Need advice please!

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Adam Flowers

Adam Flowers

Member Since 2017
Can someone please look at Mogee's SS and give me some advice. Please!

His PMPS and AMPS were super high last night and this morning. I thought maybe it was because his dose is getting to high and he is either dropping too low or is dropping to much to fast, so I reduced his dose.

Now he is 283 @ +7 today which is really high. I think I should have stayed with the 3 units but the pastcouple of weeks he has had two days where hedropped really low and it bugs me being at work during the day wondering if he is low so it is hard for me to give the 3 units.

Any advice??

Thanks guys!
 
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Alrighty guys. So this morning I increased Mogee's dose to 3.25 units as we discussed. He is having a great day thus far. I just tested him @ +5 and he is 76.

Is that too far of a drop from an AMPS of 322? I guess now my big concern is tomorrow I will not be able to test him until my lunch break from work at about +7.5. Worried he may drop lower when I am not here. Just stinks as when I give the 3 units, he doesn't drop nearly as far.
 

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That's a really beautiful number! He's about at nadir, so most likely, he will remain safe. Why not keep an eye on things today and let's see what happens...it's nerve-wracking, but as long as he doesn't drop lower and is in the same range, this dose seems to be giving him a good cycle. It's possible he'll bounce too and remain high and flat tomorrow...hard to know. I'd wait until we see what the rest of this cycle brings before we think about tomorrow.
 
Rachel said:
That's a really beautiful number! He's about at nadir, so most likely, he will remain safe. Why not keep an eye on things today and let's see what happens...it's nerve-wracking, but as long as he doesn't drop lower and is in the same range, this dose seems to be giving him a good cycle. It's possible he'll bounce too and remain high and flat tomorrow...hard to know. I'd wait until we see what the rest of this cycle brings before we think about tomorrow.
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Yes. I am not worried about a hypo today. Just more concerned if he dropped this low on the initial dose change, how low will he go tomorrow if I'm not here. It's just so crazy how 3 units doesn't out him below 100 but .25 more puts him near the low low mark.
 
Nice numbers! It's a large BG difference from AMPS to nadir but he's not a big bouncer so you should be OK. Are you using an automated feeder? If so you could have it timed to open a bit before nadir while you're away at work. It would be nice to see more of what this 3.25 u dose can do.
 
Nice job, Mogee! I agree with Kris and Rachel - so far he's been a pretty steady kitty, so see what happens tonight, but I'd guess he'll be fine. A fairly typical pattern is to have a great initial response, and then settle out a little higher on a dose, so my bet is that the cycles after this will stay safe.

Unless of course he goes long tonight and you end up with a lower-than-normal PMPS...then it might get a little trickier ;)
 
I think you might be fine with 3.25 again tomorrow. As Kris says, an auto feeder could help. But it looks like Mogee stayed safe today, so if you get something similar tomorrow, you should be fine. If I recall you shoot at 5 AM EST? That's 4 AM my time...I'm not usually up that early, but I am usually on around 4:40 my time (5:40 your time). Could be earlier depending...I'll try to check in as soon as I feed my little ones tomorrow, but will probably be past your shot time.
 
Went ahead with the 3.25 this morning, even though I was scared to, given Mogee was only 262 AMPS.

I could only make it until 9:30 at work this morning until I just had to come home to make sure he was okay. He was 232 @ +4? Which is the highest he's been at that time all year. And after that great AM yesterday, Mogee didn't go low at all last night either. It will be interesting to see what the 3.25 does tonight with a PS of 283.

Is there a reason his numbers would appear flat or higher than normal after that nice AM yeaterday? I know I need to just ride it out.

As always, any advice is appreciated. We are so grateful for all of you.
 
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Not a bounce, just a flat cycle from the lows yesterday maybe?? Just a random guess on my part, someone who really knows will be along shortly I'm sure :)
 
Alas, it's just the bounce cycle:
1. Mogee goes lower than normal
2. Mogee goes high and flat
3. Mogee starts responding again (or gets stuck and you have to increase the dose again)

The high flat part can last up to six cycles. So tonight is cycle 3. Some kitties only get stuck for a couple of cycles, some get stuck for all six, and some just get stuck. Then you do another increase to get them unstuck and moving again. I would give him another day to see if he gets back to work. This part is really hard. Waiting is no fun. There isn't really a way to speed it along though since his last responsive cycle took him to 67. But there isn't any need to worry about the high flats. They are just part of the process. This is the part where we usually tell people they have to get out their "patience pants"...:)
 
Djamila said:
Alas, it's just the bounce cycle:
1. Mogee goes lower than normal
2. Mogee goes high and flat
3. Mogee starts responding again (or gets stuck and you have to increase the dose again)

The high flat part can last up to six cycles. So tonight is cycle 3. Some kitties only get stuck for a couple of cycles, some get stuck for all six, and some just get stuck. Then you do another increase to get them unstuck and moving again. I would give him another day to see if he gets back to work. This part is really hard. Waiting is no fun. There isn't really a way to speed it along though since his last responsive cycle took him to 67. But there isn't any need to worry about the high flats. They are just part of the process. This is the part where we usually tell people they have to get out their "patience pants"...:)
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Thank you for all the information and advice. As I thought, something I will just have to ride out. He seems fine and happy. I will keep you guys updated on how he does so that you are able to help me decide what to do with his dose!

Appreciate the help!!
 
Just hoping there's not another underlying issue. First time since diagnosis he has been this high @ +3. I know I need to put on my patience pants but worry overwhelms me.

Even when he's hit those low numbers in the past, never has he stayed high for this long.
 
So.. Mogee got down to about the mid 200s last night and today got in the mid 100s on the 3.25 units..

