1/28 BuddyM : AMBG 124 | Food not working out, PM dose?

Mariette

Mariette

Member Since 2020
Previously:
https://www.felinediabetes.com/FDMB/threads/01-26-buddym-ambg-132-3-63.242133/#post-2727696

Today was day 4 of trying the early morning snack without much success. Today I thought to try giving him the food at 6am instead of 5am because he would only take a few licks of the food offered the previous 3 days. (my AMBG is at 8am) I thought it's because I woke him up and he was too sleepy to show any interest in food. But when I woke him at 6 he got up with a start. (Couldn't get the test) Leapt out of bed and bounced around the kitchen. He just wanted to go outside or play. No interest in the food. I left him in the kitchen and went back to bed to try and catch a few more zz's, figuring he'd snack on the food when he got bored. He came back to bed and I thought I smelled food on his breath so I tried to sleep a bit. Not that he was going to let me. Lots of talking from him to try and get us up. Got up at 7:30 and it didn't look like he had touched his food. Still very bouncy. He finally ate at 8 and I managed to grab a test 20 minutes later.

Long story short, this morning snack thing is not as easy as it sounds.

I could keep trying the 5am, or maybe even 4am, just to see if there's a spot where he'd want to eat. It's so strange because he certainly doesn't have this food disinterest problem during the day. I wish!

I do think his tests yesterday - 84 at 5am (+9) and 154 at 8am (AMBG) clearly shows that he has a strong 'dawn phenomenon'.

I've been trying to figure out how to handle insulin going forward. Thank you once again to @Marje and Gracie for all your suggestions and advice on our options.

I want to try a PM shot, but not sure about the time. I think I should shift the shot time later, because if I gave it at 8 then the insulin would be petering out by the time his bg shoots up. I'm usually up until 11pm or 12am so I could give the shot at 11pm. It will scramble by spreadsheet though. When I look at my spreadsheet I see time of day (that's why I added the -1, -2, -3 - so I could visualize the day) That's just how my brain works. And really what's important to me at the moment is keeping an eye on a specific time of day.

So my first question is about time of day. When should I shoot to nip that little high window in the bud?

And then my second question is about whether I should switch to a non-depot insulin.

I still have practically a whole vial of ProZinc in the fridge. I could switch to ProZinc to simplify issues with the depot. Pros and cons for that too. Maybe simpler for the depot issue, but I'm not crazy about ProZinc because of the mixing it requires. I don't fully trust that my manual mixing will deliver a consistent dose. I love that the Lantus is so much simpler as far as that goes. I rolled that ProZinc for ages to make sure the suspension was as even as possible. A bit of a pain in the butt.

And then if I switch to ProZinc I'd have to move to the ProZinc forum where people aren't familiar with Buddy's situation, so it would be a bit of a setback for getting advice from you guys too.

I would love any thoughts or input you guys might have.

Much thanks!
Mariette
 
Last edited:
Mariette said:
Previously:
https://www.felinediabetes.com/FDMB/threads/01-26-buddym-ambg-132-3-63.242133/#post-2727696

Today was day 4 of trying the early morning snack without much success. Today I thought to try giving him the food at 6am instead of 5am because he would only take a few licks of the food offered the previous 3 days. (my AMBG is at 8am) I thought it's because I woke him up and he was too sleepy to show any interest in food. But when I woke him at 6 he got up with a start. (Couldn't get the test) Leapt out of bed and bounced around the kitchen. He just wanted to go outside or play. No interest in the food. I left him in the kitchen and went back to bed to try and catch a few more zz's, figuring he'd snack on the food when he got bored. He came back to bed and I thought I smelled food on his breath so I tried to sleep a bit. Not that he was going to let me. Lots of talking from him to try and get us up. Got up at 7:30 and it didn't look like he had touched his food. Still very bouncy. He finally ate at 8 and I managed to grab a test 20 minutes later.

Long story short, this morning snack thing is not as easy as it sounds.

I could keep trying the 5am, or maybe even 4am, just to see if there's a spot where he'd want to eat. It's so strange because he certainly doesn't have this food disinterest problem during the day. I wish!

I do think his tests yesterday - 84 at 5am (+9) and 154 at 8am (AMBG) clearly shows that he has a strong 'dawn phenomenon'.

I've been trying to figure out how to handle insulin going forward. Thank you once again to @Marje and Gracie for all your suggestions and advice on our options.

