Mauer 2

SashaV

SashaV

Member Since 2020
Link to previous thread https://www.felinediabetes.com/FDMB/threads/mauer.234783/

Deb & Wink said:
You do what you need to do Sasha. You're no good to Mauer or Miver if you are too sleep deprived.
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You're so right, Deb.
I had a migraine again yesterday, not as painful as the previous. But I set an alarm to check Mauer at +6, since I got a +2. I woke up at +8, slept through my two alarms, went to pee and looked at Mauer she seemed fine, and back to bed. And I don't got the slightest idea of why the .... I had my glasses on. I don't know if maybe I'd been up earlier? Did I sleep with them on?

Thank God it wasn't last night she went low!!!! That would have been a true disaster.

I've been thinking these last few days. Why do cats drop lower during the night cycle?
I know humans do too.
But I don't understand why. Maybe cats are more active, but humans aren't.
In DK we have something called diabetic stress. The fear of going too low during the night, too low in general, not being regulated and so on.
I'm sure we who has diabetic cats can catch it too..

Hope you're doing well :bighug:
 
SashaV said:
I've been thinking these last few days. Why do cats drop lower during the night cycle?
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Yes, cats are more active, so burning off some excess glucose.

My diabetic human friend is often a bit higher BG wise in the AM. EHID (Every Human is Different)
 
Oh Deb!
We hit blue yesterday that's awesome.
Now I shot at 250, an hour after she got 5-6 pieces dry kibble... I'm afraid I'm have a PJ party tonight :banghead:
I'll get up at +4, and hopefully she'll be surfing safe numbers! Fingers crossed!!!
 
BOUNCE!
I'll check again later. Feels like I've dodged a bullet!

Is it totally unthinkable to raise am dose, and continue pm dose? Maybe up the am and potentially lower the pm, if the am has longer effect?

I'm not seeing a typical spreadsheet on Mauer. She bounces, she gets low, she gets really high, and there's nothing changing. 3.25U one day makes her low, while 2U another day keeps her steady.

I want to borrow someone else's spreadsheet for a day or two!! Blues and greens :rolleyes::smuggrin:
 
SashaV said:
Is it totally unthinkable to raise am dose, and continue pm dose? Maybe up the am and potentially lower the pm, if the am has longer effect?
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You are talking about sliding scale dosing. It doesn't usually work well, but you are certainly welcome to try it with Mauer.
It is an option that is written up in the dosing protocol for Prozinc.
 
Oh it's a thing! :D:p

What do you think, Deb?
Is it possible she'll be easier to regulate, since the low numbers seems to effect her longer?

I think its time to increase but its only a week since she earned a reduction. What am I supposed to do here?
Am I not patient enough?
 
SashaV said:
I think its time to increase but its only a week since she earned a reduction. What am I supposed to do here?
Am I not patient enough?
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Are symptoms increasing a bit? More peeing, hungrier, not as playful, drinking more water?
Then it's likely time for an increase again.
The BG numbers ARE staying too high again.

The dose can bounce up and down for quite some time.
Some kitties bounce more than others. Some never stop.
Some never settle down from getting those lower BG levels at mid-cycle.

If you want to try the sliding scale, you could.
What would you start with, as the dose for AM and the dose for PM? What were you thinking?
 
Not any symptoms like that, but the BG is too high. Its like we're bungee jumping and we get SO close to blue, but no, better luck next time.

The 3.5U terrifies me but only in the PM. I'm comfortable with her dipping down and surfing the blues and greens, during the am cycle. Its like something pushes her over the edge when I'm sleeping.

So my thoughts were if she got surfing during AM cycle she'd be generally lower, just as I think we're seeing now with lower pre-shot numbers, but just lower and not bouncing as much. She clears her bounces quite fast nowadays

As specific dosage I was thinking to raise AM until she surfes steady in the lower blues, but not changing PM - maybe only downwards so she doesn't fly over the edge, with lower PMPS.
We're almost always reducing on a PM cycle, which means her AM cycle sucks.
She needs more during daytime, less depending on PMPS or the same during nighttime. That's how I'm seeing it.

