12/19 Zeke PMPS141;+3=59;+5=52;+5.75=58;+6.5=48

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MrZ

Member Since 2013
Zeke's yesterday

Well, the s2.0 was a very good dose for keeping Zeke in the green yesterday. I am a little concerned about this dose though because I had to work a lot to keep him above 50 most of last night. Just wanting the reassurance of the ok from experienced caregivers. He's at 89 so up from the last reading of 69 at +7.5. I haven't feed, am stalling to hear from you or make up my mind on my own.

OK to shoot the s2.0?

Aw heck - It's done! I shot it.
 
Re: 12/19 Zeke AMPS 89; +2 = 47

Good morning, Laura!

What did Zeke eat for breakfast? I'm thinking that perhaps he might need a higher carb food if he's going to make these +2 dips a habit.
 
Re: 12/19 Zeke AMPS 89; +2 = 47

I think Zeke is one of those kitties that will require a little longer time to settle into a dose that's getting him into green nadirs (e.g. 1.75u) or if you want to be more aggressive and see more green and low nadirs (e.g. s2u), you will have to test a bit more and feed a bit higher LC food to manage and flatten his curve so he doesn't drop like this.
 
Re: 12/19 Zeke AMPS 89; +2 = 47; +3.5 = 61

Well, this is a new pattern that I need to figure out how best to guide with food. Fortunately Zeke picked a good time to put me to the test as my schedule is a little more flexible than usual due to the holidays. Once I figure out what works best, I will have to indoctrinate my DH a little more. He handled the +1 test while I was sleeping - I would have given higher carb food at that time because of the drop instead of a rise. Hey, we're both still learning. Of course, I know once we "think" we know how best to handle, Zekey will probably throw us a curve ball just to keep us on our toes.

I do like this s2.0 dose better than the 1.75. I'm just a little nervous about the depot getting ahead of me. I definitely don't want that to happen. I think I'll try the calipers and see if I can't find something in between.

Thank you Carl, Marje and Sienne for stopping by and providing your input. Much appreciated.
 
Re: 12/19 Zeke AMPS 89; +2 = 47; +3.5 = 61

Laura

I don't know if it will help but I dose in 0.1u increments using the calipers. I was doing fats and skinnies but ran into the same issues as you. If you are using ten drops to the unit then each drop would be 0.1u. You would then need to figure out how much .1u is on your calipers.

I use Terumos and get 1.52 mm to the unit so each 0.1u dose is 0.15mm on the calipers. The only caution I will add is that if Zeke goes below 40, you will need to take a full .25u reduction which would be about .38mm on the calipers.
 
Re: 12/19 Zeke AMPS 89; +2 = 47; +3.5 = 61

Marje and Gracie said:
If you are using ten drops to the unit then each drop would be 0.1u. You would then need to figure out how much .1u is on your calipers.

I use Terumos and get 1.52 mm to the unit so each 0.1u dose is 0.15mm on the calipers.

Marje - I'm somewhat (actually, extremely) intimidated by the idea of using calipers and having "to figure it out", that's why I haven't used up to this point. I will read your post on using calipers - hopefully my DH can help me with this task. We use UltiCare Vet Rx Syringes (U-100; 3/10cc). I have no idea how these line up with the one you're using. I also don't know if we're using ten drops to a unit. How can we determine whether or not we are?

Marje and Gracie said:
The only caution I will add is that if Zeke goes below 40, you will need to take a full .25u reduction which would be about .38mm on the calipers.

Noted, noted and noted! This is not something to play around with. I guess I'll have to figure out if the .38mm would be the same for my syringes. I'm assuming this is not universal, correct?

Thanks again for the benefit of your expertise.
 
Re: 12/19 Zeke AMPS 89; +2 = 47; +3.5 = 61

What I would suggest (and what I did with the Terumo and Monoject syringes) is to go through the box until you find a couple "perfect" syringes where the zero line is perfectly straight and lined up with the top of needle side of the syringe. Then use the calipers to measure between the needle side of the zero line and the needle side of the 1u line. If, for example, it's 1.8mm, then each 0.1u dose would be 0.18mm (1.8 mm/10 "0.1u doses").

