Evie's numbers continued

Of course, we are overdue for another surprise so Evie is delivering :confused:

She is 83 @ +8.
Is this a late nadir? +8 seems very late for Prozinc from what I've read.

At this rate she will have a really low PMPS, in preparation I just want to double check if I am still following the previous dosing advice?
(0.6 if 150ish and up / 0.2 if above 120 / NS under 120)
 
It’s the middle of the night for you now (and you have been testing.). She’s having a nice blue cycle and it’s possible she may dip into green based on that last test, but she’s not doing anything crazy— a nice sedate and safe cycle.
 
....But 116 this morning. Another token dose?
Right now I'm doing a stall to see which way the numbers are going.

By the way, I set an alarm for 2am to check her +9 last night because of that late nadir on the daytime cycle. She stayed in blue all night and recovered very nicely down to 116 now at 5:30am
 
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I went ahead and shot 0.2U because I didn't want to delay too long.
I decided to measure it on the fat side, because last time I shot 0.2U her starting point was similar and the dose didn't drop her too low. Hope that's ok.
As always I will monitor her.
 
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I've been thinking, if Evie is going to be staying in these lower numbers with very small doses perhaps it might be better to switch to those donated u40 syringes.
It's a limited supply though but I think the lady said she had 3 boxes so at least a few months worth.

What do you think?
I have no experience with u40 syringes, I am presuming the lower doses are easier to control in those syringes but I am eager to hear what you think.
 
AliceL said:
So she is 80 @ +3 which is a little early in the cycle for that low number.
I gave her a little MC food and will continue to monitor.
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Well she started from a low place this morning so not too dramatic of a drop from AMPS. I was just going to say that as long as she stays above 50 it’s all good— and that is true, but the. I remembered that her reduction point is 70. Unless she hits 50 I would not reach for the high carb or honey.
 
Her next shot is due in about 3 hours or so.
I know I gave her a token dose this morning but would I be correct in thinking I should hold today's dose at fat 0.2U / straight 0.2U for the next cycle seeing as her nadir was optimum between 70 and 150?
 
I thought we decide based on nadir? Unless pre-shot numbers are low.
This is why I don't know what to do every cycle.
I would like to test her now and shoot her in 30 mins to bring her night cycle forward a bit, is that ok? That would be moving it by 30 mins
 
Maybe how I've been conducting my pre-shot schedule is all wrong.
I do the pre-shot test usually at +11.5 in order to do the next insulin shot at 12hr intervals.
This is to accommodate feeding and make sure the food stays down, but also allows one stall.
We've been stalling a lot lately which is taking up time, but also I don't know what the general rule is to this shooting schedule and always waiting for guidance so its causing further delays to her schedule.
SLGS was pretty straightforward to follow before Evie started dropping like this, or hitting guideline nadirs on different doses.
This is all stressing me out a lot because I am a planner by nature.
I also don't want to have to rely so heavily on admins for a quick answer, I know you all have lots of cats that you help or even that you have your own life to live.
I would much prefer to set up guidelines beforehand, if such a thing is possible.
 
AliceL said:
I thought we decide based on nadir? Unless pre-shot numbers are low.
This is why I don't know what to do every cycle.
I would like to test her now and shoot her in 30 mins to bring her night cycle forward a bit, is that ok? That would be moving it by 30 mins
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Yes. Of course, we do decide based on nadir, but with ProZinc, we have to give a little more consideration to preshot numbers that we would with the depot insulins. For example, you considered her preshot number when you shot the .2 (because the preshot was low, you shot .2 instead of .6, right?) So yes, of course, we will consider her nadirs. I'm not opposed to you plan at all. You are doing great. In fact, we can just try it and see what happens. You can always go back up. She's been maintaining pretty low preshot numbers lately, so I'm actually thinking that he preshot won't be too high anyway -- so the whole point may be moot when you test her.
 
That explains a lot. I was wondering why she went up so much between the preshot test and the next test... she's eating? She gets a very big food bump sometimes (into yellow.) I was trying to figure out... still don't think I have figured it out.
 
Either way, we don’t want to get too hung up on technicalities. If you shoot at 11 hours and 45 minutes- who cares. If you shoot at 12 hours and 15 minutes then so what? I think it’s okay. Personally, I would test as close to 12 hours as possible, and feed immediately and shoot even while she was eating. If she is prone to vomiting and then refusing food after that, I would test at 12 hours and feed and wait ten or 15 minutes and then shoot (knowing that her BG is going up from the food, of course.)
 
Maybe, when she's not working, @Shelley & Jess can give us her experience with Jessie. Did Jessie tend to vomit or anything after breakfast? She had IBD, right?

