3.29 Frankie +13 151 PMPS (+22) 260

[Jay]

I'm loving the number and dislike the confusion.

Now what? To shoot or not to shoot that is the question.

Whether it is nobler in the mind to suffer the slings and arrows of outr------wait a second wrong play

The only thing I know for certain at this point is that 2.75 units will drop him no matter how high his PS readings are. 2.5 was a bit too lite. Fed him and he threw up (sopisticat Turkey and Liver, too much liquid). All bets are off today for dosing, although he is rising.

I do need to know though
A. Wwats the point in not feeding and testing in 15 minutes. Then what? After you get a reading w/o food?
Wihtout knowing what the next steps are, waiting 15 minutes, getting a reading seems to be pointless

B. I need to have a curve done at this dose. each time we have tried, either he was very high (fur shot) or I wasnt around to run a curve? Not gonna happen till this weekend. There goes my last weekend of skiing for the season.

No shot today ( I have another 40 minutes b4 I leave) as it is far better to have "a diabetic cat when I come home, then one who''s sugar is far to low or gone completely.

Will he be high tonite, of course. Will 2.75 units bring him back down again (looks that way)? Will they eat at all? Will they eat w/o spewing it up? Thats a real toss up.

Stay tuned for the next episode of

"the Sugar Dance" brought to you by Lantus.








viewtopic.php?f=9&t=10430

 

[Miriam and Putty (GA)]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Jay he is not dropping so I think it would be best to at least give him a reduced dose so you don't start all over with high numbers.
I think he will probably rebound from the blue anyway.

 

[Dyana]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

I agree with Miriam. Would you be comfortable shooting a reduced dose? Just to put something in the shed?
He will most likely be high tonight, so you can probably shoot a little earlier than +12 from when you shoot a reduced dose.

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Jay he is not dropping so I think it would be best to at least give him a reduced dose so you don't start all over with high numbers.
I think he will probably rebound from the blue anyway.

I just missed your post as I am on the bus (iPhone)

Just curious, what's the deal with testing no food and waiting fifteen minutes.
If he his still too low (remember I have no history at these low numbers with Lantus) but rising then what?
If he is still too low and dropping, well, I can figure that one out

A token dose? I know that he needs insulin, however why give a dose that
a. Won't hold him
b if it does kick in, won't do that for a few hours?
C. How much of a reduction (again I have no history with Lantus at these low numbers)
d. His rise had been slight over the past 2 hours, up only 20 plus points, why do you think h will rebound?
Aren't rebounds sharp drops quickly (this drop was over 12 hours) and very quick rises? (like a V on a chart)

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

I agree with Miriam. Would you be comfortable shooting a reduced dose? Just to put something in the shed?
He will most likely be high tonight, so you can probably shoot a little earlier than +12 from when you shoot a reduced dose.

hmmm...tsk...tsk...isn't shooting early protocol heresy?
Just kidding

I know he's going to be high, but then again who knows (food went in and came up and unless he gets back to his bowl, there are no carbs going in, I've seen this before but) in the likely event that he is high, in goes a dose.

Through all of this the only thing I know for certain at this point is that 2.75 units wil bring him down, no matter how high his PS number is. That's a really handy thing to know.

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

I agree with Miriam. Would you be comfortable shooting a reduced dose? Just to put something in the shed?
He will most likely be high tonight, so you can probably shoot a little earlier than +12 from when you shoot a reduced dose.

hmmm...tsk...tsk...isn't shooting early protocol heresy?
Just kidding

I know he's going to be high, but then again who knows (food went in and came up and unless he gets back to his bowl, there are no carbs going in, I've seen this before but) in the likely event that he is high, in goes a dose.

Through all of this the only thing I know for certain at this point is that 2.75 units wil bring him down, no matter how high his PS number is. That's a really handy thing to know.

 

[Miriam and Putty (GA)]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Jay the idea of not feeding and waiting 15 minutes is to see if you have a rising or dropping number. The reason you don't feed is so that you will not get a food spike number when you retest.
You have 3 options when getting a low ps or number you are not comfortable shooting.
1. Stall do not feed. Retest in 15 minutes to see if number is rising. If the number is rising you can shoot full or reduced dose.
2. Give a reduced dose. The reason you give a reduced dose is to put something in the shed.
3. Skip shot.....not recommended unless the other two options are not possible.

