10/29 Pumbaa AMPS/82

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Pumbaa

Pumbaa

Member Since 2012
This was yesterday's thread: http://felinediabetes.com/FDMB/viewtopic.php?f=10&t=82071.

Unfortunately, after his +8.5 reading last night, when he was down to 87, I fell into an exhausted sleep and didn't wake up for four hours. :( (Cleaning, cooking a turkey, making an apple pie and having people over for dinner wore me out!)

So, unfortunately, I don't know how much lower Pumbaa went than that 87 last night, but he started this morning at 82. At first, I wasn't going to give him any insulin, but after a half cup of ~O) , I realized that I should at least give him a big chicken shot, and did give him 1.50U.

I'm still trying to process how quickly he cleared his bounce yesterday, and that he went from a high of 420 to a low of 87 (that I know of...he obviously went lower or he wouldn't have started this morning at 82). But I am happy that I hadn't increased his dose above the 2.75U, and gave him more time to settle into that dose, and that Pumbaa hit greens on that dose. Had I increased him after 6 cycles, I wouldn't have known this. So it took him nine cycles to hit green on this dose. Interesting.

His 14-day average is 255.
His 30-day average is 263.

He's been on Levemir for a little over a month now, so I find those averages interesting, even if they aren't very significant.

I wish I could crawl back into bed and get some more sleep, but today is a very busy day for me.

Suze
 
He is doing well - and finally making progress. Probably clearing the GT/IR. He may not have gone much lower in the 3.5 hrs between the 87 and 82. He may have surfaced right there for the entire time. Where he ends up tonight may tell you, although with the reduced shot, he may be higher from that. I am NOT saying you should not have reduced. It is what I would have done (did do on Cami's 100 PS).

Now you need to watch for a nadir below 50 at least, for a dose reduction needed. I might be tempted to reduce him to 2.5u anyway, and see if he can hold the 80s with that.

At least you know he needs a long time to settle on a dose. I tend to think that is the norm, not the exception to the rule with cats on these long acting insulins. I kept Cami at .5u for almost two weeks. Her numbers kept changing in a way that made me think she was still adjusting to the insulin/dose.
 
Well, the bounce today is no surprise at all. "They bounce until they don't." I keep telling myself that. *LOL*

Sheila: I might just take him down to 2.50U due to scheduling conflicts I have in the next two weeks which aren't going to allow me to test him as frequently as I do now.

QUESTION:
Since I gave Pumbaa a big chicken shot of 1.50U (instead of his regularly scheduled 2.75U), but it was 2 hours after his normal AM injection time, do I have to back off in 15 minute increments until we get back to his normally scheduled time, or can I just go ahead and shoot him at his normal time, due to the vastly reduced dose?


Suze
 
Found out from Chippendale's that I could have shot at Pumbaa's normal test time, and will try to remember in the future that a BCS is kinda like a fur shot, even if it's late.

I did go ahead and decrease Pumbaa's dose to 2.50U tonight, even though he's bouncing and even though I have him a BCS of 1.50U this morning. I would be thrilled if Pumbaa would settle into the low 100's at 2.50U, for the next few weeks. Hey, we can dream, right? :)

Suze
 
There is no rule of thumb on that, each circumstance may be different. Normally if you shoot a full dose you'd want to realign with that time. In this case your full doses were at the old time so that would have worked for that time only.

As for parking him for a few weeks under dose, I'm pretty skeptical. But the good news is when you come back, you should be able to take him back up to whatever it takes at that time (3.5 or 4.0 units or more) for a breakthrough.

I'd love to be wrong (but I know too well it won't work like that for Chip) and perhaps if Pumbaa is reading he can defy me now that he's challenged? ;-)
 
Dale 'n' Chip said:
As for parking him for a few weeks under dose, I'm pretty skeptical. But the good news is when you come back, you should be able to take him back up to whatever it takes at that time (3.5 or 4.0 units or more) for a breakthrough.

I'd love to be wrong (but I know too well it won't work like that for Chip) and perhaps if Pumbaa is reading he can defy me now that he's challenged? ;-)
Click to expand...

