2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8u);

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Kathleen and Fred

Kathleen and Fred

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What's this??? Thought we were on a good track down to "normal" - or in the 200's. He seems OK - actually slept in 1/2 hr past normal wake-up. Ate about the same, pooped, peed, went outside for a little stroll; now cleaning up.

Are we still in the "bounce"? Is it time to consider Lantus for longer action? Seeing Vet next week. @-)

Thanks,
 
Re: 2/20 Fred:AMPS=398 (2.50u)

it looks like a bounce to me. If he was at 114 at +4, he certainly could have gone lower by +6. Kathleen, this is why I am thinking lowering the dose on the 200 preshots. If he drops low and bounces on 2.5, a lower dose on that same number could flatten out the cycle a little and stop the bouncing. You'd still shoot the 2.5 for the higher numbers when you see them.
 
Re: 2/20 Fred:AMPS=398 (2.50u)

Have to agree with Sue on a slight reduction. :thumbup

There were times I had to reduce Lucian to smooth out his cycle or he'd get in that 'very low, then swing to very high' and it's hard to get that under control, with ANY insulin. Lantus isn't any better in that aspect. If it is duration that your having an issue with, the Lantus or Levemir may help that, but it's not any better in controlling the bounces. Slight reductions can help that because it keeps them from going AS low, which means the bounces are lower too.

Of course, just about any time they go lower than what their body is used to, they are gonna bounce. I remember someone asking once "How long do they bounce?" and the answer is "Until they stop." ohmygod_smile

Hang in there!
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403

OK, just so I understand your notes, when I test and the numbers are in the 200's, shoot 2.0u. If higher go to 2.5u.
What about numbers in the 100's? Stick with 2.0?

Someone said I should stick with same dose for a while when using ProZinc. Is that really true?

A little stressed!
 
Re: 2/20 Fred:AMPS=398 (2.50u)

It is true that , if you are seeing the same general range of numbers, we suggest holding the dose for 3 cycles. And there are some cats who don't do well with changing doses, but the majority of beans here use a sliding scale. Here's why we came up with sliding scales:

We kept seeing cats with high preshots and low nadirs and they just kept bouncing back and forth from highs and lows on the same dose. And we thought that maybe it didn't make a whole lot of sense to give the same amount of insulin on a preshot of 200 that made the cat drop 150 points as it did to shoot that same dose into a preshot of 400 and have the cat drop about the same amount. (this is a very concrete example; it isn't usually so concrete. We are dealing with cats. :mrgreen: )

So we looked back at what the cat had done with the same amount of insulin on preshots and decided we could shoot a little less on the 200 preshot than we did on the 400 preshot, and lo and behold, the bouncing lessened and we saw fewer high preshots.

You can't do this same thing with depot insulin like Lantus and Levemir. They do best with holding the dose, usually for 3-5 days unless they see a big change in numbers. Maybe that's where you saw it. There is a big difference in the way the insulins are dosed because PZI doesn't need to build up a supply of insulin (depot). You shoot it and generally, 12 hours later, the insulin is gone and you shoot again. (again, a simplistic example. There are times when you can shoot earlier or later)

Have you seen the PZI protocol? It might help.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077
 
Re: 2/20 Fred:AMPS=398 (2.50u)

Kathleen, are you using U100 needles and the conversion chart? If so, please use the actual amount of insulin you are shooting. So, if you are shooting 2.5 with U 100 needles. , you are really shooting one unit of the insulin.

It makes it much easier and safer for us to advise you.
 
Re: 2/20 Fred:AMPS=398 (2.50u)

Hi Kathleen and Fred!

Those 400's you are catching to my eye definitely look like bouncing.

A bounce can look like a high pre-shot number or it can be higher for a whole cycle. There's different approaches with how to handle bounces, but I'm in agreement with Sue that a sliding scale might be just the ticket with Fred.

