2/4 Buddha

[Donna & Buddha]

Buddha thinks Bix is a show off, but I'm pretty sure he's more than a bit envious. He's getting rather impatient with me to find his proper dose so he can feel like his old lazy self again, and not like his current self which is sometimes overcome with hunger, sometimes utterly fatigued, and I so do want to deny, his hind legs don't have the spring that they used to. He's NOT walking on his hocks, but his jump up to places where he shouldn't be and doesn't belong isn't as graceful as it once was.

So I think I really do need to increase to 2.2u, and probably eventually higher. Blue numbers scare me emotionally, but rationally I know that's what I should be aiming for.

I'm still confused about PZIR. It seems to me that a cat with a amps of 200 or 400 should get different amounts of insulin. Isn't that the purpose of testing and testing and testing? So if person A shoots cat B(with amps of 400) with 2.2u in the morning, and in the evening cat B is now presenting a pmps of 200. Then what? Stick with 2.2u? OK, so the next morning cat B has an amps of 98 then what? Stick with 2.2u?

I would like to get Buddha's bg in a healthier range, but I am unsure how to do it. It's hard to stay the course when his curve seems so steep. I know the critical bg value is the nadir, go too low and and almost instant death.

But I think he needs more insulin. I think the numbers get lower on average when his dose is increased. Seems crazy that such miniscule changes make such a drastic difference. Makes me believe that PZIR should be more dillute to make it all easier. Makes me wonder if sometimes I didn't roll the bottle long enough to get it mixed properly.

 

[Donna & Buddha]

Oh, whatever. Buddha started asking for his breakfast snack around 9:30. Made him wait a bit while I got other stuff done. His bg at +3.5 was 102. Crap. I mean yeah. I mean, now I'm nore confused.

Just saw that the Relion Ultima meter is $9 from walmart.com ...

 

[Ele & Blackie (GA)]

I'm hoping that Terri and/or Joanna will give you some feedback on these questions. Until they do, here's my 2 cents. I agree that the 2 units doesn't look like enough, until we saw that 102 at +3. Now I'm wondering if the 2 units isn't too much. Too much insulin can cause high numbers. Regarding looking at the amps & pmps for dosing directions - I think you also need to factor in the nadir's. For example, is he dropping rapidly? Is it more than a 50% drop from preshot to nadir?

I hope you can keep checking today. It looks like Buddha may go much lower than the 102 today and you'll want to make sure he doesn't go too low.

 

[Terri and Lucy]

102 is nice! Sometimes cats get a really good response on the first day of a dose change but then they slip back into higher numbers. So don't panic and change the dose just because of this one response. Give him some extra food if you can't be around to test over the next couple of hours. I'm tied up in meetings for the rest of the afternoon but will check in early evening. Paws crossed for you!

 

[Donna & Buddha]

Well, when I'm wrong, I guess I'm wrong. A bigger does does not appear to be Buddha's thing AT ALL. Of course, a smaller dose didn't appear to be his thing either and where he's at now, not sucha good place.

So. Oh, crap.

 

[Joanna & Bix (GA)]

I'm still confused about PZIR. It seems to me that a cat with a amps of 200 or 400 should get different amounts of insulin. Isn't that the purpose of testing and testing and testing? So if person A shoots cat B(with amps of 400) with 2.2u in the morning, and in the evening cat B is now presenting a pmps of 200. Then what? Stick with 2.2u? OK, so the next morning cat B has an amps of 98 then what? Stick with 2.2u?

Bix says he struggles a little with jumping sometimes too, but he still enjoys being a show-off whenever he gets the chance. :lol:

As to the varying PSs, that confused me for a long time too. What I was told (Terri can probably explain it better), and found to be my experience with Bix, is that you can look at the drop in terms of percentages, rather than absolute #s. So if you shot 2.2 on a 400 (not talking about Buddhas #s here specifically, just in general terms) and got say a 180 nadir and then a 200 PS, you could expect on a PS of 200 to get a nadir around 90 (55%).

Of course there are other factors too that can affect it, so I wouldn't put money on it, but that's the projection. So if it were me, I would probably shoot a slightly lower dose, maybe 2.1 or 2.0 on the 200 PS to give it a little margin for error, especially if it's night-time or whatever and I wouldn't be able to test.

I have tried in the past reducing the dose by A LOT (like 1/2 the dose if the PS is 1/2 what it was), and... nope, does not work well, at least not for Bix. With a PS of 98, I'd check in an hour or two and shoot a slightly lower dose on a rising # above 150 or so (or rapidly rising # lower than that). For that, I'd probably drop the dose down to 2.0 or maybe even 1.8 if I didn't have much data yet on my cat. With a PS that low, my thinking would be that I need a slightly lower dose to stay shooting 12/12 comfortably. My ideal for Bix was a drop in the 50 - 65% range, something that would give me the PSs and nadirs that I wanted. (150-180 PS, 80ish nadir was my target, I would suggest target around 60 for those using human meters, or get the resting BG of a civie to get an idea where your meter is).

The purpose of testing is 1) make sure it's safe to shoot (many on PZI use a "no-shoot" of 150 or 180, or 200 for newbies), and 2) collect data to see how the doses are working, to help with ongoing decision making. If your PSs went from 400 to 200 to 98, that would tell me that dose worked well to bring the #s down, but is probably too much for keeping them steadily in good #s.

Some do have success with a sliding scale that varies by PS, and I did do that to some extent with Bix. For me it worked well as a now & then thing, to raise the dose a bit to bring down a high #s. Once Bix got regulated though, I didn't get #s very out of line - if they were creeping up I'd raise the dose 0.1u, or creeping lower I'd lower the dose 0.1u, and that took care of it.

I use the Relion Ultima, btw. If I bought again, I'd get the Micro I think. The Ultima sips a little slow for my tastes, but otherwise works fine for me.

 

[Joanna & Bix (GA)]

As far as Buddha specifically, personally I would not shoot a dose as high as 2.2 on a lower PS. A few weeks ago (could be that things have changed since then, but I'd err on the side of caution), you shot 2.2 on a 212 PS and got a reading of 46 mid-cycle, so to me that is an immediate dose decrease on any PS under 250 or so, if not on all PSs.

It's frustrating that you didn't get better results on 2.0. With 2.2 it looks to me like you are at times getting too steep a drop, which could be triggering rebound, but then on 2.0 the #s are pretty high.

I don't have any great suggestions for the moment, just hang in there! Even though it's a pain, the more things you try and the more data you get, the more you get a feel for what works and what doesn't, and then at some point hopefully it will get a lot easier!