Starting MPM Today - New Thread

Rewster's Mom (Renee)

Rewster's Mom (Renee)

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Previous thread: https://www.felinediabetes.com/FDMB...sted-for-pm-shot-options.286602/#post-3155837

Just switched to MPM this evening and so far seeing good results! Gave her a typical snack at +2, and we'll continue to monitor over the course of this evening to see how she trends (at least until we determine her drop is safe).

Thank you all for the advice so far. Anxious to start a new method but hopeful for healing greens. :D
 
I see that 71, which is good but perhaps a little early in the cycle. Be sure to give a spoonful of low carb food to help her surf in green.
 
Hi there. I see those nice greens at night. I hope soon they will also move into the daytime! I think it would have been better shooting the 177 this morning without the 30 minute stall, as long as you would be around to monitor her (but it's good data for the next time.) She's doing her daytime "bounce" -- flat yellows, but at least no pink, so I will take that as progress! Hopefully by tonight it will be over. I just wanted to stop by and let you know I was peeking in on her progress and rooting for you both!
 
Suzanne & Darcy said:
Hi there. I see those nice greens at night. I hope soon they will also move into the daytime! I think it would have been better shooting the 177 this morning without the 30 minute stall, as long as you would be around to monitor her (but it's good data for the next time.) She's doing her daytime "bounce" -- flat yellows, but at least no pink, so I will take that as progress! Hopefully by tonight it will be over. I just wanted to stop by and let you know I was peeking in on her progress and rooting for you both!
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Thank you for checking in on us! I wish I had shot the 177, but definitely learned for next time. I was surprised she was lower than normal this morning because she was on her way back up at +5 last night. Maybe she just slowly meandered from 92-177 throughout those next hours. I have to start waking up and getting those +7/+8 numbers!
 
Rewster's Mom (Renee) said:
Thank you for checking in on us! I wish I had shot the 177, but definitely learned for next time. I was surprised she was lower than normal this morning because she was on her way back up at +5 last night. Maybe she just slowly meandered from 92-177 throughout those next hours. I have to start waking up and getting those +7/+8 numbers!
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Hi @Suzanne & Darcy. We haven't seen as robust a response to insulin over the last three cycles. Should we increase up to 1 unit?
 
You have been seeing green nadirs in the target range for the last few nights. I am thinking that last night she may have been in the greens before you got the 140. So she is making progress. Would you mind holding this .75 unit dose for a few more cycles so we can see if she settles into it?
 
Suzanne & Darcy said:
You have been seeing green nadirs in the target range for the last few nights. I am thinking that last night she may have been in the greens before you got the 140. So she is making progress. Would you mind holding this .75 unit dose for a few more cycles so we can see if she settles into it?
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Of course! Thank you for your insight.
 
Hi there. I’m just checking in. I see you increased the dose and really I think you could have even done it sooner, but it’s all good. She always tends to have lower numbers at night and that’s okay. I think you can manage those cycles as long as she’s getting he smack meals at least by +2 and +4 (although you may find that you need to even give snacks at +1, 2, 3 especially in the evening — you may want to get an automatic feeder.)
 
Suzanne & Darcy said:
Hi there. I’m just checking in. I see you increased the dose and really I think you could have even done it sooner, but it’s all good. She always tends to have lower numbers at night and that’s okay. I think you can manage those cycles as long as she’s getting he smack meals at least by +2 and +4 (although you may find that you need to even give snacks at +1, 2, 3 especially in the evening — you may want to get an automatic feeder.)
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Hi @Suzanne & Darcy !

Thanks for checking in! She typically eats 60% of her 90 cal meal at her shot time, and then lazily eats the rest up until +5. We add her 20cal snack on top at +2 or +3 depending on her drop. Thanks for the automatic feeder idea!
 
She’s seeing some decent blue nadirs on this dose. I like that. I wish we had caught the nadir today, but I think we can infer that she had a blue nadir in the a.m. cycle today too. I will be happily watching her progress!
 
