12/20 Zeke-PMPS 96;+3=44;+5.5=78;+6.5=92

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MrZ

MrZ

Member Since 2013
Good Morning LL ~O) ~O) ~O)
I was just wanting to get your thoughts on the dose Zeke is currently on. He's done really well on the s2.0 but I'm finding that I'm having to monitor him a lot to keep him in a safe range. I was up with him all night (through +10). I will be trying higher carb food to keep him from dropping too much, early in the cycle.

Just wondering if you think I should be concerned about how much I'm needing to work to keep his numbers up. He's not dipped below 50 except perhaps last night to 48 (the second test registered 50) so he hasn't officially earned a reduction. At his current dose, he's doing the best he's ever done. I just want to be cautious about not letting the depot get ahead of me. Additionally, if I'm having to throw a lot of higher carb food at him then, might it be better to have him on a lower dose that won't require the higher carbs?

Thanks for advice.

Zeke's yesterday
 
Re: 12/20 Zeke - Dose Advice?

His numbers are looking really good :mrgreen: .

If you stick out this s2.00 dose and you want to try the 3 tests in the 40s on the same dose before taking a reduction, then I think if Zeke gets another test in the 40s on this dose, you can reduce back to the 1.75. Of course if he she gets a test below 40, then I would take the full 0.25 unit reduction.

If you think you are having to work too hard to keep his numbers up with HC and MC, you could try a f1.75, which would probably be only one small drop less than the s2.00. The one small drop may not make a difference to Zeke, and may not make a difference in this coming cycle.
 
Re: 12/20 Zeke - Dose Advice?

I tend to think that if you're working hard to prop the numbers up, especially since Zeke is hovering at 50, I'd be inclined to take the reduction.
 
Re: 12/20 Zeke - Dose Advice?

You have had to work to keep the numbers up lately.

I think I'd give 1.75u another try.
 
Re: 12/20 Zeke - AMPS 95; +2.5 = 40; Reducie

Well, we gave him the s2.0 - didn't see your posts until after we shot. We WILL be reducing to 1.75 tonight - I'm getting the calipers today. Just brought out the big guns - Gravy 22% (1.5t) and 1/4t each 20% & 22%. Plus feed him 11% 1t of FF. Will be testing shortly.
 
Re: 12/20 Zeke - AMPS 95; +2.5 = 40; Reducie

Yeah! +3.75 he's up to 54. This frequent testing is getting old for both Zeke and I. Fed him 1t 11%, hopefully that will bump him up into the 60s. Will be testing in an hour.
 
Re: 12/20 Zeke-AMPS 95;+2.5=40(Reducie);+3.75=54:+5=48

Down again? OK, another tsp each of 22% gravy and 11% FF. I'm hoping this additional food will bump him up. He's getting tired of both food and gravy. I will test again in 30.
 
Re: 12/20 Zeke-AMPS 95;+2.5=40(Reducie);+6=63 (Up&Down)

FINALLY! The > 60 I was wanting. Now we can both have a little break. He's had food so I think I can wait a little longer. Will test again in 1.5 hours.
 
Re: 12/20 Zeke-PMPS 96

Laura,
I know that you have been testing a lot with all these low numbers, and that routine is getting old for Zeke.
When you test him, at the times he doesn't need a "spoonful of sugar", does he get some sort of a treat? In other words, does he associate the ear poke with a "positive" when it isn't a "low numbers" crisis?
 
Re: 12/20 Zeke-PMPS 96; +2 = 60

Well, I decreased the dose to 1.75u (eyeballed). I was going to use the calipers but still need to figure it out. I've been feeding him MC and gravy but he's still dropping faster than desired. Gonna try to get him up to at least mid 60. Will test again in 20.
 
Re: 12/20 Zeke-PMPS 96

does he associate the ear poke with a "positive" when it isn't a "low numbers" crisis?
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Yes, I give him FD Pure Bites turkey or chicken but sometimes he doesn't want it. I've gotten a lot of really great tips on ear pokes (bevel/neo/location/new lancet every time) and it's going a lot better but just once in a while he just reaches his threshold. I believe last night was because he was hungry and to a lesser degree, his ear was sore.
 
Re: 12/20 Zeke-PMPS 96; +2 = 60

The effects of an increase or a decrease are typically not immediate. Because of the depot nature of Lantus, that 2.0u dose could still be a factor. In other words, tonight could be another exciting one. ;-)
 
Re: 12/20 Zeke-PMPS 96; +2 = 60

Yes, I give him FD Pure Bites turkey or chicken but sometimes he doesn't want it.
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OK, good. Just wasn't sure if he expected a special treat in return for a drop a blood. Bob got fresh shrimp as a treat after every poke. It was his favorite food by far. I think he would have let me turn him into a pin cushion as long as the shrimp kept coming. But I never had to do the "lather, rinse, repeat" thing with him. He most likely would have reached his limit with the ear pokes if I had.
 