You are still basing your shooting on your old insulin. Yes, you know 2.75u will bring him down but that is what you want to happen. These numbers are not too low.
The reason it is better to shoot a reduced dose is so that you don't deplete the shed. The reduced dose is just for that time and then you go back to regular dose on next shot.
I realize you are worried about Frankie going too low but if you skip the shot completely every time you are not comfortable with the number you are going to have higher numbers which is not what you want.

If you havent't read the stickies at the top of the page it really is helpful to read them. It will give you a much better understanding of how Lantus works so it will be more comfortable for you to handle the lower numbers.

 

[D and Noisy]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

I'm loving the number and dislike the confusion.

Now what? To shoot or not to shoot that is the question.

I would have hooted 2.75u. You had the perfect scenario +10 was BG 124, PS was BG 146.

The only thing I know for certain at this point is that 2.75 units will drop him no matter how high his PS readings are.
Not necessarily, typically the lower the numbers get the flatter the curve is.


I do need to know though
A. Wwats the point in not feeding and testing in 15 minutes. Then what? After you get a reading w/o food?
Miriam got that in her post.
Wihtout knowing what the next steps are, waiting 15 minutes, getting a reading seems to be pointless.
No, not pointless.

B. I need to have a curve done at this dose. each time we have tried, either he was very high (fur shot) or I wasnt around to run a curve? Not gonna happen till this weekend. There goes my last weekend of skiing for the season.

You should go skiing, Frankie is fine.


I like what you wrote in ss and above: "Love the number dislike the confusion as we haven't been here before."
I think that is something all of us has felt. This is a good support group -- we help each other get through that feeling.

You got to perfect numbers to shoot today -- you'll get there again and hopefully try it, and see that all is well when you do.


http://www.felinediabetes.com/FDMB/view ... =9&t=10430

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Jay the idea of not feeding and waiting 15 minutes is to see if you have a rising or dropping number. The reason you don't feed is so that you will not get a food spike number when you retest.
You have 3 options when getting a low ps or number you are not comfortable shooting.
1. Stall do not feed. Retest in 15 minutes to see if number is rising. If the number is rising you can shoot full or reduced dose.
2. Give a reduced dose. The reason you give a reduced dose is to put something in the shed.
3. Skip shot.....not recommended unless the other two options are not possible.

You are still basing your shooting on your old insulin. Yes, you know 2.75u will bring him down but that is what you want to happen. These numbers are not too low.
The reason it is better to shoot a reduced dose is so that you don't deplete the shed. The reduced dose is just for that time and then you go back to regular dose on next shot.
I realize you are worried about Frankie going too low but if you skip the shot completely every time you are not comfortable with the number you are going to have higher numbers which is not what you want.


Non diabetic numbers (I have seen with others here are numbers that are safe to dose at)
I'll take the leap of faith at shooting a dose at today's levels when I am around to monitor him (just un case, we all know why) when I see with my own eyes that 2.75 at under 200 won't cause him to tank out, them the next time we get there I can shoot with more and more confidence. Make sense?

As fat as a reduced dose is concened, how much lower by 1 unit, 2 units 1/2 unit. I'm clueless as to little to give.

If you havent't read the stickies at the top of the page it really is helpful to read them. It will give you a much better understanding of how Lantus works so it will be more comfortable for you to handle the lower numbers.

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

I'm loving the number and dislike the confusion.

Now what? To shoot or not to shoot that is the question.

I would have hooted 2.75u. You had the perfect scenario +10 was BG 124, PS was BG 146.

The only thing I know for certain at this point is that 2.75 units will drop him no matter how high his PS readings are.
Not necessarily, typically the lower the numbers get the flatter the curve is.


I do need to know though
A. Wwats the point in not feeding and testing in 15 minutes. Then what? After you get a reading w/o food?
Miriam got that in her post.
Wihtout knowing what the next steps are, waiting 15 minutes, getting a reading seems to be pointless.
No, not pointless.

