Low numbers without shooting + Bruce’s Glucose Curve

Forgive me for not reading through your whole thread, but when was the last time he had his teeth cleaned? That might sound silly, but there is a strong connection between dental health and blood glucose numbers. I'm wondering if he might be having an absorption or something that is suddenly driving the numbers higher....?
 
I got it May 17. I was wondering if that could be our issue. I’m able to leave work early today so I’m going to do a +6 on him and see where he’s at.
 
I think (could be wrong) Bruce’s new goal in life is to make me look like a goofy human and see how much I can worry about him. BG 78 at +6. I can’t wait to see what he does tonight!
 
Okay, I ended all dry food a few days ago. I l give his siblings some kibble in their wet food but he gets only wet. I supervise him while eating so I know he’s only eating his Fancy Feast; as soon as he’s done I make sure everyone else cleaned their plates. I’ve been sticking with a .25 dose. And what does he do? “Hey Ma, watch this BG go up! Isn’t that funny?”

:banghead:

Maybe I should go back to the drop dose? I don’t know... I’m definitely at a loss.
 
I wouldn't reduce the dose right now. My hunch is that Bruce is in need of more insulin and that the duration at this dose is too short. A little increase will help it last longer, which should also help lower the PS numbers.

How are his teeth? Any chance he's in need of a cleaning/extractions?
 
Djamila said:
How are his teeth? Any chance he's in need of a cleaning/extractions?
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When he had a thorough checkup at the vet in May, our vet said his teeth were good. I initially thought that was a reason he was so sick.

I bumped up his dose and his BG has been up, as well as the +3/4/5 I try to do. I’m at a loss. I’m going to purchase another bottle of ProZinc soon.
 
Okay, Bruce sent his message to me loud and clear. I dropped his dose back to .25 and it went down.

Dropped it to a drop dose after a AMPS of 141 and he went down even more!

I feel comfortable giving him the drop dose around 150. I debated the 141 but decided to go for it as he ate really good. I think that will be his lower limit for a shot for now.

If he remains relatively stable, I’d like to get one glucose curve in with the drop dose.
 
Interesting. You could also try a dose of 0.10u to see if that provides a little more duration without dropping Bruce too low when you can monitor. While his mid cycle numbers look good, it would be nice to see those pre-shots come down a bit more too.
 
Oh WOW! I'll keep my mouth (or my fingers!) quiet from now on! Seeing what Bruce did last night on a drop dose, I don't blame you for being uncomfortable shooting tonight.
 
Went away for a few days. Long story short, I won’t do that again, even though I’m sure Bruce enjoyed his high carb buffet he got. :banghead:

I was hoping that a few days of our routine would get him back into normal mode, but nope. Thankfully no ketones. Bumped him to .25 because he’s been so high. Last night was his second cycle, but he is barely dropping. Not sure if I should try his somewhat normal drop dose again and see where he goes? Or do I increase the dose and see what to do from there? With exception of a short evening shift at work and a few errands I need to run, I can keep a pretty decent eye on him this weekend.

:arghh:


@MrWorfMen's Mom ... this cat. :blackeye:
 
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So pray tell....what was this high carb buffet Bruce enjoyed in your absence? Dry food? ;) That can screw up numbers for several days after the buffet is no longer on the menu.

Looks to me like Bruce's BG is starting to come down today. I think I'd hold the course for the moment and just keep an eye on his numbers as he'll likely need to go back to his lower dose in the near future.

Sorry for the delay. I didn't get the tag.
 
MrWorfMen's Mom said:
So pray tell....what was this high carb buffet Bruce enjoyed in your absence? Dry food? ;) That can screw up numbers for several days after the buffet is no longer on the menu.
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My dad (aka Grandpaw) sucks at following directions. :rolleyes: He did what he always did before, which was topped off the food tree with SO dry, replenish water, and put out wet food.

Do you think I should go to the drop dose tonight? I don’t like that he doesn’t have much of a nadir on .25.
 
Last night and today have been pretty flat which can sometimes be an indicator that an active cycle is coming. You can try reducing him down to a drop again and if he stays higher you can always go back up. He may need a bit of extra juice for a few more days to get back on track.
 
I decided to keep him at .25 for the night because his PMPS was 370. I’ll be home and check him every few hours. I’m expecting a vicious bounce soon. I’ll assess in the morning.

Weird question, but is a drop dose with a U100 the same as a drop dose with a U40? My assumption is that they are different because of the difference in diameter.
 
You're right. The drop dose would be different between the 2 syringe sizes. The drop dose is relative. It's really just a way to get a smaller dose and have everyone understand what amount of insulin is being given. The point is to be able to consistently shoot the same amount rather than precise accuracy which isn't possible with any syringe because the lines are often a little wonky.

That looks like a bounce already. Wonder what he did in the last 6 hours of today's cycle.
 
Bruce and I had sleepover last night! I checked him throughout the night. This is what we got.

