Okay, so. Since we bumped Nico up to 4.0u he seems to be holding fairly steady (in the minimal data I have because we just changed it..) in the 300s (PURPLE!!). I’m assuming it’s good to see less huge jumps throughout the day, while also hoping to get him down a little further— maybe steady in the 150-250 range?— does that sound correct? Can someone talk to me about what I should or could expect to see now as we get closer to having a more correct dose? Just curious. I feel like right now I’m so thankful for 300s, but also have zero idea what to expect next, or what to hope for. Hoping someone knows the answer(s)! Nico’s previous thread here: https://www.felinediabetes.com/FDMB/threads/le-sigh-nico-the-rollercoaster-cat.238924/#post-2688240
Great. Thank you for this. Would you like more frequent testing for him tomorrow? I always do AMPS, mid (+5 or +6), and PMPS. Usually a +3 or +4 after his evening dose as well, just depending on our sleep schedule. I’ll look for your response.
My gut says hang tight at 4.0u for a bit longer and see where his body goes with it? I’m on the rollercoaster today, folks!
So.... ROUGH BLIP.... PMPS 600+HI. +2 455. Nearly +4 276. Is he possibly bouncing from the 203 mid this afternoon? Will see what the morning brings. (Not sure I’ll ever get used to seeing the 600+HI to be honest...)
When a cat isn't used to be 'down there' in the good numbers, their bodies sometimes shoot them right back up. So yes, the first many good numbers often follows with a bounce. Annoying as ****, but hopefully it will get better
Some pretty significant movement in the last 12-16 hours. We shot back up to 600+HI at our AMPS this morning. Can you advise on BG testing today? My gut says to monitor a little more closely with such drastic jumps, but I’m far from having any idea really (maybe it’s more for my peace of mind than for his actual health??)... scary stuff. How does one handle bounces like these? Just patience and holding the dose at 4.0u until he evens out a bit more? He’s acting totally, 100% fine— really, really energetic, has a great appetite, his water intake and urine output seem to have decreased (YAY!!) in the past two days. Honestly, I was surprised he read so high this morning, I thought he was gonna read much, much lower just based on his demeanor & energy alone. I’m hopeful these large jumps will pass soon. I’ll update as soon as there is new news.
We’re headed straight for the 600+HI reading tonight... kicking myself for not testing nearer to his mid today. Tomorrow I’ll pay closer attention. +7 441.
I should add his personality and demeanor are nearly back to normal and we are completely enjoying that aside from our current (high) blood sugar readings. That is enough for us, for now— eye on the prize.
I think probably smart, as long as it’s something you’d recommend. Unless you want me to dose him 4.5u tonight? I can test him at +3 or +4 tonight too? And/or +9 when I put up his food for AMPS?
Tomorrow morning start 4.5u or tonight? We just started our 2 hour fast before PMPS, so plenty of time to decide...
Hey, Em. If you can test a bit more this PM cycle, no reason to wait until tomorrow to bump up the dose.
So he read identical numbers at his (am cycle) +7 and his PMPS: 441. I shot 4.0u because I wasn’t sure if him staying out of the upper red & all black brackets would change anything. Please let me know.
4.5u after AMPS. Can’t kick the 400s. Seems flat for some reason— (pm)+3 421. Any thoughts on why he hasn’t budged? I’ll update in the morning. Thanks.
+6 334. Not as low as I expected it to be after a dose increase.. possible his nadir is closer to +5? Will continue to watch him. What do you think?
No, Nico staying out of those upper red and black BG ranges would not change anything. You would have been fine to shoot the dose increase to 4.5U. Hey, hey, hey! Nico dropped over 130 basis points, from the AMPS to that +8! Not too shabby! That's a good 30% drop for Nico. You don't want to see too much of a drop, no more than 50% if you get there. Hard to control the drop percentage, but "the bigger the drop, the greater the bounce" so you try to moderate those steep drops. I don't think you need to worry about "feeding the curve" at this point, to prop up the BG numbers. Lets' wait until Nico gets into some better BG ranges before you try that. Yes he could have dropped more earlier in the cycle, but you can't test every hour. You'll get a better picture of what is going on if you vary the testing a bit from cycle to cycle, to fill in the blank spots on the SS. Plus, you are not likely to see a lot of difference if you tested every hour. No need to do that much testing.
PMPS 416. Still nothing from his vet about his curve last week. I’ve left a bazillion messages.. if I can’t get her tomorrow then she’s gone until Friday. UGHHHH
Couldn’t sleep and was up at +5 so decided to give a random test and mighty glad I did too... (pm) +5 66. Scrambled to see at what level to give high carb treats (<50?) and fed some anyway. What’s next? I think at AMPS if he’s under 200 no insulin, right? But read he might also test super high.. PLEASE ADVISE.
Wo wow good catch! You didn't by any chance test twice to make sure it was correct, did you? Either way is an amazing number. BUT we have finally found his breakthrough dose!!! You have several hours before the amps, so I would bet it will go back up.
If it's under 200, stall for up to an hour and see if it goes up. He's definitly not used to these low numbers so don't be surprised at a big bounce.
