12/26 Zeke PMPS 105; +1 = 142

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MrZ

MrZ

Member Since 2013
Good morning LL,

Hope everyone is keeping warm. Healing, appy and comfort vines to all who need them.

This morning I decided to do things a little differently. Typically I get up at 4:00am and test Zeke and give him a little food before picking up all the bowls, 2 hours before AMPS. Because Zeke's been much lower of late come shot time, I thought it might be a good idea to start getting a +10.5 so I will absolutely know at shot time if he’s dropping or rising. Additionally, I’ll have valuable data early enough that I have time to post for advice if need be.

The timing for a change in routine couldn’t have been any better. Sure enough Zeke was low enough that I was already starting to debate my AMPS options. Being somewhat inexperienced with shooting low numbers, I knew I was gonna need some expert advice. Thankfully, Carl, Dyana and Sienne came to my and Zeke’s rescue. Fortunately, there was ample time to consider all their suggestions which made my decision come shot time so much less stressful. When I got the AMPS of 85, I knew exactly what I was going to do and I shot with no hesitation.

And so now, here we are. Zeke has dropped +1 to 75. I’m being a little more aggressive with my approach to stopping quickly dropping numbers. I just gave him 2 teaspoons of 20% gravy and 1/2T of 12% food. I will test again at +2, with gravy ready to go should he continue to drop below my comfort zone for this early in the cycle. Will keep you posted.

Zeke's Yesterday
 
Re: 12/26 Zeke AMPS 85; +1 = 75; +2 = 34

Automatic reduction. But should I go to 1.25u or all the way to 1.0u?

Administered maple syrup to the gums. Also gave 20% gravy 1/2t to 12% food 1t with a few drops of maple syrup.
 
Re: 12/26 Zeke AMPS 85; +1 = 75; +2 = 34; +2.5 = 48

Thank goodness Zeke likes maple syrup! Yeah, he's up to 48. Nothing more to prove. Gave him 17% food with more 20% gravy (1t each) and a few more drops of maple syrup. Will continue to test.

Come on Zekey, let's get to 70 and surf the rest of the cycle, ok?



Mommabean and your ears could use a break.
 
Re: 12/26 Zeke AMPS 85; +1 = 75; +2 = 34; +2.5 = 48

Congrats on the reducie and sounds like you really did have it all under control.
It's much less scary and panicky that way.
Great job :thumbup
 
Re: 12/26 Zeke AMPS 85; +1 = 75; +2 = 34; +2.5 = 48

Yes...it's a reduction. Let's see how the rest of the day goes and how much he comes up ....and the rate.

Thanks for your thoughts for my mom. :-D She is in TX not AZ but I was on the phone with my sisters and Mom until late. The ct scan was negative. She was very dehydrated and her BP really low so they gave her fluids and kept her overnight. They are dismissing her this morning and sending her home. Two of my sisters are there to watch her.

Come on up Zeke!
 
Re: 12/26 Zeke AMPS 85; +1 = 75; +2 = 34; +2.5 = 48

That's great news Marje. Sounds like your mom is being well taken care of. Hope she's quickly back on her feet and feeling better.

Zeke's up to 62 at +3. Will continue to monitor.
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62; +4 = 73

I'll continue to check in with you as the day goes on and we see where he is. :-D
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

Is it ok to hold off feeding to see if he can go back up on his own? He's not dangerously low, so can I wait 45 minutes to test again? He last ate at +3.5.
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

But he's trending down. I can see why you might not want to feed because he's getting past nadir but I wouldn't let the testing go more than 30-45 minutes so you can see if he's continuing to trend down.
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

You are a great mom, and I'm glad Zeke is coming up.
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

You always want to remain vigilant on the testing until Zeke is about 70 and either holding it or continuing up for at least 2 more cycles without any help from food/gravy/syrup. This usually gets easier after nadir, but since nadirs can jump around, it's never a 100% sure thing...you just have to keep testing! With China, I like to wait until she's either surfing high 60's or higher, and/or is continuing up without any food for 2 hours after the last feeding.

If Zeke bounces high at PMPS (like 300's), it'll probably be fine to "shoot through the bounce" and give the 1.5 one more time, and then reduce to 1.25 in the morning, but we have time to see where he ends up at that point before making a decision on how much to shoot.

If he doesn't bounce high, I'd reduce tonight to 1.25 ...and good luck on the reduction!!
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

Marje and Gracie said:
But he's trending down.
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Yes, Zeke dropped some since +4. Because I gave him so much syrup, I wanted to make sure he wasn't going to be crashing back down. If figured that since he was 62, I had a little room to wait and see if he was going to keep dropping. I actually need to run out but was not comfortable doing so unless I knew he was safe. I didn't want to feed him and have him spike, possibly giving me a false sense of security and leaving him when I should not.

