11/10 Bama Kitty AMBG/ns 102, +1 76, +3 72, +4 80, +6 116, +11 201; PMPS 230 +2 251 +4 209 +7 338

If you keep stalling without food, he is bound to drop. Either you shoot 6.5U and let him earn the reduction in the cycle, or you take the reduction and shoot 6U.
I would prefer the first option. You do not want to lose momentum, just as you are starting to see good numbers.
 
I believe the MC/gravy food he's had over recent blue cycles [11-7, 11-6 & earlier] may have contributed to his tummy woes. I'm trying not to use that. Feeding LC FF; Honey did not go over well with him 11-7 pm so I may try Karo.
 
Bama Kitty Mom said:
Feeding now at 80. Will monitor over next few minutes to see if he begins to rise. Otherwise, is a skipped dose.
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You do not want to shoot based on a preshot that is influenced by food. The time to shoot would have been at 102. I, quite frankly, did not understand the logic of stalling till he drops below 90 and then waiting for him to rise to shoot.
Unless the 102 was food-influenced, which I think it was not?

Below 90 is a skip with SLGS.

Bama Kitty Mom said:
I believe the MC/gravy food he's had over recent blue cycles [11-7, 11-6 & earlier] may have contributed to his tummy woes. I'm trying not to use that.
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This does happen with some cats.
 
Yes, I believe a skip is in order. He's eaten 3/4 can of FF LC within past 15 minutes, just checked & BG is 69. Gave a small drop of Karo that he licked off my finger. It went over better than the honey of a few nights ago.
 
Bandit's Mom said:
You do not want to shoot based on a preshot that is influenced by food. The time to shoot would have been at 102. I, quite frankly, did not understand the logic of stalling till he drops below 90 and then waiting for him to rise to shoot.
Unless the 102 was food-influenced, which I think it was not?

Below 90 is a skip with SLGS.


This does happen with some cats.
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The 102 was not food influenced. Anything past 80 is. Given that I am skipping dose. What # needs to go in title? Number I started feeding at? Lowest # he dropped to within the hour?
 
Bama Kitty Mom said:
Yes, I believe a skip is in order. He's eaten 3/4 can of FF LC within past 15 minutes, just checked & BG is 69. Gave a small drop of Karo that he licked off my finger. It went over better than the honey of a few nights ago.
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Good idea to skip. Congrats on the reduction. Since you are skipping, go easy on the karo. The insulin from the last shot should wear off soon.

Bama Kitty Mom said:
What # needs to go in title? Number I started feeding at? Lowest # he dropped to within the hour?
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You would put 102 under AMPS in the SS. NS under U.
How long after that test were the next - 91, 80 and 69?
 
Bandit's Mom said:
Good idea to skip. Congrats on the reduction. Since you are skipping, go easy on the karo. The insulin from the last shot should wear off soon.


You would put 102 under AMPS in the SS. NS under U.
How long after that test were the next - 91, 80 and 69?
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About 15 minutes apart. He still seems hungry and may eat the entire can. Have not offered any dry, yet, but I do have a little Dr. E's salmon left. Testing again in 5 min.
 
Bandit's Mom said:
Good idea to skip. Congrats on the reduction. Since you are skipping, go easy on the karo. The insulin from the last shot should wear off soon.
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I thought the insulin would wear off soon on Sunday night [11-7] but he stayed green for a several hours. His depot must be the size of a tanker truck. :D
BTW, thanks, Bhooma, for being here and for your expertise. :bighug:
 
FWIW, I don't think his numbers are greatly influenced by food unless we are talking about really high carb. He has been on insulin for so long with such high numbers that I believe he may have had some insulin resistance/glucose toxicity that is beginning to break. Happy about the reduction to 6u starting tonight. Maybe we can hang there more than a few cycles. :cool:
 
Bama Kitty Mom said:
FWIW, I don't think his numbers are greatly influenced by food unless we are talking about really high carb. He has been on insulin for so long with such high numbers that I believe he may have had some insulin resistance/glucose toxicity that is beginning to break. Happy about the reduction to 6u starting tonight. Maybe we can hang there more than a few cycles. :cool:
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He does look like he wants to go down in dosing at a good speed! I think you can test every half hour if not an hour now?
 
He has headed for his bed, indicating breakfast is likely over. He likes to nap afterwards. I gave another drop of Karo and will follow with more LC FF in a few minutes as he still has some in the can.

