4/11 Minnie PMPS 326

Liz & Minnie

Liz & Minnie

Member Since 2021
Caturday news. She again sneaked out to sleep on the piano stool in a bit more comfort and hasn't gone back to the front door yet.

I went with 0.75u this AM but I was originally thinking 1u before reading this.

Wendy&Neko said:
From yesterday we said "0.75 if over 350, 0.5 if under."
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I thought that was for the mid-cycle shot

Wendy&Neko said:
Last night you had a similar PMPS, and the 0.5 units of R was just a bit more action than we like. Tonight might have been better for 0.5 as well. So I'd suggest the preshot scale:

>400 1.0 unit
350-399 0.75 unit
300-349 0.5 unit
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Thanks for this! Can you give similar guidance for the mid-cycle?

Last night's 0.75u R dose didn't seem enough/have same effect as the previous night. This is where I wish I could interpret numbers & identify bounces better. PM of 4/9 was recovering from a bounce? And yesterday was another bounce from the blues?

I probably should have given her another 0.5u last night @+6 but was too sleepy, just scanned her and staggered back to bed (sofa).

Another question - do you only recommend mid-cycle shots at +6? What if (say) I had given another 0.5u yesterday @AM +10 when she was at 313? Vet had said ok to give 0.5u every 2 hours but I know you said that was pretty aggressive (and that does scare me, who can't just pump dextrose into the IV at will)

I know it's a bit early yet but it's looking to me like she's heading back to 5u L, which will be fine by me. I hate having to read between the lines!

Will see where today's 0.75u takes us, anyway.
 
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Already down by 90 after 2 hours so gave her 1/2 oz MC 12% AD (after some LC ducken) to see if that slows things down. Glad I didn't go with 1u R after all!!
 
When I wrote the above last night, she had gone down 90 points in two hours. Remember, we are trying to avoid steep drops that can cause yet another bounce to happen. So the idea is an R dose that takes her down 100 points, which she did by +3 last night. And it looks like a 90 point drop in the first two hours again today. So the results are at least consistent.
Liz & Minnie said:
Another question - do you only recommend mid-cycle shots at +6? What if (say) I had given another 0.5u yesterday @AM +10 when she was at 313? Vet had said ok to give 0.5u every 2 hours but I know you said that was pretty aggressive (and that does scare me, who can't just pump dextrose into the IV at will)
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Other guidelines, we try to avoid overlapping the nadirs of the R and L insulins - again, that could cause a steep combined drop. The mid cycle R does not have to strictly be at +6. You can give it when you see her rising again. +5 would have been OK yesterday. I didn't use mid cycle R much, but did occasionally use it at +10. Neko behaved oddly on R, both her R onset and nadirs were later than typical, so a +10 R was sort of like shooting it at PS. Her Lev onset was also later. If your question is about two shots of R mid cycle, I do not have experience with that and don't know who I could ask to help with that. I am still pondering the mid cycle scale as you gather data.

Thought for today - it's the sixth cycle after the last green. Might see some bounce breaking action either today or tonight. Second thought for the day - today is the sixth cycle on 4.75 units. If you don't see green today, that means the reduction has failed and you might want to consider bumping the L back up to 5 units. But I wouldn't do it until tomorrow, just in case today is a bounce breaker.
 
Thanks so much.

I gave her 1/2 oz of 12% ad when I saw the 260@+2 (Libre showed an arrow straight down which means rapid drop). @+2.5 she's at 225 (Libre showed a diagonal arrow i.e. slower drop) so gave another 1/2 oz of 12%. Does that seem right or do I need to give some higher carb to slow her down and stop her going too low? I also have the 25% HD but now sure how much to give. I will check her numbers again in 20-30min.
 
Drop of 139 @+4 from 0.75uR @AMPS 351. Almost identical drop from 0.5uR on 4/9 @PMPS 337. I've created a tab for the R scales, tracking the drops there.

AMPS 351 (0.75uR), +1 299, +2 260 (1/2oz MC), +2.5 225 (1/2oz MC), +3 222, +3.5 210, +4 212 (1/2 oz MC for calories not BG), +5 232. Thank goodness for the Libre :) I would never poke her this many times

A friend has taken pity on me, taking me out for a late lunch. I'm thinking she should be safe, not expecting a dramatic drop...but on the other hand I'm a bit paranoid these days.

ETA - She went back to hide by the front door again, I think the stoma is hurting her. Gave her potassium and a bit of food by tube and at one point she hissed at me. Going to have to clean it, I'm dreading looking under the kittykollar (can already see some 'discharge' round the gap). This is the hardest part of all of it so far. On the plus side, she did eat a bit more ad when I offered it. Still refusing the tiki chicken&egg in consomme!


 
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Liz & Minnie said:
Drop of 139 @+4 from 0.75uR @AMPS 351. Almost identical drop from 0.5uR on 4/9 @PMPS 337. I've created a tab for the R scales, tracking the drops there.

