10/10 Lily at 115 +4

Status
Not open for further replies.
Hi Sally,

Just had a look at Lily's spreadsheet. I see that her AM mid-cycle numbers seem to be trending down a little (nadir of 110 on yesterday's AM cycle). I also note that she's had a couple of pink AMPS readings. It's possible that the higher AMPS readings may be due to Lily's BG levels bouncing from lower numbers during the night, though no way to be sure without data.

With Vetsulin it's safer not to dip below the 100 mark at nadir, and the FDMB Vetsulin guide recommends a dose reduction if nadir drops to less than 90 (human meter).

I don't know how you're fixed for testing on the PM cycle (body's gotta sleep!) but I'd like to make a couple of suggestions that I hope are helpful to you for your testing strategy:

* PM cycle tests at +3 may give you a better indication of how low the dose may be starting to take Lily at night (many cats run lower on the PM cycle).

* Based on Lily's response thus far, PM cycle tests around the +4 mark may increase your chances of catching a nadir BG.

* Some members find it helpful to set an alarm to grab a quick BG check during the small hours, and then head back to bed.

Dose Review

Since you're now seven days on the 0.25IU dose, I've also been checking the dose adjustment criteria in the FDMB Caninsulin/Vetsulin Guide for you. Here's the relevant text:

Changing the Dose

Hold the starting dose for at least a week UNLESS

  • your cat won’t eat or you suspect hypoglycemia
  • your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12-hour curve (i.e., testing every 2 hours) OR perform an 18 hour curve (i.e., testing every 3 hours). Note: Random spot checks are essential in order to "fill in the blanks" on your kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

The general guidelines for making dose changes are:
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • HOWEVER, there are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or in the Health forum and ask for input about your dose.
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], lengthen the waiting time between dose increases. If you decide to change another factor (e.g. diet or other medications), don't increase the insulin dose until the other change is complete but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change.

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may race past the right dose for your cat.

[Emhasis mine]
​
Short of any surprisingly low nadirs that might be brought to light by a curve run over an evening cycle, it appears that Lily is finding herself already sitting in the target range for this dosing protocol. (Note: should you choose to run a full curve, I'd suggest the PM cycle because the data you've been gathering already gives a very good picture of response in the daylight hours. Start with test at PMPS and then take a reading every 2 hours right the way through to the next AMPS.)

Looks like Lily may be staying on the current dose for another while (short of any wobblers between now and when you complete your dose assessment). Most auspicious-looking. (Anti-jinx!) :)


Mogs
.
 
Critter Mom said:
Hi Sally,

Just had a look at Lily's spreadsheet. I see that her AM mid-cycle numbers seem to be trending down a little (nadir of 110 on yesterday's AM cycle). I also note that she's had a couple of pink AMPS readings. It's possible that the higher AMPS readings may be due to Lily's BG levels bouncing from lower numbers during the night, though no way to be sure without data.

With Vetsulin it's safer not to dip below the 100 mark at nadir, and the FDMB Vetsulin guide recommends a dose reduction if nadir drops to less than 90 (human meter).

I don't know how you're fixed for testing on the PM cycle (body's gotta sleep!) but I'd like to make a couple of suggestions that I hope are helpful to you for your testing strategy:

* PM cycle tests at +3 may give you a better indication of how low the dose may be starting to take Lily at night (many cats run lower on the PM cycle).

* Based on Lily's response thus far, PM cycle tests around the +4 mark may increase your chances of catching a nadir BG.

* Some members find it helpful to set an alarm to grab a quick BG check during the small hours, and then head back to bed.

Dose Review

Since you're now seven days on the 0.25IU dose, I've also been checking the dose adjustment criteria in the FDMB Caninsulin/Vetsulin Guide for you. Here's the relevant text:

Changing the Dose

Hold the starting dose for at least a week UNLESS

  • your cat won’t eat or you suspect hypoglycemia
  • your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12-hour curve (i.e., testing every 2 hours) OR perform an 18 hour curve (i.e., testing every 3 hours). Note: Random spot checks are essential in order to "fill in the blanks" on your kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

The general guidelines for making dose changes are:
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • HOWEVER, there are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or in the Health forum and ask for input about your dose.
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], lengthen the waiting time between dose increases. If you decide to change another factor (e.g. diet or other medications), don't increase the insulin dose until the other change is complete but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change.