I just went to test him for him PMPS and it was 81?!?!

I tested again to make sure, 92?

Obviously I stall and don't inject. How long do I wait to test again to see if he goes up at all (usually shoot if over 180)?

How long do I wait before I can feed him?
 
Don’t feed. You can test again in 20-30 minutes. You don’t want to feed until we see if he’s rising on his own.
 
Does this mean he needs a reduced dose as Well? Is the 3.25 units too much? Obviously I'm not injecting a 94, but how did he get this low when he was 163 @ +5?

He's a hungry boy. When can I feed?
 
It's a long cycle - the insulin hasn't worn off yet. I hate to have you skip tonight, but I also don't want you to starve him when it doesn't look like he's going up in any hurry. Go ahead and feed.
 
Shoot - it doesn't look like Kris is around. Don't give up on shooting yet. You may be able to shoot a little late tonight if the food gets him going. I'm heading into a meeting and am going to keep my fingers crossed that Kris, @Rachel or @StephG login soon and can walk you through figuring out a possible dose for a little later.

Basically you wait for the food to raise the BG, and then give a reduced dose a little off schedule. The reduced dose will be better than nothing, but still wear off before morning, so you should be able to shoot near to your regular time in the morning. I'll be back in about an hour, maybe a little less if I get lucky and we are efficient ;-)

So assuming this next test isn't a 200 (which seems unlikely), go ahead and feed, and I'll keep my fingers crossed someone logs in to walk you through the next part. If not, I'll be back as soon as I can, but really, it's okay to feed him now. I know how tough it can be to make them wait!
 
@Djamila you rock!

Just tested again. 94, which is 55 minutes after he is supposed to get his injection.

I am going to feed and then I have to run and get more strips!

Based on what I read on the Prozinc stickies, I should test him again @ +2 and we can go from there?

Thanks again. Just let me know how long I should wait to test and post again. You're the best!
 
Just seeing this now. You can try what Djamila described: feed him, retest 30-45 minutes after food and give a small dose so he's not sky high in the morning. Post as soon as you have that test and we can decide on the reduced dose.
 
Chris & China said:
How long can your schedule be off?
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Hi Chris,
You have about an hour's leeway with ProZinc before you have to adjust the dose. If it's longer than that you can get back on schedule using increments. Also the low-ish PMPS, feed test a short while after food and give reduced dose is something that can be done with this insulin.
 
Sorry just saw this! I see Kris is here, and gave the exact advice I would! Feed, retest in 45 or so, and shoot token dose. I won't be here probably when you get that number...Kris will you still be able to be around?
 
Rachel said:
Sorry just saw this! I see Kris is here, and gave the exact advice I would! Feed, retest in 45 or so, and shoot token dose. I won't be here probably when you get that number...Kris will you still be able to be around?
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Yes, I'll be here to check in.
 
Mogee gets tested, fed, and given insulin at 5:45 am CDT. All within about 5 minutes.

I do not leave for work until 7:00...

I can get up earlier, as I have an alarm set for 4 am to take his food away..
 
Hooray! I'm so glad you guys got the tag. I felt awful abandoning Adam like that!

Whoa - Mogee is in no hurry to shake off that AM dose, is he? And you were worried he wasn't responding enough yesterday! ;)

So you're about two hours past regular time now, right? Which means +14 (if I've counted that right). Prozinc rarely lasts past +14, so he's gotta rise soon. How's he doing with the extra tests? I'm inclined to say give it another 30 minutes and test again as I'm not super comfortable having you shoot on a 128. Let's see what Kris says.... I do want to be mindful that we are right on the edge of the latest you could shoot in the morning before walking out the door.
 
Djamila said:
Hooray! I'm so glad you guys got the tag. I felt awful abandoning Adam like that!

Whoa - Mogee is in no hurry to shake off that AM dose, is he? And you were worried he wasn't responding enough yesterday! ;)

So you're about two hours past regular time now, right? Which means +14 (if I've counted that right). Prozinc rarely lasts past +14, so he's gotta rise soon. How's he doing with the extra tests? I'm inclined to say give it another 30 minutes and test again as I'm not super comfortable having you shoot on a 128. Let's see what Kris says.... I do want to be mindful that we are right on the edge of the latest you could shoot in the morning before walking out the door.
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I know. I was so worried yesterday. Crazy how this all works.

I will test again in 30 minutes and post it at 8 pm cdt.

Thanks again!!!
 
OK. His evening shot would be almost 2 hours late, right? So - given that factor and also that his BG is only 128 I was going to suggest 1 u. I like Djamila's idea of waiting another 30 minutes but my feeling is he won't be a lot higher.
 
Kris & Teasel said:
but my feeling is he won't be a lot higher.
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You're probably right, but it has to wear off sometime! I feel good with the 1u as well. And that puts your shot time at 8pm, which means you can definitely shoot at 7am (numbers willing), but can most likely shoot at regular time since I can't imagine one unit won't have worn off in plenty of time.
 
You guys are great. Still waiting to get that 8pm reading.

I trust you guys but it does worry me to shoot low, given I have never done it before. But it also worries how high he may be if he gets none at all.

Just another new step in this process.
 
Kris & Teasel said:
Chris might be referring to dosing later this evening and how that will impact what you can do if your AM dose time is set by needing to leave for work
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Yes....when you stall, what you can do and when you can do it also depends on your shooting schedule. Luckily with ProZinc you have a little more flexibility with time, but it's important that we know how much flexibility you have
 
Chris & China said:
Yes....when you stall, what you can do and when you can do it also depends on your shooting schedule. Luckily with ProZinc you have a little more flexibility with time, but it's important that we know how much flexibility you have
Click to expand...

Good to know! I posted my AM availability above.
 
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