2/13 - Sami PMPS 183; +2 152

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Tina & Sammy

Tina & Sammy

Member Since 2010
HELP!

Yesterday's Condo

Sami is at 97 this morning after surfing the BLUE all day and all night yesterday. I am VERY NERVOUS about giving her a full 2 units today. I have just gave her breakfast, her regular low carb, but I am wondering if I should reduce the dose a bit, or if I should add some HC or MC food to the mix this morning.
 
Well, I need to give the shot. I went ahead and gave her about a teaspoon of medium carb food with her regular LC breakfast. I was planning on giving fluids again today, but I think I will hold of until tomorrow. I will see about get a +0.5 and a +1 just to make sure she is rising from the food. If she seems to still be dropping should I give her a bit of HC to slow her down? I want to try to let her earn a reduction today if that is what happens. What does she need to be at in order to earn the reduction and how much would the reduction be .25 unit or .5?
 
Getting early tests is the smart thing to do. Do you have lots of test strips?
If she goes below 50, then you can reduce by 0.25. That was a beautiful 2 cycles, yesterday. Hopefully she's on a roll now. :)
 
I am not familiar with your routine, but I would not feed her all her food now, but feed her in small meals so that she will still be a little hungry later, should need her to eat.
I wish I could stay and watch this cycle, but I have to go to work in an hour. Others will be around for you.
Right now she is surfing along. If she goes lower fast, then give her a teaspoon or two of MC or HC depending up how low she goes.
 
@Dyana

I only gave her part of her food this morning. I have been trying to feed her about every 2 hours or when she seems to want more to eat. I will hold back all food for now to see what she does in the next couple of hours. We have an hour and 45 minutes before we leave for the office. Sami has been going to work with me for the past week or so, which makes it convenient for monitoring her. If I see that she is getting close to the danger zone before we leave for the office I will give her a bit of LC food to tide her over until we get to the office, which is only about 10-15 minutes away. I usually give her a bit more food as soon as we get to the office along with fresh water.

I have a feeling that either she will earn a reduction today, or bounce from the GREEN. We will see what she decides to do. It is Friday the 13th so anything is possible.
 
The "rules" for a long term diabetic or a kitty back from the Falls are a little different. For Sami to earn a reduction, her numbers have to drop below 40, she has to have three drops into the 40 - 50 range on separate days, or she has to be in normal (50 - 120) numbers for a week. The reduction would be 0.25u.

I think Dyana missed that Sami is back on insulin and was first diagnosed in 2009.
 
@Sienne and Gabby

Got it. If she drops below 40 then she earns an automatic reduction. But she also has the ability to earn a reduction if she stays below 120 for a week straight. Does that include food spikes? For instance this morning se was at 97 but at +1 after eating she is at 124, would that still qualify her if she only goes up over 120 after eating? Or does she have to stay under 120 even with food influence?
 
@Dyana before Sami was coming to work with me I would run home to check her every few hours, that was when she was still really high and I didn't have to worry much about her dropping too low. One time I accidentally left my phone at the office while I was gone and my alarm kept going off because no one knew how to stop it. LOL!
 
Well, I couldn't wait. Sami started to drink a bunch of water, which is what she does when she wants to eat and I don't feed her, then she throws up. I didn't want that to happen so I went ahead and gave her 2 tsp of LC food.
 
It's always ok to give some lc if kitty is hungry - unless they're being fasted or on a diet or something so good move. I'm just going to have a look at her spreadsheet brb
 
@Vyktors Mum

Sorry, I didn't check again until now. I just tested at +4 and Sami was 79. I will plan on testing again at +5, unless you think I need to test sooner. I won't give her any food unless she wants some. She has been trying to sleep for the last hour, but I keep checking on her and waking her up.
 
That's okay I know you're at work and figured you were probably doing some of it, which is a pretty good idea really! +5 will be fine, she's having a nice surf there :D
 
@Vyktors Mum

Okay, thanks. I am in the Eastern Time zone so +5 will be at 10:30 am EST. I will check back in after her test, and again I am going to try to hold off on food until then if possible.
 
I wouldn't worry about holding off on food if she wants it, is there any reason you're thinking you should?

I'm in Australia so none of your time zones mean anything to me, what I meant was how much time to the next test e.g. 30 mins or whatever, but I've got you pegged now ;) conveniently we're testing around the same time!
 
@Vyktors Mum The only reason I am holding off on food, unless she seems to want some, is I am hoping she might earn a reduction today. But if she starts to get anxious or if I see her acting funny I will definitely check her and give her food. 30 more minutes until +5
 
+5 69

I tested about 10 minutes early because Sami was getting a bit antsy for food and I wanted to see what her number was before food influence. I just gave her 1 tsp 4% and 1 tsp 1%.