I did check and see earlier in the evening that she had a lower than normal preshot and I was thinking this could happen — it’s a good sign of progress, I think. Did you retest after the MC (like 30 minutes after?) to see how she responded to the MC? I hope that it didn’t make her jump up too much. Normally we don’t recommend MC or HC until they are at or near 50 — but we do also have to take into consideration how early it was in the cycle so I’m not saying you did anything wrong, but I would like to get an idea of how the MC affected the BG.
 
Suzanne & Darcy said:
I did check and see earlier in the evening that she had a lower than normal preshot and I was thinking this could happen — it’s a good sign of progress, I think. Did you retest after the MC (like 30 minutes after?) to see how she responded to the MC? I hope that it didn’t make her jump up too much. Normally we don’t recommend MC or HC until they are at or near 50 — but we do also have to take into consideration how early it was in the cycle so I’m not saying you did anything wrong, but I would like to get an idea of how the MC affected the BG.
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Yes, we just did a test at 9pm which is +3.5 and she went up to 64. We did an additional 1tsp 15C snack, but in retrospect I think I would have done 8C. We sort of balked at the low drop.

We were just thinking about it and looking over her sheet, and noticed that evenings with steep evening drops like this are also evenings where we are lighting a fire in the wood stove. It seems like there is a positive correlation between insulin absorption and body temperature.

My partner is planning to test again at 9:30 and 10:30pm.
 
Rewster's Mom (Renee) said:
Yes, we just did a test at 9pm which is +3.5 and she went up to 64. We did an additional 1tsp 15C snack, but in retrospect I think I would have done 8C. We sort of balked at the low drop.

We were just thinking about it and looking over her sheet, and noticed that evenings with steep evening drops like this are also evenings where we are lighting a fire in the wood stove. It seems like there is a positive correlation between insulin absorption and body temperature.

My partner is planning to test again at 9:30 and 10:30pm.
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Okay. All good. She did start with a lower PMPS than she has before on this dose of 1 unit. So that plays into it. We don’t have data from today to tell us of she was trending downward all day, which definitely does happen. If she has a lower preshot test, then maybe you want to go with a little bit higher carb (like 8-9 percent) at preshot mealtime — so it’s still low carb but just on the higher end but still 10 percent or under. And/or you may want to give an earlier snack at +1 instead of waiting until +2 when she’s already dropped a lot.
 
Suzanne & Darcy said:
Okay. All good. She did start with a lower PMPS than she has before on this dose of 1 unit. So that plays into it. We don’t have data from today to tell us of she was trending downward all day, which definitely does happen. If she has a lower preshot test, then maybe you want to go with a little bit higher carb (like 8-9 percent) at preshot mealtime — so it’s still low carb but just on the higher end but still 10 percent or under. And/or you may want to give an earlier snack at +1 instead of waiting until +2 when she’s already dropped a lot.
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Yes we have 8 percent soulistic that she likes we can do that with next time. Thank you!
 
I’m just trying to offer up some different strategies for dealing with lower preshots. A lot is trial and error with different cats because they respond so differently to food at times. Y’all are doing a great job!
 
Thank you so much! It’s sometimes a bit harrowing when they go low so it’s good to have different opinions when dealing with a low pre-shot number. Just tested her she’s at 67 it seems like she’s going up she was at 60 an hour ago. I’m planning on going to bed for the night. May test in a hour if I’m still up. Thank you again!!
 
That’s a beautiful cycle, but it is nighttime so I understand! If I needed to go to bed, I used to set alarms to wake me up to test Darcy at certain points in the nighttime cycle. Of course, he usually slept right by me and I kept my testing stuff right next to me so it was easy to grab a test quickly with just a small amount of light like from my cell phone or from a small head light. You have options like giving a little MC before you go to bed. Also, the automatic feeders that give small amounts of food at certain hours during the night can be very helpful stabilizing their BG. You can also leave food out for Rewster to eat when she wants to. Of course, I don’t know if you have other cats!
 
Suzanne & Darcy said:
That’s a beautiful cycle, but it is nighttime so I understand! If I needed to go to bed, I used to set alarms to wake me up to test Darcy at certain points in the nighttime cycle. Of course, he usually slept right by me and I kept my testing stuff right next to me so it was easy to grab a test quickly with just a small amount of light like from my cell phone or from a small head light. You have options like giving a little MC before you go to bed. Also, the automatic feeders that give small amounts of food at certain hours during the night can be very helpful stabilizing their BG. You can also leave food out for Rewster to eat when she wants to. Of course, I don’t know if you have other cats!
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We're a single cat household so at least we don't have that to also think about. AMPS was 333 and she was certainly still full from her snacks last night (not much interest in breakfast at the moment). Hoping the bounce isn't so bad! Thanks again for all your help Suzanne&Darcy!
 