As always, hind site is 20/20, when ever I tried to be on the side of caution,with Frankie, I blew it. (testing later, revealed to me that whatever I didnt do, was ok to do) Now, I know though and the more time we spend dosing him with his new insulin, the more comfortable I will be. No matter what though, I have always erred on the side of caution to regret it later. When the opportunity arises again, I wont let it pass.

I know we have all been "happy with numbers but confused as to what to next" which is exactly what I was referring to a while back with respect to getting this on "cruise control". Test. feed shoot and go.

B. I need to have a curve done at this dose. each time we have tried, either he was very high (fur shot) or I wasnt around to run a curve? Not gonna happen till this weekend. There goes my last weekend of skiing for the season.

You should go skiing, Frankie is fine.


I like what you wrote in ss and above: "Love the number dislike the confusion as we haven't been here before."
I think that is something all of us has felt. This is a good support group -- we help each other get through that feeling.

You got to perfect numbers to shoot today -- you'll get there again and hopefully try it, and see that all is well when you do.


viewtopic.php?f=9&t=10430

 

[D and Noisy]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Should I be seeing a response to Miriam's and my posts? I see them quoted but not seeing if you wrote something.

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

I'm loving the number and dislike the confusion.

Now what? To shoot or not to shoot that is the question.

I would have hooted 2.75u. You had the perfect scenario +10 was BG 124, PS was BG 146.

The only thing I know for certain at this point is that 2.75 units will drop him no matter how high his PS readings are.
Not necessarily, typically the lower the numbers get the flatter the curve is.


I do need to know though
A. Wwats the point in not feeding and testing in 15 minutes. Then what? After you get a reading w/o food?
Miriam got that in her post.
Wihtout knowing what the next steps are, waiting 15 minutes, getting a reading seems to be pointless.
No, not pointless.

B. I need to have a curve done at this dose. each time we have tried, either he was very high (fur shot) or I wasnt around to run a curve? Not gonna happen till this weekend. There goes my last weekend of skiing for the season.

You should go skiing, Frankie is fine.


I like what you wrote in ss and above: "Love the number dislike the confusion as we haven't been here before."
I think that is something all of us has felt. This is a good support group -- we help each other get through that feeling.

You got to perfect numbers to shoot today -- you'll get there again and hopefully try it, and see that all is well when you do.



As always, hind site is 20/20, when ever I tried to be on the side of caution,with Frankie, I blew it. (testing later, revealed to me that whatever I didnt do, was ok to do) Now, I know though and the more time we spend dosing him with his new insulin, the more comfortable I will be. No matter what though, I have always erred on the side of caution to regret it later. When the opportunity arises again, I wont let it pass.
I know we have all been "happy with numbers but confused as to what to next" which is exactly what I was referring to a while back with respect to getting this on "cruise control". Test. feed shoot and go.
















viewtopic.php?f=9&t=10430

 

[D and Noisy]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

You didn't screw up. Screwing up might be something like never trying it. Being cautious is not screwing up when you are open to trying it later.
I was cautious like that with Noisy, as is tons of peeps. I remember running to "Health" with a BG 70 at +10, or something late in his cycle, thinking Noisy was in trouble. He wasn't and not terribly long later I was shooting 50s.

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Should I be seeing a response to Miriam's and my posts? I see them quoted but not seeing if you wrote something.

Dont you see it?

The posting gets iffy after 2 or 3 quote responses, As I try to reply by using the quote, the page starts jumping all over the place and I'm not sure if what I typed appears, let alone where?

 

[D and Noisy]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Yes, the next time I saw you post I did ssee it.

 

[Dawn & Nova]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Bah you didn't screw up! Those blue numbers are tough PS's to get over.. I'm sure you've done the same thing I did.. read all sorts of stuff that says basically never shoot under 200! Takes a bit for it to sink in that the rule is designed for people that don't test very much.. and that the data you gather really DOES prepare you to shoot under those numbers..

