http://www.felinediabetes.com/FDMB/...-kits-switch-to-modified.228585/#post-2563932 Thread was getting long.
kit was flat yellow all day and surprised us w PMPS 143. we will stall 20min feel free to chime in with thoughts
141 (i.e. flat) after the 20 min stall. @Deb & Wink any thoughts if this is still within parameters to shoot her full dose of 2.25U ? and we monitor the PM as needed
I'd suggest the 2U. I'd say she cleared the bounce today. OK, let's see how Kit does on this dose for a few cycles.
Stinky pinkies for Kit today. But a better PMPS! p.s. Gardens, my gardens called strongly to me today. First nice day, sunny and warm that we've had in a long, long time. No rain, and the Baltimore Orioles are back!
sounds lovely. glad you got out there! JOJI is gardening upstate w her mom while kit and i are in the studio painting and bird watching. yep, be happy for things that are happy.
one cycle of s2.0u and four cycles of 2.0U resulting in a basically flat cat. we are wondering if it's the right time to try 2.25U again in the AM (04may2020), although kit didn't last there very long last time before we had to reduce....hmmmm. inputs are welcome. thanks. ^jw @Deb & Wink
Bump the dose back up to 2.25U jw. She has been in the yellows and pinks for too long. Time to see more green, and not just a single green number either. This time, you would only reduce if Kit falls below 50 mg/dL (68 on your pet meter), since you are now using the MPM protocol. So she may stay at this dose a bit longer. p.s. Hope you are having a lovely time with your latest painting project. Please let us see it when you are willing. WIP or finished product, we like to see both.
will do beginning w AM 04may. thanks. okay. so that means longer than the 3-6 cycles the guidance talks about? thanks. i'm working on a bunch of things right now, mostly fruit. usually at this time of year i'd be doing landscape of some local scenes. but since we seem to be a popular day trip destination, i'm opting to paint inside. i'm not sure how much longer i'll last doing that now that the weather is getting so nice.... hope you got out into your garden. ^jw
So, you will increase the dose for Kit on Monday, 5/4/20 AM cycle. (half the time, I can't remember what day of the week it is anymore.) If Kit does not drop below 50 (68 on the Alphatrak), then the dose would not be reduced. On the other hand if she does not respond with lower mid-cycle BG readings, to the increase in dose, you may need to increase the dose after 6 cycles. Yes, the last 2 days were the first warm non-rainy days here in a while. I did get out into my garden, to putter and prune some shrubs. And watch and listen to the Baltimore Orioles that just returned.
PMPS 121 stalling ... 133 after 1st stall 139 after final stall. going w the skinny 2U @Deb & Wink AMPS 252 327 @3 305 @5.5 218 @ 9.75 if we can get her to 140 like the other night, we are thinking we will shoot as we did then, i.e. skinny2U if we cannot get her that high, considering what to do maybe 1.75U ? PS we don't understand why she so often drops at the end of cycles!
Skinny 2U was a good call, since that 139 is almost the same as the 140 you shot before. I'm wondering if Kit is doing a "double dip". Some, only a few cats do a second dip, later in the cycle. Until you mentioned it, I had forgotten about that phenomenon. Never seen it before myself, but I remember reading about it. p.s. Sorry I didn't get back to you in time. Running very late today, getting on the message board.
hmmm, not sure if she dips twice, or just kind of declines for an entire cycle with the AM nadir being around PMPS the PM cycle doesn't seem to follow the same pattern. we fill this picture in by sampling over different PM's. i think we're doing a reasonable job of sampling various times during PM, but maybe not? over the recent week we've gotten PM +9, +7, +4 in addition to the usual +3/+2 and here is a WIP painting of two tomatoes to acknowledge kit's AMPS today.
Nice WIP JW. Thanks for sharing. Not so nice, but expected, was Kit's bounce up to red this AM after dropping low last PM. Wish she would stop that bouncing for you and Joji.
I think Kit is either still bouncing from the low on 5/5/20. Or she dropped low again last night, and you didn't catch it. You'll probably hate to do this, but next time Kit is in the lower yellows (<250 mg/dL) at a PM pre-shot. Get a +6 test. You'll likely need to set an alarm, to wake you up to do that +6 test. If I had to take a "wild guess", I'd say that Kit is headed for those lower yellows at pre-shot tonight, 5/8/20.
yay! your crystal ball is back on track! PMPS 204 08may2020 we still plan to shoot 2.5U unless you see this in the next short while and suggest otherwise.
