Ricky's PMS is 224 points lower than his AMS. Do I give smaller dose?

[PamJV]

The last 6 days I have been trying 4 units again. Today I did another glucose curve with results of a high AMS of 392 then straight downward to a nadir of 131 at +9 hours ! His PMS was 168 which is 224 points lower than his AMS. What does this mean? Is his dose is still too high, or is it that the Lantus is staying in his system longer and there is overlap of effect, possibly a bounce during the night?

I don't think I should give the 4 units tonight. Should I give a lower dose? Or wait and test again in two hours?

Today he did looked better, fur shiny and more awake than before.

 

[Chris & Lucy]

Ricky gets some crazy looking curves. His nadir is really late in the cycle. And the Lantus seems to really carry over for him into the next cycle. I think the important number is the PMPS that shows he's on the way back up. And that Lantus takes quite a while to kick in.

 

[PamJV]

Ricky gets some crazy looking curves. His nadir is really late in the cycle. And the Lantus seems to really carry over for him into the next cycle. I think the important number is the PMPS that shows he's on the way back up. And that Lantus takes quite a while to kick in.

Yes, he has gotten crazy curves which makes it hard to figure out what is the right dose. I had previously tested him on a 4 unit dose and back then it was a flat curve in the 300's.

I was so glad that his number actually did start to go up last night. That has made me wonder if his dose has been too high and he has carry over insulin in his system when I'm giving the next shot? Which then might cause a bounce producing a higher number at the AMS. Last night after the PMS 168 I gave 3 units as I was afraid of a drop going to low. This morning his BG was 326.

Maybe this means nothing, but I noticed that in the AM when his BG was higher he seemed more active and seeking out attention. Then the rest of the day he slept. So is that a result of his BG getting lower as the day went on? Or maybe he just had a sugar high in the AM because of having eaten during the early AM before I tested him?

 

[Lilly’s Mom]

Lilly does the same thing so I will be watching this for sure. I've tried pushing her night dose out a couple of hours to help combat the morning highs. She also sleeps most of the day but she roams much of the evening/night. I'm trying so hard to get that morning number down - so far, no luck of any consistency. For the next week I'm going to try pushing her evening dose out by a couple of hours....her daytime numbers slide down nicely but that morning number is always too high. I'll be watching this to see if anyone else has good idea's.

 

[PamJV]

Lilly does the same thing so I will be watching this for sure. I've tried pushing her night dose out a couple of hours to help combat the morning highs. She also sleeps most of the day but she roams much of the evening/night. I'm trying so hard to get that morning number down - so far, no luck of any consistency. For the next week I'm going to try pushing her evening dose out by a couple of hours....her daytime numbers slide down nicely but that morning number is always too high. I'll be watching this to see if anyone else has good idea's.

I have wondered if the morning high could be do to a bounce after the previous night shot ? Have you found pushing the night time dose out farther helps? I read that Lantus insulin can last for 12 to 18 hours. If it lasted for 18 hours that would mean the night time dose would get an overlap.

 

[PamJV]

Lilly does the same thing so I will be watching this for sure. I've tried pushing her night dose out a couple of hours to help combat the morning highs.

. I looked at Lilly's spreadsheet. Do you feed her at specific times or is she free feeding? This morning you got a morning low.

 

[Lilly’s Mom]

She eats at 12 hr intervals. I am not free feeding her. The other two cats do free feed so they are in different area's. At night I pick up the food so Lilly cannot get to any food.
On the spreadsheet, note that I waited to give her night dose till 9:30, instead of her usual 7:30. So Im wondering if holding off will help stave off those morning black numbers. Her morning numbers are typically the worst. So I tried it last night. I've found though that one time does not mean it works necessarily. Its a continual work in process for me. Yesterday, I was out of Tiki Cat so she had Fancy Feast pate....so still low carb but not zero like her Tiki Cat. I wondered if that made a difference. And she at 2 cans in the am instead of 1, (I was worried she wouldn't eat so I gave her two different FF to make sure she ate. ) Honestly, I can't figure out what works for her. She hasn't been off dry food for long so maybe it just takes time. But I will not give up. My goal is to get rid of those black and red numbers.

