10.8 PMPS

Becki and sox said:
@Kris & Teasel do you think 1u? Or a little less. I only ask that as back last week some time I was giving 1u at night and his numbers were to low to inject in the morning.
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You could draw up 1 u and expel a tiny drop so that you have a little more than 0.75 u but a little less than 1 u. Tricky to be consistent though.

If these tiny fractional changes are what Sox needs, your best bet is to use U100 syringes with the conversion chart. It's not nearly as complicated as it seems: http://www.felinediabetes.com/insulin-conversions.htm
 
Yes I do have some u100 needles to try so will try them when I feel confident.

What is it I'm looking for with regulating Sox.
Am I aiming for yellow numbers in the morning then nice blues and greens in the day. Or are the pinks ok in the morning as long as I'm getting blues and greens in the day?
 
Ideally you want to keep them no higher than the low yellows - under 220 is good. A well regulated cat can stay in blues and greens most of the time. If you scroll through Sam's spreadsheet you'll see months where he was almost all blues and greens. Not all cats get to "well regulated"
 
Yes, but it does take time and patience. As they get used to the lower numbers, you'll start to see longer duration and more and more yellows show up at PS time. And it's usually a bit of a dance as you're already experiencing: lower the dose...wait...raise the dose...wait...lower a teeny bit....raise a larger bit....and on and on. Just doing the best we can to respond to the numbers and be patient all at the same time. o_O
 
So do you think maybe stick with the 0.75 abit longer or try maybe 0.80u or 0.90u rather than going straight back to the full 1.0u after that was keeping him low for abit longer than the cycle?
 
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I tend to slide Sam into his new doses instead of jumping to a new line. So I might go to your usual 0.75u, and then just a smidge more, then a smidge more, and then 1.0u. Each little "smidge" just being for one cycle (unless something surprising happens with the numbers). So call it 0.75F, 1.0S, 1.0 with the F = Fat and the S = Skinny.

I think it would be safe enough to just jump to 1.0, but it might be less dramatic to sneak into the increase. Especially if you're not feeling really comfortable with the idea of going back to 1u. It gives you a little more time to make sure everything is okay.

Eventually you'll be able to shoot on those blue numbers, but it does take some trials and data to know what is safe and helpful for Sox.
 
Djamila said:
I think it would be safe enough to just jump to 1.0, but it might be less dramatic to sneak into the increase.
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Ok great thank you.
So maybe do 0.75u possibly 0.80u tonight. Then go with the 0.80u a few days. Then 0.90u for a few days then see where we stand then before going back to the 1.0u

I can't see there been much difference in swapping from 0.75u to 0.80u tonight would you think?
 
Well, sometimes they surprise us :cat:. There are three options when responding to a dose change (even a very small one):
1. no real change (most likely what will happen going from 0.75 to 0.8)
2. a dramatic response followed by a return to the regular response (and then you have to increase again)
3. an increase in BG for a cycle or two, and then finally responding to the increase in the 3rd or 4th cycle

Sam often goes with option 3, but sometimes he'll choose an option 2. Because why would they be predictable? ;)

With the very tiny increases (less than 0.25u), and Sox' current data, I wouldn't think you'd really need to hold them for a few days. A cycle or two is likely sufficient. Again though, it's up to you and what you feel comfortable doing. And of course up to Sox and what he decides to do.
 
Djamila said:
Especially if you're not feeling really comfortable with the idea of going back to 1u.
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I'm happy to give the 1u again the only problem I have is if he's too low on the AMPS I have to skip the dose for the day as no one there to watch.

Unless I try 0.9u tonight.
What do you think what would you experienced guys do :D
 
Can you draw up 0.8u? I think he needs a little boost but I like Djamila's idea of easing him into it. His PMPS is a bit lower tonight than the last few days.
 
I hear you! Been there....done that! Just do the best you can. ;) It might be a good idea to grab a used syringe and draw up some coloured water to where you perceive the dose to be, then use that coloured water for comparison to draw up the insulin. Consistency is more important than absolute accuracy.
 
I had to get reading glasses to help with the syringes and blood tests too. I don't need them for anything else (yet), but they really helped with accuracy with those tiny lines!
 
Djamila said:
Cats like to keep us on our toes
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Sox is a big one for that.
The +9 was a suprise today didn't think he would go that high. Could that be either not enough juice so not lasting him long enough or just a bit of a bounce from last night's green and today's blues?
Stick with 0.80u again?
 
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Sorry I think we missed your PMPS Becki! Looks like you did 0.8? I think that was fine. Let's see what happens tonight and if he doesn't drop low, you can probably do the increase to 0.9 if you want to do that small increase to try the easing him in to it thing. :)
 
@Rachel not sure what the reading was in the night as I didn't get up and check.
But he was quiet low this morning so have told Brad to do a few checks on him today to as he was 12.1 and I still gave him 0.8 so hoping for some nice numbers today.
 
It's nice that Brad is home and able to do some checks today! Let's see what happens, but I'm guessing you're going to want to increase.
 
Becki, do you have the syringe conversion chart printed out and right beside you? U40 syringes hidden away? I agree that you can try 0.9 u. Those U100 syringe marks are tiny but having a pair of reading glasses (even if you don't normally need them) and a good strong light behind the syringe is very helpful. I always sit at my desk to draw up insulin to take advantage of my bright desk lamp. I then view the syringe against a white background - tissue, piece of paper, etc. - to check the insulin level.
 
Sox is staying pretty flat today. I think I'd keep the 0.8u tonight just because it's a nighttime cycle, then I agree with Rachel and Kris about the 0.9u if nothing interesting happens during the night. The mid-cycles you're getting are pretty good, and there is still a fair amount of room below that to keep him safe. At this point you aren't trying to bring the nadir down as much as you're trying to build longer duration. And if the nadir does go down a bit, it's okay, as long as he stays above 50. A normal, non-diabetic cat will stay around 50-80 most of the time, with occasional dips higher or even a bit lower than that.

Now that being said, if he gives you a lowish yellow PMPS, and gets another green tonight, and another yellow AMPS, I might stay at 0.8u one more day. But if he gives you a pink PMPS or AMPS (or a high enough yellow that if you squint it's really closer to pink), I think I'd go to 0.9u
 
Okie dokie @Djamila that sounds like a good idea to me. I'm out tomorrow so may keep the 0.8u then but am in all day Sunday so could do it then and keep an eye on him :D
 
Sox has been pretty flat all day. Not much difference between AMPS and PMPS. You could shoot the 0.8u if you are game for a little more testing tonight should it be needed or you could reduce slightly if you are not up to monitoring or uncomfortable with the possibility of having to steer him a bit. That reading is not much below 11mmol and could be a tad lower or a tad higher when you take meter variance into consideration. Decisions.. decisions!
 
BG gone up again after eating :confused:
I'll test again tonight at +6.
Think I'll stay with 0.8u tomorrow as I've got to go out and do my shopping so can't watch him all dat. And then depending on tomorrow test I do get I'll try 0.9u on Sunday
 
He has been quite flat today, hasn't he? Reasonably good numbers though considering his usual patterns! I really like today's cycle, and I think sticking with 0.8u again was a good call. Curious what tomorrow will bring!
 
Sox had quiet a nice PMPS but 2 hours later gone up quiet abit. I think Brad might be stressing him abit and Brad shouts at the TV when playing FIFA :confused: could that cause his levels to go up do you think?
 
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