For example, on the PM cycle of 2/17, you shot 3u on a 220 pre-shot. Fred was at 94 at +4, and I'm guessing he may have gone a fair bit lower a few hours later. Then the next cycle (AM of 2/18) looks fairly high and flat, and that definitely looks like bounce cycle. Not sure which direction he went on the PM cycle of 2/18. If I had to guess, maybe a bit of a lower nadir, but still looks bouncy. Then Fred appears to clear those bounces by around 2/19 for both cycles, but he probably went lower on a couple hours after the 114 you caught at +4, and he's bouncing this cycle again.

There's nothing per se bad about bouncing, other than it can be frustrating for mom and dad beans :).

Since it looks like, for example, that Fred is bouncing when you're shooting 3 or 2.5u's on those lower pre-shots, he may be going a fair bit lower than you're actually catching on your meter. I think it's worth a try to maybe do a trial of something like 2u on 200-250, 2.25u on 250-300, and 2.5u on 4u and see if you can get continuing good numbers while reducing those bounces a bit. It does look like 2.5 on a pre-shot in the lower 200's might be a smidge higher than necessary.

You'd have to either eyeball those quarter and half units on u40 syringes, or you can dose in increments of 0.2 units using u100 syringes and a conversion chart.

I use a sliding scale with Eddie and tweak it up or down depending on how he does with it.

The general idea behind sliding scales is sort of math-based. You figure out what you're aiming for at nadir, look at the number on the pre-shot, see how much insulin it took to accomplish that decrease when you had a cycle that looked good, and then adjust around that dose looking at percentages - for a simple explanation. Since ProZinc is in-and-out (mostly), you have the flexibility to adjust the dose as often as you need to, unlike the depot insulins like Lantus and Levemir. The other nice thing is, if something isn't working, you can scrap the plan and try something else without having to wait several cycles.

For a more complicated (and much better) explanation on the some of the math/proportion concepts behind sliding scales, check out this post on one of Eddie's condos where Carl helped me come up with a very effective sliding scale for Eddie: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=112998.

He's seeing some nice numbers in there! I think it's possible to achieve those better numbers perhaps more consistently if you can ease the bouncing just a little bit.
 
Re: 2/20 Fred:AMPS=398 (2.50u)

I am shooting 1u of insulin, when SS chart says 2.5u.

My vet thinks I need to stop stressing over all this testing. She feels that his behavior is a better indicator of how Fred is feeling. She also says we may consider Lantus.

Having said that, I will continue to test and report results. I've read the protocol on ProZinc, and I think I'll stick with that for a while. The sliding-scale concept might help us to regulate things....if I can get my head around the math. May ask Carl to do a chart for me!!

Just to be sure I understand, you are recommending that I shoot just under 1u of insulin when numbers are around 200 or less. (That's 2.0 on my syringes.) If pre-shooting is around 400, going up .5u would be recommended. (That's probably 1/4 of a notch on my syringes to 2.25.)

I'll post as often so I can while working....his poor little ears look grim!!

Thanks for your help
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403

Kathleen and Fred said:
Just to be sure I understand, you are recommending that I shoot just under 1u of insulin when numbers are around 200 or less. (That's 2.0 on my syringes.) If pre-shooting is around 400, going up .5u would be recommended. (That's probably 1/4 of a notch on my syringes to 2.25.)
Click to expand...

Oh boy! Yes, the recommendations from my previous post were assuming that you were noting units in u40 numbers, not u100 numbers! I'll have to look at the actual math conversions a little bit later...
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403

Thanks for clarifying, Kathleen. Yes, please use the amount of ProZinc you are actually shooting. (If you can, It would be helpful for you to go back and change the amounts on your ss.)

It does make your numbers look much different. If you are getting a +4 of 114 on one unit of insulin, he is doing very well! Just for reference, we consider a cat well regulated if they are in the mid 200s at preshot and in double digits at nadir, but under 40. which is hypo territory. So he is not in bad numbers at all, except when he bounces up in the 400s.