+5 156, but I think I may have only shot 4.0u this morning.. I can’t be sure. I think I may have been on autopilot because it was so early and I didn’t get much sleep. Right after I shot I thought, “oh my god, did I just shoot 4.0u or 4.5u??!” “Now, I don’t know and there’s no way to check..” Has this ever happened to you guys? Should I just assume it was 4.0u? 4.5u?
sometimes when they are in glucose toxicity like your cat was (where a the insulin wasn't doing as much as you'd expect and they are stuck in high numbers), once you find the "breakthrough dose" it comes down. For my cat in the beginning it was 3 units. Before that she didn't have a number under 300... suddenly I started seeing fast progress. For you it was 4.5. Don't be surprised if we need to lower the dose soon.
Nico is doing SO MUCH better, since you found that "breakthrough" dose. You broke through the HI (black) BG numbers, and overcame (or broke through) some insulin resistance. A BG of 66 last night?!?!? That probably caused the bounce up to the red BG range for the pre-shot this morning.
PMPS 600+HI Sigh. I’ll test again in a few hours to make sure we are moving.. these bounces are discouraging.
The average am preshot the past 7 days was 428. The average for the 7 days prior was 546. The average pmps the past 7 days is 503. Prior it was 560. You can't let a single reading drive you crazy. Look at the big picture. He's making progress.
It's a marathon, not a sprint. That sentence helped me a lot, when it seemed like nothing was happening.
Thank you both. Sometimes it’s hard, I’m sure you’ve both been there. I feel better this morning. AMPS 383.
If it's low like low 200's I would reduce tonight. I think like 2 units. I think overall your dose has to come down. Id say go back to 4u because we are seeing a steep drop now. Let's see what others think.
Emily contacted me privately so I'm updating here I suggested she test again in 30 minutes (and NOT feed). If he's still too low, stall for another 30 for a total of 1 hour. She also asked about the AM dose....I told her to test at the normal time and if he was high enough, she could go ahead and shoot at the normal time but if not, she'd need to stall and work her way back by 15 minutes per cycle or 30 minutes per day
Do you feel her regular dose needs to come down a bit in the am? I'm thinking of like to see what happens now at 4u or 4.25.
Recap: Last night after three sets of testing he finally rose to 262 at approx. +13, and was given 3.0u. Retested at +3 and was 291, so left him alone for the rest of the night. **Ran AMPS at 6:45a and he is 88, so we are holding until 7:15a then retesting. If above 250 then giving 4.25u— as discussed last night with Chris and Janet— if not, we hold again. I’ll be back after that. But, I believe the plan is on try 3 if he’s above 250 shoot 4.25u, if lower than 250 (but still rising) shoot 3.0u as we did last night. If still under 200 and not really rising, skip the shot entirely? Or give 1.0u? Or, 2.0u?
ok we have to rethink this. Don't give 4.25. Clearly that pancreas had woken up. I think even 3 might have been too much last night. Let me think.
Will retest and post here. (Will hold insulin until we come to a consensus on this morning’s dosing needs) Be right back. UPDATE: retested at +12.5, 100. Will continue to wait 30mins more and retest.
Id do 0.5 and check in a couple hours. If you totally skip he may wind up back in black. He may wind up high later but it's safer than dropping too low.
I will let him eat a bit then shoot 0.5u. Will retest at +3 and let y’all know where we are at. Advisement for this evening, should it occur again?
omg i have no idea. His numbers are so wacky and unpredictable right now. hahahaha Ill take this over 400+ though!!!! I think I'd go with 190-250 do 2, and over 250 do 2.5 over 300 do 3 @Chris & China (GA) What would you suggest.
Just shot 0.5u. He’s eating well! I’ll check back in a couple hours, and let you know how he’s doing— this is CRAZY
That we wait until a lot closer to PMPS to see what's going on. Obviously something is happening with Nico's pancreas so it's in charge!
Thought I updated this, but I guess I didn’t. His +6 was 409, so I’m full on prepared for a 600+HI reading as we near PMPS. Anticipating shooting 3.0u if above 300, yes @JanetNJ & @Chris & China (GA)??
Just a quick update: PMPS 600+HI, as anticipated. Shot 3.0u after dinner. Will get a +3, then update here after his AMPS. Here’s hoping..!
(Pm) +4 394. AMPS 257. 2.5u given. Question though. He’s had really stinky poops over the past two days, this morning it is looser than usual. Is this common? Does this have to do with reaching a breakthrough dose? Or his pancreas now being a little more alert? He hasn’t had any diet changes or issues eating or drinking. I’ll keep my eye on it. Poor guy, can’t catch a break!
Probably be a good idea to start a new thread at some point too. This one's getting pretty long. Just include the link to this thread in the message part of a new one. How long until PMPS? Might want to get a +11 or +11.5 if you can so we know if he's going up or still dropping.
@JanetNJ @Chris & China (GA) Nico’s +8 was 134, so I anticipate his PMPS will be above 190 but on the off chance it’s not I wanted to grab advice before it gets to be too late. Assuming I’ll still do 2.0u if he’s 190-250, 2.5u if he’s 250-300, and 3.0u if he’s 300+?? Let me know.
PMPS 370. 3.0u given. Moving this thread momentarily— here’s the new thread link: https://www.felinediabetes.com/FDMB/threads/nicos-getting-closer-breakthrough-dose-achieved.239567/