6/16 Merlin PMPS 133

I am wondering if even .1 is too much for Merlin. How can it be good for his system to put him through this dropping and bouncing over and over? I wonder if it would be better for his system to have very very little and adjust to that for a while?
 
Merlin’sMama said:
I am wondering if even .1 is too much for Merlin. How can it be good for his system to put him through this dropping and bouncing over and over? I wonder if it would be better for his system to have very very little and adjust to that for a while?
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It’s not the dose that is making him bounce. It is because he is dropping too fast or too low or he has to get used to low numbers again. Cats can be on any dose and they can bounce. He is having very little insulin now. If you give him less insulin than he needs he could develop glucose toxicity and it will be even harder to get the BGs down.
Do you have your patience pants on?;)
 
Bron and Sheba (GA) said:
Remember bounces can last up to 6 cycles. And it only takes one cycle of too fast, too low or lower than he is used to so set off another bounce.
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It’s not that I am impatient. Staying up til 3 and getting up at 830 to sit by Merlins side and test him every hour and feed him whatever is required at the moment, day after day is proof of that. I am concerned about Merlin’s health. I want to know why things happen the way they do and if they are happening in a way that is healthy. I want to do what is best for him. I am trying to understand all of this and make the right decisions. I appreciate you taking the time to answer my endless questions, Bron.
 
Merlin’sMama said:
It’s not that I am impatient
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I know you are not impatient, but you do need to remember that Merlin is still very new to all of this and his body need time to get used to insulin. The most important thing you can do for him is make sure he gets the dose of insulin he needs so that he can utilise the food he is given and for the insulin to do all the other things it does in the body so it can function properly.
Bouncing is no fun..nobody likes it …but it is something the cat does ‘to save itself’.I’m sure many cats have been saved by this phenomena without many caregivers who do not test, realising it…

Use the knowledge you are gaining from his drops to adjust the snacks if you think that is needed.
 
I hope you can get a nap today, Jill. So far, a very good cycle dropping into blue. Who knows, maybe he will go green later on, but I don't think you have to worry about the deep diving like last night. You are an amazing cat mama!
 
Suzanne & Darcy said:
I hope you can get a nap today, Jill. So far, a very good cycle dropping into blue. Who knows, maybe he will go green later on, but I don't think you have to worry about the deep diving like last night. You are an amazing cat mama!
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Thank you, Suzanne. He’s at 113 now. Still dropping. Not sure about feeding. Fed last at +4 LC. Maybe wait another hour and give another LC snack?
 
An hour ago I fed him 10g of 3.7. I guess he will be ok now. Or should I give another snack? Not sure, he’s never been in green this late.
 
Merlin’sMama said:
Ok. How low is too low to shoot tonight? I just dont know what would happen with him.
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I can't answer that Jill, hopefully @Suzanne & Darcy can but you have given him his shot as low as 11.4 mmol/L (205 mg/dl)
If you take a reading at AM+10 or AM+11 you will know where Merlin is at with his BG in relation to his PMPS.

Why the +10s and +11s? These spot checks will help keep you out of trouble. Again, let’s say that you have a lower than usual preshot. If your preshot is higher than +10 or +11, you know the insulin from that cycle is waning, the cat is on his way up, and the number is probably shootable. If you have a preshot that is much lower than your +10 or +11, knowing why will help you decide whether or not to shoot. Some Lantus, Levemir, and Biosimilar users notice a dip at the end of the cycle, meaning that the preshot is always a bit lower than +10 or +11 (but usually still higher than the nadir – the cat dips to a nadir at mid-cycle, then rises, then dips again). If this is your cat’s pattern, then this type of dip is not a reason to delay a shot. On the other hand, if your cat has a bounce clearing and is still careening downhill at shot time (usually characterized by numbers that drop for the whole cycle, without a clear nadir), then you will want to take that into consideration as you make a decision about shooting. Know thy cat.
Taken from
https://www.felinediabetes.com/FDMB...y-to-shoot-handle-lower-pre-shot-numbers.147/
 
Merlin is still at 112@+11. I wonder if he will go up at all?? I am not comfortable shooting him so low, not after last night.
 