But...I don't want to get you off what you've been doing if you are comfortable with it. I thought you were already using calipers. If you start using them, you'll need to compare his dose now to what would be the closest dose using the calipers. It's going to take a little time to figure it out and it might need some fine tuning. Bottom line: do what YOU feel comfortable doing with his dosing in terms of using calipers or not using them. You need to be comfortable with how you draw the dose.
 
Re: 12/19 Zeke AMPS 89;+2= 47;+3.5= 61;+4.5= 79

I think it would be wise to use the calipers - it's just too difficult to be consistent with minor dosing adjustments which is what I think we'll need to do with Zeke. I'm torn because I think "no time like the present" to start getting used to the calipers but on the other hand, this dose for now seems to be a good one and I don't want to get him off track messing around with a learning curve. That being said, I'm leaning towards the calipers because my DH and I can differ quite a bit in our interpretation of what a particular dose looks like in the syringe. Additionally, there's always the possibility of inconsistencies with the syringes themselves. I will definitely mull over your advice provided before deciding.
 
Re: 12/19 Zeke AMPS 89;+2= 47;+3.5= 61;+4.5= 79

Zeke working on recovering from lack of sleep due to last night's frequent pokes


I've gotta work or I'd be doing the same myself.
 

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Re: 12/19 Zeke AMPS 89;+2=47;+3.5=61;+4.5=79;+6= 71

Just wanted to pop in to say hi. Aww, another sweet belly kitty picture! LL is full of them lately :-D I hope you get some sleep tonight :mrgreen:
 
Re: 12/19 Zeke AMPS 89;+2=47;+3.5=61;+4.5=79;+6= 71

Laura,
An option for the calipers. I started using them (Made a HUGE difference), at a time when I liked Twice's dose. I didn't mess with it, and instead I adjusted the calipers for the current amount I was giving. So say I was giving him what I thought was 1U. I drew it up in the syringe that first time, and set the calipers to THAT amount as though it is 1U. Then adjusted from there for dose changes. The thing that made the big difference, was that each shot was consistent now.
Not sure if that makes sense how I wrote it :? :smile:
 
Re: 12/19 Zeke PMPS 141

That's a great suggestion. I'm gonna try it. Thanks Kim.
 
Re: 12/19 Zeke PMPS 141; +1=132

He's down a little at +1. Should I feed and if so what? He normally gets 4% or if I want him surfing some, 2% or 0%. There's definitely room for a drop. I will be taking a +2. I don't typically use food proactively to prevent a huge slide - it's all been proactive up to this point.

Carl and Marje both commented about feeding him early in the cycle. I worry about feeding now because I may need him to eat later, although I'm not particularly concerned aboutt hat this cycle as he didn't start out that low.

What do you think?
 
Re: 12/19 Zeke PMPS 141; +1=132

A tsp or two of 4% should be fine and still keep him hungry.

Love the photo - he looks so chilled. :cool:
 
Re: 12/19 Zeke PMPS 141; +1=132

Carl and Marje both commented about feeding him early in the cycle.

I think that there are two ways to approach it.

1 - I think that what Marje and others do is feed a set amount of food, like what you would give Zeke as one meal, and split it into mini-meals. Like feed half of it at AMPS/PMPS, then 1/4th at +1 and the last 1/4 at +2? That puts the same amount of carbs into him, but spaces it out so the "boost" lasts longer. I think the concept is to avoid a quick drop before +3, which is hypothetically about the time the insulin should onset.

2 - I was thinking more along the lines of increasing the carb value at shot time. Like from 2% to maybe 4% or 5%. That increases the "boost" from eating, so it might avoid the early drop. So when the insulin reaches onset, it's fighting against a higher BG than it would be on lower carb food.

I think either way might achieve the goal of stopping the early drop at +1 or +2.

All that said, Zeke could just be a kitty who has an onset early, and has a nadir that is earlier than the "typical" +6 or so. All you can really do, since ECID, is experiment to find out what makes Zeke tick. And then feed/shoot accordingly. Every cat is a puzzle to some degree.
 