So yes, I like .8 or so for the 200s (you should be able to dose that with your U100 needles) and maybe 1.2 for the 300s. So maybe something like this

.8 200-250
1 unit 250-300
1.2 300 -350
1.5 350 and over

This would be a starting point that we could tweak in the different ranges as you get more data. I would think lowering the dose a smidge in the 200 range may stop the bounces. Adding more insulin in the higher ranges may help bring things lower for those cycles. Does that make sense?
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315

Ok I've changed the spreadsheet so you can see exactly how much ProZinc insulin I am shooting. I'll do the conversion at my end for my u-100 syringes.

Here's what I was told some time back:

if PS is: Then use (insulin):
100-125. .4
126-150. .6
151-200. .8
201-225. 1.0
226-250. 1.2
251-300. 1.4
301-350. 1.6
351-400. 1.8

I stopped doing this when my vet said there was no need to test so often and that I should just leave it around 1u all the time, while watching general well-being, activity and getting weight lowered.

So that's where we are!
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315

Well, I would say that scale is a little scary at the lower ranges. I would not shoot under 150 unless I had lots of data to show how Fred would react.

i know it is hard when you have lots of different information coming at you. I don't know where you got the scale, but I am thinking it was not from someone here on the PZI forum. We increase by .25 units and we don't advise anyone without data to shoot under 150.

All I can offer is to pick a dose for preshots in that 200 and in the 300 range, which seems to be where he is right now. Try that for a few cycles, getting preshots and mid cycles. Then we can see how he is doing. With ProZinc, getting preshots and a few midcycle numbers is all you need for awhile.

I understand that your vet is not keen on testing, but if you have been looking on this site, you know that cats are not very predictable and they often throw low numbers when you don't expect it. None of us would get insulin from the doctor for our child and give it daily, testing once a month. We treat our 4 legged children the same way. It looks to me like Fred is responding very well to the insulin, giving you pretty nice numbers at low doses. A little tweating with the doses may help a bunch. We'd be glad to help you with that, if you want.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Sorry, but I got those shooting numbers on this site a few years ago.....I'll modify my chart if you'll give some guidance.

Anyway, I agree with sticking to a dose for a while. With his low PMPS tonight, though, I felt I should drop from 1.0 to o.8. Hope that wasn't a big mistake. may know by final pet sting this evening.

Thanks for sticking with us while Fred and I learn (again) what yo do.

Also...related info....how should I reduce food to get his weight down safely and gradually so ad not to upset his bg levels?
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

That was a long cycle with a big drop overall. I am a little concerned about your shot. 150 is a pretty low number and we want to be sure is that the number is rising, not still falling when you shoot, so you don't add insulin to a cycle where the insulin is still present and working. ( a way to do this is to retest in 20 minutes without feeding so you can be sure he is going up, not still going down). I am glad you shot less than one unit. I hope you can see why sticking with the same dose regardless of the number can be unwise. One unit on 157 would have been too much. I am a little worried that your .8 may have been too much.

Can you get a test in 2 hours to see how fast he is dropping?


Re your food question, what and how much are you feeding Fred?
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Ok...will test 8:30pm (EST) and post on his chart. This is hard to know what to do! So, if his numbers are below 200 at test time I should wait 20 min. and retest? What if the stay low or get lower? No insulin? Won't that upset his BG balance over the next 12 hours?

I feed Fancy Feast and Friskies. He usually gets about 14oz. total in a day spread over 2large meals at shooting time and two smaller snacks in between. Bella, his civi housemate is in need of a diet, too.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

I think my original scale has doses that are too high. Sliding scales change as you get more data. Today's numbers look like he needs less insulin. For a while, I hope you can post with your preshots and ask for advice.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Kathleen and Fred said:
Ok...will test 8:30pm (EST) and post on his chart. This is hard to know what to do! So, if his numbers are below 200 at test time I should wait 20 min. and retest? What if the stay low or get lower? No insulin? Won't that upset his BG balance over the next 12 hours?

I feed Fancy Feast and Friskies. He usually gets about 14oz. total in a day spread over 2large meals at shooting time and two smaller snacks in between. Bella, his civi housemate is in need of a diet, too.
Click to expand...

