Dose reduction? 2.75u or 2.5u? 12/26 AMPS 154 /+5.5 79 /+10 151 /PMPS 307

Emily Tuomey

Emily Tuomey

Member Since 2020
Shelley & Jess said:
How about a +4? Let's see if he's heading towards a big bounce or hopefully, fingers crossed, we haven't caught the onset of the insulin yet.
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Almost no movement in two hours... +4 323. :( Still possible he could move downward, his lower numbers tend to sit in the +5-+7 range. But, I’m nervous about it at this point. Planning on a +6. Will be in touch— please let me know any thoughts!!
 
@Shelley & Jess +6 265. I’m gonna leave him be now until PMPS. I don’t think we are in any danger of falling too low. Not sure what’s going on honestly. Sometimes I think it might be operator error but every test today I’ve done two in a row and same range so I know it’s not me or the monitor or the strip. Just when you think you know...
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Shelley & Jess said:
I see big progress on your spreadsheet. Gosh only a month ago, look at all that black - you (and Nico:)) are doing an amazing job!
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SO MUCH BLACK. I was so scared, especially with all the talk of potential ketones when all I was getting was “HI.” So many sleepless nights. We are making progress, just wish his body wasn’t so unpredictable— although that’s precisely what all bodies are, unpredictable. I never know where or when he will be up or down or middle of the road, whether he’s bouncing or not, or even what his next dose is gonna be LOL I am starting to kind of see it in his eyes when he’s gonna read high though, he just gets a look, again like all bodies get. I work in pediatric medicine so I’m used to “the look,” just not in feline form. Until now. Anywho.. I’ll be back before dinner time to check in, but I’m anticipating his full 2.75u dose this evening.
 
Shelley & Jess said:
How's Nico doing today?
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Whoa my ears must’ve been burning.. I was just coming to update! Just tested a +6, he’s at 96. Want to leave him be until PMPS today, since we tested so frequently yesterday, unless I see an immediate need for it like extreme lethargy or food aversion, etc. Do you think that will be okay? I’m feeling like I should try to ride out these waves without constantly increasing or decreasing doses to accommodate unless he’s in immediate danger just to see if he will flatten out a little lower than his usual 200s-300s on 2.75u. I’m home, for the most part, so am able to monitor closely if needed. Let me know your thoughts! @JanetNJ & @Chris & China (GA) too!!
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Emily Tuomey said:
+6, he’s at 96.
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:D!!!!

Emily Tuomey said:
Want to leave him be until PMPS today, since we tested so frequently yesterday,
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I'd do a late cycle test, say around +10 or +11. That way if PMPS is on the low side we'll know if he's on the rise when the time comes and it'll help give us an idea of duration too.

That's one gorgeous boy you've got there!
 
Emily Tuomey said:
Whoa my ears must’ve been burning.. I was just coming to update! Just tested a +6, he’s at 96. Want to leave him be until PMPS today, since we tested so frequently yesterday, unless I see an immediate need for it like extreme lethargy or food aversion, etc. Do you think that will be okay? I’m feeling like I should try to ride out these waves without constantly increasing or decreasing doses to accommodate unless he’s in immediate danger just to see if he will flatten out a little lower than his usual 200s-300s on 2.75u. I’m home, for the most part, so am able to monitor closely if needed. Let me know your thoughts! @JanetNJ & @Chris & China (GA) too!! View attachment 58747
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Great number!
 
Shelley & Jess said:
I'd do a 30 minute stall to be absolutely sure.
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Ok. So retest in about 20 mins now then I’ll be back. I’ll just update here and tag y’all, if that’s okay? << here’s hoping >>

UPDATE @Shelley & Jess @Deb & Wink @JanetNJ @Chris & China (GA): he’s now 118 @+12.5. :confused: Crap. I really don’t want to set him up for another bounce by reducing to 2.5u though. I feel like we keep going in circles by doing that, but I know no one is gonna be comfortable with me shooting his full (2.75u) dose at 118 for sure. :( What to do...
 
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I'm going to re-post what Deb said in your previous thread for us to re-visit.

Deb & Wink said:
Ah, contingency planning. Both Janet and I are on the east coast. I think I have an earlier bedtime than Janet does.:)

Nico is working his way back down the dosing scale.

I don't think you have enough data to judge how Nico would do if you shot the full dose when he is in the low blue range. Yes, using MPM dosing method, you can still technically give your cat the full shot as long as the BG is >50 IF you are around to monitor and guide with food more intensively AND you know how low a particular dose takes him. When you don't have that capability for monitoring, than you need to more slowly work your way down to a lower and lower pre-shot in order to be giving the full dose, by striving for lower and lower pre-shots where you give Nico his full dose of insulin.

For now, I think you want him to be >150 at pre-shot to give him his full dose. As you gain more data on how Nico is doing on a particular dose, you can lower that guideline to 140, then 130, then lower.

It was much easier when Nico was really high, BG wise. Now, it takes a bit more thought to decide what you want to do. So now is the time to restudy those
Sticky PROZINC DOSING METHODS and make sure you know what to do if no one is able to get back to you in time. "Better too high for a cycle, than too low." Too low would be <50 mg/dL.
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Emily Tuomey said:
I really don’t want to set him up for another bounce by reducing to 2.5u though. I feel like we keep going in circles by doing that, but I know no one is gonna be comfortable with me shooting his full (2.75u) dose at 118 for sure.
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118 and 122 are basically the same number. I don't recommend shooting 2.75u.
 
If he were my cat I'd do no more than 2.0u and I'd be monitoring all night :nailbiting:
I'm looking at 12/13 PMPS @ 113 mg/dL, you shot 1.0u. You hold the syringe. What do you think the next step up would be?
I can't stay up with you (it's 11:30pm here)
 
Shelley & Jess said:
If he were my cat I'd do no more than 2.0u and I'd be monitoring all night :nailbiting:
I'm looking at 12/13 PMPS @ 113 mg/dL, you shot 1.0u. You hold the syringe. What do you think the next step up would be?
I can't stay up with you (it's 11:30pm here)
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I know it’s late, thank you for staying up for us. I’m prepared to stay up throughout the night— I’m on a pain medicine schedule myself anyway. I have supplies for a potential hypo. It’s just never been his mo to drop super low. I’m nervous if I decrease too much it’ll just set him back up for this same cycle. Luckily I’m working from home so I can nap tomorrow if I’m up with him tonight. Every 2 hours test?
 
See what way the numbers are trending. If he's dropping, look at the percentage of the drop or the momentum the drop has and ask yourself if he keeps dropping at the same rate where will he be in 30 minutes, 1 hour, or 2 hours from now. Look at where you are in the cycle. Are you at the point in the cycle when the insulin is just kicking in or starting to wear off?
 
Shelley & Jess said:
Em, that's not bad at all, just squeaking over the yellow line to barely pink. Look at your last blue AMPS 12/19 - he gave you a red PMPS that cycle. Progress!!
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Trying! I did a +4 on him and he’d come down a bit, 262, planning to get a +7 here shortly before I head out to an appointment just to be sure he’s okay— but I’m suspect of higher numbers, I don’t know why. Just a feeling. I’ll be back soon with a new number! (Oh, and still no sleep. I’ve never really been a very good napper.. early to bed tonight, hopefully; if his numbers are play. :coffee:)
 
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