Bandit's Mom said:
He does look like he wants to go down in dosing at a good speed! I think you can test every half hour if not an hour now?
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I'll test again in 5 min. and then either start testing on the 1/2 hour or wait an hour depending on what number I get. Still not used to these greens. :D
 
+1.5 68; gave 1t FF LC. Still not convinced he is steady. Meter variance, I know, but in past readings steady readings don't vary by more than a couple points so 4 or 5 drop on a green # indicates to me continued drop but that's just me. :blackeye: Nervous, not nerves of steel.
 
+2.5 69; fed last spoonful of FF LC; had offered Dr. E's salmon kibble earlier and he wasn't interested; will try that + Squeeze Up next 1/2 hour if numbers continue to languish in the cellar. He's eaten 1 whole can of FF LC this morning which happens occasionally on a really good day but he almost always wants some kibble to go with it.
 
Bandit's Mom said:
He is in safe numbers. Let's see if he stays up without food.
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Probably will have to see if he is stable w/o food as I am interrupting his nap as I interrupted his sleep every hour all night long. He is tired and tired of me bugging him and not hungry. The vacuum cleaner is still coming to his room for a visit later today. Probably. ;)
 
+3 72; no food since 2.5; he is resting. This may be the beginning point of his rise. He seems to have a couple of hours of carryover from his previous insulin dose. That plus his abundant depo stores. Maybe he will rise slowly and not shoot the moon. His last dose of insulin was more than 14 hours ago.
 
Bama Kitty Mom said:
+6 116, he's still sleepy and not interested in food; after my nap, I cleaned his litter box and vacuumed his room; he just looked annoyed.
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I had to laugh - Callie lets me know that she's done with me and my pokes by going into the house part of her cat tree and facing the back so I can't get to her ears. She puts up with a lot ... but when she's done, she's done! :rolleyes:

Really nice to see Bama in these great numbers and getting reductions (though I know too well that lower numbers can be quite stressful for us moms & dads!) You are doing such a good job with him! :bighug:
 
Jessica A said:
I had to laugh - Callie lets me know that she's done with me and my pokes by going into the house part of her cat tree and facing the back so I can't get to her ears. She puts up with a lot ... but when she's done, she's done! :rolleyes:

Really nice to see Bama in these great numbers and getting reductions (though I know too well that lower numbers can be quite stressful for us moms & dads!) You are doing such a good job with him! :bighug:
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Yes, Bama has taken to twitching his ear flap while I'm trying to grab it for a poke. And I am beyond stressed over these near pre-shot free falls. What is it about the insulin carryover and/or depo that is causing the spewing of insulin into his body like water from a burst pipe? I thought near pre-shot the insulin action should be almost done--hence the need for a fresh shot. Is he likely getting more than a 12 or 13 hour boost from the insulin? Is the depo too full?
@Bandit's Mom @Wendy&Neko @FrostD @tiffmaxee
Can anyone else enlighten me? I have misplaced my patience pants or maybe I should just fortify them with a pair of Depends. Anxiety starts to creep up as soon as the time arrives for pre-shot. :eek:
 
+8.5 offered him about 1Tbsp Dr. Elsey's kibble which he ate. Maybe this will prompt him to take a pee break from his slumber and I can nab a sample for the ketone sticks. Also hope he'll avoid nausea if he eats something since it has been 6+ hours since he had anything. Planning to get a +11 BG test, give another Ondansetron @ 11.5 and pray for a calm, sleep-filled evening. I am still adrenaline-fueled but may be able to grab a nap soon. This has got to get better.
 
It looks like a couple things are happening, but I'm not as good with "reading" Lantus as some of the other insulins

1. He's hitting those nice stretches and then bouncing.
2. Those skipped shots are basically "aiding' the inevitable bounce - I'm sorry I don't have time to fully read the history, but it is much better to try to give at least some insulin. If you are around to monitor, need to work on lowering your shootable number. Remember, shoot low to stay low!
3. Nadirs on the bounce breaking cycle do often happen later, so I think that's also an element to these "late" (+13/+14) nadirs...if that's what they are.
4. If nobody has mentioned it to you - flat yellow cycles can often indicate an active cycle is coming next.

I also would not feed after nadir if you can help it. That dry food stays around longer and may be part of the explanation here, even though it is low carb, it still affects things longer than the wet food would.
 