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may race past the right dose for your cat.

[Emhasis mine]
​
Short of any surprisingly low nadirs that might be brought to light by a curve run over an evening cycle, it appears that Lily is finding herself already sitting in the target range for this dosing protocol. (Note: should you choose to run a full curve, I'd suggest the PM cycle because the data you've been gathering already gives a very good picture of response in the daylight hours. Start with test at PMPS and then take a reading every 2 hours right the way through to the next AMPS.)

Looks like Lily may be staying on the current dose for another while (short of any wobblers between now and when you complete your dose assessment). Most auspicious-looking. (Anti-jinx!) :)


Mogs
.
Click to expand...

Hi Mogs, that is great news! I thank you for all the information and I will try to do a full curve soon, if not tonight. How many nights will we do the curve? I am excited to be staying at .25 for the time being.

Hope you are feeling better Mogs, I have missed you!
 
Nice to know someone does, Sally. :woot:

Re the PM curve, you only need to do it for the one night. For 'nadir hunt' spot checks on the PM cycle, as and when you can manage them.

Still have the cold, but not quite as sneezy today (spent most of the weekend hiding under my duvet). How are yourself and Lily keeping?


Mogs
.
 
Critter Mom said:
Nice to know someone does, Sally. :woot:

Re the PM curve, you only need to do it for the one night. For 'nadir hunt' spot checks on the PM cycle, as and when you can manage them.

Still have the cold, but not quite as sneezy today (spent most of the weekend hiding under my duvet). How are yourself and Lily keeping?


Mogs
.
Click to expand...
We are wonderful thanks. I am getting some errands done today and Lily and the others are sleeping. What a life!! LOL.
 
Critter Mom said:
Hi Sally,

Just had a look at Lily's spreadsheet. I see that her AM mid-cycle numbers seem to be trending down a little (nadir of 110 on yesterday's AM cycle). I also note that she's had a couple of pink AMPS readings. It's possible that the higher AMPS readings may be due to Lily's BG levels bouncing from lower numbers during the night, though no way to be sure without data.

With Vetsulin it's safer not to dip below the 100 mark at nadir, and the FDMB Vetsulin guide recommends a dose reduction if nadir drops to less than 90 (human meter).

I don't know how you're fixed for testing on the PM cycle (body's gotta sleep!) but I'd like to make a couple of suggestions that I hope are helpful to you for your testing strategy:

* PM cycle tests at +3 may give you a better indication of how low the dose may be starting to take Lily at night (many cats run lower on the PM cycle).

* Based on Lily's response thus far, PM cycle tests around the +4 mark may increase your chances of catching a nadir BG.

* Some members find it helpful to set an alarm to grab a quick BG check during the small hours, and then head back to bed.

Dose Review

Since you're now seven days on the 0.25IU dose, I've also been checking the dose adjustment criteria in the FDMB Caninsulin/Vetsulin Guide for you. Here's the relevant text:

Changing the Dose

Hold the starting dose for at least a week UNLESS

  • your cat won’t eat or you suspect hypoglycemia
  • your kitty falls below 90 mg/dL (5 mmol/L). If kitty falls below 90 mg/dL (5 mmol/L) decrease the dose by 0.25 unit immediately.
After 1 week at a given dose perform a 12-hour curve (i.e., testing every 2 hours) OR perform an 18 hour curve (i.e., testing every 3 hours). Note: Random spot checks are essential in order to "fill in the blanks" on your kitty's spreadsheet. The goal is to learn how low the current dose is dropping kitty prior to making dose adjustments.