I think I remember at one point posting to either Sienne or Libby (possibly both ) that I thought they were crazy with the advice they were giving me.. I didn't think I was ready for the next step, but they knew I was.. and that's all these fine peoples are telling you today.. not that you screwed up.. but that you are ready to move on to the next phase.. giving you a bit of a nudge .

Next time.. you know you have lots of choices.. you can still error on the side of caution.. but shoot some.. maybe go for 50% or 75% regular dose or something so you can keep your sanity while you are out at work.

As for skiing.. I do think you should go too.. if you want to make up for the guilt.. grab some extra PM tests this week so that you can put your mind at ease while on the slopes.

 

[Marvie and Tugger]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Dang this conversation seems somehow oddly familiar to me :smile:

Jay, you are in excellent hands. They've done wonders for my Tug. I've learned one very important lesson in all of this (I've learned a lot of them but this is the one that applies here) They aren't mistakes honey, they are learning experiences. I've been having learning experiences left and right. So don't beat yourself up, really. There's no point. Just pick up and start over with the help here, then sit back, strap in and hold on. Cuz your kitty is about to take you for a ride. It might be a wild one, it might be a nice Sunday drive in the country, it might go both ways depending on cattitude and situations. But it's a ride, that's for sure.

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

You didn't screw up. Screwing up might be something like never trying it. Being cautious is not screwing up when you are open to trying it later.
I was cautious like that with Noisy, as is tons of peeps. I remember running to "Health" with a BG 70 at +10, or something late in his cycle, thinking Noisy was in trouble. He wasn't and not terribly long later I was shooting 50s.

awwww...what I actually meant was "missing an opportunity" much better way to say it then "srewing up"

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Dang this conversation seems somehow oddly familiar to me :smile:

Jay, you are in excellent hands. They've done wonders for my Tug. I've learned one very important lesson in all of this (I've learned a lot of them but this is the one that applies here) They aren't mistakes honey, they are learning experiences. I've been having learning experiences left and right. So don't beat yourself up, really. There's no point. Just pick up and start over with the help here, then sit back, strap in and hold on. Cuz your kitty is about to take you for a ride. It might be a wild one, it might be a nice Sunday drive in the country, it might go both ways depending on cattitude and situations. But it's a ride, that's for sure.

I sell for a living and get beaten up all day every day, 5 days a week.

When it comes to Frankie and his dosing, I gave up on "beating myself up" about 6 months into the process of learning PZI Vet. I know its about learning. Trial and Error with minimizing the error part as much as we can.

I call the ride you refer to as the "sugar dance". It just goes on and on and on, and before you know it, (actually before I knew it) it was like 5 years later and we are still dancing. More importantly so is Frankie. Hopefully I'll keep dancing for another 5 years or so. That would be great.

Thanks for the words of encouragement.

KEEP ON DANCING

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

Bah you didn't screw up! Those blue numbers are tough PS's to get over.. I'm sure you've done the same thing I did.. read all sorts of stuff that says basically never shoot under 200! Takes a bit for it to sink in that the rule is designed for people that don't test very much.. and that the data you gather really DOES prepare you to shoot under those numbers..

Thats what its about, generating historical data, and once or twice of being not sure, the data if consistant, takes the worrying out of the equations, IE. Cruise Contro, test.feed, shoot and forget

I think I remember at one point posting to either Sienne or Libby (possibly both ) that I thought they were crazy with the advice they were giving me.. I didn't think I was ready for the next step, but they knew I was.. and that's all these fine peoples are telling you today.. not that you screwed up.. but that you are ready to move on to the next phase.. giving you a bit of a nudge .

Next time.. you know you have lots of choices.. you can still error on the side of caution.. but shoot some.. maybe go for 50% or 75% regular dose or something so you can keep your sanity while you are out at work.

As for skiing.. I do think you should go too.. if you want to make up for the guilt.. grab some extra PM tests this week so that you can put your mind at ease while on the slopes.

