Mimi 11/20 PMPS 212, +1 248, +3 139-- is she thinking of swimming tonight?

Good Morning Rosa! Looks like Mimi is a little high at the end of her cycle. What is her AMPS for today? There's nothing on her SS for today. Did you give her a shot? Apologies if your time is different and that's still coming...I don't know what time you usually test/feed/shoot.
 
Sue and Luci said:
Good Morning Rosa! Looks like Mimi is a little high at the end of her cycle. What is her AMPS for today? There's nothing on her SS for today. Did you give her a shot? Apologies if your time is different and that's still coming...I don't know what time you usually test/feed/shoot.
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Not yet. I’m going to very shortly. I did her +11 at 8:45
 
Mimis mom said:
No. I just eyeballed it a touch. Didn’t go quite to the .75. I really need to get one. I’m going to today
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The problem with syringes is that they are made in a factory and the lines are not all printed in the exact same place, they can vary up to .25 of a unit either way. I Have had a few that were way off. Calipers really help to keep your dose consistent.
 
So... I kind of did something- first I want to say I need a digital caliper so I don’t drive myself nuts with accuracy which I think I’m pretty decent at but I would like to be “checked” there’s a part of me that wonders how close I actually am to these decreases and say the off chance it went low yesterday because I gave her 1.1 units - because I’m eye balling it you know? So today I didn’t go quite to the .75- I went just a single hair above it- to possibly .90? It’s my own experiment because I’m still nervous about her getting too little insulin having DKA in her history regardless of how long ago it was. I am also home to monitor it today- but I wouldn’t see the impact right because it’s possible she will be high because of how low she was yesterday?
I didn’t test her during the night because I’m also nervous it’s stressing her out and she’s the kind of cat that I think let’s stress make her ill. I think she internalizes what bothers her- I could be sounding bonkers but it’s just the energy I get from her vs r other cat who lets you know when you’re pissing him off. Testing has become thing dreaded thing for me and her- but has been at least better since going back to the freestyle but still. I also hold pressure on her ear after a prick, and put neosporin on it but I still think she’s getting some hardening where I poke - even it’s it’s in a different spot. She seems very reactive to any trauma. She got those hard lumps of injecting in the same spot only after a few weeks, and she seems to scar easily. Again- might just be me overreacting..
 
Sandra And Buddy said:
The problem with syringes is that they are made in a factory and the lines are not all printed in the exact same place, they can vary up to .25 of a unit either way. I Have had a few that were way off. Calipers really help to keep your dose consistent.
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How were they way off? You mean when measured against the caliper? Can someone again just post what caliper to get - it’s just a digital one right? I know I was sent a link to one somewhere but it’s been lost in the feeds
 
Mimis mom said:
How were they way off?
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if you hold them up side by side the lines on 1 syringe were lower than the other.

Mimis mom said:
Can someone again just post what caliper to get
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https://www.harborfreight.com/4-in-digital-caliper-63710.html

A lot of people use these ones, I had trouble with them because the upper and lower jaws were not the same length, I ended up with a pair from Lowes. Make sure which ever pair you get has a locking screw, then you don't have to set it every time.
 
Sandra And Buddy said:
if you hold them up side by side the lines on 1 syringe were lower than the other.



https://www.harborfreight.com/4-in-digital-caliper-63710.html

A lot of people use these ones, I had trouble with them because the upper and lower jaws were not the same length, I ended up with a pair from Lowes. Make sure which ever pair you get has a locking screw, then you don't have to set it every time.
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does the one from harbor freight have a locking screw? If you had better luck with the one from Lowe’s maybe I’ll go there instead
 
I hope Mimi slides down for you today Rosa! I switched to callipers a few months ago and so far I do like it, I feel a lot more confident in my dosing consistency. I will admit that it took me a few days to catch on and feel confident so don't be discouraged if you're struggling when you try!

If Mimi gets stressed with testing I think it is smart that you're being strategic with timings, just gradually fill in the data across time frames so that you can get somewhat of an impression of how she is doing :)
 
@Mimis mom
Rosa, I have just looked at Mimis SS and see you have decided to try only reducing the dose by 0.1 and going against the advise of experienced people to decrease the dose by 0.25 after dropping to 43.
I would strongly urge you to reduce the next dose down to 0.75 units as advised otherwise you are risking Mimi dropping under 50 again when you are not there to bring her back up to a safe number.