 

[PamJV]

She eats at 12 hr intervals. I am not free feeding her. The other two cats do free feed so they are in different area's. At night I pick up the food so Lilly cannot get to any food.
On the spreadsheet, note that I waited to give her night dose till 9:30, instead of her usual 7:30. So Im wondering if holding off will help stave off those morning black numbers. Her morning numbers are typically the worst. So I tried it last night. I've found though that one time does not mean it works necessarily. Its a continual work in process for me. Yesterday, I was out of Tiki Cat so she had Fancy Feast pate....so still low carb but not zero like her Tiki Cat. I wondered if that made a difference. And she at 2 cans in the am instead of 1, (I was worried she wouldn't eat so I gave her two different FF to make sure she ate. ) Honestly, I can't figure out what works for her. She hasn't been off dry food for long so maybe it just takes time. But I will not give up. My goal is to get rid of those black and red numbers.

It looked surprising that today you gave 2 units with AMS of 76 but then the BG did not go lower, instead it climbed a bit but was fairly flat all day (92, 84, 115) but then by the 11+ or 12+ hour it shot up to 499. Did she have a very big meal before the PMS reading? I wonder what is the explanation to go from 115 to 499 in just two hours? What does your vet say ?

 

[Lilly’s Mom]

No, I never feed her before I take her blood reading. She eats at 7:30am and 7:30pm with shots usually at 8am and 8pm. I never leave food down. Thats what the vet said to do so thats what I have been doing. I cannot figure out why she has such swings. In any event, we have a much bigger problem right now. We are having a family reunion and someone left her door open and she is out somewhere and I cannot find her. Even when she has gotten out before, she has always stayed right on our lot...about 3/4 acre. But its always just us and its quiet. Now there are people everywhere and she is a fraidy cat.....so I'm concerned she won't come back because of all the people. I'm looking and looking but so far, no Lilly. She missed her am shot and feeding so I'm certain she is not doing well. So right now, finding her is my big concern.

 

[PamJV]

No, I never feed her before I take her blood reading. She eats at 7:30am and 7:30pm with shots usually at 8am and 8pm. I never leave food down. Thats what the vet said to do so thats what I have been doing. I cannot figure out why she has such swings. In any event, we have a much bigger problem right now. We are having a family reunion and someone left her door open and she is out somewhere and I cannot find her. Even when she has gotten out before, she has always stayed right on our lot...about 3/4 acre. But its always just us and its quiet. Now there are people everywhere and she is a fraidy cat.....so I'm concerned she won't come back because of all the people. I'm looking and looking but so far, no Lilly. She missed her am shot and feeding so I'm certain she is not doing well. So right now, finding her is my big concern.

I am so sorry to hear that. I will be praying for you to find her. Can you ask everyone to go inside and be quiet. That might help you find her.

 

[SpotsMom]

So sorry your kitty is on the lamb! I'm sure you've tried everything at this point, and I don't know how food motivated she is, but my guy will come running from across the yard at the sound of a can of food being cracked open. Every time he plays escape artist that's how we get him back in. Won't be much help if she's scared or wandered too far though. Hope you find her soon

 

[Lilly’s Mom]

Yep, I’ve walked around shaking her treats - which she LOVES and I put her litter box outside. Someone said smelling her litter might draw her. I’m going to do another walk around the neighborhood now

 

[Tanya and Ducia]

The last 6 days I have been trying 4 units again. Today I did another glucose curve with results of a high AMS of 392 then straight downward to a nadir of 131 at +9 hours

Hi Pam,
sorry but I cannot see any updates in the SS past June 13th.
Was it the last curve you've done? The last test you have taken?
My old PC is tired and perhaps it is me who can't see.

If you have any more data would you please enter in to the SS?
Hard to see what's up w/o data taken in recently.

RC Glyco balance is extremely high in carbs. The flat yellow cycle on AM 6/13 could be blamed on that food.
Congrats on beating the nephropathy! (from you Sig: PLANTIGRADE GAIT CURED!)

 

[PamJV]

Hi Pam,
sorry but I cannot see any updates in the SS past June 13th.
Was it the last curve you've done? The last test you have taken?
My old PC is tired and perhaps it is me who can't see.

If you have any more data would you please enter in to the SS?
Hard to see what's up w/o data taken in recently.

RC Glyco balance is extremely high in carbs. The flat yellow cycle on AM 6/13 could be blamed on that food.
Congrats on beating the nephropathy! (from you Sig: PLANTIGRADE GAIT CURED!)

I did enter the data I have. The last curve was on 6/19/18. I will be doing another curve this week. Vets say that it's not the amount of carbs but the carb source that matters. Ricky is on less insulin now than when he was eating EVO and EVO only had 5% carb. I really don't know but I am down to just feeding him what he will agree to eat and if that means more insulin that's fine. He's 14 and has a heart condition so I'm just trying to make him happy plus manage his diabetes as best I can. He won't eat the lower carb foods like YAZ or Epigen. None of my cats will eat YAZ or Epigen