1/10 Eddie FLAT CYCLE JUST UNDER 300 ALL DAY - DOSE HELP

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Jen&Eddie

Jen&Eddie

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Yesterday's condo: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=111578

AMPS = 300
+6 = 242 (WHAT THE HECK)
+11 = 282 (WHAT THE HECK)

PMPS = 309
+3 = 326 (WHAT THE HECK)

The numbers today make no sense.

No court today, so it's blue jeans day at work today. The best patience pants I have :-D

Are there other ProZinc kitties that don't get a full 12 hours out of a dose? Does raising or lowering the amount of the dose have any impact on the length of it's effect? I'm aware that you can do sliding scale dosing with ProZinc once you have a handle on your kitty's patterns, and if I'm not mistaken, I think I read that you can also dose ProZinc on a different schedule than +12 if appropriate. Wondering if anyone has had success with that. Putting on my patience pants, I intend to compile a lot more data on Eddie's patterns before attempting any changes to his dosing schedule. :)

Hope all my fellow PZ'ers and all other sugar kits and their beans have a wonderful Friday! :mrgreen:
 
Re: 1/10 Eddie - AMPS 300

Yes to all your questios. :mrgreen: They are why this sugar dance is so complicated.

Yes, sometimes the insulin doesn't last the whole cycle. It may be because the dose is too light, it may be the pattern in the beginning which changes as time goes on (Simon's ss may be an example of that) and it may be that the cat needs insulin more often. PZI is the only one of the one lasting insulins that can be shot TID or every 8 hours. ( i think Lisa - bookworm- did that on and off in the beginning) the trouble is that it is hard to figure out which of those three without quite a bit of data.

Eddie does seem to be jumping up in that last hour. But the insulin does seem to be lasting long enough that three times daily would be complicated. Usually you try 3x with a cat who starts to climb at +8 or even earlier. Another option - if this trend develops- is to give a different dose depending on the number. So maybe 1.8 on pinks and 1.2 on yellows for example. (lots of PZI users do this - it's called a sliding scale) Another option - if this pattern develops - is to shoot early at one preshot. So if the amps is lower than the pmps consistently, give a dose at +11 at night and +13 in the am. Several cats have done this at some point in their PZI careers (bookworm tried this also for awhile)

I am a cautious advisor. I like to see quite a bit of data (at least a couple weeks) before I suggest alternatives, other than the customary dose changes. Some people think I am too cautious and I accept that. I just always worry because I am advising someone else and if things go bad, it is because I gave them advice. i tend to advise waiting longer before making changes and I like small changes, one at a time.

So, you are the one with the syringe and he is your cat. You get to decide. Luckily there are alternatives. Did you study the spreadsheets in the remission thread? There are lots of different approaches there and obviously, they all worked. The nice thing is, no matter what you decide, we will be here to help as we can.

I like his blues midcycle but he does seem a little higher for preshots. You might up the dose to 1.75 If you can eyeball it or 1.6/ 1.8 if you have the U100 syringes?
 
Re: 1/10 Eddie - AMPS 300

Hi Jen....enjoy those blue-jean patience pants today. :lol:

Looks like Eddie's nadir is coming in at +6 to +7. You are going to do a curve or two this weekend correct? That would be great data to have on Eddie's spreadsheet to see how the 1.5 unit dose is really working. Then we can make adjustments as needed.

Once you have more data, we can look at a sliding scale. OHHHHH...WE LOVE DATA !!!! :-D :lol:

Glad you have been looking at RumpelT's ss. I believe it has a lot of info that gives new sugar-beans an idea of what goes on. :smile:
 
Re: 1/10 Eddie - AMPS 300

Thanks Sue and Misty!