Re: 12/19 Zeke PMPS 141; +1=132;+2= 84; +3 = 59

Looks like I'm gonna need to really tweak this feeding business. It's tricky because I don't want to break out the higher carbs prematurely. I'll keep working on it.
 
Re: 12/19 Zeke PMPS 141;+1=132;+2=84;+3=59;+3.75 = 53

Oops. Knee-jerk reaction. Just gave him another 1t of 20% gravy. Really, this reading is the same as the +3. Probably should have just waited? Though, there are still about 2 more hours until nadir. Would you have waited or given him the gravy?
 
Re: 12/19 Zeke PMPS 141;+1=132;+2=84;+3=59;+3.75 = 53

I would have suggested a tsp or so of the normal food, but not a problem.
Important to keep in mind - the carbs don't stick around forever, no matter what the % is. Gravy digests faster than canned food. Canned faster than dry. So it (the gravy) might push his numbers up faster, but won't last as long as solid food might. The goal is to try to keep the numbers from dropping early in the cycle once you see a number that is low enough. That (in theory) keeps him flat, low and safe for as long as possible. In general, the object is to keep numbers in the "greens" for as many hours a day as you can. It gets a bit easier as time goes by, if the preshots are blue or green because the difference between where he started the cycle, and the nadir, is smaller. The closer those 2 numbers are to each other, the more times he is in the good numbers. And the less likely it is that he'll drop too far and end up bouncing later. Make sense?
 
Re: 12/19 Zeke PMPS 141;+1=132;+2=84;+3=59;+3.75 = 53

Ahhh. That's so cute Carl. Zeke definitely needs to read that post. I don't know what's gotten into him lately. Maybe a little

(btw - that's suppose to be a glass of juice ) :smile:

So Zeke's been a little mellow of late. I'm thinking (and hoping) it's just a lack of sleep. It's odd that he seems to have much more energy when his BG is higher. Is that normal? You'd think he'd feel bad. What about higher carbs? Would it have any affect on his energy level?
 
Re: 12/19 Zeke PMPS 141;+1=132;+2=84;+3=59;+3.75 = 53

So Zeke's been a little mellow of late. I'm thinking (and hoping) it's just a lack of sleep. It's odd that he seems to have much more energy when his BG is higher. Is that normal? You'd think he'd feel bad. What about higher carbs? Would it have any affect on his energy level?

What was his activity level like before he became diabetic? I'm sure the testing and feeding frequency has probably messed up his "sleeping cycles" so that might be part of it. He might be tired, like you are thinking.
I'm not sure if higher carb would have an effect. It more about how much of that glucose his body is able to absorb and turn into energy I would think? I have read where people have said that their kitties act "better" when the numbers are higher. I don't have much to offer as far as how Bob acted. He was way overweight before diagnosis. And I never noticed a difference based on high or low BG. Even after he went OTJ, he was still pretty much like a sloth. :lol: His activity level was fairly low. The biggest difference when he went OTJ was a vast improvement as far as climbing or jumping up on the bed or sofa. He didn't do that for months before, during, or after he was on insulin. That was more related to his potassium deficiency than to the diabetes. Once that got fixed, he was much more mobile and agile.
 
Re: 12/19 Zeke PMPS 141;+1=132;+2=84;+3=59;+3.75 = 53

What was his activity level like before he became diabetic? I'm sure the testing and feeding frequency has probably messed up his "sleeping cycles" so that might be part of it. He might be tired, like you are thinking.

Well, he didn't seem to sleep as much but maybe it's just that we weren't around as much as we are now, monitoring him. These last two days, while he's been spending some much time in greens, he's just been exceptionally lethargic. Sleeping a lot and not really interested in eating much. I guess it's cause I'm disturbing him frequently to test and he's probably just tired.

Well, he did just get off his chair and played in the scratch lounger, tossing one of his favorite feathered toys about. That's good to see.
 