Well at least her AMPS isn’t too different than her normal (for now.). When you are using food to try to steer her numbers like last night, it only takes about a teaspoon at a time to do the job. This way you don’t fill her up as quickly and can keep her interested in the food in case you need to keep giving the snacks.

Have a good day y’all! I know you will leave her some food so when she gets hungry later she’ll have it available.
 
Suzanne & Darcy said:
Well at least her AMPS isn’t too different than her normal (for now.). When you are using food to try to steer her numbers like last night, it only takes about a teaspoon at a time to do the job. This way you don’t fill her up as quickly and can keep her interested in the food in case you need to keep giving the snacks.

Have a good day y’all! I know you will leave her some food so when she gets hungry later she’ll have it available.
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Will do, have a good day too!!
 
Whoa. But look at those great green numbers! I’m smiling at her spreadsheet! She usually has the greens at night and it’s been frustrating to me that she’s never done it in the daytime. Maybe something good is happening!
 
Suzanne & Darcy said:
Whoa. But look at those great green numbers! I’m smiling at her spreadsheet! She usually has the greens at night and it’s been frustrating to me that she’s never done it in the daytime. Maybe something good is happening!
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I’m hoping so! I wished I hadn’t given her the tsp of 8C at +4, but she only nibbled it slightly and didn’t really eat all of it. Hoping she meanders down as we near PMPS. Thanks for the vote of confidence!
 
Hi @Suzanne & Darcy! I switched injection sites to the side of her chest (like her shoulder area) and I noticed she responds so much more robustly with that injection location. Any ideas why? For example--last night I went back to the typical scruff site, and she hovered in the blues/yellows. Sunday/Monday I did the side of her chest and she went green both AM and PM cycles. Just curious! Hope you're doing well!
 
Rewster's Mom (Renee) said:
Hi @Suzanne & Darcy! I switched injection sites to the side of her chest (like her shoulder area) and I noticed she responds so much more robustly with that injection location. Any ideas why? For example--last night I went back to the typical scruff site, and she hovered in the blues/yellows. Sunday/Monday I did the side of her chest and she went green both AM and PM cycles. Just curious! Hope you're doing well!
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Some cats seem to absorb the insulin better from diffuse sites. I’m happy your baby is doing better with this new injection site. I’m going to check out his spreadsheet now!
 
I looked at this early this morning and am perplexed. She does have better numbers at night but she goes down quickly and starts back up again more quickly than we would like. The only thing I can think of right now is to perhaps move her snack to +2. If we can slow her down at about the time the insulin onsets then maybe she will nadir a little later and get to spend a little more time in the greens and blues.
 
Suzanne & Darcy said:
I looked at this early this morning and am perplexed. She does have better numbers at night but she goes down quickly and starts back up again more quickly than we would like. The only thing I can think of right now is to perhaps move her snack to +2. If we can slow her down at about the time the insulin onsets then maybe she will nadir a little later and get to spend a little more time in the greens and blues.
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Okay well give that a go! Maybe it has to do with the new site location? Seems like more data is needed for us to see a correlation. Thanks!!
 
Oh my that is so good! Especially for a daytime cycle! You will see green tonight, I dare say, but that’s not unusual lately. I am really happy to see such a nice relatively flat cycle for her in the daytime. That color looks so pretty! Congratulations! Go Rewster!
 
Suzanne & Darcy said:
Oh my that is so good! Especially for a daytime cycle! You will see green tonight, I dare say, but that’s not unusual lately. I am really happy to see such a nice relatively flat cycle for her in the daytime. That color looks so pretty! Congratulations! Go Rewster!
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Spoke too soon--202 at +5 last night and 306 this morning. I think the 8C mixed in might have hurt the pattern. Hoping for some greens today. Thanks for the encouragement!!
 
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