The general guidelines for making dose changes are:
  • If nadirs are more than 150 mg/dl (8.3 mmol/L), increase the dose by 0.25 unit
  • If nadirs are between 90 (5 mmol/L) and 149 mg/dl (8.2 mmol/L), maintain the same dose
  • If nadirs are below 90 mg/dl (5mmol/L), decrease the dose by 0.25 unit
  • HOWEVER, there are some situations which signal that a larger than usual dose reduction is needed. If you are unsure, please post on this forum or in the Health forum and ask for input about your dose.
As your cat's blood glucose begins to fall mostly in the desired range [lowest point of the curve approaching 100 mg/dl (5.5 mmol/L) and pre-shot value around or below 300 mg/dl (16.6 mmol/L)], lengthen the waiting time between dose increases. If you decide to change another factor (e.g. diet or other medications), don't increase the insulin dose until the other change is complete but decrease the dose if your cat's glucose numbers consistently fall below 90 mg/dl (5.0 mmol/L) as a result of the change.

Don't be tempted to rush the process along by increasing the dose more quickly or in larger increments no matter how high your cat's blood glucose is! Rushing towards regulation will cost you time in the long run, because you may race past the right dose for your cat.

[Emhasis mine]
​
Short of any surprisingly low nadirs that might be brought to light by a curve run over an evening cycle, it appears that Lily is finding herself already sitting in the target range for this dosing protocol. (Note: should you choose to run a full curve, I'd suggest the PM cycle because the data you've been gathering already gives a very good picture of response in the daylight hours. Start with test at PMPS and then take a reading every 2 hours right the way through to the next AMPS.)

Looks like Lily may be staying on the current dose for another while (short of any wobblers between now and when you complete your dose assessment). Most auspicious-looking. (Anti-jinx!) :)


Mogs
.
Click to expand...
Hi Mogs, sure hope you are feeling better!

I checked Lily last night every 2 hours and plan on doing spot checks at +3 and +4 some this week too. If you get a chance and feeling like it please check our spreadsheet.
Thanks!!
 
Hi Sally,

Sorry for taking so long to reply to you (been trying to help Patty).

Just had a look at Lily's spreadsheet. I have a question: I saw in the spreadsheet notes your comment about feeding both FF and DM. Is this the first time you've fed Lily the DM food? (I'm assuming that it's the Purina DM canned food. If that's wrong, please let me know.)

I'll reply again to you tomorrow, Sally. You and Lily keep safe and well in the meantime.

:bighug:


Mogs
.
 
Last edited:
Critter Mom said:
Hi Sally,

Sorry for taking so long to reply to you (been trying to help Patty).

Just had a look at Lily's spreadsheet. I have a question: I saw in the spreadsheet notes your comment about feeding both FF and DM. Is this the first time you've fed Lily the DM food? (I'm assuming that it's the Purina DM canned food. If that's wrong, please let me know.)

I'll reply again to you tomorrow, Sally. You and Lily keep safe and well in the meantime.

:bighug:


Mogs
.
Click to expand...

Hey Mogs, that’s ok, I know you helping Patty and Blue and they really need it! What a dilemma.

No, I have been feeding Lily the Purina DM all along and switched to the fancy feast pate. Not sure if that made a difference in her numbers or not.
 
Hi Sally,

Sorry to take soooooo long to get back to you. :oops:

Thanks for the info about the food. What prompted the question was the rather flattish result from the curve you ran the other night (great job overall with the testing, BTW!) and also that Lily had been showing a better response earlier.

The FF patés are lower in carbs than the DM canned. While logic might dictate that the lower the carbs the better the BG should be, we're dealing with living beings here and sometimes oddities can arise. Counterintuitively, some cats don't do as well on low or ultra-low carb diets, and seem to respond better when eating a food in the 6-8% carb range. I did wonder whether the carb % might be affecting Lily's mid-cycle BGs. As you've already been doing in places, if you keep a brief note of what foods you give on AM and PM cycles in the remarks, it might help you to spot any pattern.

Lily's dose is due for evaluation in a couple of days' time. If her nadirs stay above the 150 mark then, per the FDMB Vetsulin guide, you might want to consider making a small adjustment to her dose.

Please be sure to post for help when you need it. :)


Mogs
.
 
Last edited:
Critter Mom said:
Hi Sally,

Sorry to take soooooo long to get back to you. :oops:

Thanks for the info about the food. What prompted the question was the rather flattish result from the curve you ran the other night (great job overall with the testing, BTW!) and also that Lily had been showing a better response earlier.

