07/23/11 Zener PMPS 344;+2.5 274 A Trak HELP tomorrow dose?

[Anne & Zener GA]

Zener's condo 7/21/11

Summary
07/22/11 Alpha Trak
AMPS 545 1.5 u
+6 344
PMPS 302 1.5 u
+2 345

Today
07/23/11
AMPS 402

Zener is doing an excellent job of cheering Anne up. She keeps trying to do more than she is ready to do, so he has to scold her from time to time. His numbers are coming down a little from the skipped dose and I am getting a bit more comfortable with doing all of his care.

I am an engineer and love numbers so I have been studying his spread sheet and he seems to be consistently inconsistent. He is most often lowest during the night and higher in the morning. How much data or how long do you watch the data before you start to see trends in how the cat responds to food and insulin? Are there ever instances when a cat will have a slightly lower dose in the evenings or is Lantus always given as an equal dose twice a day?

Anne says thanks for all the get well wishes. She is only on Tylenol now for pain and starting to move around the house a little bit. Getting to have a shower yesterday was a real treat and she is already looking forward to another one this afternoon. Zener has informed us he will not assist with the shower.

 

[Libby and Lucy]

Re: 07/23/11 Zener AMPS 402 A Trak dose ?s

it looks like Zener is still refilling his shed from the missed dose. Hopefully today or tonight he'll start to come down. If not, then you'll probably want to increase the dose back to 1.75. It looks like you guys have had a LOT going on this week, so it might take a bit to get back on track but sometimes you just have to let life take you where it will.

It's good that you're studying Zener's spreadsheet! That is the best way to learn this stuff. Next step is to study others' spreadsheets. ;-) Because Lantus works by creating a lot of overlap from one dose to the next, the trick in recognizing patterns is to not look at each cycle individually, but to look at "waves" that span several days. Every dose affects the next several cycles too. Usually when someone tries to give different doses in AM and PM, the result is kind of a constant state of adjustments where the numbers get higher and bouncier overall.

If you can look at the waves and see the big patterns, you can see that on 1.75 units Zener would have a good cycle (blue/green), then bounce higher for a day or two, then go lower again, go back up for a day or two, etc. That's a normal place for a cat to be at this stage in the game - next step would be to decide when to increase the dose to try to help shift the whole range downward a bit.

Now that you have had some reduced and skipped shots, you probably won't see any recognizable patterns right away. I'm guessing the dose will need to be increased, but I would see how today goes before deciding.

 

[Anne & Zener GA]

Re: 07/23/11 Zener AMPS 402; +6 335 A Trak dose ?s

Thank you Libby, I understand what you mean. More study is in order!

Today
07/23/11
AMPS 402
+6 335

Now that we are getting Zener shifted to an earlier shot time, it will be easier for us to monitor him in the evenings and not mean one of us has to stay up late hours and still get to work. Will post a PMPS for more experienced eyes to view and consider when to increase back to 1.75. Thanks for help.

 

[Marje and Gracie]

Re: 07/23/11 Zener AMPS 402; +6 335 A Trak dose ?s

Good job, Liz. Great to have Libby go through that with you. She's super!!

Hope to see Zener come down some. Tell Anne we hope she feels better soon.

 

[Anne & Zener GA]

Re: 07/23/11 Zener PMPS 344 A Trak HELP tomorrow dose ?s

Today
07/23/11
AMPS 402 1.5 u
+6 335
PMPS 344 1.5 u

I gave Zener the 1.5 u again tonight and posted on his SS. Not much change in the numbers today. Would like the experts opinion on going back up tomorrow to 1.75 u. We will have Zener on a 6:45 am/6:45 pm schedule then and will be able to more easily check in the mornings before heading to work and in evenings after his shot when he seems to like to go down.

Anne is up and about a little bit today, eating pasta and pudding and will start helping tomorrow with BG checks and PM shot. We will tag team Zener for now with me the AM person and Anne the PM person, unless she is worn out! Zener is instructed to help by jumping onto his special foot stool for his BG checks and PM shots, so Anne will not need to lift him. We'll see how that works out. He is usually quite good about helping, especially if freeze dried chicken is involved.

 

[Sienne and Gabby (GA)]

Re: 07/23/11 Zener PMPS 344 A Trak HELP tomorrow dose?

Just a comment about your observation regarding the lower PM vs. AM numbers. Many cats have lower BG numbers at night. I'm not entirely sure what that is. AM numbers often do start out higher due to dawn phenomenon. The higher BG in the AM is due to the natural release of cortisol -- a stress hormone -- that aids in preparing the body for the stress of the day.

 

[Anne & Zener GA]

Re: 07/23/11 Zener PMPS 344;+2.5 274 A Trak HELP tomorrow do

Today
07/23/11
AMPS 402 1.5 u
+6 335
PMPS 344 1.5 u
+2.5 274

Thank you Sienne, that is very interesting about the secretion of cortisol in the mornings. I just posted Zener's +2.5. Any thoughts from the experts on when to increase Zener's dose back to 1.75?

Anne is feeling better and will take over posting tomorrow!