Yes, because you want to be sure he is rising. If the numbers continue to drop, then you want to be cautious and yes, wait till he is rising. Skipping is not ideal but sometimes it is the best way to keep him safe. This is complicated, but I guarantee it will start to click for you, and very soon, you will know what dose for each number.

A vet has this formula for how much to feed:

Required calories per day = [13.6 X optimal lean body weight in pounds] + 70

So if his ideal weight is 12 pounds, then he needs about 233 calories per day. Look on your cans and see how many calories in each flavor. If he needs fewer calories, then there are foods that are lower calorie but still low carb.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Kathleen, this is the 3rd insulin my Lucian is on. Each time I have to learn it NEW. I know how frustrating it is when you're not sure what to do.

Hang in there hon, everyone will do anything in their power to help. Wish I knew more, but I'm back to being a newbie. But I'll be your cheerleader! I'm good at that! :RAHCAT

Big Hugz! :YMHUG:
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

I've looked on all the cans and there is no listing of calories. Are you referring to one of the charts from this site? Also, once the calories are determined for the optimal weight, isn't it best to reduce to that amount gradually? For sugar cats, what is the best way to slowly scale down the calories per day?

Looking at my chart, I was trying to see when his numbers were rising or falling at AMPS and PMPS. Between 2/15 PM and 2/16 AM he was dropping. Should I have shot less?

Same between 2/16 and 2/17.

On 2/18, between +7 & PMPS he was going down. Should have shot less then, too?

Ok will test Fred now. Look at chart in next few minutes to see +2 results.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

I think I can answer the weight loss question. Let's say 12 pounds is his optimal weight and for a 12lb cat, they need 600 calories a day. (have no clue, just using 600 for a figure) If his optimal was 16lbs, the calories may be 800 a day. So for him to loose that 4 pounds, he needs to eat the 600 calories. Understand what I mean? You wouldn't reduce it from the 600, unless you wanted him to be 10lbs, then you would feed the caloies for a 10lb cat.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Kathleen and Fred said:
I've looked on all the cans and there is no listing of calories. Are you referring to one of the charts from this site? Also, once the calories are determined for the optimal weight, isn't it best to reduce to that amount gradually? For sugar cats, what is the best way to slowly scale down the calories per day?

Looking at my chart, I was trying to see when his numbers were rising or falling at AMPS and PMPS. Between 2/15 PM and 2/16 AM he was dropping. Should I have shot less?

Same between 2/16 and 2/17.

On 2/18, between +7 & PMPS he was going down. Should have shot less then, too?

Ok will test Fred now. Look at chart in next few minutes to see +2 results.
Click to expand...

Try this food chart to see carbs/calories.

http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf. The last column is calories.

Yes, I would reduce the amount of food fed, if he needs it, but slowly. Give us an idea of what difference you are looking at and maybe we can figure it out together

If you are looking at 272 and 279 on 2/16 they are in the same general range. (meters vary by 20% and those numbers are in the 20% variance). So they aren't a big issue. Same on 2/18. Today was an issue because he had come down about 50% in the five hour period. And the number he came down to was a number that was low to shoot. The other cycles he was in a shootable range. Make any sense?
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

I understand your concept. But do we cut down to the optimal weight calories all at once or should we feed the calories for, say one pound down, then one less pound, etc. I don't want to reduce his calories so fast that he has a bigger sugar problem.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

I would cut him back slowly over time. Maybe a couple tablespoons less daily until he is where you want him? It'd depend on how much he complains too; you don't want him miserable. Try it awhile, weigh him, try a little more, weigh him.

I keep meaning to ask. What meter do you use?
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Yes now I am beginning to see the range for shooting & non-shooting. But what should I do now that he's still dropping? Give him a snack? He usually gets something small around 10 pm.