The FF patés are lower in carbs than the DM canned. While logic might dictate that the lower the carbs the better the BG should be, but we're dealing with living beings here and sometimes oddities can arise. Some cats don't do as well on low or ultra-low carb diets, and seem to respond better when eating a food in the 6-8% carb range. I did wonder whether the carb % might be affecting Lily's mid-cycle BGs. As you've already been doing in places, if you keep a brief note of what foods you give on AM and PM cycles in the remarks, it might help you to spot any pattern.

Lily's dose is due for evaluation in a couple of days' time. If her nadirs stay above the 150 mark then, per the FDMB Vetsulin guide, you might want to consider making a small adjustment to her dose.

Please be sure to post for help when you need it. :)


Mogs
.
Click to expand...
Thanks for checking on us Mogs. I will keep track of her food in the notes. I think she is doing well and I appreciate all the help! Take care!
Sally
 
Critter Mom said:
Whoa! Just seen Lily's spreadsheet. Anything different today?

Lily's in safe numbers, but do you need any help, Sally?


Mogs
.
Click to expand...
Thanks for looking in on us Mogs. No nothing different at all. The only thing I can think of is I have a little hard time pulling up just .25 of insulin. I just eyeball half of .50 and maybe sometimes a little off. She is 102 now at +7.
 
Hi Sally,

Glad all's OK. :)

Re drawing up small doses, sometimes using two pairs of cheap 'n' cheerful reading glasses stacked one on top of the other can make it easier to see where the edge of the plunger is. I also used a cheap and cheerful jeweller's loupe to magnify the markings:

Q5OPLhWWkSh2lT1EfIGKrMIjdO0cyMVAaZkgxG9r-ti-6G7y1yLFW6N0zz3pyqwPGlJG19uELyZO49QGK_gDV17dlVGLgyfkpz6E61dIyUuiBKnBADUAY_oOR_GN8UlvtoYBexX1


Some members - particularly those using depot insulins - use digital calipers to measure their doses. Also, you need to watch the position of the printed markings on the syringes because they can move around a bit between batches.

BTW, today is a very good example of why it is important to keep a very wide BG level safety buffer when using Vetsulin. It gives that bit more room for manoeuvre room when oddies happen. :)


Mogs
.
 
Critter Mom said:
PS:

Meant to say in the above post that you're doing OK with the dose measuring because you're seeing quite a consistent response to the dose in Lily's BG data. :)


Mogs
.
Click to expand...
Thanks Mogs! I know the trick of the two glasses very well, unfortunately! I will look into the jeweler loupe though. Also I read somewhere about counting drops but that didn’t go so well when I tried it.
 
When trying the drop counting, I smeared a small sheet of regular printer paper with Vaseline and wiped off the excess to create a moisture barrier. Then I would practice getting the drops the same size using water in the syringe. The oil barrier helps the droplets to bead up and it's easier to compare sizes that way. Also, twisting the plunger like you'd do with a corkscrew makes it easier to s-q-u-e-e-z-e out little droplets. The Vaseline-smeared paper can also be wiped off and used again. Adding a little food colourant to the water in the syringe might help you judge drop size better too.

Talking of food colourant, some members will keep a 'reference syringe' filled with coloured water to the level of the current dose. It can then be used as a comparator when measuring subsequent doses.


Mogs
.
 
Last edited:
Critter Mom said:
When trying the drop counting, I smeared a small sheet of regular printer paper with Vaseline and wiped off the excess to create a moisture barrier. Then I would practice getting the drops the same size using a water in the syringe. The oil barrier helps the droplets to bead up and it's easier to compare sizes that way. Also, twisting the plunger like you'd do with a corkscrew makes it easier to s-q-u-e-e-z-e out little droplets. The Vaseline-smeared paper can also be wiped off and used again. Adding a little food colourant to the water in the syringe might help you judge drop size better too.

Talking of food colourant, some members will keep a 'reference syringe' filled with coloured water to the level of the current dose. It can then be used as a comparator when measuring subsequent doses.


Mogs
.
Click to expand...
Those are awesome tips Mogs! I am excited to try them. I am going to test Lily one last time now at +8 to make sure all is well and go get a flu shot. Appreciate you so much!
 
Status
Not open for further replies.
Back
Top