really need at least an occasional picture of what's happening at nadir in order to gauge the dose. The evening mid-cycles are helpful so keep doing those, but since we aren't sure how close those are to nadir, I'm not sure if those are the low numbers, or if she's dropping farther after that. The curve will help clarify that. I hope you and Izzy are doing well!
 
Thank you I will work on delaying food and insulin for 20 minutes at a time for up to an hour. I am always unsure on what to do if levels are just below 200. I know they must go up but sometimes i have noticed they have gone low (below 50's at nadir) which is scary. This is great info Djamila! Thank you again.
 
Djamila said:
Hi Lauren - There is still some bouncing, but it doesn't look terrible. It does look like you've skipped a number of shots because of blue pre-shot numbers. A couple of things to consider: when you get a number under 200, stall for 20 minutes without feeding and then retest. If the number is rising and getting closer to 200, you can give the shot. Skipping shots contributes to the bouncing, so the more consistent you can be the better. Using the stall technique can help you be consistent. You can stall in 20 minute increments for up to an hour. Second, schedule a day when you can do a curve to get a picture of what Izzy's BG is doing in the middle of the cycle. I'm guessing you work long hours since there aren't any mid-cycle numbers during the day. Doing a curve on a day off will help to see if she is needing more or less insulin at this point. We really need at least an occasional picture of what's happening at nadir in order to gauge the dose. The evening mid-cycles are helpful so keep doing those, but since we aren't sure how close those are to nadir, I'm not sure if those are the low numbers, or if she's dropping farther after that. The curve will help clarify that. I hope you and Izzy are doing well!
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Djamila,

This morning she was at 339 so we insulined as usual. Tonight I tested normal time 179, 20 minutes later 171, 20 minutes after that 185, then an hour after normal insulin time she was 182, and finally an hour and half after insulin time she was 207. So i fed her and insulined her. Is an hour and a half too long to wait to see if it goes up? Does this mean her schedule will be bumping an hour and half or more each insulin time? I guess we'll see after i do this for a week to see her pattern. Thanks for helping me! I appreciate it tremendously. Have a good night.

Lauren
 
Usually we say after an hour to just go ahead and feed and either shoot or not depending on the numbers. However, if your schedule has the flexibility to be able to adjust the morning time dose as well, then an 1.5 hours isn't bad. Just make sure that the morning dose is as close to 12 hours after the evening dose as you can.

If you want to get back on regular schedule, you can adjust a bit over a few cycles. So maybe tomorrow morning you test at 11.5 hours, and then again in the evening, and that should put you close to normal time again. That only works if her numbers are high enough to cooperate though.

When you get a minute, could you update your spreadsheet? It looks like the numbers I'm seeing aren't the most current ones.
 
Djamila said:
Usually we say after an hour to just go ahead and feed and either shoot or not depending on the numbers. However, if your schedule has the flexibility to be able to adjust the morning time dose as well, then an 1.5 hours isn't bad. Just make sure that the morning dose is as close to 12 hours after the evening dose as you can.

If you want to get back on regular schedule, you can adjust a bit over a few cycles. So maybe tomorrow morning you test at 11.5 hours, and then again in the evening, and that should put you close to normal time again. That only works if her numbers are high enough to cooperate though.

When you get a minute, could you update your spreadsheet? It looks like the numbers I'm seeing aren't the most current ones.
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Updated....a bit confusing so i could get all her numbers in there for that hour and half period. If you have any suggestions on recording it differently feel free to let me know. Thanks
 
It is tricky to add extra information, and different people do it different ways. I usually just add one value to the box, and then I right click on the box, go to "insert note" and type the extra information in the note. When I do add extra info to the box, I'll usually go up to the top and manually add the background and font color, but that is kind of a pain.

When you have info that would be two different colors, for example when you got a 185 (blue) and a 210 (yellow), I'd probably go with whichever one was mattered the most. In that case, you were comfortable to shoot when you go the 210, so I would use the 210 as the more important number.

Again, it's really up to your personal preference though how you want to manage the extra info. It's most important that it makes sense to you.
 
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