370 PMPS (.25 dose)
234 +3
222 +6
374 +9

I feel like the logical thing thing is to increase his dose this morning. But I also know he doesn’t like insulin and when I increase, I tend to have more problems where he doesn’t drop very much. I just get nervous when his numbers have been this elevated for so long... this is not his norm.
 
Are you sure Bruce doesn't have something else going on....a UTI, a bad tooth? Has his water intake/output changed since before your few days away? Has his activity level changed?
If you can monitor today, you could bump him up to 0.5u and see what he does. It may be that he got a little stuck in higher numbers and just needs a little kick to get back to business.
 
He’s acting normal. I would say his water intake has stayed the same... he is peeing okay, which is always my concern. I tried looking in his mouth and from what I could see he looks fine. Activity level is normal. If I didn’t see the glucose meter readings myself, I’d assume he’s at his normal levels and normal dose. He’s just getting a tad grumpy that he’s getting poked a bit more than normal, yet he jumps up when I get the glucose meter because he knows he’a getting a treat.

I’ll be home most of today and all of tonight and a good chunk of tomorrow. I might see where this .5 takes us. From my experience, when his dose is a bit high, he drops pretty quickly and dramatically.
 
Yeah! I felt good when his +2 was 210... ecstatic about a +5 of 98! Now let’s see how dramatic he gets later on. I did give him a spoonful of his normal FF classics after his +2.
 
So Bruce was a bit elevated today during his midday reading... elevated tonight PMPS 348... appetite is a bit less than normal and his poop is not diarrhea, but softer than his norm. I’ll be keeping an eye on him tonight. He is making his mama work. :(
 
Well, I was going to write a lamenting message as to Bruce’s high blood sugar lately and how his appetite isn’t normal and how I don’t know what to do, but the solution apparently is to make sure that the sealed cardboard box of his sibling’s kibble is nowhere he can access it.

:banghead:

Hopefully better readings tonight and tomorrow!

80781BC7-21FD-4273-9CA3-BE66E47702EA.jpeg 4341CF67-8629-4CA4-8F7B-53066CD7A69B.jpeg
 
So a stupid question—at what point do I increase Bruce’s dose? Or decrease because he’s such a stinker?

To me, he should be dipping a bit lower during his mid readings. I’ve been trying to get a reading from him as close to +6 hour as I can and to me his nadir should be lower than it is.

I do have U100 syringes that I could try a .8 dose. He’s so finicky that I hesitate to increase. Last time I gave him a .5 dose he stayed up; I dropped it and his BG dropped.

I’m trying to plan ahead. I’ll be able to check him mid cycle AM and PM 8/29; but I won’t be able to check his 8/30 AM cycle until +9 (still able to check and shoot for AM, but stuck at the office all day). For the most part, I’ll be able to keep an eye on him over the weekend.
 
I agree you want to get Bruce's mid cycle numbers lower but you really want a downward shift across the board not just the middle of the cycle. Usually the middle of the cycle is the first to come down because we deal with those pesky bounces that occur from mid cycle lower numbers.

Generally I'd reduce if BG goes down to roughly 90 or lower mid cycle for starters. As for increases, I'd hold a dose for at least 3 days, possibly up to 5 days depending on the results you are seeing and increases/reductions should be 0.25u or slightly finer using the U100 syringes.

Nadir or lowest point in the cycle with ProZinc generally occurs between +4 and +7 hours. It may or may not occur at exactly the same time each day. Nadir can and does move. I'd scatter midcycle testing across that 4 hours time frame rather than necessarily trying to keep close to +6 all the time.

It looks like Bruce is working that 0.5u a bit better now (love that yellow start today) so I'd hold the dose for today and see what he does. Maybe a product of removing the buffet he found for himself! ;) I always suggest doing increases when you can monitor the cycle so holding the dose for another cycle or 2 is fine. Safety first.
 
I tried four cycles with .8... he did well until cycle 4 when he hit a 67 at +3. As I had to work around 5.5, I got nervous so I fed the very hungry, starving lad! Expecting some weird numbers by going back to .5, but I’d rather regulate there than having him go too low when I can’t check on him on the work day.
 
How about just doing a skinny .8u? Line the stopper up at the top of the 2u line on the U100 syringe instead of right on the line. You'd be surprised the difference such a miniscule change can make. Bruce was in no danger yesterday but I agree you don't want him going any lower.
 
I’ll try that! He had .5 last night and this morning. We are going to stay there for a few days. It seems like there is always a dramatic change for him after about 4 to 6 cycles.
 
Some kitties just take longer to figure out what to do with a new dose than others. The first couple of new dose shots often result in wonky numbers that make no sense whatsoever and them WHAM! Not unusual at all....just frustrating.
 
Our sweet spot is a skinny .8! Or at least that’s where we’ve been at now for five days. I’ve noticed for the past few days he’s been finishing his whole dish of food instead of walking away and finishing it later. In fact, he just licked his dish clean. Can’t wait to see his inevitable bounce!
 