Those tiny increases/ decreases such as 0.1 are not for when you have earned a decrease in dose but when you are just tweaking the dose when you have just about found the correct dose. We are not there yet with Mimi.
 
Bron and Sheba (GA) said:
@Mimis mom
Rosa, I have just looked at Mimis SS and see you have decided to try only reducing the dose by 0.1 and going against the advise of experienced people to decrease the dose by 0.25 after dropping to 43.
I would strongly urge you to reduce the next dose down to 0.75 units as advised otherwise you are risking Mimi dropping under 50 again when you are not there to bring her back up to a safe number.

Those tiny increases/ decreases such as 0.1 are not for when you have earned a decrease in dose but when you are just tweaking the dose when you have just about found the correct dose. We are not there yet with Mimi.
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I will I was just nervous I gave her 1.1 units when she dropped. Just being paranoid- I guess I’m just surprised she got dropped so quickly and worried it could be due to a simple error on my part, or maybe my little girl is fixing herself!
 
Mimis mom said:
I will I was just nervous I gave her 1.1 units when she dropped. Just being paranoid- I guess I’m just surprised she got dropped so quickly and worried it could be due to a simple error on my part, or maybe my little girl is fixing herself!
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Always discuss this if you are unsure. Not in PMs as we are not allowed to give dosing advice in a PM. It must be here where everyone can see. This is a peer review board so that if someone doesn’t agree with what is said, they can have their say.

I would not make dosing decisions on your own yet until you are more experienced. You are learning heaps and it’s great you want to learn more, but with the dosing, listen to the experienced people at this point.
So next dose should be 0.75 units.
Are you happy with that?
 
Rosa, I have also just seen the SS I know that you don't like the high numbers, none of us do.

This is what it says on your SS
Seems very tired out. Didn’t run away after last test at 343. Didn’t keep in bed last night either. I wonder if high BC makes her feel crappy. Was reading up on TR and I saw you can decrease less even by .1 - so against advice to do .25 I’m trying the smaller reducie and I’ll be home to monitor. I just have this feeling .25 might a hair too much but it’s my experiment :)

I'm not sure what you are basing the 'feeling' on?? could you expand?
To Explain what is going on with her cycles.
  • lets look at Mimis numbers look what happened when you reduced from 1.25 to 1u,


  • upload_2019-11-20_23-5-54.png

  • she was yellow for two cycles (this was her bouncing) and then she came back down into blues, bouncing is normal, and we largely ignore these numbers when considering dosing
  • I suspect, that given that she jumped to pink on 11/17 late in the am cycle and given the mid blue amps, that she saw lower blue or even green either later in the pm cycle of 11/16 or early in the 11/17 cycle.
  • She held on to that dose reduction from 1.25 to 1.00u

I guess you saw that pink amps and tried to shoot it down by increasing the dose, but lantus is not dosed like that it is dosed based on the nadirs and you have to wait for the bounce to clear to see where that is taking you.

She seems to be clearing bounces every 2 to 3 cycles to clear the bounces so if I had to predict, I would say you would see her clear the bounce either tonight or tomorrow.

The Beauty of TR is that we don't have to wait long if we need to take her up.
I'd hate for you to be in a position to have to skip (far from ideal with the DKA) or get hugely off schedule because she was too low to shoot (below 50), not taking the full reduction could easily result in that sort of situation. Or have to rush her to ER because you can't get her numbers to stay up. I had one day when I was fighting numbers for almost 4 hours, George was hanging around in the 30's and 40's, just as he was getting full his numbers came up finally, I was getting ready to drive him to the vet, I'd even phoned the vet to warn her.

I hope the above helps explain the reasoning behind the advice.

I agree with Bron, I think you should be shooting 0.75u


How is Mimi feeling today? Have you done a ketone check?
 
Can someone link the video how to use the caliper? From what I am seeing- .75 is actually right on top of the line for 1- if you go off of the line it’s less like .60-so I actually gave her the correct dose this morning when I thought it was .90
 
let me see if I am lining the caliper up correctly- so measuring on the line- right at the bottom of it is 1, and right at the top of it I'm reading is .75 do you think I am using it correctly?
 
