1/9 Eddie PMPS = 349, +2 = 287, +4 = 208

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Jen&Eddie

Jen&Eddie

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Good start for the morning!

AMPS = 250
+6 = 118 (fed 1/2 can FF)
PMPS = 349
+2 = 287
+4 = 208

Helps that test time and shot time were more consistent. It's hard to tell whether the reduced 1.5U is having the desired effect of smoothing out Eddie's curve a bit so he's not in the pinks and even reds pre-shot. We consult with our vet Friday afternoon. I'm leaning towards increasing to 1.75 after Friday to gradually try to bring his numbers further down. Not seeing greens at nadir lately. Eddie is overall feeling better though. His coat is looking good, he's not as demanding for food, and he's put on 1/2 pound in approximately a week.

Jen and Eddie
 
Re: 1/9 Eddie - AMPS = 250

That is a nice amps! Remember, we would urge you not to shoot on a pre shot under 200 so this is a very reasonable number. Can you get a midcycle number today to see how low he drops?

If I were you, I would hold this dose a few more cycles. Reasoning? 1) It may take him a while to settle into this dose. If the lower dose means he is not bouncing, then you want a few cycles for this to become his pattern. 2) Yesterday was a messed up cycle so today is the first one really on this dose. 3) This is a process that can't be rushed. First you work to get some blues and see how the dose that produces them is doing - what preshots are you consistently getting? Does he drop 50% or more mid cycle? Then you adjust. 4) You don't want to set up a counterproductive pattern of bouncing high and dropping low. You want a nice smile shaped curve that keeps him in good numbers all day. 5) A 1.5 took him down 300 points last night. If he drops 300 points today, you would be in trouble. I don't think he will - they don't drop a specific number of points on a specific dose. But you want to be careful. Better too high for a day than too low for a minute.

These early days are all about collected data. Once you have an idea of what the dose did and how long it took him to settle into it (some cats take a week, some a few cycles) then you have the data to change the dose. The first goal is regulation - mid 200s at preshot and 100s or below (but not under 40) at nadir. He is approaching that already. Then you make tiny adjustments to try for remission.

As someone wise once said, this is a marathon, not a sprint.
 
Re: 1/9 Eddie - AMPS = 250

Thank you so much Sue. Your advice is always so very much appreciated.

This is the third day on the reduced 1.5U. The first day looked good, but yesterday was all messed up. I think I can sneak out at around +6 or so today to see how low he's going.

When Eddie was on 2.0U, he was pretty consistently in the 300-350 range pre-shot, then going to the low 100s or even slightly lower at nadir, so he was going down well over 50%. The hope with reducing to 1.5U is to maybe see if we can get the pre-shot down to the 200-250 range if he is bouncing a bit. His nadirs have been more towards the 150 range on the 1.5U, which I think are OK, assuming that the pre-shots are down a bit. The pre-shots so far on the 1.5U are kind of all over the place, almost certainly due to our messed up timing. It looks generally like he's going down approx. 50% or just a bit less, although there's not a lot of data yet. I agree that maybe a few more days at this dose will hopefully give us some more data.

With ProZinc, once a cat is seeing a nice smooth curve, keeping him in the mid-200's at pre-shot and around 100 or so at mid-point, is the idea to very gradually increase to get those numbers closer to the normal range? Or is the goal to keep in the "regulated" range at 250-100?

I've read about patience pants in a few different places here. Looks like I need to go buy myself a pair :smile:

Thank you!
Jen and Eddie
 
Re: 1/9 Eddie - AMPS = 250

The goal is eventually remission, but not every cat will get there. We have lots of cats on the forum who are diabetic, healthy and happy after many years on insulin. But lots do go into remission and it is certainly worth trying for.

If you look at Misty's spreadsheet (Rumpel) you can see how the process works. Rumpel took a long time and a lot of adjustments in dose in small amounts to get OTJ. Also you might look at the remission thread at the top of this page and check out the spreadsheets there. It can take a long time (months) or a shorter time. Someone called this process a sugar dance once. And Eddie is the only one who hears the music. You have to figure out the steps by watching him and experimenting.

For example, if your pre shot would be a little lower tomorrow, then maybe the nadir would drop a little lower. Or if the nadir is too low and he bounces, you might drop the dose a smidge. It is all about following where he leads you. And yes, patience pants come in many colors and styles and are needed by almost every bean here, at one time or another. :mrgreen:
 
Re: 1/9 Eddie - AMPS = 250, +6 =118

Looking good for the AM, Eddie!

AM + 6 = 118. Fingers crossed for a PMPS in the yellow.
 
Re: 1/9 Eddie - AMPS = 250, +6 =118

I'll be glad when you have time to get a curve on this dose. I wonder if there is a green hiding in there before or after +6. Regardless, it looks good.
 
Re: 1/9 Eddie - AMPS = 250, +6 =118

He frequently does go a little bit lower till about +7. In the first several days of testing I tried to test until he was going up to get a handle on when nadir was happening, and it seems to be about that +6 - +7 point. I do wish Eddie would hit nadir at a little bit more reasonable time of the night. ;-) It also seems like if he had a really high PS, he will drop faster and hit peak earlier than when his PS is a little lower. I may attempt a curve this weekend to see what 1.5U is doing. I'm a little nervous about consulting with Vet on Friday since I went down to 1.5U without consulting :?

