11/24 Pimp - Microdosing is Hard! AMBG 62; +13 86; 18HR PS 177; +2.5 231; +5 324; +11 394

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Andy & Pimp

Andy & Pimp

Member Since 2015
yesterday

last night's #'s PMPS 266, +2 247; +6 143
Thought he was having a gentle slide down overnight and then BAM he shows me low numbers again for AMPS. WTF (fudge) is up with this cat? Looks like we're down to 0.1u now...should I shoot it now or wait until he comes up a bit? I'll have to do two 18-hr cycles if I wait too long, but it's an option today.
 
I think that one's a bit too low for you to shoot, especially when you don't know if he's still heading down. Based on past performance I think it might be a while before he gives you a comfortable number to shoot so I recommend you get a little btb and see where he's at when you wake up.

My crystal ball was in fine form ;)
 
Vyktors Mum said:
I think that one's a bit too low for you to shoot, especially when you don't know if he's still heading down. Based on past performance I think it might be a while before he gives you a comfortable number to shoot so I recommend you get a little btb and see where he's at when you wake up.
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carfurby said:
I wouldn't shoot a number that low. You don't have the data to know what he'll do. Are you going to be home today to monitor?
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Ok, I'll wait a few hours. Day off work again and no plans except taking care of this guy :)
Should I let him eat?
 
if you're home today, you could take another approach rather than the 18 hours. You could just shoot the 0.1 dose whenever he gets to a comfortable number, then use today to collect some data. For example, if he does get lower again, instead of going straight for high carb food to bump the number, try his regular low carb and see if that works. Often it does once they are on this low a dose (there's not very much insulin the food has to counteract). Remember that you don't really need to bump the number up as much as you just need to make sure he stops dropping - a 10 point bump is usually plenty. Once I learned that low carb food was enough to keep Lucy safe, it made me much more comfortable when I had to leave her during the day.

I think it's pretty clear that Pimp is nearly done with this whole insulin thing (anti-jinx), and our job is to try to get him there safely and in a way that will make it easier for him to stay off insulin. From yesterday's response, we can see that he is not quite ready to do it on his own. That's not surprising, since he was in pink just a few days ago. We need to give his pancreas a little more time to heal, and we can do that by supporting it with insulin. We just have to follow his lead with regards to how we can do that. I think you'll probably be winging it for a bit but you seem to be pretty good at that.
 
the "shoot whenever" approach does mess with your schedule more than +18, but I'm assuming Pimp will help you get back on schedule sooner rather than later by giving you another unshootable preshot.
 
Libby and Lucy said:
the "shoot whenever" approach does mess with your schedule more than +18, but I'm assuming Pimp will help you get back on schedule sooner rather than later by giving you another unshootable preshot.
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Let's make sure I have this straight...I can basically shoot whenever his #'s are appropriate, as long as it's more than 12 hrs from the last shot, correct?
As of now I was planning on shooting at (what would have been) +6. But if I need to wait a bit longer it's ok? We just need to be back on schedule by tomorrow morning.
 
right, shooting "as needed" seems like a good approach for Pimp right now, consistent with the thoughts behind the SLGS method. Your goal at this point is to try to keep him close to 100, but not too low, so if he gets to maybe 100-120 before +18 I would probably go ahead and give insulin at that time. The next shot would be due 12 hours after that, but if that's the middle of the night then I wouldn't get up at 3am or anything like that! Just check in the morning to see where he is and decide what to do. His cycles are longer than 12 hours right now, which is GREAT for him but not as convenient for you!
 
and if he is ready for his next shot at +12 after you eventually give this one, if you're up and ready to give it, then go ahead. You'll end up having to skip something somewhere probably if you have to get back on schedule, but with his pattern, I don't think it will be a problem to find a low cycle you can skip. I just thought it would be productive to go ahead and get some insulin into him today if possible, since you'll be home.
 
Well I screwed up!
Decided to take more advantage of the day off work and run him to the vet for a quick weigh in. 7lbs6.5oz, so he's at least maintaining. I know there would be a stress spike from the car ride...went up 40 points while we were gone. But from the rest of his numbers this afternoon, I can't tell if it's stress, a bounce (didn't expect that and don't think it is) or a failed reduction?
I used Carla's technique of depressing the plunger firmly and inserting into the vial, and letting it go. I confirmed there was a drop there by squeezing it out and letting it go back in. I confirmed it went into him by squeezing after the shot- no drop. And no smell on fur.
So who thinks these numbers are:
-stress
-bounce
-failed reduction
 
Don't worry about a single test - you're looking at how he looks overall. And overall he looks fantastic.