Re: 12/20 Zeke-PMPS 96; +2 = 60

Carl is right...the depot can affect up to six subsequent cycles although for many cats, it's 3-4. So don't be surprised if he runs low again tonight. If he goes below 50, don't reduce his dose again tomorrow....that is unless he goes into the 20/30s and doesn't come up....then you might want to think about a larger reduction.
 
Re: 12/20 Zeke-PMPS 96; +2 = 60; +3 = 44

At + 3 he's 44. I've been feeding him food trying to keep him from dropping but it hasn't worked. I just gave him a tsp 22% gravy. Do you think I should give him 2 tsps? I want to minimize testing while keeping him safe.
 
Re: 12/20 Zeke-PMPS 96; +2 = 60; +3 = 44

Yes, I think more gravy is fine.
The bump in numbers from gravy doesn't last forever (it won't still be around hours from now giving you high number).

He just got a reduction, so he's got nothing to "prove". ;-) And getting the numbers up might help avoid a bounce later (although Zeke isn't the world's biggest bouncer lately).
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

Perfect timing Marje. Well, the gravy isn't really doing the trick. I've given him nearly 2 tsps 22% gravy and he's still under 50 (approaching +4). I gave him food earlier to try and get him to not drop but that didn't work. So now Zeke has had his fill of both gravy and food. I'm holding off rubbing syrup on his gums because I don't want to have to deal with a crash later in the cycle. He finished up his gravy about 5 minutes ago. Should I test in say 20 or can I hold off 30?
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

I'm also already thinking about shot time come tomorrow. I have been working WAY TO HARD to keep his numbers up. I'm contemplating shooting a 1.5 tomorrow to drain the depot a little. My concern is that (a) I'll still be dealing with the depot effect of the prior s2.0 dose next cycle anyway and (b) decreasing his dose too quickly may get him back up to pinks (or worse). Not sure what to do.
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

I'd give him 30 minutes after he finished eating. Let me look at his SS and I'll BRB.
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

I think you are most definitely dealing with depot. Last nights cycle was a pretty good indicator he was ready for a reduction. Looks to me like the depot has gotten ahead of you.....I've had it happen and it's really hard.

You can drop the dose back to 1.5u if you want to but if you don't want him to lose momentum, I'd likely just stick with the 1.75u dose or reduce to 1.5u once to drain the depot and then go back to 1.75u.

I'm not sure if you've seen this post I wrote on Reductions.

It's really hard when they are doing so well to reduce the dose. But after the night I discussed in the post, I'd rather reduce and have to go back up than to deal with that kind of cycle again.
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

I haven't feed him since +2. Tried giving him some food (17% carb - 1/2t) after last reading but he didn't want it. If I try to get him to eat, what percent carb should I feed him and how much?
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

Something high carb, a tbsp or two tsps.
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

Looks to me like the depot has gotten ahead of you
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I'd posted my concern about this happening (see yesterday's condo). I didn't get advice in time for this mornings shot and shot the s2.0.

So the depot's gotten ahead of me. Now what for tonight?
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

Carl & Bob (GA) said:
Something high carb, a tbsp or two tsps.
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I tried the 17% he wouldn't take it. I can try again. When you say HC, would 17% be high enough? Have you seen Zeke's SS and how much I've fed him so far?
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

Yes, 17% is high enough
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

I'd get his numbers up even if you have to use karo. I'd abort the cycle. Do you think he'd eat LC with a drop or two of karo?

Gravy doesn't work for all cats. I had to quit using it for Gracie because it would take forever to work and then it would skyrocket her. Sienne can't use gravy with Gabby either. I can usually get Gracie to eat and so it works better for us to give her a big helping of a higher carb food once or twice. I wonder if Zeke would do better with a bigger helping of food as opposed to gravy? Just have to be sure he doesn't get full.
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

So the depot's gotten ahead of me. Now what for tonight?
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After reading what Marje posted above, here's what I would do...

Reduce this shot to 1.5u to make the depot drain a little. Then, you can increase back to 1.75u tomorrow night. Unless he keeps on doing this, in which case I'd probably stay with the same 1.5 tomorrow night too.
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

OK, panic attack was premature. The gravy finally kicked in. At + 4.5 he's at 60. Now that he's up, what percent carb do you think I could feed and how much? Last night I gave him the usual 4% and he dropped again at 2:30 AM. I'm thinking maybe give him some 11% or perhaps just 7%. I just don't want to be in the same boat as last night needing to stay up until 5AM.
 