Gill & George said:
To Explain what is going on with her cycles.
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Thanks Gill for the screen shots and the explanation. It's very helpful to have a step-by-step explanation to start to better understand how to read the SS and interpret the meaning behind the numbers. One take away is to only change one thing at a time so a person has a better idea of what is influencing kitty's responses. Thanks for taking the time to share your knowledge and do a "play by play" of Mimi's spreadsheet. I am definitely learning from Mimi and all the people on here who are being so generous sharing their time and knowledge to help total strangers. It's very inspiring!:)
 
Gill & George said:
Rosa, I have also just seen the SS I know that you don't like the high numbers, none of us do.

This is what it says on your SS
Seems very tired out. Didn’t run away after last test at 343. Didn’t keep in bed last night either. I wonder if high BC makes her feel crappy. Was reading up on TR and I saw you can decrease less even by .1 - so against advice to do .25 I’m trying the smaller reducie and I’ll be home to monitor. I just have this feeling .25 might a hair too much but it’s my experiment :)

I'm not sure what you are basing the 'feeling' on?? could you expand?
To Explain what is going on with her cycles.

  • she was yellow for two cycles (this was her bouncing) and then she came back down into blues, bouncing is normal, and we largely ignore these numbers when considering dosing
  • I suspect, that given that she jumped to pink on 11/17 late in the am cycle and given the mid blue amps, that she saw lower blue or even green either later in the pm cycle of 11/16 or early in the 11/17 cycle.
  • She held on to that dose reduction from 1.25 to 1.00u

I guess you saw that pink amps and tried to shoot it down by increasing the dose, but lantus is not dosed like that it is dosed based on the nadirs and you have to wait for the bounce to clear to see where that is taking you.

She seems to be clearing bounces every 2 to 3 cycles to clear the bounces so if I had to predict, I would say you would see her clear the bounce either tonight or tomorrow.

The Beauty of TR is that we don't have to wait long if we need to take her up.
I'd hate for you to be in a position to have to skip (far from ideal with the DKA) or get hugely off schedule because she was too low to shoot (below 50), not taking the full reduction could easily result in that sort of situation. Or have to rush her to ER because you can't get her numbers to stay up. I had one day when I was fighting numbers for almost 4 hours, George was hanging around in the 30's and 40's, just as he was getting full his numbers came up finally, I was getting ready to drive him to the vet, I'd even phoned the vet to warn her.

I hope the above helps explain the reasoning behind the advice.

I agree with Bron, I think you should be shooting 0.75u


How is Mimi feeling today? Have you done a ketone check?
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AHHH!! Sorry I didn't notice the above response until I got to my laptop! The phone makes it more difficult to keep track of replies.
Thank you for taking the time to explain it!! I think because I had another member saying they didn't think the dose should have been decreased I wanted to balance both opinions (advice) and just try and do something in the middle. I am reading on measuring and there is so many small mistakes that can be made- like a .3 mm being outside the needle as a droplet!? what about if there are any bubbles in the syringe- they count as space right? I try so hard to draw the liquid up and push it back in until I stop seeing bubbles but there are teeny tiny ones that just won't go away.
Also- is "1 unit" is at the top of the line, the middle or the bottom? Also it could depend on what angle you're looking at the syringe right? do these .1, .2 mm really make that big of an impact on their systems since they have such tiny ones? They should come out with syringes that measure even .25 units special for our small sugar babies!
 
Judy and Freckles said:
generous sharing their time and knowledge to help total strangers. It's very inspiring!
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I 100 % AGREE!!!! I only wish I found this site when she FIRST got diagnosed it may prevented her from going DKA and putting me 8000$ in debt!!!! In a perfect world the vets would tell us at the first appointment along with showing you how to inject, to also stay in constant contact with a community dedicated to feline diabetes- and direct all newly diagnosed kitties here!!! IF ONLY IN A PERFECT WORLD....:bighug:
 
Mimis mom said:
I also don't even think I gave her .90 How do I really even know for sure if I didn't have the digital caliper yet. I think having one now will be a great help, once I figure out exactly how to use it.
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@Marje and Gracie would be the one to help set up and dose properly with your new calipers. Remember how I told you that the lines were not printed the same on all syringes? Don't use the lines with your calipers. You will use the spot where the plunger stops as your zero line.
 
