11/02 Cole - PMPS 241 / +1 281 / +2 248

Butters & Lyla said:
I'd say we're good. Nice job. Carry on as normal with dinner. You can give him a poke break to PMPS. But do post at PMPS time with the number.
Remember Cole earned a reduction to 2.75u.
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I will post the PMPS

So I am still shooting tonight with a reduction? Feeling nervous.... :nailbiting:
 
I recommend you check his PMPS roughly 30 minutes before shot time and post here for help first before shooting. The question of whether "to shoot the full reduced dose or to not shoot the full reduced dose" may be crystal clear then, or may not. I'll be back around then to see.
 
Colio said:
It used to be 2 meals, with dry down all the time. Now that we are only having wet food, it's several small meals, and two larger ones for breakfast and dinner. Evening shot is about 2.5 hours after dinner.
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Cool. Maybe solicit input from others but I think it could help to move the larger meals to shot time so that when the insulin onsets, there is a little extra food in Cole; lantus doesn't require food on board since it's gentle acting (unlike other, harsher insulins) but the food could help the onset. I use +9.5/+10 as a small snack to help "waken" jax's pancreas for the pre-shot test. Maybe @tiffmaxee can set me straight :p

Colio said:
Will do - despite all the food today he is still looking at me like - I need more food! :)
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Haha, I swear the kitties drop low for sugar and gravy.
 
At +11.5, Cole is now at 209. He did eat a larger snack at +9.5 (saving dinner size for the PM insulin shot)

Looking for help please - do I shoot 2.75u (a .25u reduction) or other advice?

This is what happened today -

AMPS 137 *breakfast
+2 49 *3 tbs 3%, 1 tsp honey (Beyond the Grain Chicken and Sweet Potato)
+2.5 77 *no food
+3 *missed due to work conflict
+3.5 52 *1 tbs 3%, 1 tsp honey (Beyond the Grain Chicken and Sweet Potato)
+4 59 *1 tbs 3%, 1 tsp honey (Beyond the Grain Chicken and Sweet Potato)
+4.5 65 *1 tbs 3%, 1 tsp honey (Beyond the Grain Chicken and Sweet Potato)
+5 59 *2 tsp ~7%, 2 tsp honey (RC Fiber Vet Diet Wet)
+5.25 70 *no food
+5.75 95 *1 tsp Fiber Rx ~7% (RC Fiber Vet Diet Wet)
+6 99 *no food
+6.5 122 *no food, test in 1 hour
+7.5 135 *no food, test in 1 hour
+8.5 193 no food
+9.5 no test - large snack LC food
+11.5 209
 
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If you want help deciding whether to shoot the full dose (2.75u) or a smaller dose, I recommend you edit your thread title with an abbreviated version of your question, like “need help deciding PM dose” or something like that. You can remove some of the earlier numbers. :)
I’ll see who is online right now.
 
Butters & Lyla said:
If you want help deciding whether to shoot the full dose (2.75u) or a smaller dose, I recommend you edit your thread title with an abbreviated version of your question, like “need help deciding PM dose” or something like that. You can remove some of the earlier numbers. :)
I’ll see who is online right now.
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Thank you - I accidently deleted all of the numbers... sigh
 
tiffmaxee said:
Get another test in 30 minutes please.
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Will do

AMPS 137 *breakfast
+2 49 *3 tbs 3%, 1 tsp honey (Beyond the Grain Chicken and Sweet Potato)
+2.5 77 *no food
+3 *missed due to work conflict
+3.5 52 *1 tbs 3%, 1 tsp honey (Beyond the Grain Chicken and Sweet Potato)
+4 59 *1 tbs 3%, 1 tsp honey (Beyond the Grain Chicken and Sweet Potato)
+4.5 65 *1 tbs 3%, 1 tsp honey (Beyond the Grain Chicken and Sweet Potato)
+5 59 *2 tsp ~7%, 2 tsp honey (RC Fiber Vet Diet Wet)
+5.25 70 *no food
+5.75 95 *1 tsp Fiber Rx ~7% (RC Fiber Vet Diet Wet)
+6 99 *no food
+6.5 122 *no food, test in 1 hour
+7.5 135 *no food, test in 1 hour
+8.5 193 *no food
+9.5 * no test *large snack w LC food
+11.5 209 *no food
 
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His PMPS is 241 - identical to last night, and it's been suggested he probably slid down fairly low last night, given where he started this morning.

Please let me know what you think - reduce to 2.75u? Feeling a bit nervous...