I want to try a PM shot, but not sure about the time. I think I should shift the shot time later, because if I gave it at 8 then the insulin would be petering out by the time his bg shoots up. I'm usually up until 11pm or 12am so I could give the shot at 11pm. It will scramble by spreadsheet though. When I look at my spreadsheet I see time of day (that's why I added the -1, -2, -3 - so I could visualize the day) That's just how my brain works. And really what's important to me at the moment is keeping an eye on a specific time of day.

So my first question is about time of day. When should I shoot to nip that little high window in the bud?

And then my second question is about whether I should switch to a non-depot insulin.

I still have practically a whole vial of ProZinc in the fridge. I could switch to ProZinc to simplify issues with the depot. Pros and cons for that too. Maybe simpler for the depot issue, but I'm not crazy about ProZinc because of the mixing it requires. I don't fully trust that my manual mixing will deliver a consistent dose. I love that the Lantus is so much simpler as far as that goes. I rolled that ProZinc for ages to make sure the suspension is as even as possible. A bit of a pain in the butt.

And then if I switch to ProZinc I'd have to move to the ProZinc forum where people aren't familiar with Buddy's situation, so it would be a bit of a setback for getting advice from you guys too.

I would love any thoughts or imput you guys might have.

Much thanks!
Mariette
Click to expand...
I love your thought process. I agree that it’s time to try some insulin. I also agree that switching to PZ at this time is not warranted but it’s a back pocket option.

Do you have the higher LC foods? I have to go out but will be back in an hour or two and will check back in to discuss potential shot times.
 
We all know ECID, but hercules numbers were all over the place on PZI... so if you are trying to avoid surprises, not sure that would be the best option. No depot, but much harsher variation in our experience....

Also, the very late shot makes sense based on the dawn effect avoidance, but you will have to often stay up or wake up after that to check is not an active cycle?

I know I am not helping, just giving you more food for though....Sorry!
 
Marje and Gracie said:
I love your thought process. I agree that it’s time to try some insulin. I also agree that switching to PZ at this time is not warranted but it’s a back pocket option.

Do you have the higher LC foods? I have to go out but will be back in an hour or two and will check back in to discuss potential shot times.
Click to expand...

I haven't gotten any higher LC foods yet. I'm not as concerned about it when I'll just be giving insulin for the evening cycle because he's higher then. And I'll be giving just a small amount. And I do have some MC and HC if needed.

I just thought switching the food will complicate things a bit more... I will order some today though so that I can introduce that if needed.
 
Hercule's mum said:
We all know ECID, but hercules numbers were all over the place on PZI... so if you are trying to avoid surprises, not sure that would be the best option. No depot, but much harsher variation in our experience....

Also, the very late shot makes sense based on the dawn effect avoidance, but you will have to often stay up or wake up after that to check is not an active cycle?

I know I am not helping, just giving you more food for though....Sorry!
Click to expand...

Haha thank you! Buddy also didn't make much headway on the ProZinc. But I didn't have him on it for very long so can't really judge his response to it sufficiently. I appreciate your feedback.

I do realize that giving the shot later will mean it's coming on right as I'm heading to dreamland. :nailbiting: That is definitely a concern.
 
Mariette said:
I haven't gotten any higher LC foods yet. I'm not as concerned about it when I'll just be giving insulin for the evening cycle because he's higher then. And I'll be giving just a small amount. And I do have some MC and HC if needed.

I just thought switching the food will complicate things a bit more... I will order some today though so that I can introduce that if needed.
Click to expand...
Remember my last comment was that we should start by giving him a drop twice a day. I misunderstood that you wanted to change the shot time for shooting bid. He will tell us if that’s too much but it might allow him to flatten out just where we want him.

You can also do as some others do and keep using the 3% but add a tiny bit of karo if he needs a little boost.
 
Marje and Gracie said:
Remember my last comment was that we should start by giving him a drop twice a day. I misunderstood that you wanted to change the shot time for shooting bid. He will tell us if that’s too much but it might allow him to flatten out just where we want him.

You can also do as some others do and keep using the 3% but add a tiny bit of karo if he needs a little boost.
Click to expand...

Okay gotcha, I could give the bid a shot first. That would simplify things regarding depot weirdness. So keep shot time the same then you think?

Are there instructions on how to give a drop dose please? I thought it looked pretty much the same to my eye than 0.1. Meaning if I do a 0.1 unit draw and squeeze it out I only see one drop, but the 'drop' must be a smaller drop than that?
 
Mariette said:
Okay gotcha, I could give the bid a shot first. That would simplify things regarding depot weirdness. So keep shot time the same then you think?

Are there instructions on how to give a drop dose please? I thought it looked pretty much the same to my eye than 0.1. Meaning if I do a 0.1 unit draw and squeeze it out I only see one drop, but the 'drop' must be a smaller drop than that?
Click to expand...
Yes...you can use whatever shot times work best for you as long as they are 12 hours apart.