AMPS 351 (0.75uR), +1 299, +2 260 (1/2oz MC), +2.5 225 (1/2oz MC), +3 222, +3.5 210, +4 212 (1/2 oz MC for calories not BG), +5 232. Thank goodness for the Libre :) I would never poke her this many times

A friend has taken pity on me, taking me out for a late lunch. I'm thinking she should be safe, not expecting a dramatic drop...but on the other hand I'm a bit paranoid these days.

ETA - She went back to hide by the front door again, I think the stoma is hurting her. Gave her potassium and a bit of food by tube and at one point she hissed at me. Going to have to clean it, I'm dreading looking under the kittykollar (can already see some 'discharge' round the gap). This is the hardest part of all of it so far. On the plus side, she did eat a bit more ad when I offered it. Still refusing the tiki chicken&egg in consomme!

I thought you were checking the stoma daily? Aren’t you taking her back tomorrow? They can take a good look at it. Did they show you how to check for negative pressure to make sure it is still functioning properly? Nice friend!
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Yes, checking the stoma daily..I've just been delaying today's check. Need to give it a bit of a clean and switch the gauze. And yes, I'll definitely get them to take a look at it. They didn't show me anything, just sent me a link to their YouTube which was a bit disappointing. Said they'd provide some cleanser and spare gauze, which I didn't get. When I asked about it they said no need for the cleanser and gave me cotton discs with holes in the center, but they're sticking to the gunk so I went out and got some non-adherent bandages last night. Geez I hope it's working and the stuff is actually going where it's supposed to go. Ugh!!

@Wendy&Neko what do you think about 0.5uR now at +10? Or better to wait and give it at PMPS (it may be 0.75uR then)?
 
R now can help with the current rise. But you've still got 6 hours to onset of Lev so she'll like still rise a bit after the R is done. I'd also have to factor in whether you were thinking R on tonight's cycle and timing of when you'd do that.
 
What are the options for timing of R on tonight's cycle and does it vary based on whether she gets R now vs waiting til PMPS?
 
If you shoot R at PMPS, you can shoot again at +6. If you shoot now, then a bit earlier. But it depends whether tonight is a bounce breaking cycle or not - too early to tell.
 
@Suzanne & Darcy or others who have used feeding tubes. I just found instructions online for checking negative pressure to make sure it is still functioning properly. My question is, does the plunger need to go all the way back to the starting position? I used a 12cc syringe and started all the way closed. The plunger moved back but not all the way back. I retried starting from the 1 unit line and same happened. Is that ok or an issue?

I think this will be quicker than sitting on hold with the hospital! Luckily she is eating so I should be able to sneak in the potassium and orbax

"Step 1: Check that the tube is in place. Remove the end of the tube from the neck wrap. Before each feeding, attach an empty syringe (10 cc) to the external feeding port and pull back on the plunger. If the tube is in place, the plunger should move back to its starting position on its own (negative pressure), and you may proceed to step 2. If the plunger does NOT move back to its starting position, DO NOT PROCEED WITH FEEDING. The E-tube may be displaced, and you should call a veterinarian for further instructions."
 
Wendy&Neko said:
If you shoot R at PMPS, you can shoot again at +6. If you shoot now, then a bit earlier. But it depends whether tonight is a bounce breaking cycle or not - too early to tell.
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Thanks. Wasn't worth shooting 'early' by the time I finished cleaning the stoma together with bringing shot time 30min early.

Thank goodness they made the Orbax so tasty she was trying to lick it out of the syringe and she has an appetite so I squirted the potassium into her dinner. I am definitely getting them to give the e-tube a once-over tomorrow and not using it til then.
 
Hi Liz. I was concerned about Minnie since you hadn't posted, but I see you've updated your spreadsheet and I read about the vet visit. Seems okay. I hope your are resting! Kisses to Minnie and Sam!
 
Hi! Thanks for checking in. Finally seeing some improvement - hoping to get rid of the feeding tube at the next checkup. Her appetite is great which is such a relief. I will check in now to see how Mr Darcy is doing (well, I hope) - and also Tinkerbelle and Bingley and Emma and whoever else is in your menagerie!!
 
Liz & Minnie said:
Hi! Thanks for checking in. Finally seeing some improvement - hoping to get rid of the feeding tube at the next checkup. Her appetite is great which is such a relief. I will check in now to see how Mr Darcy is doing (well, I hope) - and also Tinkerbelle and Bingley and Emma and whoever else is in your menagerie!!
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Bingley, Jane and Emma! Don't forget Jane!
 
Liz & Minnie said:
Hi! Thanks for checking in. Finally seeing some improvement - hoping to get rid of the feeding tube at the next checkup. Her appetite is great which is such a relief. I will check in now to see how Mr Darcy is doing (well, I hope) - and also Tinkerbelle and Bingley and Emma and whoever else is in your menagerie!!
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How are ketones? Going down?
 
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