Should I wait to test again in an hour? She seems to be droping about 10 points every hour for the last few hours, I just don't know if her drop will accelerate. Looking at the past couple of cycles it looks like Sami is having her nadir at around +8, is that what everyone else is seeing? I just want to make sure I understand how to read her spreadsheet.
 
Okay, so I shot a low number this morning, 97. So far everything seems to be moving along slowly, which is nice because if she dropped 100 points in 30 minute that would put me over the edge.

My question is this: How low of a number can we safely shot? I looked back at Sami's spreadsheet from 2010 and I saw that one time Sami was under 50 and we skipped the shot. Is there a rule on this? And if she is under 50 do we have to skip or would it be better to reduce the dose.
 
It's very unlikely the drop will suddenly accelerate I think you can wait another hour, especially since she's eaten some. She has had her nadir at +8 in the last couple of cycles, with a little bump up at +6 that doesn't really seem to be food related - how cute! Of course past performance doesn't necessarily mean it will be so again...

I see others are starting to log on now and it's gone midnight here so I'm heading off to bed. Just keep doing what you're doing. I'm not sure she'll make the reduction tonight but I'll keep my fingers crossed for you. Once you get two in a row that have risen you can give her ears a rest. If she gets down in the 50s you could start testing every 30 mins to try and catch a reduction.

Under 50 is a no shoot (a very experienced bean that knows their cat well may sometimes feed and shoot something in the forties but it shouldn't be done unless you really know what you're doing and know your cat very well). In that circumstance you could stall (without food) to see if you get something over 50 but you don't want to shoot a reduced dose - with lantus there's no guarantee a reduced dose will affect the cycle you've reduced in. Other than that anything over 50 is shootable when you can monitor closely and have the appropriate supplies on hand - strips/hc or syrup.
 
This is an ECID/every caregiver is different thing. Overall, the objective is to get comfortable shooting lower numbers over time. This is where your data collection comes in, because that tells you how your own kitty usually responds to juice (keeping in mind, of course, that there can always be a "unique" cycle where a kitty doesn't respond as expected). Ideally, a kitty's cycles will "flatten" out, meaning that as you shoot lower, you will see nice flat curves rather than steep dives and climbs.

In general, the "rule" is to not shoot anything below 50 - there definitely is not enough wiggle room if a kitty does drop after shooting such a low number. I would never shoot anything under 50, and you do want to have a good deal of data and experience before you shoot anything in the 50s, or even 60s and 70s, and 80s.

Whenever you shoot your lowest PS number for the first time, you want to be extra-diligent about testing....you don't want to shoot and run out for the rest of the day. You want to have plenty of strips and HC food and Karo on hand when shooting your lowest PS for the first time.

There are other options, too, such as stalling (personally I was never a fan of stalling, as it was too challenging for us to get back on schedule), or shooting a one-time reduced dose, too, when you are facing a number that is lower than you've shot before.

Great job shooting today, and great job surfing it, Sami!!!
 
Thanks, @Vyktors Mum and @Amy&TrixieCat, so you are saying that if Sami is ever below 50 at PS then to SKIP the shot entirely, then go back to the current dose for the next shot as long as she is above 50?

How do I determine if I can shoot something say in the 60's, 70's or 80's? After today I would probably feel okay about shooting in the 80's, but not so sure about 60's or 70's. Maybe 70's if I give MC food at PS and monitor very closely.

Night Night @Vyktors Mum sleep tight, catch you in the morning.
 
Yes, I would skip anything below 50, and the reevaluate when the time for her next dose rolls around. If you do shoot, you would most likely return to the same dose (unless Sami has earned a reducie).

You do kind of have to evaluate each situation individually. With what I was used to doing with Trix (again, ECID!), given your experience today I would feel comfortable shooting, say, mid-70s and above - as long as I was around to monitor. But you do have to do what you're comfortable with at them time, since there are many factors that come into play (ie, if it's late at night, or you have to go out, or for some reason Sami's appy is off, etc).
 
@Amy&TrixieCat Okay, thanks. I will keep that all in mind as we approach PMPS. I am still hoping for a reduction during this cycle, but if it doesn't happen I know I can handle just about anything. I might not get any sleep tonight again, but that is okay as long as Sami stays on the healing path.
 
+6 - 91

I hope this is not the start of a bounce and just food influence from +5. She keeps trying to sleep, but I think I keep waking her up. Now that she is at a slightly higher number I feel a little more comfortable about letting her be for a bit. I will still test again at +7, or should I wait until +8 since that seems to be her nadir as of late?