I am going to try to do a curve probably this Saturday, although I may try to get out of the house for a couple hours to experience life outside of FD for a little bit :) When I initially curved him, I focused either on +2 or +3, and then every hour around nadir, and then +10. I'm thinking it might be helpful to get a better idea as to what's going on at the end of the cycle. Suggestions on how frequently to test? I could probably do every hour, but Eddie might not be very patient with that. The couple times I've tested in the +10 or +11 timeframe, it does look like Eddie's BG climbs pretty quick. There's so many variables as to what could be responsible for that climb (i.e., a mini-bounce at the end of the cycle, increased BG since it's almost time to eat and he's hungry/stressed?, or the insulin is wearing off short), it's hard to know what to experiment with to narrow down the possibilities.

The nice thing is that on the 1.5U, Eddie's numbers are generally not too bad for most of the day, except right before and after his shot, so there's a little room for experimentation. I think that's reflected in his weight gain, and his better appearance overall. Less ravenous and not trying to steal food, less peeing, much improved coat, more playful, etc.

I have no idea what this means, but a couple times, I've noticed that at around +2 and +10, Eddie is bouncing around and feeling playful and he's generally in the 200's and climbing. I've also noticed that he seems to be sleepy and feeling meek (for a lack of a better term), when he's in the greens. I'm going to take a shot in the dark that as his body is getting adjusted to more normal glucose levels, his liver might be getting nervous and he doesn't feel quite as good yet in the normal glucose range.

I have studied several of the PZ OTJ kitty spreadsheets (as well as pretty much anyone else's that posts in the forums), and it looks like there's about a million different approaches. The only thing that seems consistent across the board for the remission kitties, is that one day, suddenly, they're in the greens and require lower and lower doses, until they require none. :)

I'm on board with the slow approach. I think changing too many variables at once makes it impossible to narrow down which change is causing a given result. For the time being, I'm going to curve him at 1.5U this weekend, and assuming he continues to have pink pre-shots, increase to 1.75U. I'm ordering U100 needles today, but we'll have to try to eyeball it till then. Maybe call it a "fat" 1.5.

Misty - I love reading your comments in RumpelT's spreadsheet. I think it's helpful to be able to look back at your notes to be able to remind yourself how things have progressed, and to be able to note what questions or concerns you have -- and sometimes to vent a little bit too!

Thank you both!!
 
Re: 1/10 Eddie - AMPS 300, +6 = 242

Eddie was happy and bouncy and awake at lunch (AM +6), and his BG was 242. What the heck?

My vet tech texted me as well and indicated that she and the vet reviewed Eddie's spreadsheet and said to keep doing exactly what we're doing! YAY!
 
Re: 1/10 Eddie AM +11 = 282, PMPS = 309

So I made a discovery.

I am aware that DH gives everyone treats when he gets home for work around +10. This has been a routine for all the kitties for several years. They all run to the cat tower in the computer room, sit in their respective places, and wait for a treat. They all get fish flakes. Or so I thought. We bought a couple packages of "grain-free" "all natural" soft treats shortly after Eddie's diagnosis, before carefully studying the ingredients to avoid. I forgot about them. So, I learned that DH had been feeding him a couple of these "grain free" treats, not realizing that they are not OK. I looked at the ingredient list on the ones he has been feeding, and not only are they not grain free, but they have malted barley, which I now know is pretty much sugar. ohmygod_smile The unopened package has maple syrup as an ingredient! ohmygod_smile I guess we can keep them in the hypo kit. I suspect these treats may be responsible for Eddie's BG spike leading up to PM. Ugh.

None of these treats today, and at least between +11 and +12, there's not a huge spike...
 
Re: 1/10 Eddie AM +11 = 282, PMPS = 309

Glad you found what might be the culprit to Eddie's PM spike. Looking forward to awesome numbers now.....YAY !!!! :-D
 
Re: 1/10 Eddie AM +11 = 282, PMPS = 309

Aha! Yep, that'd probably up it a few points... Amazing how little details can make a differenc.
 
Solve one mystery, and another pops up. Totally flat cycle all day today. I don't know if yesterday Eddie went low enough to produce an all day bounce like this. Might it be that he's settled in to the 1.5U dose and today's numbers are the result?

I'm home all day tomorrow, and had intended on doing a curve anyway. I'm wondering whether I should continue the 1.5U and curve it, or to go ahead and increase at this point.

Thank you!!
 
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