And yes, a drop is less than 0.1u. To get a drop, press the syringe plunger all the way in and hold; then insert the needle into the pen. Let the pressure off the plunger and it will draw up a drop. You can try it once to see the amount it draws up just for fun. :p

Thank you for being willing to try. I know all of us really, really want Buddy to be done with this dance and have a peaceful, happy life. He’s been through enough.
 
Marje and Gracie said:
Yes...you can use whatever shot times work best for you as long as they are 12 hours apart.

And yes, a drop is less than 0.1u. To get a drop, press the syringe plunger all the way in and hold; then insert the needle into the pen. Let the pressure off the plunger and it will draw up a drop. You can try it once to see the amount it draws up just for fun. :p

Thank you for being willing to try. I know all of us really, really want Buddy to be done with this dance and have a peaceful, happy life. He’s been through enough.
Click to expand...

Great. I'll definitely try it out first.

Thank you for your kind words. It is so wonderful to know we have the support of folks on here. <3

Yes, Buddy's been through so much suffering already in his little life. I would love for him to get a strong remission chance.
 
Mariette said:
Thank you so much Marje!

Here's Buddy watching 'Movies for Cats' on Amazon Prime last night. :joyful:

Click to expand...
That is tooooo adorable. My Tobey is a cat TV addict. He sits in front of the TV every morning like a little child and waits for us to put his video on. Our cats have an enclosed patio with a huge tree in the courtyard where they can safely watch all the birds but, no...he wants to watch TV.

I’m so happy to see Buddy enjoying the perks of being an indoor cat!
 
Marje and Gracie said:
That is tooooo adorable. My Tobey is a cat TV addict. He sits in front of the TV every morning like a little child and waits for us to put his video on. Our cats have an enclosed patio with a huge tree in the courtyard where they can safely watch all the birds but, no...he wants to watch TV.

I’m so happy to see Buddy enjoying the perks of being an indoor cat!
Click to expand...

That's hilarious! :cat:
 
Just checking in before I head to bed. Glad you shot....but the “?” means....you think you gave a fur shot or not sure you gave a drop?
 
Marje and Gracie said:
Just checking in before I head to bed. Glad you shot....but the “?” means....you think you gave a fur shot or not sure you gave a drop?
Click to expand...

The drop dose is very tricky. I'm going to have to get used to the technique.

I suspect that the drop may have been sucked back into the the syringe as I was giving the shot because after I pulled it out I pressed the plunger up to check and a drop came out.

Do people push the plunger up tightly while withdrawing? My muscle memory of giving the shot is used to pushing the plunger, and then taking my finger off the plunger before withdrawing. I think with the drop dose I'll have to keep pushing the plunger up as I withdraw.
 
Mariette said:
Do people push the plunger up tightly while withdrawing? My muscle memory of giving the shot is used to pushing the plunger, and then taking my finger off the plunger before withdrawing. I think with the drop dose I'll have to keep pushing the plunger up as I withdraw.
Click to expand...
It's best to hold the plunger in for about 10 seconds if you can while giving the shot so the drop does come out.
 
Well that AMPS is almost green!!! Because you are restarting insulin, and even though it is a small dose, I’d be sure and get a +2 every cycle until we know that dose won’t send him plummeting.
 
Good luck with the drop dose!:bighug:
Like Carla, I have to hold the plunger down for about ten seconds or so to get that last drop of insulin into butters. I tried withdrawing while I had the plunger pressed down, but I found that i couldn't bring the needle out of her smoothly.
 
Butters & Lyla said:
Good luck with the drop dose!:bighug:
Like Carla, I have to hold the plunger down for about ten seconds or so to get that last drop of insulin into butters. I tried withdrawing while I had the plunger pressed down, but I found that i couldn't bring the needle out of her smoothly.
Click to expand...

Thank you Lyla! You'd think doing a tiny dose would be easier than doing a larger dose, but no. It's so hard to be sure you have a good dose and that you got it in.

Do you press the plunger up before the shot to make sure the drop is there? Because if there's any air that could mess things up royally too. It's taking me quite a bit longer to prepare the shot now.
 
I would not press it up before shooting buddy.

I would practice drawing up the dose a number of times and then pressing the plunger like you will do when you shoot buddy. You should see that you are consistently getting a drop with each practise dose. Do it until you are confident. That way when you do it for real, you can be confident he will get that drop.

I hope this helps. Just a suggestion. Others may have more ideas for you.
 
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