Nice improvement. Love that green! It would be nice if those pre-shots would come down a bit more. They might be from a bit of bouncing from the lower mid cycle but they seem to be gradually dropping. :D
 
Ask and you shall receive! 152 this morning. Waiting 20 and retesting. If it’s still hovering around 150, I don’t feel comfortable giving him a shot because I won’t be home to keep an eye on him. I thought about a drop dose, but I feel like it’s a very dramatic change to go from a skinny .8 to a drop dose.
 
If you were able to monitor I would suggest dropping the dose back a wee bit to 0.6u but since you can't I think a drop dose would probably be fine. Just leave some food out for Bruce to munch on in your absence. Take dose back up to 0.6u tonight and Bruce will get back on track soon enough.
 
Oh good, this was my exact plan! I gave the drop dose after seeing he did alright with a drop during his mid 100s before. Im also leaving out a can or two of food before I go to work. I’m going to attempt to stop by home, but I just don’t know if I’ll be able to do that today. I’ll see how things are tonight—I’ll be able to keep an eye on him for his PM dose. Thanks!
 
Okay, I’m back to being boggled by this boy.

I have admittedly not been as good about mid cycle checks as I was. Bruce’s numbers have been kind of high lately. But something bizarre happened this past week.

I had to go away for a few days with little notice. I took Bruce to my boyfriend’s place. I gave him strict instructions to not allow Bruce to graze on his cats’ food, so Bruce stayed in the bedroom the whole time. My boyfriend didn’t feel comfortable giving him shots, so I kept my fingers crossed and figured I would brace myself for sky high numbers when I came back.

His last insulin dose from me was Wednesday AM, he was a 373. I came back Friday morning—so that would be missing three insulin shots. I told my boyfriend to feed Bruce a half of a can of FF and I would give him his regular amount when I got back.

I braced myself. And got a 271 after he ate about 2 hours prior. He ate his full one can for me, I gave him his shot, and that evening, he was at 216. And ever since then, he’s been climbing up.

Now, there is the factor where we still are at my boyfriend’s place, so this isn’t quite his place and he tends to run a tad higher here. But I’m perplexed as to why his numbers are climbing with his insulin shots. Is his dose too high?
 
HMMM! Interesting. While I can see how you would conclude that the dose might be too high, I am wondering if the extra food he's now eating again is more than what the insulin is able to deal with for him. The fact that the amount of food given was half of his usual during the days without insulin would lower his BG overall. I'm more inclined to think Bruce may need a little dose increase. If the dose was too high, I'd expect his BG to be dropping to lower levels and if he was going lower than you are seeing, that BG might be even more elevated due to bouncing. I'd suggest getting back into the habit of checking BG during the mid cycle as often as possible and also to always get at a minimum at before bed test to see what Bruce is doing overnight. Right now you are missing half the day's data when no night test is done.
 
Oh, he only had a half of a can the morning I was flying back—I wanted Bruce to be able to have something while my boyfriend was at work just in case my flight was delayed—which it was! He had a whole can when I came back and that is when he got his insulin again. I just confirmed with my boyfriend that Bruce had his normal AM one can and PM one can while I was away. He is at 384 tonight. I think I may adjust tomorrow evening when we are back at home—I’m sure being away has an influence on some of these numbers.
 
So if you think his numbers might be elevated because he's out of his normal environment, then hold off for a day or so before making any adjustments and see what he does. Don't want to be increasing doses if BG is artificially elevated due to a bit of stress. :)
 
After a few cycles, I decided to bump Bruce just a tad to .6–I have both U40s and U100s. He’s staying high! He’s eating now and I’m going to be shooting him with a 0.8. I’ll be able to stop by around +3 to check on him, plus I have the weekend to keep an eye on him.
 
That 0.8 dose did nothing for him. He was going down a bit over the weekend, and then shot back up again. In his defense, yesterday PMPS he seemed like he was trying to hack up a hairball. He’s also been acting like a starving kitty lately, so when he seems the glucose meter he’s getting worked up.

I am going to buy a new bottle of ProZinc soon. I’ve been using the U100 for his .6 and .8 shots, and it’s weird, but he cringes when he gets the U100. Everything is the same, he just feels the U100 for some reason. So I may give him an easily measured U40 dose tonight depending where he’s at. I’m pretty frustrated considering his numbers were better a few weeks ago when he wasn’t getting insulin!
 
Looks to me like he's bouncing. Bounces are relative. He's not used to being in blue numbers so when he gets to blue his defenses kick in and then you end up with higher numbers. I'd hold the course for the moment. The bouncing will ease off as he gets used to those lower numbers. Also try to get a BG EVERY night before bed. It won't show his lowest BG of the night but it can often provide clues as to where kitty is headed for the night. If BG is same or down +2 or +3 hours post shot at night, chances are good the cycle will be a little more active. If numbers are up at +2/3, chances are good it's going to be a flat or rising cycle.
 
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