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Awesome to see Merlin flattening out!:cool: Lantus (and Levemir), once the kitty learns how to work it, can result in some nice flat curves. If you shoot lower numbers, you don't get the same drops as you do from higher numbers. I loved giving insulin in the 80's to Neko, as she'd usually move no more than 10 points the entire cycle.
 
Wendy&Neko said:
Awesome to see Merlin flattening out!:cool: Lantus (and Levemir), once the kitty learns how to work it, can result in some nice flat curves. If you shoot lower numbers, you don't get the same drops as you do from higher numbers. I loved giving insulin in the 80's to Neko, as she'd usually move no more than 10 points the entire cycle.
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Id love to see that happen, Wendy, but Merlin doesn’t seem to be following many rules lately…
 
Your choices are to shoot now, and get the usual early tests. Option 2 is delay some more, but that delays tomorrow morning's schedule too. Option 3 is a reduced dose or skip. There are pros and cons to all of them.
 
Wendy&Neko said:
Awesome to see Merlin flattening out!:cool: Lantus (and Levemir), once the kitty learns how to work it, can result in some nice flat curves. If you shoot lower numbers, you don't get the same drops as you do from higher numbers. I loved giving insulin in the 80's to Neko, as she'd usually move no more than 10 points the entire cycle.
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I'm not a Latnus user Wendy and i know Lantus works differently to Prozinc but i find the same thing happens with Duke, if he's low preshot i give him his normal dose and he just drops nice and slowly.
I've shot as low as 6.4mmol/L (115 mg/dl)
 
At a 47, Merlin has just earned a reduction.... and some high carb gravy or other high carb options that I know you have, Jill. There's nowhere else to go but to a one drop dose, I believe.
 
As an exercise, you might want to try counting the number of drops in your 0.1 unit dose. Use an old syringe and some coloured liquid (juice, tea, etc) and draw your 0.1 unit dose. Gently twist the syringe to bring out one drop. Continue doing that until the syringe is empty. Practice so that the size of drops is consistent when you draw a drop. Sometimes people are surprised at how many, or how few drops are in a 0.1 unit dose. Depends on the syringes too. The next dose might be 1 drop, or maybe 2, depending on the experiment.
 
Wendy&Neko said:
As an exercise, you might want to try counting the number of drops in your 0.1 unit dose. Use an old syringe and some coloured liquid (juice, tea, etc) and draw your 0.1 unit dose. Gently twist the syringe to bring out one drop. Continue doing that until the syringe is empty. Practice so that the size of drops is consistent when you draw a drop. Sometimes people are surprised at how many, or how few drops are in a 0.1 unit dose. Depends on the syringes too. The next dose might be 1 drop, or maybe 2, depending on the experiment.
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I dont really understand this, Wendy. You are talking about how many drops are in a .1 dose? How would you count the drops in a dose before giving it? All you really have to go by is the line on the syringe for each injection, which, apparently, is inconsistent. Why would practicing drop size help if you base a .1 dose on lining it up under the first line? Also, isn’t a drop dose done by pushing the plunger all the way in, inserting it into the insulin, and then letting go of the plunger?
 
You wouldn't count the drops in the dose you are going to give. You would draw 0.1 units as you have been doing, in an old syringe with coloured liquid. Then counts the drops in that. I've seen people find their 0.1 is just 1 drop, and others find it's 4 drops. For people with larger number of drops in their 0.1 dose, they could get, say, a 2 drop dose by drawing up 0.1 units, then squeezing out two drops.

The reason for the experiment is that cats that are on tiny drops of insulin and close to ready to go off of insulin, shouldn't be seeing yellows, much less pink/red on their spreadsheet. The experiment was to see if there was a way to give Merlin dose between 1 drop and what you are doing now.

And yes, a drop dose is as you described.
 
Very nice cycle Jill, this is much closer to what you want to see on Lantus minus the lime green value. To be honest we were happy to get a 47 cause it meant a reduction but Chico was on much higher doses back then.
Merlin clearly likes it a bit differently :rolleyes: Good luck finding a dose that would suit Merlin’s insulin needs because you are on the right track :cat:

Wendy explained the reasons and the way to decide the next dose very nicely, hope it will help you
 
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