He's up a little or flat (68) 30 minutes after the 62. If I test in another 30 minutes and he's back up over the 73 that he was at +4, I figure it's safe to conclude he is not going to crash. Would you agree? If so, then I will feed him and head out.

But what if he's only up a little more (or flat) and still under the 73 he was at earlier? Should I wait before feeding and heading out?
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

Did you feed him this time? And how long do you need to be gone?

Might give him a little of his usual low carb and see if he'll surf for you..but Marje is the expert!
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

My feeling is that if you are attempting to see if the numbers are stabilizing, you can hold off on feeding but I'd re-test in 30 min. If numbers are dropping, there's a good chance you'll catch it in 30 min. and have sufficient time to intervene.
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

Sienne and Gabby said:
My feeling is that if you are attempting to see if the numbers are stabilizing, you can hold off on feeding but I'd re-test in 30 min. If numbers are dropping, there's a good chance you'll catch it in 30 min. and have sufficient time to intervene.
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No problem, I can continue testing every 30. He just tested 63. He was 68 at the immediately prior test. So he's flat, right? However, he was higher at +4 (73). So am I looking for a number above the 73 (from the last time he ate, over 2 hours ago) or just any two consecutive rising numbers since food (not given within the last 2 hours)?

What about what Chris posted? Is if safe to relax * (a) ONLY if his numbers are trending up AND the most recent number is above 70 or (b) anytime numbers are trending up for two hours, without the benefit of food?

* or go to bed; or head out the door; or feed him if I like - assuming it's not within the 2 hour window from his next shot; or do anything else but monitor him
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

Poor Zekey. Ok, I know his safety is first and foremost but I really would like to try and not test more than I have to. So for today, I’ve tested him TEN times. I was trying to avoid having to continue testing him by not feeding and hoping that his numbers would rise. Well, if you look at his ss or the posts below you can see how well that plan went (NOT). Trying to manipulate his feedings to keep him safe AND surfing good numbers has been one of the biggest challenges for me. I’m still trying to figure out what works.

Ok so at +7.5 he’s at 72. He hasn’t eaten in over 4.5 hours. Darn, I guess I have to wait for one more reading above 72 or at least flat. His poor little ears. Fortunately, he’s being very cooperative so far.
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

Chris & China said:
If Zeke bounces high at PMPS (like 300's), it'll probably be fine to "shoot through the bounce" and give the 1.5 one more time
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My understanding is that since he dropped below 40, shooting through the bounce is not advisable. Correct?
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

No, you don't have to wait for a number over 72.

I want to mention the concept of "aborting the cycle". Be right back, I have to switch keyboards...
Carl
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

My understanding is that since he dropped below 40, shooting through the bounce is not advisable. Correct?
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Last question first - I wouldn't shoot through the bounce tonight. I'd reduce. 34 says he needs less insulin, period.


Poor Zekey. Ok, I know his safety is first and foremost but I really would like to try and not test more than I have to. So for today, I’ve tested him TEN times. I was trying to avoid having to continue testing him by not feeding and hoping that his numbers would rise. Well, if you look at his ss or the posts below you can see how well that plan went (NOT). Trying to manipulate his feedings to keep him safe AND surfing good numbers has been one of the biggest challenges for me. I’m still trying to figure out what works.

Ok so at +7.5 he’s at 72. He hasn’t eaten in over 4.5 hours. Darn, I guess I have to wait for one more reading above 72 or at least flat. His poor little ears. Fortunately, he’s being very cooperative so far.
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OK.... If he hasn't eaten for 4 1/2 hours, then it isn't food keeping him flat. That food is "gone". He's stayed flat since that 73 you got at +4.

Aborting the cycle. Zeke dropped to 34 at +2. I wish I'd been able to get online then. I would have told you to feed him Cap'n Crunch soaked in syrup. Sure, it is nice to have him come up a little and surf all day long. But when he hit 34, he insisted that he needs less insulin going forward. He "Made His Point". After that, the cycle is no longer the most important thing. The most important thing is to get the numbers up, and keep them up. You don't have to "nurse" them up. If he hit 120 at +5, would that be a real problem? I don't think so. Not if you tested him again without feeding 30 minutes later and he was till in low blue or high green numbers. At that point, you give him a couple tsp of LC food, and leave his ears alone for an hour. Then you're past nadir, you probably still have a high green or low blue number, and you are good to go till PMPS.