What do you think Deb?

This pandemic sucks. We're having more infected than ever.... and people start dying again...
 
SashaV said:
As specific dosage I was thinking to raise AM until she surfes steady in the lower blues, but not changing PM - maybe only downwards so she doesn't fly over the edge, with lower PMPS.
We're almost always reducing on a PM cycle, which means her AM cycle sucks.
She needs more during daytime, less depending on PMPS or the same during nighttime. That's how I'm seeing it.
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Ok. Let's have you try that for a few days.
Hope that Mauer doesn't hand you any real surprises while you are trying this.

Don't raise the AM dose too fast would be my suggestion. It can take a few cycles to settle into a dose. So give Mauer some time.

SashaV said:
This pandemic sucks. We're having more infected than ever.... and people start dying again...
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Yes well, it certainly does. Still in the first wave here in the US, since not even 40% of people across the country are willing to wear masks. Mask wearing is mandatory in MA, if you go into a store. But some people are still using bandanas which do no good or those masks with vents, which simply spew your breath out into the air for everyone else to breathe. Mask wearing is optional outdoors, but required if you can not keep at least 6 feet from someone. Of course, with aerosol transmission, the virus travels much further than 6 feet. Next town north of me has increased positivity rate. Too close for comfort.

I'm a homebody anyway. Plus now I'm a real convert to on-line ordering and home delivery. Still need to go to the grocery store about every 3-4 weeks, for fresh food. Curbside pickup is available at lots of stores here, but not the grocery store. Bummer.

Got my first delivery of flower bulbs today. Spent about 1 hour looking them over, and plotting and planning where they will go. Already have lots of holes dug for the bulbs. Tomorrow is the first planting day for them. I'm excited!:):cat::) Rain expected later this week. It will be the first rain we've had in over 3 and a half weeks.
 
Any surprises? Deb, be honest is it a bad idea?

At least you aren't so stupid you've almost got rid of it, and then invited it back in even worse than the first wave.
I had my first mask on yesterday, its mandatory in restaurants - but only when standing, not sitting......
And I had it on the wrong way, I couldn't see out of my glasses.. it sucked big time.

The twins is getting christened next month on the 25. I really hope everything looks better soon, so they don't need to postpone.

Why not in grocery stores? I doesn't make any sense..

Oh! Tulips and so on? They're so pretty!!!
No rain? Really? I've had a warning on my phone about dangerous weather, just because of rain. Wanna switch? I want the sun back!
 
SashaV said:
Any surprises? Deb, be honest is it a bad idea?
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No, I don't think that trying the sliding scale dosing is a bad idea. It's simply not a dosing method that is done here often.
The sliding scale is usually "shoot this amount of insulin if the BG number is between this one number and this other one." with various doses for the different pre-shot BG numbers. Sometimes, it works and sometimes it doesn't.

An example of a sliding scale would look something like this, replacing the double letters with an actual dose amount.

If the pre-shot BG is 100 t0 199, then give ww amount.
If the pre-shot BG is 200 to 299, then give xx amount.
If the pre-shot BG is 300-399, then give yy amount.
If the pre-shot BG is 400-499, then give zz amount.

More people have luck dosing based on the nadirs or lows, and making dose adjustments that way. Not basing the dose on the pre-shot numbers, like the sliding scale dosing.

p.s. Daffodils (narcissus), crocus, grape hyacinths, hyacinthoides (wood hyacinths), other small bulbs. I didn't order enough, for all the holes I've dug. :(
 
But that's what I want! Dosing on nadir and or lows, but only AM cycle.
Is it insulin resistance I'm dealing with here?

I would like to increase, like I've been doing with 0.25U at a time, based on the last few cycles, but keeping the PM shot the same, or lower depending on PMPS test.
Kinda like I've been doing when I get afraid of the the lows, but not tampering with the dosage long term.

I feel the language barrier here.