Re: 12/19 Zeke PMPS 141;+1=132;+2=84;+3=59;+3.75 = 53

I just got another 52. He didn't go up even with that 20% gravy. And I got a very big sample. Should I just hold tight or feed some food? What carb content? Going on +5
 
Re: 12/19 Zeke PMPS 141;+1=132;+2=84;+3=59;+3.75 = 53

So Zeke's been a little mellow of late. I'm thinking (and hoping) it's just a lack of sleep. It's odd that he seems to have much more energy when his BG is higher. Is that normal? You'd think he'd feel bad.
I hear this a lot. It used to be that Neko was playful in the low 300's and quiet in the blues and very quiet in the greens. Now she's lethargic in the pinks and playful in the blues. As their body gets used to the new normal, they become more comfortable there.
 
Re: 12/19 Zeke PMPS 141;+1=132;+2=84;+3=59;+3.75 = 53

See if he wants some regular carb food. Like a tsp or tbsp?
 
Re: 12/19 Zeke PMPS141;+1=132;+3=59;+5=52-Can't get him up.F

He took the Tbsp. When should I test? Can I wait at least 30?
 
Re: 12/19 Zeke PMPS141;+1=132;+3=59;+5=52-Can't get him up.F

Yes, When I follow along in one of these low number threads, my standard is "30 minutes between tests" unless you see a 30 or something. I think it takes 30 minutes for the "boost" to get from the bowl to the meter.
 
Re: 12/19 Zeke PMPS141;+1=132;+3=59;+5=52-Can't get him up.F

some cats will show a carb lift in 15-20 minutes. punkin took closer to 30 minutes. the main thing is to keep up the testing! refer to the Low Numbers sticky at the top of the forum page.

punkin was lethargic in low numbers most of the time. i thought it was like someone took away his caffeine. i like Wendy's explanation of how they get used to a certain range - i think that's very true. most cats thrive in flat numbers, too.
 
Re: 12/19 Zeke PMPS141;+1=132;+3=59;+5=52-Can't get him up.F

to clarify what I said...

I think low-carb canned food is good for a "every 30". Solid food in general.
But if you are dealing with low numbers, and having to use gravy or karo/honey, then it's likely that the boost in BG will show up more quickly. It goes back to "how long does it take for food to digest" that I mentioned earlier. Liquids will digest faster, and the carbs will show up in the bloodstream (and on the meter) faster.
 
Re: 12/19 Zeke PMPS141;+1=132;+3=59;+5=52-Can't get him up.F

Whoa. Someone is very angry cat(2)_steam . I'm gonna need to give him a few minutes. Never fails - when you need the test most the kitty is uncooperative.
 
Re: 12/19 Zeke PMPS141;+1=132;+3=59;+5=52-Can't get him up.F

OK. He's up a tad. +5.75 = 58. I'm gonna hold off and test again in an hour. You think that would be ok?
 
Re: 12/19 Zeke PMPS141;+1=132;+3=59;+5=52-Can't get him up.F

Yes. :smile: Just keep good notes so you'll know what works for Zeke.
 
Well darn it! I had an issue with Zeke -again at the most inopportune time. He would not let me test him. He got down right feral.

Unfortunately the last tests I was able to take showed he had dropped to 50 (48 on the first try). It was 2 hours after I'd last feed so I wanted to wait and see if he could go up on his own. However, once he decided he was not going to let me test him, I felt like I had no choice. If I continued to try and test, I was concerned that this could really cause an issue going forward - an ongoing problem I do not wish to have to deal with. But, I couldn't just assume that he was going to be ok. I feed him -and with the expectation that I would not be able to test him for a few hours.

So, despite it being so late in the cycle (+ 7.5) I gave him gravy (17% & 20% - 1/4t each) and food, 7% 1t and 4% 1T plus 1t. He was ravenous. I was able to get a test, just as soon as he'd finished eating. He was at 54. Now I'm keeping my fingers crossed that this feeding isn't going to make his BG sky rocket. Guess we'll see come shot time (or before if I can get a test without a lot of drama).

Do you think I need to scale back the frequency of tests? I feel like I'm doing what's needed to keep Zeke safe but I thought I'd ask.

BTW - I was able to take a +8.75, he's at 72. I think the issue was that he was grumpy because he was hungry and I wouldn't feed him. He was 78 at +10.
 
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