As for contacting someone with his AMPS, who will be up at 6:30am (EST) to advise me on shooting? He knows he gets breakfast right after and won't be happy if he has to wait. Any advice now on what to do if #s are low (or high) tomorrow morning?
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Forgot to add...Fred is a large, tall 16 lbs. the vet would like him to be at 14lbs. He used to be 18 lbs on kibble!
Now I feed him about 14 oz. in 2 large meals and 2 snacks. Haven't gotten a vet weight in a while. Will be going in next week for checkup and I'll find out his true weight then.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

That's a number that is less worrying. (if he had dropped into double digits by +2, i would be worried.). Can you get a before bed test to be sure he is still in a safe range?

I can try a temporary scale, but things are changing fast with today's lower numbers. It's a cautious scale, but I am thinking better a little higher than lower. We can always adjust it as you get more data.

No shot under 180
180-220. .4
220-280. .6
280-320. .8
350 -400 1 unit
400+. 1.2

We do have some earlier risers. You can always post and see if someone is around.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

at least your scale will give me some guidance for a while - thanks.

I'll try to test again at 10:30. can he get his snack before I test? (usually around 10pm)
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

If you can find the caloric count on the charts for his food, you could always reduce him by say XX calories a week. That probably wouldn't be more than 1 tbsp a day.

I know, with humans, 1 pound =3500 calories. Have no idea if it's the same with cats, but would think that a pound is a pound. To lose 1 pound, you either have to reduce your caloric intake by 3500 cals and/ or burn that much in exercise. Don't know about Fred, but the height of Lucian's exercise is sleeping! :lol: So I'd have to go with caloric reduction for Lucian to lose weight.

To figure out how much to reduce on a weekly level, you need to find out how many calories he's taking in and deduct from that. Personally, I wouldn't deduct more than 10% daily. If he was eating 700 cals, drop him by 70 a day. Crash diets don't work for people and I doubt they work for cats. A little at a time will get him where he needs to be and keep him at a healthy weight. Thankfully, he only needs to lose 2#. :thumbup
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

A safe range at +4 would be in the lower hundreds or high double digits. An unsafe range would be in the 70s or below, because we would worry he might drop into the 40s in 2 more hours (hypo range is the 40s). A safe range at +6 is 50 and above. Those are general ranges based on your +2 tonight,

What we want to see is a cat in the 200s at preshot and in double digits at nadir, but not below 40. A good cycle with ProZinc is a smile shape. Higher on both ends and lower in the middle.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

thank you, McKitties for great diet advice! It confirms what I was thinking. Hopefully the weather will warm & we all can get some exercise, too.

Sue, thanks for hanging in with me tonight. I'll test & post @ 10:30 but don't think I can make it to +6....very long stressful day. Hopefully his PM snack will keep him out if hypo danger.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Yes, leaving out something to eat is a great idea. Most cats eat if they feel themselves dropping low.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

I'm trying to catch up with the events of the day, but I'll be around when your 10:30 test is done. Let me catch up...
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

OK, for starters, let's assume that the higher numbers you saw this morning were due to a bounce from a low number that might have happened during the night last night.

What I see -
Fred was pretty high this morning, and unchanged at +3 this morning. That's just about the time the morning dose would have been kicking in.
It worked. It dropped his BG, and it also looks like it made the bounce clear. Sometime between +7 and PMPS, the bounce "went away".
That left you with a beautiful blue PMPS number.
What is "unknown" with that number is whether it was rising from a lower number, flat, or maybe still dropping.

In any case, I don't think giving the shot at PMPS was a bad thing. The shot time meal was going to either push up his BG, or at least stop it from dropping.
It may have been a tad "heavy", but there's only one way to see if that is the case, and that is to try it and see what happens. Which you've done.
And the +2 tonight is what I'd call "flat" from his PMPS. It's only 21 points, and that's within the meter's margin of error.

From this point, you just test again like you have planned to do. By then, he will have reached "onset", and you could see a lower number. How much lower? No idea, but that's why you're testing. And the next number will indicate how, or if, you need to do something as far as reacting to it.

If you post the number, and give me or anyone else watching a couple of minutes, we can help you determine "what's next".

Sound good?
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Sounds great!!

But, by the end of this LONG day, I'm the one who'll need insulin.