An example:
Day 1:
AMPS red I shoot 3.50U
She reaches the higher blues during the cycle
PMPS pink I shoot 3.25U

Jumping a few days

Day 4:
AMPS pink 3.75U
She's in the lower blues during this cycle
PMPS higer yellow I shoot 3.25U

Day 7:
AMPS higher yellow 3.75U
She surfs dark higer greens and low blue
PMPS higher blue then I decrease 3U PM

Day 10:
AMPS low yellow 3.75U
Dips to neon green and the disaster happens and I don't know.

It seems like when she reaches the good numbers she keeps steady and down there, like a breakthrough of some kind, until I panic and decrease too much.
My thoughts were to decrease on real numbers, not the PM cycle witch typically is lower for some reason.

Anyhow I'm getting a new vial in a few days, and that earned her a reduction last time without touching the dosage. So I'm letting that play out, until I see where it takes her

We've had a good run at the blues starting this month. And since she's keeping herself JUST a tiny bit above the blues.

It seems wrong to me to decrease on a PM number witch is bound to be lower, when she's doing fine during AM cycles, and can take it going lower.
When she's going study in the yellows it seems like the insulin is working longer.

Does it make sense? I don't even know if it makes sense to me.

You need more bulbs! Definitely a good excuse to buy more! :D:D:D:p
 
SashaV said:
I would like to increase, like I've been doing with 0.25U at a time, based on the last few cycles, but keeping the PM shot the same, or lower depending on PMPS test.
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So are you asking if you could base the dose changes, the increases, only on the AM cycle readings?

SashaV said:
Day 1:
AMPS red I shoot 3.50U
She reaches the higher blues during the cycle
PMPS pink I shoot 3.25U
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The thing is, by reducing Mauer from 3.5U to 3.25U for that "Day 1 cycle", because you got higher blue BG readings for nadir, means that she wasn't getting enough insulin for the PM cycle.

You don't let a single cycle guide you, to adjust the dose for the next cycle. (Except if you want to try sliding scale dosing)

You WANT to see LOW blues and some greens, not just 1 or 2 blue numbers, sprinkled around the SS here and there. Her appetite makes a big contribution to the BG readings too. So if she isn't eating well, she's likely to drop more in the middle of the cycle.

SashaV said:
It seems wrong to me to decrease on a PM number witch is bound to be lower, when she's doing fine during AM cycles, and can take it going lower. When she's going study in the yellows it seems like the insulin is working longer.
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SashaV said:
Does it make sense? I don't even know if it makes sense to me.
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Or the insulin takes her down into the lower blues and high greens, which is where you want to see those BG levels.
"Shoot low to stay low."

You don't want only yellows, or yellows and pinks for those cycle tests. You want pre-shots in the blues and maybe the low yellows, and you want to see the mid-cycle numbers down in the blues and greens. Consistently down in the blues and greens.

Mauer hasn't had a blue BG reading for 11 cycles. That's way too long.
 
I think we're saying the exact same things.
I do not wanna regulate only on AM cycles, but I want to keep PM the same, since the lower AM cycle has a carryover and she always gets reduced on PM cycles cause she goes too low. So I reduce on a "fake" BG reading during PM in both cycles, witch makes her too high during the day. And then I increase again, and the same thing happens.

I want her in blue and green, I want to shoot those, I just want to take into account that she goes lower in PM cycles and not reduce on something that's going to happen whether I increase or decrease.

I know its been too long now, I'm getting a new vial tomorrow so I'm ready Tuesday morning, but I'd like to see what's going to happen on her regular dose 3.25 with a new vial. Since that earned her a reduction the last time.

She's eating well, I'm just not giving her food in the AM cycle. Only if I'm not going to be home and able to test.
 
O.1 from shooting on blue on a fat 3.25U
She's been dangling down there, not reaching the blue but SO close.
One decimal from blue.

I WANT to shoot those blues, even though I'm still rather uncomfortable with it. Not yet anyway.

If a fat regular dose does this, I'm definitely not changing her dosage before seeing what the new vial does.