I hope Pumbaa does defy your history with Chip and Levemir, and that parking him at a dose will keep his numbers under renal threshold, and reduce bounces, etc., so I don't have to worry so much about testing him when I won't be able to do it as regularly as I have been. :)

And I shouldn't say "parking him at a dose" because if he stalls out and goes all pink or even high yellows, I'm going to increase him again, and pray that he doesn't go hypo. His history on 2.75U tells me that it's a good dose for him without dropping too low, but, who knows what the future would bring on the same dose.

I wish I didn't have to slow down this Pumbaa momentum for other life stuff.

Suze
 
Dale 'n' Chip said:
... perhaps if Pumbaa is reading he can defy me now that he's challenged? ;-)
Click to expand...
I was going to say, "Make sure Pumbaa reads the memo, Suze."

My answer to your question (and I am sorry I didn't see it earlier) is that it would depend on the BG at the old shot time. And probably a couple of spot checks earlier so you know if he is rising, falling , or surfing at the old shot time. The smaller dose is NOT like a fur shot because you know he got some insulin. With fur shots you don't know and can't even really guess - until at least 12 hours later.

When I got a much lower than usual PS and reduced the dose, or a really low nadir, which caused a bounce at the next PS, I would often shoot the old dose that caused the low to deal with the bounce and then reduce the dose at the next shot. A lot of times you can see a pattern of low to high numbers on a 24-36 hour cycle. You are trying to keep the momentum going as the pendulum reverses direction only (top of the bounce) and reduce the momentum before it hits the bottom of the swing (the low) so it won't swing back up as high.
 
I, too, would have shot at the regular time since it was a reduced shot.

And I find I have to look real closely at Sneakers BG when I have fur shots and only shoot a token dose b/c I know she didn't get much with the first one. Although I have found if a reduced shot happens the next PS usually isn't off- it is the one after that. I tack it up to the elusive 'shed'.

Hopefully he will continue to give good numbers even when your busy elsewhere :-D .
 
Hi, Suze,

Looks like Pumbaa is doing well. I'm very glad to see that. You must feel much better.

I'm happy to see Chip's spreadsheet, too. Very nice.

By the way, it's possible that Max is having an issue with cancer. We still don't know what's up, but we go to the vet again tomorrow for another ultrasound and some bloodwork. I've been posting in LL since he went OTJ (and he's still OTJ eventhough this might be a pancreatic cancer). We've had the aspiration and the cytology for that. It was mostly inconclusive, but the tech said "probably carcinoma/possible sarcoma/possible pancreatitis." Yeah, 300 for a whole lotta nothing. I am not sure if we will do a biopsy. He's eating less than before but regularly, and although he doesn't poop in his box -- not sure where he's pooping, probably outside -- he's not showing any signs of distress.
 
Dale, I am very sorry to read this about Max. Sending prayers that it is just pancreatitis and that he continues to do well. What symptoms made you start the whole investigative process in the first place?

(((hugs)))
 
Dale: (((HUGS)))

I just went and read your posts about Max. Like everyone else, I'm praying it's just pancreatitis, or maybe simply just a cyst of some kind that got large, drained, and will be cleared up with antibiotics! Crossing my fingers for a non-life-threatening diagnosis for your little boy!

How are you and hubby and Emma doing now that you're not testing Max every hour? Has the last month seemed like a vacation? His numbers are still wonderful! :thumbup

I'll start watching your posts to see what you find out about the little guy. Prayers coming your way!

Suze
 
I didn't have time to post a thread on Pumbaa yesterday, but Heather was correct - Pumbaa's numbers were elevated a bit yesterday morning, and I take that to be a result of the BCS. But, the good news is, that as of last night, he's been surfing the blues! Now, that could still be the difficult-to-figure-out shed, but hopefully it's how he's reacting to the reduced 2.50U dose. If I can just keep him below renal threshold for the next week, we'll be in great shape!

Suze
 
Good luck with Pumbaa. Of course, I hope you can keep his BG below the threshhold at this dose. I'll be thinking of you.

Thank you for your kind thoughts about Max. He seems to be fine this morning. We have a vet appt in 2 hours. If he weren't so skinnny I would think he was just an old guy who had slowed down.
 
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