We're still using the U40 syringes with 1U increment markings, so we are eyeballing the 1/2 increments. Assuming that at some point, we will be adjusting by quarter units, I think the standard syringes are going to be a challenge to use and be consistent. Do you know if there is a U40 syringe that has 1/2 U markings, or do we switch over to the U100 ones and use the conversion chart? I get the conversion chart, but I'm not clear on exactly what type of syringes to get for accurately measuring those smaller increments, and how to actually go about getting those syringes. Is that something you can get at the pharmacy without a prescription? Do you need a prescription? Can you order them online somewhere?

Thank you Sue for your encouragement.
 
Re: 1/9 Eddie - AMPS = 250, +6 =118

Paula was just asking about the U100 needles. Here's the thread

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=111530

I am pretty sure they don't make 1/2 unit 40 U needles. The conversion chart is tricky in the beginning. Lots of beans put it on the cupboard door so they will see it and be reminded every time they draw up insulin.

Re your vet. You can be honest and say you were worried about the highs and lows and so reduced the dose (and tell him, btw, the lowered dose is working well). Or you can be a little facetious and say you were frightened and wanted to start lower and go slower. Hard for a vet to argue with an owner who wants to keep their cat safe. And he can't very well argue with the results. If Eddie had gotten 3 units on that 161, he would have hypoed.
 
Re: 1/9 Eddie - AMPS = 250, +6 =118

Sue.....I was just going to post about the U100's. You much faster than me. :lol:
 
Re: 1/9 Eddie - AMPS = 250

bunni9 said:
I've read about patience pants in a few different places here. Looks like I need to go buy myself a pair :smile:

Thank you!
Jen and Eddie
Click to expand...

Did someone say they needed some patience pants????? Ok, the vast and never ending lending closet is open for you Jen. How about this selection? Which are your favorite color?
 

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Re: 1/9 Eddie - AMPS = 250, +6 =118

Did someone say they needed some patience pants?????
Click to expand...

WOW! That's an amazing selection! haha_smiley I'd probably take the lavender ones but I may need a pair for every day of the week :-D

Thank you for the info on the syringes! In MN it does not appear that you need a prescription. Probably simplest to order online I'm thinking.

PMPS = 349. If I have the opportunity to do a curve this weekend, I'm curious to see if his numbers are skyrocketing up just before PMPS.
 
Re: 1/9 Eddie - AMPS = 250, +6 =118, PMPS = 349

Glad you like the patience pants...they are an invaluable tool during the sugar-dance. :-D :mrgreen:

Rumpelteazer had a hypo-episode in the beginning due to my now-ex vet's dosing. FDMB members helped me through it....vet was not available...did not call me back until the next day. Never took RumpelT back to that vet. Her sugar-dance to almost OTJ (ssshhhh...whisper) has been totally through everyone's help here on FDMB. :-D :-D :-D

New vet was totally amazed at spreadsheet when Rumpelteazer went for a check-up. I can't wait to let her know when RumpelT is finally otj (no caps....quiet). :mrgreen:

Eddie will get there....just keep those lavender pants handy. :lol: cat_pet_icon
 
Re: 1/9 Eddie - AMPS = 250, +6 =118, PMPS = 349

Rumpelteazer had a hypo-episode in the beginning due to my now-ex vet's dosing
Click to expand...

I think I spotted that incident in Rupelteazer's spreadsheet. Been studying her spreadsheet extensively. :D It really makes you wonder. When Eddie was diagnosed just before Christmas, we had friends and family act like it was a death sentence and suggest that we should put him to sleep if he was suffering. And of course, they all had stories about someone they knew who had an animal who died shortly after a diagnosis of diabetes. I wonder how common it is for pet owners to accidentally OD their pets and never realize that it was due to too much insulin.

I'm so glad we started hometesting, and after dipping into the 70's on our first day of testing (at about 2:00 a.m.), I spoke with a tech and a vet who we don't usually use, and they didn't want us to reduce from 3U bid!! We could have accidentally killed him. I talked to our regular tech and vet the next day who agreed that the 3U was too high, but I wouldn't have known that if we hadn't started testing. The reduction to 2U bid was with their approval. Our current 1.5U dose is to test my hypothesis that Eddie is bouncing a little bit. I know some vets dislike dose adjusting without consulting, but I feel that with the data we have, and are collecting with home testing, and the massive amount of info I've already digested, we are in a good position to safely make small adjustments, rather than waiting to do a weekly phone consult for approval to make a change. I'm hoping they're receptive. I'm guessing that they don't get a lot of FD patients who are willing to do the testing and the learning.

RumpelT's progress is so EXCITING! I'm watching closely and keeping fingers and paws crossed!! Thanks for the advice and encouragement!
 
Re: 1/9 Eddie - AMPS = 250, +6 =118, PMPS = 349

So you like those purple shades, huh?

Here are some more, but in dark purple.
 

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Re: 1/9 Eddie - AMPS = 250, +6 =118, PMPS = 349

OOOOH! For some reason when I think "patience pants" I envision them as being purple ;)

Patience pants clearly come in a wide variety of styles and colors! haha_smiley
 
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