Melissa has given you good advice. Duration of Lantus can vary from shot to shot. The carryover is what can lead to nice flat Lantus cycles. Reduction earned with dropping under 90. It’s hard to keep them over 90 but not too high to me.
 
Ok I caught up on some skimming - they also do tend to swing lower on the bounce breaks. So I understand the logic of skipping the 75 (obviously) and kinda-sorta the 102, but this is where it gets tricky with the late nadirs. You're shooting the number they'll be in a few hours.

Hopefully Wendy pops by as I'm sure she has good advice for those. I'm not sure how to best advise on dosing a bounce break late nadir vs just a regular late nadir. I'm not sure if the effect " stacks" - as in bounce break is Kate nadir, then your shot is normal nadir, so you effectively have a long running low cycle.
 
Bama Kitty Mom said:
Is he likely getting more than a 12 or 13 hour boost from the insulin? Is the depo too full?
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Sometimes I saw Neko nadir at +15. It happens. Expect later nadirs in bounce breaking cycles. And there is extra downward momentum on bounce breaking cycles - the main reason we try to not to increase on those types of cycles. But no problem shooting regular dose. Today Bama Kitty's 6.5 unit depot showed itself, and told you he no longer needs that much insulin. I'd try 6.0 units next.

"Levelling him out into the blues" never works, as much as we'd love it to. Just based on almost 10 years of looking at cat spreadsheets. They don't "get used to blues then get used to greens".
 
You all make valid points that I'm not sure my sleep-deprived brain can analyze just yet. My concern is not with the bounces. I know they will occur and I'm hoping they become lower and shorter in duration as he adjusts to low numbers. What concerns me is that he does go so low and yet, apparently, the advice would be to shoot anyway. Well this morning, he was 102 but then 15 minutes later 91 and 15 min. after that he was 80. That's 20 points lower in 30 minutes while stalling. If I had begun feeding, he may not have gone down to 80 30 min. later but when I did start feeding at 80, he was 69 15 minutes later and 76 15 minutes after that--a full hour after the 102 BG reading. If I'm not shooting where he is *now* but the number he will be in a few hours, what number is that? 116 @ +6? I just took a +11 and he is only 201. I mainly took it so I could see if he will still be rising at pre-shot. Thanks for your input. I appreciate it and maybe it will make sense as I study your answers. You all are the best!! :bighug::bighug::bighug: @FrostD @tiffmaxee @Summer and Susie (GA)
 
Wendy&Neko said:
Sometimes I saw Neko nadir at +15. It happens. Expect later nadirs in bounce breaking cycles. And there is extra downward momentum on bounce breaking cycles - the main reason we try to not to increase on those types of cycles. But no problem shooting regular dose. Today Bama Kitty's 6.5 unit depot showed itself, and told you he no longer needs that much insulin. I'd try 6.0 units next.

"Levelling him out into the blues" never works, as much as we'd love it to. Just based on almost 10 years of looking at cat spreadsheets. They don't "get used to blues then get used to greens".
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I still don't understand. Should I have shot the 102 given the numbers that played out? Should I have shot 6 instead of the 6.5? When I compare his +9 and +10 BG readings when I have taken them, they are almost always higher than two or three hours later at pre-shot. Thanks for your input. I will continue to study yours and others responses and it means a lot to me that you are trying to help. @Wendy&Neko :bighug:
 
Bama Kitty Mom said:
You all make valid points that I'm not sure my sleep-deprived brain can analyze just yet. My concern is not with the bounces. I know they will occur and I'm hoping they become lower and shorter in duration as he adjusts to low numbers. What concerns me is that he does go so low and yet, apparently, the advice would be to shoot anyway. Well this morning, he was 102 but then 15 minutes later 91 and 15 min. after that he was 80. That's 20 points lower in 30 minutes while stalling. If I had begun feeding, he may not have gone down to 80 30 min. later but when I did start feeding at 80, he was 69 15 minutes later and 76 15 minutes after that--a full hour after the 102 BG reading. If I'm not shooting where he is *now* but the number he will be in a few hours, what number is that? 116 @ +6? I just took a +11 and he is only 201. I mainly took it so I could see if he will still be rising at pre-shot. Thanks for your input. I appreciate it and maybe it will make sense as I study your answers. You all are the best!! :bighug::bighug::bighug: @FrostD @tiffmaxee @Summer and Susie (GA)
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Sorry, Gina. I guess my input was useless. Just another "strike out" with a moderator. I wish you the best. Bama is definitely seeing some wonderful numbers. I wish you could find that magic dose to keep him safe and steady. As I said, I don't blame you for wanting to skip when he drops too low. I just hate to see those bounces but Susie was always a bouncer too. I'll check back with you in a few days. You and Bama stay safe and I hope you can sleep tonight.
 