This is exactly what I mean. Let's say she gets a reduction based on this cycle (I hope not, if she follows her own usual way she bounces) then what?
Then I'll reduce on a carryover, on a not even low AM cycle. Then 3.50U will be too much, 3.25U too little, and probably if one goes up, the other must go down, if this is the show she'll be running.

I don't know if I can make myself understandable. It just seems like I'm constantly running into a wall going up and down. And this is about to get silly, it shouldn't be this difficult. I'm frustrated about this. And the freaking language barrier :banghead::banghead:

I'll go to bed. I'm not hopeful about my sleep tonight :(
 
Aaaaaand a bounce. Just as predicted

Just asked my sister how awful my English is. At least I haven't done the barf-thing :D
And grammar ain't my sh.....
She called it danglish :oops::smuggrin:

I'll do a +5 as usual :cool:
 
Sasha, you've got this. You know what you want to try so try the different management of the feline diabetes for Mauer.
By that I mean not reducing the dose when you know Mauer's patterns so well, and the fact that reducing the dose always ends up meaning a bounce.

It's like Mauer is getting longer duration from the insulin in the AM cycle, and that means the PM pre-shot tests are always (or most times) much lower than the AM BG's.

Let's see what the new vial does.
 
I'm so excited about tomorrow and the new pzi vial!

I've been thinking today, Im actually starting to feel she's going somewhere.
She's yellow all day, but she hangs around there going nice and steady.
Not bouncing as much as she has been.
If we could switch the yellow out with the blues I'd be very happy.

So even though she isn't there yet, she is kinda flat. In the wrong range, but she's rarely pink besides the pre-shot.

So I put my patience hat back on!

Deb, if I should do one PM test, when would it be? Is the +5 good enough?
I want to catch her early so she doesn't go way down, but not so soon I don't realize what's about to happen, if you get where I'm going.
It actually doesn't bother me anymore getting up at night to test... sometimes I even wake on my own +4.5 and test then.

Its really amazing what we're able to do, when it's life or death for a loved one.

:bighug::bighug:
 
SashaV said:
So even though she isn't there yet, she is kinda flat.
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Numbers that are "kinda flat" in the yellows, often indicates a bounce that is breaking.
SashaV said:
Deb, if I should do one PM test, when would it be? Is the +5 good enough?
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That is fine Sasha. The +5 BG test will let you know if Mauer needs a bit of food assistance, to bring her BG levels back up.
A +2 is often an indicator of where the BG numbers are headed for the cycle.
Mauer often doesn't give you good signals at +2, but more often at +3 her BG levels seem to indicate where the cycle is headed.
ECID (Every Cat is Different) and Mauer has a different time for letting you know where the cycle is going, BG number wise.

SashaV said:
I want to catch her early so she doesn't go way down, but not so soon I don't realize what's about to happen, if you get where I'm going.
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Yes, we do get used to a lot of situations in dealing with a loved one, weather furry or human.
Here is the writeup on that +2 numbers again and what it can indicate. It's long, so you might want to print it out to refer to. Just change all the references of +2 to +3, for your Mauer baby.

With Prozinc by Deb & Wink

More than a number range, think of the percentage of the drop at +2, that may tell you if your cat is going to drop much lower. Think of that +2 as being an indicator of what direction the BG levels may be headed.
With Prozinc, if you see a 40%, 50% or greater drop, between the pre-shot and that +2, that's a serious heads up warning.
If you see a 20-25%, 30% drop, not quite so worrisome. But still be cautious.

Your cat drops 2 color ranges between pre-shot and the +2, pull out your hypo kit and plan on staying up to test.
Your cat drops 2 color ranges between pre-shot and the nadir, that is to be expected. But you don't want the drop to be much more than 50% between pre-shot and nadir with Prozinc.
Cats tend to bounce high if the drop is 50% or more from pre-shot to nadir.
So you steer those mid-cycles with food, to slow down the steep drop and stop the bounces from being too high.

The steeper the drop, the higher the bounce.

It's a balancing act.