Other people might disagree and that's okay with me. I'm not a Lantus user or expert or anything. But Laura, you have been "doing this" for days. He's been diving regularly early in the cycle on 2.0, 1.75u and now on 1.5u doses. You even skipped a shot to drain the depot. And he just keeps "telling you" that his dose needs to be lower. You've had to stop the drop several times, and then worked at it to keep his numbers from falling for three or four hours.

To me, his spreadsheet lately looks like it says "I'm an early nadir kitty". He wants to drop before he's "supposed to". He doesn't want to wait until +6 like a "typical cat".

The only way I can think of avoiding the early drop is to feed him 7-8% food at shot time and probably again by +2 at the latest. Try to push the nadir out past +2 or +3. Anything under 10% carbs is considered "low carb". It doesn't have to be 2% to work. Some cats just need carbs in % higher than 2%. That's not a bad thing.

I thought the 1.5u dose this morning would be okay. I was wrong. I'd probably reduce to 1.0u tonight rather than 1.25u.

Carl
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

If he hit 120 at +5, would that be a real problem?
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Good point because Zeke's body doesn't know the difference between 70 and 120.

I think reducing to 1u might be worth a try. As Carl says, he keeps repeating the same pattern. His depot keeps getting the upper hand even when you've tried to drain it a bit.

Would you be willing to try it along with feeding a little higher LOW carb early?

I also agree with Carl that if Zeke goes up by PMPS, I would NOT shoot through the bounce. He needs a reduction; I've seen cats with really full depots go up a lot by PMPS, the CG shot through the bounce, and kitty came right smack back down.
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

Marje and Gracie said:
I think reducing to 1u might be worth a try. As Carl says, he keeps repeating the same pattern. His depot keeps getting the upper hand even when you've tried to drain it a bit.

Would you be willing to try it along with feeding a little higher LOW carb early?
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Yes, if you and Carl think it would be advisable, based on what's been happening these last few days, to reduce to more than just to 1.25u, I would be willing to do a fat 1.0u. Marje, I know you understand my hesitation towards reducing too quickly. However, if you think he could still do well on 1.0u then I would prefer that he not be diving to 50 or lower early in the cycle. I know there are no guarantees but I know you've seen a lot of ss and if you think Zeke has a very good chance of staying green, I would be willing to give it a try.

I would be willing to give him 7%. If that doesn't do the trick, then next time I could try 10%. That would be ok, right?
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

I would be willing to give him 7%. If that doesn't do the trick, then next time I could try 10%. That would be ok, right?
Click to expand...
I think that is a good plan.

I know there are no guarantees but I know you've seen a lot of ss and if you think Zeke has a very good chance of staying green, I would be willing to give it a try.
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This might sound weird, but don't get married to the color green, Laura. A non-diabetic cat can have a low blue BG and it's not a problem. If you have preshots of 120 and a nadir of 90, those are all still good numbers. If he were on a dose like .25u, I can understand the bummer it would be if you saw a 150. But he's still on a dose where most kitties can still bounce a lot.

Marje, Gracie's on what, .4u? I know you don't like seeing bounces, but she can still hop on her trampoline, right? It just happens.
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

Carl & Marje - right now my schedule is flexible and I have the opportunity to monitor Zekey closely. After the first of the year that will not be the case. As long as I am not putting Zeke's wellbeing in jeopardy, I don't want to rush the reductions. I don't want to find out later that I may have skipped over the optimal dose and then not be able to go back up because my schedule does not allow for it. I would rather up his carbs and follow the allowable reductions as per the protocol but if you think I'm putting Zeke in danger then I am open to tweaking the dosing as you feel is advisable. I know the Protocol is not hard fast rules but just wanted to let you know where I'm coming from. As always, your advice is greatly appreciated.
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

No, I am glad you explained where you're "at", Laura.

I do not think that you are putting Zeke in danger with anything you have been doing. Because you are able to monitor closely, and you know what to do if you see low numbers, he's in the best of hands he can be in. You might not realize what a terrific job you're doing with him.

Here is where I am coming from...

I would rather see you reduce to 1u and have a few cycles where you aren't having to test him 10 times a day and lose sleep at night, and have that "fail", then see you raise it to 1.25u after six cycles.
I think that is better than reducing to 1.25u, having the depot continue to have an effect that makes it look like 1.25 is still too much, end up test him all day and night for three days and then dropping down to 1.0u. And then have to repeat the same cycle all over again.

I think it's better to try 1.0u and have it not work, than it is to go with 1.25u, go thru what you and he have gone through on 2, 1.75 and 1.5. And keep doing this all the way down the dose ladder.

That and I think I'd like to see the 1.0 work, of course.

edited because I didn't proof read...
 