2.5 hours since he ate
 
You definitely need to reduce to 2.75. Then get a test at +1 and +2. He might bounce and go high. If not you can feed mc food at +1 and +2. Can you monitor as long as needed? Do you have enough test strips and hc food?
 
tiffmaxee said:
You definitely need to reduce to 2.75. Then get a test at +1 and +2. He might bounce and go high. If not you can feed mc food at +1 and +2. Can you monitor as long as needed? Do you have enough test strips and hc food?
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I have mc, test strips and hc food - and I can monitor (who needs sleep :) ) If I reduced to 2.5u does that set Cole back? Would it be safer?
 
There’s no guarantee he will not drop low on 2.5 because the depot will be in play and might be for 4-6 cycles, usually 4 or less. You can drain the depot and shoot 1.0 and then shoot 2.75 in the morning if you want.
 
The difference between last night and tonight, is he didn't drop to 49 yesterday am cycle. Try and look at the cycles as of "waves of action". Don't focus on one cycle exclusively, you won't necessarily see the same blood glucose lowering effects of the insulin every cycle. Try and look at the patterns over a period of 6 cycles. He hit some lower numbers today, and has come up now to your preshot. The last time he hit greens, he bounced.

I'd take the reduction to 2.75u and test as Elise @tiffmaxee suggested, if you are nervous about how the cycle will go. My crystal ball is a little dusty, but I see a bounce coming.
 
tiffmaxee said:
There’s no guarantee he will not drop low on 2.5 because the depot will be in play and might be for 4-6 cycles, usually 4 or less. You can drain the depot and shoot 1.0 and then shoot 2.75 in the morning if you want.
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Thanks for the insight on the depot. I decided to shoot 2.5u, and monitor at +1 and +2 and see where we are.
 
Your dose tomorrow morning is 2.75 units. As others have said, the 3.0 unit depot may control the first part of this cycle. Or not, he could bounce. Which brings me to another topic that wasn't mentioned today. Your other option tonight was "shooting through the bounce". It's a technique we use right after a reduction is earned and you are following TR, if we are pretty sure kitty will bounce. We shoot the old higher dose for one more time (that would have been 3.0 units tonight), then take the reduction the following cycle. Just something to tuck away for the next time you see Cole earning a reduction. When kitty stops bouncing, this technique no longer is a good one to use. Today is your first low numbers event, so lots to learn. I'd also recommend spending some time reading today's post again when you have time. It might help you be prepared for next time.

On the discussion of whether to feed MC or HC when he goes under 68, there are a couple factors to consider. First is how carb sensitive he is, and each cat really is different. That's what you'll have to learn about Cole. Some people need HC over 20%, some do fine with MC. In a case like today, I'd also consider how hard it is to get them up. Your goal when feeding a low numbers is to pop them up around 30 points for safety. Cole spend part of 4 hours today below 68, that's too long and hard on you too. That doesn't leave any margin for safety. Second topic to consider when feeding MC or HC is what part of the cycle you are in. As I mentioned before, you typically need bigger guns (carbs) earlier in the cycle. A low after mid cycle might be fine with just MC. And lastly, I always erred on higher carbs for safety, until I learned it was too much. I'd rather complain about overboosting the numbers than fight low numbers for hours.

Curious to see what Cole does tonight. We don't usually suggest shooting lower numbers to "drain the depot" unless kitty is on much higher dose (thus larger depot), or the caregiver is exhausted and can't monitor. You've had a day! :bighug:
 
Wendy&Neko said:
Today is your first low numbers event, so lots to learn. I'd also recommend spending some time reading today's post again when you have time. It might help you be prepared for next time.
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I definitely learned a lot today - and spent most of the day feeling pretty emotional. Lots of help from people on the food, and thank goodness I had honey and syrup to help since I didn't really have MC or HC food.

Knowing that the 2.5u may not really make a difference in the cycle - I was afraid to set Cole back by draining, and afraid of having a night like today was.

He's up a bit at +1 to 281, but he also had his dinner with his PMPS - so we'll see what +2 is like. Poor baby is pretty tired of being poked.

Thank you everyone for your help (especially @Butters & Lyla :)) and for everyone's patience with me.

It has definitely been a day...
 
At +2 tonight, Cole is moving down again to 248.

Was going to feed him a little bit in about 30 minutes - should I stick with LC or move to MC?

And should I get up later tonight to test again?
 
He is really staying pretty flat, considering meter variance. The numbers may come down gradually, so stick with the LC, and if you can test again before bed or set an alarm, maybe around +4 or +5 just to be sure the cycle isn't really going down.
 
LC. Cole is in very safe numbers. Save the good stuff (gravy ;)) to slow a steep drop or for those #s near the take action number.

He’s flat from PMPS - that +1 was a food bump. A +4 will tell you more (continuing up or breaking a bounce). I’m on my phone but looking at your SS he looks bouncy so my guess is he’ll go up.

@Christie & Maverick are you still on to weigh in?
 
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