BTY, Fred is punching me for his usual 10pm snack. Any problem with him getting it now or should I wait for the 10:30 test?
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Maybe save back a little so he has a treat at 10:30 too? Tests require treats. :mrgreen:
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Here's what I was told some time back:

if PS is: Then use (insulin):
100-125. .4
126-150. .6
151-200. .8
201-225. 1.0
226-250. 1.2
251-300. 1.4
301-350. 1.6
351-400. 1.8
Click to expand...

That's actually not a bad scale, IMHO. The only issue I'd have with it is that it might be a little too detailed. For instance, it calls for a different dose between a BG of 201 and 226. In my mind, those are virtually the same number on the meter, as they are only 10% apart from each other. The meter can be that far off if you test twice in two minutes. And suggesting you shoot at a BG of 100 is very aggressive. I did that a couple of times, but not until I had a good idea of how Bob would react to a dose, so I felt comfortable doing so. Shooting low numbers is doable, but it requires a good bit of data before trying it. And teeny doses of insulin. I think the lowest number I ever shot was in the 90s, and the smallest dose I ever measured with any chance of accuracy was .25u (I used U40 syringes and you know how hard it is to measure "in between doses" with those. Not easy at all. With how Fred is responding to his current doses, the above scale is probably too aggressive though. Especially at the lower ranges of BG. I'd have to look more closely at the data to figure out what might make sense, and I'll do so later.

One word about "the shape of the curves"...
What we want to see is a cat in the 200s at preshot and in double digits at nadir, but not below 40. A good cycle with ProZinc is a smile shape. Higher on both ends and lower in the middle.
Click to expand...

I agree with this, in part. But I don't agree that you always want a curve that is shaped like a "smile". It depends on what ranges of numbers you're talking about. Sue's example is good though. If you start around say 250 and can get a nadir in the 70s or 80s, that might give his body a chance to spend time healing, and eventually you might see the preshot numbers trend lower.

If you start a cycle at 300, then yes, by all means, you want a "smile". You want the numbers in the middle to be lower. How much lower is strictly up to you. If you feel okay with upper blue numbers, okay. That would mean a fairly conservative dose. If you're looking for greens in the middle, it would mean a more aggressive dose.

If you start at 200, then I think you'd want a green nadir? And you'd want Fred spending the majority of the cycle in "normal" numbers (120 or lower), but above 40. That's where experimenting and gut instinct are going to be important. Mostly it depends on how likely it is that you can be around to get mid-cycle tests. Because if you want to be aggressive, you have to be able to monitor the cycle.

IMHO, as the preshots trend to become lower numbers (sub-200), if you plan on giving shots, then you do so with doses that are logical, that won't cause a drop below 40. But you want a dose that won't leave him with a really flat curve all cycle either. You're after a "flatter curve" but still some dip in the middle.

A "perfect curve" would be one that leaves him at or near normal BG all day long. It isn't something you can expect to happen overnight. But it can be done. At that point, you're dealing with very tiny doses of insulin. Alternately, you might be able to manage the curve better with food than with insulin. You can feed multiple small meals that will not boost the BG much, but might also help his pancreas to produce enough insulin to keep his BG under control. That's a bridge to cross later though.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

that's a lot for me to take in this evening. will read again tomorrow. is there ever a hope for fred to be otj after all this time?
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

I don't think you are in trouble. Did you give him a snack?
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

I don't know, Kathleen. He could be fine or he could drop; it could go either way. I think I'd give him some food and retest in 30 minutes if you can. If he is headed up at that point, I would think he would be fine.....
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

is there ever a hope for fred to be otj after all this time?
Click to expand...
It's never too late for that to happen, Kathleen.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

He got a hefty snack just before the test and a little after, as you suggested. I'll test again at 11:30 and send you the results. Thanks
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

Good, that food should slow things down, and I think you (and he) are doing fine.
 
Re: 2/20 Fred:AMPS=398 (2.50u); +3=403; +7=315; PMPS=157 (.8

I think you're right. Have a good night!
 
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