Also, my good friend @Linda and Newman definitely has experience with Newman sometimes doing a "scarf and barf" of his breakfast. Linda, you have a built in way of handling this situation, don't you?
 
Suzanne & Darcy said:
Either way, we don’t want to get too hung up on technicalities. If you shoot at 11 hours and 45 minutes- who cares. If you shoot at 12 hours and 15 minutes then so what? I think it’s okay. Personally, I would test as close to 12 hours as possible, and feed immediately and shoot even while she was eating. If she is prone to vomiting and then refusing food after that, I would test at 12 hours and feed and wait ten or 15 minutes and then shoot (knowing that her BG is going up from the food, of course.)
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I used to do 15 mins before the 12hrs intervals but since the low numbers I have been leaving a bit extra for stalls... and waiting for dosing instructions.... and then trying to walk backwards here and there to maintain an appropriate shoot time every cycle.

Anyway, I have always included my AMPS / feed / insulin / test times in the end column of her spreadsheet.
If I look back my average window between AMPS and insulin is 15-30 mins, with food somewhere in between.
 
Well you really do have to do what works for you and for Evie. I understand about the low preshot numbers that you have been seeing. I think that the whole point of stalling without feeding though is to give the BG time to rise before shooting a more comfortable number (again showing that we do give some consideration to preshot numbers with ProZinc.). If Marje were here, she’d be telling you to shoot anything 90 and above.
 
Suzanne & Darcy said:
Also, my good friend @Linda and Newman definitely has experience with Newman sometimes doing a "scarf and barf" of his breakfast. Linda, you have a built in way of handling this situation, don't you?
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Evie is a total scarf and barf cat. She even inhales treats without even chewing.
Plus dinner & breakfast are the big meals before insulin where she has had no food for at least 2 hours prior so she usually eats them faster.
To counteract this I feed her 1/4 portions at a time, let her finish and ask for more, so it will take her about 30 mins to eat her dinner or breakfast and I usually shoot insulin before she is finished eating anyway.
She is getting better at not vomiting since the sugar is lower overall, feeling less ravenous I guess.
 
Suzanne & Darcy said:
I understand about the low preshot numbers that you have been seeing.
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But I have been shooting this way since the very beginning, even when her pre-shot numbers were higher. The only times I did test, feed & shoot in quick succession were when I was running late to catch the 12 hr intervals.

I will make a change to test, feed & shoot in quick succession from here on and see what the effect is on her AMPS/PMPS.
 
AliceL said:
To counteract this I feed her 1/4 portions at a time, let her finish and ask for more, so it will take her about 30 mins to eat her dinner or breakfast and I usually shoot insulin before she is finished eating anyway.
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It sounds like you have a system that is working for her. We usually recommend dividing up the total amount of food (that you want your cat to eat for the day) into smaller portions -- a small amount at shot time. More at approx +2, etc., etc. So you probably already are doing that. Except she's been getting extra stuff when she's going lower than you are used to ? And yes, it should help if she's not as ravenous now that she's in better numbers. Most cats appetite is more moderate when they get into better numbers.
 
AliceL said:
But I have been shooting this way since the very beginning, even when her pre-shot numbers were higher. The only times I did test, feed & shoot in quick succession were when I was running late to catch the 12 hr intervals.

I will make a change to test, feed & shoot in quick succession from here on and see what the effect is on her AMPS/PMPS.
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Well, as I said, your care of Evie has gotten her into a very good place now. So you had to be doing something right? Right? :-) You are a very precise person, I think? A rule follower? ;-) I always liked how precise everything has been on your spreadsheet. It's really helpful to see. You have all the food and times/intervals in the comments. It's awesome.
 
Suzanne & Darcy said:
You are a very precise person, I think? A rule follower?
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Absolutely :smuggrin:
To my own detriment sometimes I think.
I am also analytical so I am always looking for the patterns in the numbers.

And feline diabetes does not play by the rules or have definitive patterns which I'm finding incredibly stressful :D
 
Oh well, no greens, but there's something to be said for a basically flat blue cycle (I'm looking at her spreadsheet up to +5) and some sleep, hopefully.
 
Oh my gosh!! I got a green AMPS 65.
I am stalling just to double check it.
It is 12 hrs 15 minutes since the last shot cause I overslept.

Evie is really hungry and wants her breakfast :smuggrin:
 
She is still acting crazy hungry today though.
I fed her a full portion at 6:15am , another half portion at around 8:40am after a test and she wanted more now at 11am, which I gave her after another test.
I don't want to bump up her glucose but I don't want her to be stressed out with hunger.
 
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