Super low PMPS, skipping tonight

Discussion in 'Prozinc / PZI' started by Megan and Bernie, Jul 12, 2020.

  1. Megan and Bernie

    Megan and Bernie Member

    Joined:
    Feb 11, 2020
    @Deb & Wink
    Me again! :rolleyes:

    Bernie's numbers have been awesome lately, but tonight, she was acting really hungry around +11 and chomping on me. She's a very sassy lady who likes to nibble fingers, so I thought she just was just trying to play at first. Then, she started biting me and running to her testing spot, so I was planning on testing her, feeding her early (around +11.5), and shooting her between +11.75 and her normal time, so long as her PS was good at +11.5. WELL LET ME TELL YOUUU... it was either really good, or really not good o_O I'm leaning towards really good cause she earned herself a reduction, but it was definitely a pucker factor haha!

    She read 56 and 61 mg/dL (I immediately retested) on the ReliOn, but 41 and 51 mg/dL on her AlphaTrak2 (which has NEVER been lower than the ReliOn; it's always been the other way around). I treated her based on the AT2 numbers, and was initially going to just give her 2 Tbsp of her sister's Blue Buffalo kibble (she was thrilled), but, she started to get shaky while eating it, so I have her 2 blobbish drops of karo with it. She also ate 2 oz of her TikiCat. I retested her at +20m, and she was up to 86 mg/dL on the ReliOn and 90 mg/dL on the AT2. Her +1 was 138 mg/dL on ReliOn and 190 mg/dL on AT2. Hopefully I didn't overshoot with the kibble and land her numbers on the moon come tomorrow morning :banghead: :banghead:

    What do I reduce her to tomorrow? She's sensitive to dose changes, so I have been upping her in fat doses instead of 0.25u (so from 3 to 3f). I combed through the MPM protocol and it says to decrease 0.25u in the first 3-6 months, but 6 months-1 year you can shave a little off the dose instead of a full reduction. She's teetering right on the edge of 6 months...

    Should I decrease her from 3f to 3, or to 2.75f?
     
  2. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Looks to me like Bernie has been surfing in those greens a lot lately, especially during the PM cycle.

    Six of one, half a dozen of another as the saying goes, in regards to the dose reduction.
    I expect she'll bounce in the AM, with the skipped dose.
    I'd still go with the 2.75f dose in the morning, and give Bernie a few cycles to even out from the expected bounce.

    She's probably dropped lower before, and you haven't caught it.

    Good thing that Bernie "spoke to you" and told you she needed to be tested. And fed.
     
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  3. Megan and Bernie

    Megan and Bernie Member

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    Feb 11, 2020
    Awesome, will do. Thanks for your help! :)
     
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  4. Megan and Bernie

    Megan and Bernie Member

    Joined:
    Feb 11, 2020
    Hey, hope your evening is going well! How many cycles should I wait for her to even out? Is tomorrow morning too soon to bump her up to 3?
     
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  5. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I see you already bumped Bernie back up to 3U.
    Don't be surprised if Bernie gives you another low green in tonight's PM cycle, 7/15/20.

    It may have been a cycle too soon to bump the dose back up. That PMPS on 7/14/20 could have been a high BG level before the bounce broke. No worries on a bit more insulin for Bernie.

    You posted at 11:30 my time. I'm never on that late, especially not when I have an early morning wakeup to get to the dentist on time. :nailbiting:
     
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  6. Megan and Bernie

    Megan and Bernie Member

    Joined:
    Feb 11, 2020
    Oh my gosh, I didn’t even realize what time it was! I’m a night owl, like the cats haha! At least it makes night curves when she’s more active easier :smuggrin::smuggrin:

    I was expecting her nadir to be lower with the 111 mg/dL PMPS, but she’s been surfin’ so far, fingers crossed. I sprinkled a little crushed Dr. Elsey’s Clean Protein Chicken on top of her TikiCat to make sure she had a nice hearty meal with that shot, maybe I gave her a little too much sprinkle, my carb sensitive baby LOL
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Some people are night owls. Some people are early risers. Some people live on the east coast of the US and others on the west coast. Some members live in the UK, France, Mexico, Spain and so many other countries. It's why we use the + hour system to indicate the BG tests.

    No worries. It's only that I didn't see your post until almost 20 hours later.
    You "did good" on making your own decision to change the dose. Rely on your instincts.

    Too many "jimmies" on top of Bernie's meal huh? Could be. But if it gets her to eat better, I wouldn't worry about it too much.
     
  8. Megan and Bernie

    Megan and Bernie Member

    Joined:
    Feb 11, 2020
    Thank you! :):)

    I think I totally jinxed her last night, her cycle was beautiful, surfing in the blues for a couple of hours, it looked like she had herself a little food bump at +2, started coming down at +4, and then out of nowhere shot way up into the yellows and then this morning was in the purples :eek::eek:, even though she had no carbs and never went into the greens (*cue juggling chainsaws*;)). I’m so confused, she didn’t drop too far, she didn’t drop too fast... Did she bounce because I upped her too soon from her initial bounce? How many cycles should I hold her at 3u before considering increasing her back to 3f? Tonight was her 4th dose at 3u.
     
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  9. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    So Bernie bounced up from the low PMPS last night, 7/15/20 and you got that pink (purple) pre-shot this AM, 7/16/20.
    Her body isn't used to the lows, so that self protection mechanism kicks in, and raises the BG levels back to what her body thinks is a better level. It usually overcompensates for lows (not necessarily hypoglycemic numbers) but lower than she is used to, which is why you see the "bounce" to the higher numbers.

    I don't think you jinxed her. Not at all. Bernie's own body pushed her BG levels back up. Not something that you did. OK?

    With MPM (Modified Prozinc Method) protocol which you are now using, it depends on what the nadir is, for making that decision. Plus, you need to wait for the bounce to clear, before you decide the lower dose isn't working and it's time to increase.

    Bernie is already lower at PMPS tonight, 7/16/20 from this mornings high AMPS. I'd give it at least 1 more cycle, probably (maybe) 2 cycles to see where Bernie's BG levels are trending before you change the dose.

    p.s. Does it feel like you are juggling fire torches, sometimes?
     
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  10. Megan and Bernie

    Megan and Bernie Member

    Joined:
    Feb 11, 2020
    Thanks! I swear, she must know when I'm asking about her, because right after I asked about her dose, she dipped into the greens for a nadir tonight. Granted, she basically refused to eat until her BG was in the 80s, but I bet if my BG was in the 200s I wouldn't be too hungry either (her ketone blood test was negative). Her +6 was 60 mg/dL on the ReliOn, so out of sheer curiosity I checked her on the AT2 (I usually only use it for PSs because the vet likes those numbers), and it was 61 mg/dL, so technically a reduction by the AT2 but not by the ReliOno_O. She was completely asymptomatic other than finally eating her food. I gave her 5 pieces of her sister's HC kibble just to stave off any further drop while waiting for the TikiCat to "kick in" so to speak. I don't know, does that qualify for a reduction? I feel like if she had just eaten her dinner to begin with, she wouldn't have dropped. I guess I'll wait until the morning and see how her numbers look:)

    And those fire sticks are amazing! Such a good representation haha! :cat:

    ETA: I decided to go off the ReliOn since I’ve based all dosing off that one previously, so I didn’t reduce her this morning
     
    Last edited: Jul 17, 2020
    Reason for edit: added in morning
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  11. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    A cat not eating as well can definitely lead to lower BG levels. Not how you want to get there, but simply something to be aware of. So that you take that into consideration when you are thinking about decreasing the dose.

    Good call on keeping Bernie at the old 3U dose.
     

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