Summer and Susie (GA) said:
Sorry, Gina. I guess my input was useless. Just another "strike out" with a moderator. I wish you the best. Bama is definitely seeing some wonderful numbers. I wish you could find that magic dose to keep him safe and steady. As I said, I don't blame you for wanting to skip when he drops too low. I just hate to see those bounces but Susie was always a bouncer too. I'll check back with you in a few days. You and Bama stay safe and I hope you can sleep tonight.
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Thanks Summer. Don't worry about "striking out". Keep getting to know your new Boo baby! Hope he settles in good with the dogs.
 
Ah but you should be somewhat "worried" about the bounces - not worried as in nervous, but they should factor in. You are right they will happen, but the skipping allows him to go much higher than he would with something like a token dose. So he kind of gets trapped in this cycle of shoot to the moon, slam to earth, skip insulin, shoot to the moon, repeat (I don't mean this as harsh, I've been there! Just trying to give analogy/explanation). Giving some insulin will help cut through those bounces a bit, provided it's safe and you can monitor and intervene if needed. I'm guilty of leaving a can of MC/HC out so I can get some freakin sleep

The short answer is we don't know how he'll handle a shot on a bounce break late nadir because it hasn't been done yet (I perused spreadsheet and couldn't find a good recent example). His usual nadir is +4 to +6 ish.

If he were my cat, following SLGS? When I got the 75, I'd have stalled up to an hour to see if he came up to 90, and given a BCS of something like 1/2-2/3 dose if he did come up. If he didn't, I'd have done a very small token dose of 10-25% in the hopes of cutting a bounce a bit (yes I realize this goes against the SLGS rules as written). Just something to help drain the depot a little bit but also help tamper the inevitable bounce.

Today, I'd have shot probably a 1/2 dose BCS when I got the 102, or a token dose if that's more comfortable. Remember food takes at least half hour to kick in.

Also remember, on TR youd be "letting" him get down to 30s before a reduction so the numbers you're seeing are still ok!
 
FrostD said:
Ah but you should be somewhat "worried" about the bounces - not worried as in nervous, but they should factor in. You are right they will happen, but the skipping allows him to go much higher than he would with something like a token dose. So he kind of gets trapped in this cycle of shoot to the moon, slam to earth, skip insulin, shoot to the moon, repeat (I don't mean this as harsh, I've been there! Just trying to give analogy/explanation). Giving some insulin will help cut through those bounces a bit, provided it's safe and you can monitor and intervene if needed. I'm guilty of leaving a can of MC/HC out so I can get some freakin sleep

The short answer is we don't know how he'll handle a shot on a bounce break late nadir because it hasn't been done yet (I perused spreadsheet and couldn't find a good recent example). His usual nadir is +4 to +6 ish.

If he were my cat, following SLGS? When I got the 75, I'd have stalled up to an hour to see if he came up to 90, and given a BCS of something like 1/2-2/3 dose if he did come up. If he didn't, I'd have done a very small token dose of 10-25% in the hopes of cutting a bounce a bit (yes I realize this goes against the SLGS rules as written). Just something to help drain the depot a little bit but also help tamper the inevitable bounce.

Today, I'd have shot probably a 1/2 dose BCS when I got the 102, or a token dose if that's more comfortable. Remember food takes at least half hour to kick in.

Also remember, on TR youd be "letting" him get down to 30s before a reduction so the numbers you're seeing are still ok!
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Thanks, Melissa. That's the kind of explanation I need to hear. Better choices than skips and examples and what you would have done. That is very helpful!!!:)
 
Re: 6 vs 6.5 - you always take the reduction as soon as you see the number below 90. Some of today's numbers got lost in the mix, but it appears you got a sub-90 AMPS at first - so AM shot would have been 6U max
 
FrostD said:
Re: 6 vs 6.5 - you always take the reduction as soon as you see the number below 90. Some of today's numbers got lost in the mix, but it appears you got a sub-90 AMPS at first - so AM shot would have been 6U max
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But because he continued to drop, the better choice would have been a token dose of 3U?
 
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