The +2 is like an "early warning" for most cats!
If the +2 is about the same as the PS, it's usually a pretty normal cycle...dropping down to nadir and then rising back up again. (About the same means taking meter variance, that 15% variance that hand held glucometers are allowed to have into account)
If the +2 is higher than the PS, that usually signals a bounce, and those are the cycles when you can usually take a break from testing.
If the +2 is lower than the PS, that's your "Early warning" that kitty might be going much lower later in the cycle so it's important to plan on getting another test or two (or 6) in.

It doesn’t work every time or with every cat. But it does hold true most of the time, so keep this in mind for next time.

It also kind of depends on what BG pre-shot your cat started out the cycle with. Lower than normal, keep a closer eye on the cycle. Lower than you are used to shooting, a number you may not have given insulin before, keep a closer eye on the cycle. Stalled and number rose some, but you did a reduced shot, maybe another test or 2 to see how much the number is rising.

It makes a big difference if your cat starts the cycle in the pink 300-399 mg/dL range (16.6 - 22.16 mmol/L) then if they are in the blue 150 mg/dL range ( 8.3 mmol/L).

p.s. Food notes in the Remarks column can be very useful. Helps to interpret what is happening in the cycle. Notes are done on AM and PM cycle basis and notations need to be with the + time format.
 
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Are you telling me she's been bouncing for so long?

True, she doesn't tell me anything useful at +2, it might even be higher than the AMPS, just to drop an hour later.
But in the PM cycle it tells me a bit more at +2
She's a funny cat, making up her own rules :oops:
But in the lower yellow I do see improvements, she is happy, playful, awake and aware and she minds being pricked. When she is high she doesn't care..
Its also like her pupils is getting bigger when she's lower? Is that normal?

I'm so excited and I just can't hide it :D:p
Sing with me :D:D lol :woot:
 
Hi Sasha, Just wanted to let you know that you have my sympathies. Hercules is very much like mauer and does hiw own thing..... Is mentally and physically tiring, but you are doing really well! :bighug:
And is so nice when they get playful again, isn't?
 
Hercule's mum said:
Hi Sasha, Just wanted to let you know that you have my sympathies. Hercules is very much like mauer and does hiw own thing..... Is mentally and physically tiring, but you are doing really well! :bighug:
And is so nice when they get playful again, isn't?
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Its so nice! It almost feels like I've slowly lost her without even knowing, and now she's coming back.
So are you! Nice to know I'm not alone in having one that breaks the rules :bighug:
 
So no bouncing in her first AM cycle of the new vial. So that's great!
Other than that it didn't do much, but she kept down in the yellow half the cycle.

I'm so excited about how she'll respond to a PMPS of 15 and a fresh pzi. And I won't contaminate this one!
I really do hope she's done with all that bouncing. Huge ANTI-JINX!!!!!

If she seems steady ill increase to 3.50 on Saturday. But I'd really like to see one more full cycle.
 
17.4 at +2 bouncing again

My spreadsheet won't update for the second time today. I'll fix it tomorrow! Until then I'll note her readings here and put em in her ss tomorrow first thing

I'm back in 3 :D:woot:
 
SashaV said:
Are you telling me she's been bouncing for so long?
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Some cats go from one bounce and straight into the next bounce.
Some cats start to clear the bounces faster, get their BG levels back to a more even keel, when their bodies get used to the drops.
Some cats bounce all the way to remission.
Some cats never get to remission and bounce cycle after cycle, pausing one cycle, starting up on another cycle.

It's just too unpredictable to say sometimes.
 
PMPS 13.4
2.3 above blue.
3.25U is 8.1 - 3.50U is 8.8
I gave her 8.5. I chickened out in the last minute :oops: this takes some getting used to, sadly.
Unless she bounces I'm guessing its my time to have at pj party.....

But we got blue! :cool: < blue is awesome!

Why is she always holding her BG so nicely this late in the AM cycle?
She had food at +6, and she's more together with the rest of us, moving around, playing with Miver and teasing him at the end of the AM.
Just a crazy though, if I was up all night would she go low during the AM when I'm sleeping? Is it their inner watch that makes them go too low at night time? Is it something we humans do? Its not like Mauer is more active during the night, even eating more. It makes no sense.