I see that my Relion syringes are 1.32 mm for 1 u on the digital caliper. now, how do I know what mm is .75, or .50, or 1.25, etc? whats the math equation?
 
Mimis mom said:
I see that my Relion syringes are 1.32 mm for 1 u on the digital caliper. now, how do I know what mm is .75, or .50, or 1.25, etc? whats the math equation?
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0.13 mm = 0.1u
0.26 mm = 0.2u
0.33mm = 0.25u
0.39 mm = 0.3u
0.52 mm = 0.4u
0.66 mm = 0.5u
0.79 mm = 0.6u
0.92 mm = 0.7u
0.99 mm = 0.75u
1.05 mm = 0.8u
1.18 mm = 0.9u
1.32 mm = 1u
1.65 mm = 1.25u
1.98 mm = 1.5u
2.31 mm = 1.75u
2.64 mm = 2u
 
Mimis mom said:
let me see if I am lining the caliper up correctly- so measuring on the line- right at the bottom of it is 1, and right at the top of it I'm reading is .75 do you think I am using it correctly?
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ok wait- I just realized the numbers are mm, and they don't translate to units... ok so Relion is 1.32 for 1 unit.
 
Sandra And Buddy said:
In this pic, see where my top jaw is? That is incorrect. Measure from where the red line is. Basically ignoring the printed lines.


View attachment 49261
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aw man really? so Ive been measuring wrong the whole time then. are you saying the plunger is supposed to line up with that very top line always?

actually the plunger on my relion syringe does line up with the top line. I also decided I'm going to use my computer screen as the "light box" because those are 60$
 
Mimis mom said:
aw man really? so Ive been measuring wrong the whole time then. are you saying the plunger is supposed to line up with that very top line always?

actually the plunger on my relion syringe does line up with the top line. I also decided I'm going to use my computer screen as the "light box" because those are 60$
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nice blues he's had!!!! change your last reading to green? could he be heading towards a reduction soon? Mimi seems to be all over the place- he seems pretty balanced
 
Bron and Sheba (GA) said:
Always discuss this if you are unsure. Not in PMs as we are not allowed to give dosing advice in a PM. It must be here where everyone can see. This is a peer review board so that if someone doesn’t agree with what is said, they can have their say.

I would not make dosing decisions on your own yet until you are more experienced. You are learning heaps and it’s great you want to learn more, but with the dosing, listen to the experienced people at this point.
So next dose should be 0.75 units.
Are you happy with that?
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Yes I am. I would have discussed it but by the time I thought of doing it, in the moment, I couldn't stall her shot long enough to get a conversation going about it so I just made the judgement call. without a digital caliber who knows what I was really dosing anyway. could have been .75 all along
 
Mimis mom said:
aw man really? so Ive been measuring wrong the whole time then. are you saying the plunger is supposed to line up with that very top line always?

actually the plunger on my relion syringe does line up with the top line. I also decided I'm going to use my computer screen as the "light box" because those are 60$
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But it won't line up every time. That's why you just ignore the printed lines and use the true zero of the syringe.
 
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Gill & George said:
ketone check
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I haven't yet.. I will try and get one soon- either by urine or blood. I need a lot of blood (1.0 μl) and I usually wait till I draw a big amount (usually on accident or by chance) before I take it, which has consistently been at least once a day or once every other day. those strips are 2$ a strip- its insanity!
 
Rosa,
From what I can gather above you are saying that the measurements on the calipers do not marry up with the measurements on the syringe...Is that correct?
It is all about consistency..........
If you are going to use calipers now, you need to draw up 0.75 units on the syringe and measure what that is on the calipers, and that measurement is the dose you should be giving now.
If you are finding that 0.75 units on the calipers is more than 0.75 units on the syringe....than that would be an INCREASE in dose, not a decrease and we don't want that.
You need to be consistent with how much you are going.
Does that make sense to you..?
@Marje and Gracie
@Gill & George
Do I have this right?
 