I wouldn't call this a failed reduction either - he was too low for you to comfortably shoot this morning, so that doesn't sound like too large of a dose to me!! I definitely wouldn't increase his dose.

The dose you're describing, sucking in one drop, is what most people call 0.05, rather than 0.1u. If you take a look at the New to the Group sticky you'll see photos of the 0.1u. Most people report that has at least a 2-3 drops of insulin in the dose, rather than just one. It may end up to be an unimportant point, but one of the main things with any dose is that you can replicate it, reduce or increase it. You do want to know how it compares with what you've been measuring at 0.25u. I'd suggest you draw up what you were giving at 0.25u and see how many drops were in it so you can compare with what you're doing now.

and woot - Pimp's looking great!
 
I don't think you can have a failed reduction that quickly. I'd wait and see what he does the next cycle. You've got a combination of things going on with the vet trip stress and the 18 hour shot and the dose change. Hopefully, his pancreas will kick in and bring his numbers down.
 
Andy, would you say your 0.1 units looks like this?

01unit-1.jpg


Or more like this?

someinsulin-1.jpg


Just my thoughts, I wouldn't call it a failed reduction yet. Stress is possible, but also he has had a missed shot and a +18 in the past two days, so those could be catching up to him (remember Lantus works on a cumulative basis, so each shot affects the next 2-3 days worth of cycles).

A bounce is an interesting possibility too, and would actually explain a couple of things that don't quite make sense to me on his spreadsheet otherwise. Normally we don't see bouncing on a cat that is this close to going off insulin, but it happens sometimes. This morning's 62 was on the way up from somewhere, but from where?

It seems like his low preshots tend to happen the morning after he had a high preshot the night before. Maybe next time you shoot a higher PMPS, try getting a +9 or +10 overnight so you can see what is going on. It could be that when he is clearing out of those high numbers, he starts dropping faster or lower than we realize, and that, coupled with skipping or delaying shots, sets him up to bounce. We'll figure it out.
 
julie & punkin (ga) said:
You do want to know how it compares with what you've been measuring at 0.25u. I'd suggest you draw up what you were giving at 0.25u and see how many drops were in it so you can compare with what you're doing now.
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You must have been beaming that to me...it's what I was doing just now. The dose from last night was 4 drops. That's about the smallest that I can see to measure with calipers. So tomorrow morning, I'll measure last night's dose of .25u, and twist out 2 drops.
I'm really tempted to give him another ".05" tonight. I have a feeling I'm going to get yelled at for that, lol
 
Libby and Lucy said:
Andy, would you say your 0.1 units looks like this?
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It was "some insulin". Apparently not enough. I'll measure 1/4 and twist out two drops tomorrow.
Libby and Lucy said:
This morning's 62 was on the way up from somewhere, but from where?
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That boggled my mind, since he tested in blue numbers at what should have been close to nadir. I'm betting he went lower than the 68 on the 22nd pm cycle too...I stuck a bowl of HC in front of him and went to bed that morning. That would have set him up for a mild bounce yesterday evening....hmmm....I'm seeing the pattern too. I'll watch him close later on tonight.
I guess that's a positive of 18hr cycle...you get to test them at a different time.
 
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honestly I think I would let it ride until +18 tonight, even if he's high. And that is something I rarely say! That might answer some questions. If today's highs are from stress, then they should start to clear out by then. If he has been going too low and bouncing, then the extra time will allow some of those counterregulatory hormones to clear out and we can see where he really is. It will be interesting to see how much, if any, he comes down without insulin.

What time would your next shot be if it is at +18?
 
I was going to offer to check in with you to see where he is at shot time, but honestly I'm not sure I trust myself to be up at 7 on my day off. LOL! My cat has been off insulin for years, I'm spoiled.

You could grab another test some time tonight to get an idea of whether he is dropping or rising. Or maybe not - if he's going up it will be even harder to not shoot. ;)
 
Andy & Pimp said:
Please don't yell at me, I promise I won't do it! It's just tempting. I understand why it's a bad idea.
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I don't think anyone here ever yells at people. We can give you ideas and suggestions, hopefully accompanied by reasons why we're suggesting whatever, but the choice is always yours. We're just offering our opinions - your job is to sort through the ideas and figure out what works for you and Pimp. :D
 
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