Re: 12/20 Zeke-PMPS 96;+3=44; +4.5 = 60

I'd get his numbers up even if you have to use karo. I'd abort the cycle. Do you think he'd eat LC with a drop or two of karo?
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I'd go with that. Abort the cycle. Get him up to the 90s. Even if he goes over 100, the food won't "be there" by AMPS.

We usually tell people "don't feed for the two hours leading up to a shot" so that they aren't getting artificially high readings due to food. So, the boost from food, even HC food, is not going to stick around and screw up his AMPS. Unless it were dry food, which takes a while to digest and longer to wear off.

You can carb him up with 11%, or you can put a couple drops of caro in a lower carb food as Marje suggested.
 
Re: 12/20 Zeke-PMPS 96;+3=44 - PROBLEM

MrZ said:
Looks to me like the depot has gotten ahead of you
Click to expand...

I'd posted my concern about this happening (see yesterday's condo). I didn't get advice in time for this mornings shot and shot the s2.0.
Click to expand...

Correction - See the first post in today's condo - not yesterday's. Yes, Marje I have seen your post on reductions. In fact, I've attached a link to it in some of my prior posts. See Reductions link in my initial post on Zeke's condo from 12/8.
 
Re: 12/20 Zeke-PMPS 96;+3=44; +4.5 = 60

I love that "reductions" condo. I try to bump it every month or so, or whenever I happen to see a condo where it looks like somebody missed a reduction.
 
Re: 12/20 Zeke-PMPS 96;+3=44; +4.5 = 60

Laura

I'd also consider giving the full .25u reduction unless you see he's consistently not holding them. And also remember that any time you are having to fight to keep him up and work most of the cycle at it, you should probably reduce regardless of whether he's earned it.

What I've found is that if you have to work that hard, the "earned" reduction is often the next cycle.

I'm headed for bed now that he's up some but I would definitely get the numbers up above 100 and get some rest.
 
Re: 12/20 Zeke-PMPS 96;+3=44; +4.5 = 60

Sleep well Marje!

Laura, I'm good for another hour and half or so, so I'll be watching for any new numbers.
 
Re: 12/20 Zeke-PMPS 96;+3=44;+4.5=60;+5.5=78 HELP

Carl - Zeke won't eat anymore. I feed him a lot at +1, +2 to try to keep him from diving as a result of discussions last night. Now he's full. I served him 1.5 T of 11% but he only ate 1T. I offered an extra tsp of 12% with a drop of maple syrup. He ate some of it. Marje had suggested that I get him above 100. Well he's only up to 78. I could put maple syrup on his gums but that's just gonna wear off anyway so I figure I should keep that in my back pocket should he drop again below 50. I was up with Zeke until 5AM yesterday and am exhausted. My DH is taking over monitoring Zeke. Hopefully he won't need to feed. The plan is just for him to take Zeke's readings over the next 2 hours and make sure he doesn't drop again.

As Zeke is not wanting to eat anything more at this time, I'm treating this as the 2 hour window to not feed but just test to make sure he's going up. Do you think that would be ok despite not being able to get him above 100?
 
Re: 12/20 Zeke-PMPS 96;+3=44;+4.5=60;+5.5=78 HELP

Laura, yes. The 100 was just a good number to try for. But 78 is good enough for now. Just let DH know that if he dips back down, use syrup if he won't eat. If he drops to 50, it's not an emergency. But you don't want lower than that if you can avoid it. See where Zeke is in thirty minutes. If lower, try to feed or use syrup if need be.

And tomorrow AM, I'd say shoot less. You can't keep doing this 24/7. You're going to crash and burn.
 
Re: 12/20 Zeke-PMPS 96;+3=44;+4.5=60;+5.5=78 HELP

OK, Carl. Thanks. Will get a test at 1:30.
 
He's up to 92. My DH will be taking another test in an hour. Does the "need to have two rising numbers" still apply because of the trouble I've had keeping him up or is he high enough (and it's late enough in the cycle) that if he's down a little that's not a problem?
 
Down a little bit is probably OK. Remember that with meter variance, a little down could still be a surf. I think it's also been close to two hours without food? Sleep well.
 
If he drops a little, it's not a big problem. The 70 range is fine. I think it's late enough in the cycle an hour from now that he'll either stay flat or start to rise as the insulin wears out. If DH sees a flat number, have him leave a snack out for Zeke and call it a night.
 
Darn carbs are still in his system. :sad: :sad: :sad: :sad:

+12 = 171. I shot 1.5u as advised but I'd feel better if his BGs hadn't continued to rise since. I fear this is gonna cause a bounce.
 
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