Bron and Sheba (GA) said:
If you are going to use calipers now, you need to draw up 0.75 units on the syringe and measure what that is on the calipers, and that measurement is the dose you should be giving now.
If you are finding that 0.75 units on the calipers is more than 0.75 units on the syringe....than that would be an INCREASE in dose, not a decrease and we don't want that.
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Bron and Sheba (GA) said:
Do I have this right?
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This is how Marje and Gill explained to me and what I did when switching to calipers. I only jumped in to help her with this because I am also using the relion syringes and have just figured this out and am pretty confident about it. I hope I did ok. :)
 
Sandra And Buddy said:
This is how Marje and Gill explained to me and what I did when switching to calipers. I only jumped in to help her with this because I am also using the relion syringes and have just figured this out and am pretty confident about it. I hope I did ok. :)
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Sandy I have never used calipers. That is why I wanted more input:)
I'm just concerned Rosa may be giving more insulin than the 0.75 units Fifi is meant to be having.
 
Bron and Sheba (GA) said:
Sandy I have never used calipers. That is why I wanted more input:)
I'm just concerned Rosa may be giving more insulin than the 0.75 units Fifi is meant to be having.
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Oh yes, I gotcha! As long as she does what you have explained then she should be ok. I actually found that the dose I had thought I was giving (1.3) measured 1.5 on the calipers. so I have stuck to that "caliper measured" dose
 
Sandra And Buddy said:
Oh yes, I gotcha! As long as she does what you have explained then she should be ok. I actually found that the dose I had thought I was giving (1.3) measured 1.5 on the calipers. so I have stuck to that "caliper measured" dose
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Calipers are much better and more reliable than syringes..
It is just when swapping over, Rosa needs to make sure she is actually still giving the 0.75 units (the amount that was in the syringe). If that does not marry up with 0.75 on the calipers, but is more, than she needs to use the syringe measurement moving forward as the new dose on the calipers.
Does that make sense to you?

I think we were discussing different things...you were telling her how to use the calipers and I was telling her to make sure that the doses marry up.
 
Bron and Sheba (GA) said:
Does that make sense to you?

I think we were discussing different things...you were telling her how to use the calipers and I was telling her to make sure that the doses marry up.
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Perfect sense, Yes we were sort of discussing two things I did try to touch on what you were talking about (marrying the dose) but didn't have time at that moment to get too far into it. I kind of butted in to your convo a bit :oops: , This is the first real advice I have really tried to give and was hoping I did ok with it.
 
Sandra And Buddy said:
Perfect sense, Yes we were sort of discussing two things I did try to touch on what you were talking about (marrying the dose) but didn't have time at that moment to get too far into it. I kind of butted in to your convo a bit :oops: , This is the first real advice I have really tried to give and was hoping I did ok with it.
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You didn't butt in at all. And it's great you are helping others.. that's what this board is all about.
I know nothing much about calipers, but I do know that the dose needs to stay the same when swapping over.
If I find I can't help someone, or I am not sure, I will tag someone who I know knows more about that subject.
So please keep helping when you think you can.......and if you are not sure, tag someone who you think will know about it. :)
Good to meet you!
 
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But the measurement is .99 mm for .75 u on the caliper right? I’ll bring up what I think is .75 and see how accurate I am. But at least I’ll know maybe what dose I have been giving if that makes sense?
 
Mimis mom said:
But the measurement is .99 mm for .75 u on the caliper right? I’ll bring up what I think is .75 and see how accurate I am. But at least I’ll know maybe what dose I have been giving if that makes sense?
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Are you measuring the caliper or the syringe when you say "the measurement is .99mm for .75 on the Caliper right?"
What I am saying is that you need to draw up 0.75 on the syringe and see what it says on the caliper.....and that is the dose you should be giving....Because you need to make sure you are giving the same dose of insulin as you were giving when you were drawing up 0.75 units on the syringe.....
The important thing is the consistency of the dose..
 
As Bron has said above.

  • Draw what you call 0.75u on the syringe/ without the caliper as you have been doing
  • Measure that with the caliper
  • That is the dose you are sticking with (we can work out what that is in units once you have the measurement)
@Sandra And Buddy
Gave you some good pictures above on how to measure the dose with the caliper in post #33 look at that again before you measure.


I didn't use calipers, I tried not to fret too much about the inconsistencies inherent in measuring a dose, but just tried to the best I could.
 
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