3/12 Eeyore in 200/100's past few days until recently

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Melanie and Eeyore

Melanie and Eeyore

Member Since 2014
previous post: viewtopic.php?f=9&t=115098

On 3/08/14, Saturday, I was contemplating raising Eeyore's dose as he had remained above 300, really in 400's for days even after I felt his 'new dose' bounce was over. Then just as I decided that in the morning we would increase, he was only 281! (3/9). Then remained in that realm until his PMPS where he was back up to 461 again. I decided to keep him at the same dose and see nadirs for the next day. Again, he was back down in the 200-high 100's range but then back to 500's by his PMPS. Yesterday (3/11) started out in 200's again but didn't get as low as the previous days, and I didn't really get good nadir numbers because my husband (who flies the F22 fighter jet in the Air Force) had an important flight that I needed to attend on base.

This morning his AMPS is rather high again so I am wondering if now (will be tonight) is the time I should increase his dose. I have read and re-read the guidelines but because the last few days have different number patterns than the previous several days I can't count them all together right? I should just look at the nadirs for the past 3 days while he was lower?
Increasing the dose:
Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
when your cat starts to see nadirs under 100, hold the dose for at least 10 cycles before increasing.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.
Click to expand...

Based on this, I feel this evening I should increase him by .25 units. However, even though he had three days with lower nadirs, he had rather bad nadirs previous to that so should I maybe increase him by .50 units?
 
Hi guys .. no dosing advice from me, but it's nice to see some of the yellows and blues showing up! Have a great day guys!
 
Morning Melanie, ~O)

Did you skip the pm shot for the last two nights? There isn't anything in the box. If you skipped, you should write it in so others know what happened.

I will pm someone to come notice. Eeyore seems capable of grand leaps downward.
 
Rhiannon!

Thank you for catching that, I did still give him the same 1.25 units those two evenings I just forgot to put them in the chart! It should be updated now! Thank you!
 
Eeyore's +8 is 557. Whatever he was going through the last few days where he was lower, is now over, and he is back to being high again!
 
I do know there are others coming later to advise. They are talking amongst themselves . :lol: ;-)
just tbp gets in the way... ( that's the bad place .... i.e. work)
 
hi melanie!

i'm wondering if there are any times when you can get a test in the day cycle earlier than +5?

We are talking about mr eeyore! ;-) for example, on 3/10 he was 377 at amps and 119 at +5, then straight up from there. I'm just wondering if he's doing any diving after that am shot, then shooting upwards from it.

that doesn't answer your question about dose, but i did want to ask you if it's possible for you to get a +2, say, or a +3. I'd choose the am +2 with him just cuz i'm curious, if it's possible for you to get one.

somebody will get back to you. hang on.
 
oh shoot, melanie, i'm sorry we didn't connect in time. today's been a bit crazy. what did you end up doing?

let me share some thoughts:

one is that he does look bouncy, but at least some of the time, he's clearing the bounce within a day.

another is that he might not be getting good duration from the lantus - sometimes going up in dose can be helpful in that.

another is that he's new to seeing blue numbers. The guidelines say
if your cat is new to numbers under 200, it is recommended to hold the dose for at least 8-10 cycles before increasing.
Click to expand...

He's got 6 cycles after starting with the blue numbers on the 9th, seven if you held the dose tonight. Because he is new to the numbers under 200, probably holding for at least 8 cycles (through tomorrow morning) would be a good thing. I'd love to see the am+2, in particular. Anytime you see areas in the ss that are completely wide open white, it's a good idea to get a test here and there in all the different time slots.

So in other words, getting a few more varied times is going to be helpful. If he hasn't come back down to blues by pmps tomorrow, i'd probably go ahead and increase by 0.25u, so to a new dose of 1.5u.

Hope you're having a great evening!
 
Julie!

Thank you for getting back to me, I am sorry I wasn't on sooner myself to get back to you! I did end up just keeping him at the 1.25 units figuring one more night wouldn't hurt since I hadn't heard from you guys! I will definitely get numbers earlier in the cycle tomorrow to see what is going on! Thank you all for taking time to look over Eeyore's chart!
 
sure - it wasn't as late as i thought. i haven't changed the time yet on my control panel since we went to DST last week, so i thought i was answering you an hour after you meant to shoot.
 
