01/18 Ethan PMPS 311, +1 328, +2.5 319

Erin Ethan

Erin Ethan

Member Since 2023
Yesterday's post.

Ethan seems to have a pattern of running higher during the night (except on 01/15). Not sure if that is common to see?

He is dropping a bit this morning. I already gave a snack of LC food; going to try to hold on to see if he flattens out but if he drops lower I will give more (or switch to HC if needed).

Also- today is day 5 of Phase 2 I believe. If I understand the algorithm correctly, if his peak is higher than 11.1mmol/l (~200) today we are supposed to increase his dose by 0.25 units.

I might hold on one or two more days at this dose as he does seem to be making progress at 2 units, and I think some of the higher peaks might be caused by reacting to drops by giving extra food.
 
Last edited:
Erin Ethan said:
Ethan seems to have a pattern of running higher during the night (except on 01/15). Not sure if that is common to see?
Click to expand...
Actually many cats go lower at night. It's good he is giving you active cycles in the day so you can monitor him and you can sleep at night when he is bouncing :-)

Erin Ethan said:
Also- today is day 5 of Phase 2 I believe. If I understand the algorithm correctly, if his peak is higher than 11.1mmol/l (~200) today we are supposed to increase his dose by 0.25 units.
Click to expand...
What is Phase 2? Actually, dosing is based on nadirs - how low a dose takes a cat. Considering that he saw 56 on this dose a couple of days back, you would hold the dose. if he drops below 50 today, you would reduce his dose by 0.25U. It would be good to verify any lows with a meter since the Libre does tend to read much lower at lower levels.

Here are the TR guidelines for increasing the dose:

Increasing the dose:
  • Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
    • if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
    • when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.
  • Increase by 0.25 unit after 3 days (6 consecutive cycles) if nadirs are greater than 200, but less than 300.
  • Increase by 0.5 unit after 3 days (6 consecutive cycles) if nadirs are greater than 300.
 
Bandit's Mom said:
Actually many cats go lower at night. It's good he is giving you active cycles in the day so you can monitor him and you can sleep at night when he is bouncing :)
Click to expand...

Very true...I am thankful for that! Our cats tend to be more active during the day and generally sleep soundly throughout the night so maybe that has something to do with it...

Thank you for sharing these guidelines- glad I checked! I was referencing the decision tree in Table 1 linked here (I got this link from FMDB when looking into TR & bookmarked it). Rechecking the sticky now, I see that we follow a modified TR protocol.

The past couple days I think I've been preventing Ethan from going low as low as he potentially could by giving snacks when he is dropping 'really fast' (usually in the AM). He is starting to have less dramatic drops, so moving forward I will stick to a more structured meal schedule to let the BG #s play out without intervening.

Trying to balance between getting the "real data" on how his BG #s behave on 2 units without reactive intervention, but not landing him in a critical situation where we have to give HC/honey.

Thanks also for the note on the Libre #s reading lower. After our first successful prick test we've attempted a few more tests- Ethan seems to be more aware of us touching his ears than he was the first time and we were not able to 'milk' enough blood before the puncture closed. We're going to try spending more time warming the ear properly with the rice sock.
 
Having said that, I just checked and he is at 43 at +3.25 (on the Libre). He is non-symptomatic. I gave him his lunchtime snack ~15 minutes early.
 
Was not able to get the test- had a really good warmup and good amount of blood but the blood sort of smeared around on the strip which caused it to error out. Tried to get a second one but it had dried up by then.

Ethan's eaten a very significant portion of food now as I let him keep eating while attempting the test. Libre still reading 43 about 15 minutes since first reading.
 
Last edited:
No luck with test attempt #3; he's a bit fed up with all the poking for now.

He is back up to 158 now on the Libre. I gave LC over an hour ago (was prepared to give HC if he continued dropping).
 
Yes- not sure if its a reaction to the drop or the LC kicking in. I am watching him like a hawk.

86 now.
 
79 at +5.

He still seems comfortable (he is sleeping, but he does seem to perk up if I come and pet him/he doesn't seem 'out of it').
 
Last edited:
148 at almost +6. I let him have about a tsp more of LC food just now to keep him going. So much for the "structured" mealtimes today :rolleyes:.

He's up and prowling around now.
 
I am preparing myself in case we have to give him 1.75u.

I have seen the 1/2 unit marking diagram in the forum, and have watched the YouTube video on drawing insulin from a Lantus pen.

I've added a picture of the syringes we have into Ethan's SS (BD ultrafine u100 with 1/2 unit markings)- did I indicate the correct position to give a 1.75u dose?
 
I'm adding your pic here. That looks correct to me but I am not an expert in these syringes.

IXYAEFugNyI7yTCdAbmJv8z_1T74SqJI13A_r207BOxTvtN4gwFpXuEfggZxtlg5-S9JHn-M0HGFh0OGJXKgaIcktSMWF-ZwOmu6hRQi1grS57fV47GE_zwGEp-OBsrkV7YekRofHV1blAI7Srr8S96q6tqUEZUJy3QSWeJRZOPeIwGD1yEU
 
Kept him at 2u for tonight since he is tending to run higher at night, and also given the Libre might be running lower. I am watching in case of another drop. He seems to get his drops over with pretty early in the cycle.

I'll aim to do 1.75u tomorrow AM.
 
Couldn't see the pic you added. Here's a pic with 0.25U.

49822973683_0559ae843a_o.jpg


ETA: Saw the pic in the SS. Looks good to me. Btw, the +4 cell on the SS would be coloured in dark green and not blue.
 
You must log in or register to reply here.
Back
Top