1/27 Domino AMPS 455, Puff AMPS 337 Dose Advice Please

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Yesterday's Topic:
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Domino: After last night's low pre shot he has predictably jumped really high this AM. What should I do with his dose?

Puff: still holding in the 200's and 300's -- should I increase to 1.5U?

Both cats are being their normal selves -- eating, drinking, being spoiled rotten!
 
Good morning Connie!

as suggested by Libby previous day

For Puff, as soon as you can get a couple of spot checks (preferably around nadir, but something around the middle of the cycle anyway) we can recommend a dose.

For Domino, hang on for some insight thru the day, ok?
Someone will be along to advise.

Is anyone around today to get any spotchecks for both kitites day cycles?
 
No, no one will be home today until about +10.

Approximately when should I look for the nadir -- Puff never seems to have one, and Domino can be low anywhere from +5 to +12. I'm confused!
 
Domino and Puff said:
No, no one will be home today until about +10.

Approximately when should I look for the nadir -- Puff never seems to have one, and Domino can be low anywhere from +5 to +12. I'm confused!

Every cat is different (ECID) some start a nadir at +3,4,5 and the usual of +6, some are late nadir kitties.
Spotchecks will give that pattern...as an example, my cat was always a morning nadir kitty, then gradually, he went up to +6 sometimes +7....you will prob have to rely on getting most of ur spotchecks in the evenings, days off and weekends to build ur data for both kitties.

On one day u are home, u may want to do ur own "curve" that is usually a BG test every 2 hours for one cycle. Some here will pull an all-nighter on a weekend night for example, to get those late evening/early morning numbers.

Using the chart below, don't worry - u dont need to test every hour..but the key +hours would be +3, +6 and +11...take a look around at other kitties spreadsheets...again - don't despair when u see some SS's with spotchecks every hour.
you don't have to do the same, but u will need those nadir checks as dosing is not based on preshot numbers alone.


This is from up above, the "New to the Group" stickie...

Learn how YOUR kitty is responding to insulin:
Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
Peak/Nadir - the lowest point in the cycle
Duration - when the insulin is strongest or works the hardest
How to do a Curve

Example of a typical curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
 
My thinking right now is that a curve for both kitties would help. More info from the PM cycle is important for both Puff and Domino. But, I think if you can plan on doing a curve (testing every 2 hrs) over the weekend we may have more info on what's going on with Domino. I think he's rebounding which is why you are seeing such highs and lows but with a tight work schedule there's no way to know if this is actually the case. Having those data will make it easier to take a look at dosing decisions. I hope others will be by to offer some suggestions.
 
Thanks for your help. I will try to get a curve this weekend.

If this is rebound, should I reduce his dose or just hold the 2.0 until after the curve this weekend? I did start lower and work up to this dose, and have even come down from 2.75, but I have also wondered about rebound because of the extreme lows and highs.
 
I hope someone with more experience chimes in but I wouldn't change anything at this point. There's too much going on. You shot early tonight, which is the equivalent of a dose increase. Even though Domino's numbers were high at PMPS, there was a 100 point drop by +2 so the early shot was having an effect. I think letting everything settle so a curve isn't influenced by any dose changes makes sense, at least to me.
 
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