Hi Melanie!!

Looking at Eyeore's SS, I definitely think he is not getting duration in some cycles which we refer to as "big insulin poop out". Examples are on the a.m. Cycles of 3/6 am and 3/7. He really had no reason to pop up from the 300s to 500s at the end of the cycle.

A couple things can cause BIPO and one of them is feeding after mid-cycle. Perhaps you could put an asterisk in the squares where you feed him? That would help us see how the insulin is possibly affecting his numbers. The other thing is absorption. In any given cycle, even at the same dose, absorption can vary by up to 50%.

I agree that he needs more insulin and I'd try to take him up per the protocol.

My husband flew F-16s for 21 years and worked on the F-22 program during his staff tour. Hope your DH enjoys flying them :-D
 
Melanie:

I'm sorry it took so long for a reply. I had looked at Eeyore's SS and was scratching my head regarding whether he was bouncing or if this was BIPO. I asked a few others to take a look with those questions in mind. It seems like the consensus is that it's both. The good news is that the action is the same -- increase Eeyore's dose.
 
So I had posted a reply to Julie saying that we stuck with the 1.25 last night but my husband really wanted to 'help out' so he gave Eeyore his insulin and said it was fatter and closer to the 1.5 mark. As you all know they don't make small enough syringes to really tell! Based on his AMPS of 188 this morning I'd say the slightly fatter dose helped, but who knows! Eeyore is so bouncy. I did give him an actual 1.5 units this morning and then test at +2 like Julie was suggesting. He is 84!! I'll watch him to make sure he doesn't get too low, and im sure the bounce will start in soon enough and he'll go high, but for me we are happy.

I have been giving him 'lunch' but I portion out how much food he should get for the day, and then just divide it up for the morning, lunch, and evening. In Eeyore's early years he would always scarf up any food in the dish, a frustrating thing when his brother wanted to graze all day long. In the last few years, since switching him to a grain free diet and then months ago giving up dry food entirely, he was more of a grazer. His brother passed away to cancer a year ago, and Eeyore lost a good 1.5 lbs as a result- over the course of a year. So this January when I was noticing the diabetes signs of peeing and drinking, he was also losing a bit more weight and was only 9 lbs 2 ounces. After all the trauma we went through losing his brother, he quit eating and withered away to 4 lbs, I didn't want the same to happen to Eeyore. So alas, since the diabetes diagnosis, the new insulin regiment, and us getting settled in from moving here to Florida, we decided to capitalize on his increased hunger and 'bulk him up' a bit. Also with taking away his dry food he was allowed to eat more wet food. So that is why I have been allowing him to have a middle meal for 'lunch.' He is now at 10 lbs 13 ounces which we and our vet feel is good, (since he is older and doesn't exercise a lot) and we want to keep him there so I've been making sure he gets the approx. 200 calories a day as per Dr. Lisa's advice.
SO all that being said.. maybe I shouldn't allow him to have that third meal? Maybe that could be messing up our numbers? He usually eats at 7:30-8 am. 12:30pm, and again for dinner at 6:30ish pm.
 
Thanks for clarifying on the meals.

I would say it would be worthwhile to try to get all his meals for both cycles into him before nadir or mid cycle until we can really tell where his nadir is. If you think of it as a car coming up to a stop sign where the car is actually the effects of the insulin; if you slam on the brakes (i.e. feed after nadir) before you get to the stop sign (the next PS), then the car comes to a fast halt (the duration of the insulin is minimized). But if you just take your foot off the brake and let the car glide (i.e. just let the insulin do it's job), then you make it to the stop sign.

Before Gracie was dx, I portioned out her calories for the day and then whenever she wanted food, I'd give her a little all day long and all evening until bedtime. Once dx, I had to change her feeding so as not to impact the effects of the insulin because she also showed BIPO. She did just fine. If she gets really hungry later in the cycle, I just give her a little bit of boiled chicken (about 0.2 oz). Sometimes even this can affect her BG but often times, it's just fine and satisfies her hunger.
 
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