Re: 12/26 Zeke AMPS 85;+2=34;+2.5=48;+3= 62;+4=73;+6=62 Ques

Carl & Bob (GA) said:
I would rather see you reduce to 1u and have a few cycles where you aren't having to test him 10 times a day and lose sleep at night, and have that "fail", then see you raise it to 1.25u after six cycles.
I think that is better than reducing to 1.25u, having the depot continue to have an effect that makes it look like 1.25 is still too much, end up test him all day and night for three days and then dropping down to 1.0u. And then have to repeat the same cycle all over again.

I think it's better to try 1.0u and have it not work, than it is to go with 1.25u, go thru what you and he have gone through on 2, 1.75 and 1.5. And keep doing this all the way down the dose ladder.

That and I think I'd like to see the 1.0 work, of course.
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I too would love to see the 1.0 work but the rest of what you describe is exactly what I don't want. My preference would be to work down the doses just as called for by the Protocol. I would rather test the heck out of him right now (while I'm able to do so) and have him earn the reduction to 1.0u as called for by the Protocol (preferably by stay within 50-100 for seven days - but going below 50 (just a little) would work too) than to jump to a 1.0u reduction and have it fail and I have to start all over again on the 1.25u. I've seen how quickly he can drop and the thought of not being here when that happens is something I can't bear the thought of. My hope is right now we determine that 1.25 is too high and go to 1.0 where he's not having these crazy drops and I can go back to work without worrying about him. I'm hoping we can get him stabilized before the 1st of the year. That is kinda what I'm focused on right now.

So, now I'm leaning towards shooting 1.25u tonight but really, I'm still undecided.
 
Re: 12/26 Zeke PMPS 105

Laura

I don't think there is a right or wrong answer here and, ultimately, you hold the syringe. Yes, I've seen many SSs and I've dealt with many of the same issues with Gracie. (Carl...she's on 0.5u right now and a bit bouncy but what's new? :-D ). I think Carl's point is very well taken ...and to tell you the truth, I'd much rather have Gracie surf and stay between 70-100. I'm not a big fan of her being in the 50s or below and usually at 60, if I catch it (like this morning), I bring in my big gun (12%).

What I've seen on SSs is that either the cat has just decided he/she is done and the trip down the dosing scale is fast and furious OR they come down slowly on their own time....some preferring to be in green for a week as a way to earn their reductions (wouldn't that be a dream?). I've also seen them come down fast and earn too many reductions too fast and get to the point of "almost" being in remission and then the CG has to go up above the highest dose they'd been on to get them to come down. This happened to Libby's Lucy. The second time around, Lucy came down much slower and went into remission. Libby says that many cats like to rehearse going into remission a time or two before they actually do it.

The long and short of it is we don't know what Zeke will do or when he will do it. I can't predict how he will do on 1.25u or 1u (I might have a thought or two but it's pure speculation). Yes, you can follow the protocol down but you will have to keep testing him early in the cycle and feed the higher low carb food early on. You might even think about feeding him a double portion at AMPS since he likes to drop from the get go. If we could just flatten him out when he likes to drop and nadir, he might be able to do better with a little more insulin (e.g. 1.25u but no more than that right now).

There are pros and cons to both sides and Carl is right.....if you take him to 1u and let the depot drain, if he fails the reduction, you can go up. And you don't have to wait six cycles to see if he's failed.

The other thing to remember is your goal is tight regulation. Yes...we would all like to get our kitties in remission but the first step is getting them tightly regulated and I'd say he's pretty much there.

PS...just saw you shot 1u. Now don't panic at any blue numbers....let's give him a chance. :-D :-D :-D Good job!
 
Blue is not bad. Elvis made millions off of Blue Hawaii, and "I'll have a green Christmas without you..." probably wouldn't have made the top 40. Just sayin' ...
 
My husband gave Zeke 17% gravy at +2.5 tonight while I was out when he was 117. Now at +4 Zeke has gone up to 134. Is it ok to assume that Zeke will be safe tonight if his number continues to trend up at +4.5? I think this HC so early in the cycle combined with a lower dose (and possibly a bounce) has ruined this cycle. As a result, I am considering going up to 1.25u tomorrow morning to hopefully get Zeke back on track. Do you think that would be ok?
 
Carbs usually wear off after about two hours. I'd say by +5, if he's still on the way up, you are probably fine to go to bed for the night but I'd suggest you get no later than a +11 test.

If the numbers are due to carbs, they will come back down and you wouldn't need to shoot more tomorrow to get him back on track.

IMHO, it's a good idea to give a reduction more than one cycle and see what it's going to do. You don't have to wait six cycles to see how he's going to do.....if it becomes a failed reduction, you can go up to 1.25u but, if he were mine, I'd just see where he is in the morning and also what he does in the a.m. cycle.
 
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