I see that 2.5U was what you shot. Do try to get that +6 tonight (or a +5 or a +7) to see where Kit drops after the low yellow (low 200's) pre-shot. p.s. No, Deb was off trying to take care of a few things, and get myself dinner.
She's doing another one of her famous "drop lower at PMPS" Kit cycles. But at least, it's only to the lower yellows, those 200's.
we won't tell her she's famous, otherwise she'll keep doing the bounce/dive act purely for the attention thanks for checking in on us
We are really wondering if it is time to look at another insulin. We've been with Prozinc since diagnosis at mid December. A few weeks ago we thought we were getting somewhere, now it seems like we've lost ground. How do you know when it's time?
5 months with not much progress in regulation is certainly time to think about another insulin. Would you try Lantus or Levemir do you think?
Hi Deb, We're open to suggestions. Lantus seems to be very popular, but we'll have to do some reading. Do you have a crystal ball reading on which we should try next? joji
Pat we've had Kit on Prozinc since December, so 5 months without significant progress has us thinking that this may not be Kit's best insulin option. We will continue to follow the modified protocol for Prozinc but meanwhile we'll be researching other insulins.
Ahhh ok, so im assuming there is a time frame on the insulin to make good progress...I guess I will have to pay attention to that as well.....Im still learning
So Joji and JW, you should read the "Sticky" or pinned posts over in the Lantus forum first. Lot's of information there for you. Lantus / Basaglar (glargine) and Levemir (detemir) forum. The first 6 months is usually enough time to tell you if your cat is doing well on a particular insulin. There are no guarantees that Kit (or any cat) would do better on another insulin. Since Prozinc is one of the longer duration in-and-out insulins, the next logical step is to try one of the depot insulins. The 2 main depot insulins used here are Lantus (Basaglar, a biosimilar to lantus) and Levemir. Using a "depot" type insulin has been compared to maneuvering a huge cargo ship, where as the in-and-out insulins are compared to maneuvering a speed boat. Some cats do not bounce as much on the depot insulins. Some cats bounce and bounce no matter which insulin they are using. Some cats achieve diet controlled status. Some never do. Patty & Teal'c switched to Lantus about 6 weeks ago, and Teal'c is still bouncing and not doing much better on Lantus than he did on Prozinc. Insulin dose has bobbled up and down a bit, but not much progress in getting Teal'c BG levels regulated or into the healing green numbers. Here is Teal'cs SS, so you both can look. Teal'cs SS Patty works an erratic night work schedule (usually) so can't test when she is away at work. Makes it hard to see if Teal'c is dropping lower in the PM cycle.
That wasn't quite as steep of a dive as Kit often takes. She dipped one toe into the blues, just under 200. What do you think helped her today, to keep her BG levels more even?
She's been so flat with pinks and yellows lately, except for the occasional blue. We can't make sense of any of it.
Yes, still really horrible numbers in the pinks and yellows. I think you may need to increase the dose again. Tomorrow, AM cycle. The 2.75U isn't cutting it for Kit.
What doesn't make sense to us is that she acts great! Playful, energetic, curious. She is not overly drinking water, or excessively dumping water. Her numbers don't match her behavior. What's up Kitaibelia?!
we increased kit to fat 3U yesterday AM (17may) bc of her history of high rise dives we went w fat over a full 0.25 increase. yesterday she was riding high, but today the picture is a bit different and down to a low yellow at 6.5 (probably bc of that red yesterday....) if this is her nadir for the day, then it will be unlike the most recent days on 3U when she went slowly down, if at all, until PMPS be sure to tune back in after the commercial break to see what happens in kit's world during the second half of today's AM cycle 18may2020 372 AMPS 363 @3.5 207 @6.5
so not what i'd call a "smile day" more like a "smirk" 250 @9.5 330 PMPS staying w fat 3U for the PM and likely take it to 3.25U in the AM (19may2020) unless she surprises us w a super low AMPS in other news, despite the bg's all kit systems are looking good: personality, play, pee, poo. ^jw
Kit, when are your BG levels going to settle down? and agree with your "external systems" all looking good? Guess that is the $64000 question.