Oh well, we've got blue! Now I better get some sleep. (Yeah I'm hoping to jinx the pj parrrrrty)
We need a surfing smiley!!! Cause thats what we want, right?
 
SashaV said:
And now the fear comes sneaking.
Feline diabetes is definitely not for nervous people! Or anyone without huge nuts....
I'm just saying.
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Oh Sash! You are a hoot!

surf pyramid.jpg

No surfing smiley, but I hope this picture is a good substitution. It even has most of the color ranges that we use on the SS.
 

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HOUSTON WE HAVE GREEN!!!!!!! :D:D:D:D:D:D:D:D:D:D < freaking green!!!!

3.50U is 8.8, 3.75 is 9.4, so I gave her a fat 3.50 at 9 straight.

Deb, you still think 3.75U? Cause I don't..

I thought she'd bounce since her +3 was higher than her pre-shot, but she didn't. What if I hadn't tested and just gone on with my day?
I actually forgot to feed her at +3, so she got food at +5.5.

Any thoughts on what to shoot PM?
I do not want to shoot 3.50f, not since her history of dropping low in PM cycle.
A fat 3.25U maybe?
Anyone kick in with thoughts, Deb won't be here until PM +4 :nailbiting:

@JanetNJ perhaps?
 
Ahh sorry Sasha, got your PM but about to step out. Unless Janet comes with more concrete advice I would say if pre-shot is below 150 you want to reduce but not sure by how much ... half maybe? technically we're supposed to give full dose at 150 but even 150 is lower than usual for Mauer so a reduction either way is wise. Hopefully Janet will come because I don't feel like I have enough time to really look at her spreadsheet.

Or she may surprise you and be back up by then!
 
Even if she comes back up, witch she will...she better...
I won't shoot 3.50. She always goes low while I'm sleeping, its unsafe and I don't got the nuts for it.
Not that I don't want her healthy and in the great numbers, I really do want that. But she is so unpredictable, especially in the PM cycle. I have all day free to watch her day in and day out, I'd rather go nuts during my daytime.
3.25U maybe? If she's where she usually is at pmps
 
SashaV said:
HOUSTON WE HAVE GREEN!!!!!!! :D:D:D:D:D:D:D:D:D:D < freaking green!!!!

3.50U is 8.8, 3.75 is 9.4, so I gave her a fat 3.50 at 9 straight.

Deb, you still think 3.75U? Cause I don't..

I thought she'd bounce since her +3 was higher than her pre-shot, but she didn't. What if I hadn't tested and just gone on with my day?
I actually forgot to feed her at +3, so she got food at +5.5.

Any thoughts on what to shoot PM?
I do not want to shoot 3.50f, not since her history of dropping low in PM cycle.
A fat 3.25U maybe?
Anyone kick in with thoughts, Deb won't be here until PM +4 :nailbiting:

@JanetNJ perhaps?
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Yeah!!!!!!! What perfect numbers! Let’s see what what tonight’s number is. If you are worried 3.25 is ok. If it’s well over 200 I’d do 3.5... but I get not wanting to be up testing.
 
JanetNJ said:
Yeah!!!!!!! What perfect numbers! Let’s see what what tonight’s number is. If you are worried 3.25 is ok. If it’s well over 200 I’d do 3.5... but I get not wanting to be up testing.
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I'll be up testing no matter what I shoot. I don't have the ballz for anything else.
I just don't want to end up giving her another reduction on a low that's bound to happen only due to moon in the horizon. Cause she clearly needs this dose but its too much in the PM cycle.
 
I decided on a 2.5U since she got up to 164 after her pre-shot meal. I'll set an alarm at +4 and cross my fingers that I did the right thing.

I didn't want to ruin that we finally had a PERFECT day! I wouldn't mind having a yellow pre-shot number.
Depending on her numbers at +4 and AM pre-shot ill give her a fat 3.50 again.
 
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