Suggestions PLEASE.
 
Hi Tina,
Going back to the earlier part of this discussion, I think that it is more important for Sami to eat than to withhold food in the hopes of getting a dose reduction. It seems as if such a dose reduction would be obtained on false premises. According to the protocol, the only time to withhold food is 2 hours before PS (so that the PS number won't be heightened by food and therefore give a false impression). The rest of the time it is fine to feed small meals (or to let the cat free-feed--if they are grazers). That said, there are many approaches that people use: some will feed small meals up to nadir and then don't feed again until after PS. The reasoning here is that food after nadir will cut short a good surf. (but be careful if your cat has an early nadir! you don't want her to starve!) Some long-term diabetics benefit from a snack at about +9, just to keep their equilibrium.

If you skip a shot or do a fur shot, the protocol states that you start over with the three-times-below-50 count. But a number in the 30s is always an automatic reduction (.25 unit).

Complicated, isn't it!

Have a good weekend,

Ella & Rusty
 
@Ella & Rusty & Stu(GA) Yes, I have sort of been hoping for Sami to earn a reduction, but I haven't been withholding food if she seems like she wants some. I just haven't left it out for her to eat a lot at one time. Sami tends to eat most of what I put out so I wanted to be able to get some MC or HC into her if she did dip too low, and I figured if I let her have all the LC she wanted then it might be more difficult to get her to eat if that time arose. So just know if Sami seems like she is looking for something to eat I do go ahead and feed her. The only time I will withhold food for a short time is if I want to test her in the next 10-15 minutes. I might hold back for that time just so that I can get a test without too much food influence, but if she seems to get more anxious I am more inclined to test early than to keep her waiting.

Thanks so much for caring about Sami's well being to make sure her belly is full. She thanks you for that.
 
@Amy&TrixieCat I will try really hard to hold off until +8. LOL! Sometimes I just sit and bite my nails while watching the clock so that I can test her. But as long as seem seems content I will try to let her relax for a bit. Right now she is sleeping in my chair while I have to sit on the edge, because her comfort is WAY more important than my own. LOL!
 
Tina & Sami said:
Right now she is sleeping in my chair while I have to sit on the edge, because her comfort is WAY more important than my own. LOL!
Click to expand...

THIS is the story of my life! If I'm not sitting on the edge, I'm sitting on the hard dining room chair instead of the padded computer chair because I cannot disturb the kitties who are snoozing on the computer chair!
 
+8 - 118

I am going to assume that Sami will be okay until PMPS, but should I still test her at +10 or +11 to see if she is taking another dip by PMPS?
 
The word on the street is that you have about 20 minutes after feeding (normal foods, not Karo syrup) for that food to show up in the blood glucose number.

Have a restful afternoon!

Ella & Rusty
 
Sami has had an amazing day and a half. She's a great little surfer! :D:cool: I love shooting lower numbers like you did this morning, makes for such a nice flat cycle. Great job managing the cycle Tina.

The more time in green, the more her pancreas will heal. In some ways it's good she didn't earn a reduction yet today, cause it means she'll spend more time in the healing zone.
 
+11 - 178

@Wendy&Neko Yes, she did surf nicely. I am wondering if she is heading for a bit of a bounce because of all the GREEN she saw today. I hope not, and I hope I can nip it in the bud with her PM shot in just over an hour. But even if she does bounce then I can probably get some sleep tonight.
 
I have a slightly different view to Amy on what numbers would be okay for you to shoot with Sami at this point - because you are able to monitor so well I would shoot anything over 50, unless there's going to be fluids involved that adds a whole other dimension.

Sorry no reducie I think my fingers must have uncrossed in my sleep - doh! But what a wonderful healing surf, really fantastic :D I was going to say something similar to Ella about withholding food for a reduction - it will come when it's ready - but I see that you're not really withholding just not encouraging. Great job today!
 
Thanks for all the encouragement today. I am very happy with how the day went. Sami was a little higher at PMPS than at +11, so I am holding off until +2 to test. I figured she earned it since I tested so much during the day today. I will probably also plan on getting a +4 as well, and depending on where she is for those two readings will determine my course of action for tonight. I am just hoping that she doesn't go up much from the PMPS, and maybe we will see a similar cycle to last night.
 
+2 PMPS - 152

I am going to try to get a couple hours of sleep since Sami is higher than she was last night. I will get up to test again at +4 I will also leave out some food for her so if she is hungry she can eat. I will check back in at +4.
 
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