We can always go "cat skiing"

http://www.mustangpowder.com/whatiscatskiing.htm

http://www.generallyawesome.com/photos/ ... ny-cat-ski

 

[Marvie and Tugger]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

I was having connection issues with the yucky weather we were having and couldn't get Frankie's SS to open so I didn't see how experienced you are, I guess you have had lots of learning experiences! So far, our experience has been much more like a ride than a dance. I really do feel like I'm just along for the ride right now. I kind of hope it slows down and becomes more of a dance soon, I've never been fond of roller coasters or speed and I could use a chance to absorb some of what I've been learning. I hope you get another 5 years of dancing too! We get so close to them when we spend so much time caring for them... Tugger was always our son's cat. From the moment of Tug's birth, the boy claimed him. But I've gotten so close to Tugger during all of this that sometimes I feel like we read each others minds. I want that to last as long as possible =) I've never had this bond with any other animal, not even Boomer and we're pretty tuned into each other.

 

[Jay]

Re: 3.29 Frankie +11 124 +12 146 +13 151???

I called it a dance, Frankie and his BG lead, which is supposed to be my job. Go figure

We all can relate about the bond that develops thru this adversity. I wasnt as close to either Frankie and Chubbs until Frankie was dx'd. I used to pet them, put out the food, give em a quick kiss goodbye and begone. A bit different these days. For sure.

By the way, who's an animal? These guys are just creatures of a different species, who happen to have fur and a tail. Afterall they do communicate with us. How ironic it is though, that we understand them and they pretend (very very selective they are) not to understand what we are talking about.

Go Figure.

Cats Rule.

I was having connection issues with the yucky weather we were having and couldn't get Frankie's SS to open so I didn't see how experienced you are, I guess you have had lots of learning experiences! So far, our experience has been much more like a ride than a dance. I really do feel like I'm just along for the ride right now. I kind of hope it slows down and becomes more of a dance soon, I've never been fond of roller coasters or speed and I could use a chance to absorb some of what I've been learning. I hope you get another 5 years of dancing too! We get so close to them when we spend so much time caring for them... Tugger was always our son's cat. From the moment of Tug's birth, the boy claimed him. But I've gotten so close to Tugger during all of this that sometimes I feel like we read each others minds. I want that to last as long as possible =) I've never had this bond with any other animal, not even Boomer and we're pretty tuned into each other.

 

[Jay]

Eureka,

That must have been one hell of a dose to carry that much duration and the food was all gone when I got home.

Even better, even though he threw up this morning, the bowls were empty when I got home. (need to drain off some of the sauce, so he keeps it down) and it appears that Sophisticat Liver and Chicken was a hit or they just got very very hungry and their collective food strike is over temporarily.

Cats, do they know how to get you to worry. Amazing isnt it.

Gave him his dose at +22.

Now the issue becomes this. If we get to where we were this morning, and me not being aroound all day, do I dose him at under 200. As you may recall he was at 146 this morning for hs AM shot. Or, do I pass again, knowing he'll be okay when I get back from work and shoot lower this weekend when I'm around. Sat seems so far off.

 

[D and Noisy]

+22 BG 260, shed action most likely.

Shed is depleting so you would likely* shoot your 2.75u in the AM if you see blue.

*I use the word "likely" because I don't like saying what someone should do 12 hours from now -- things can change, my likely means yes provided things don't change drastically.

On spreadsheet, I think it might be confusing down the road to have it the way you do now. How about putting the n/s next to the AM BG and then BG 260 2.75u at the PM spot with an asterix, keep note saying +22. Where you have it now we haven't gotten to yet.


Shed:
There's a storage shed/insulin depot under your cat's skin. It has first dibs on the insulin. Once it is filled, the insulin that you shoot doesn't have to go into the shed. It can be used. The shed HAS to be filled before the Lantus or Levemir gets to use the extra on cat's BGs. So by skipping shot, or waiting too long to shoot, or giving a fur shot... the cat starts dipping into it's shed and the next shot or shots have to partially go to refilling shed before they can work on BGs.

When you get impatient and overfill the storage shed by upping the dose too fast, you get into a situation where at first it looks like nothing is happening because the shed is still filling up. Then you reach the point where it is totally full and yet you are still giving a dose that's too high. Now suddenly none is going into shed, because that is full. It is all working on the cat... and the numbers drop out on you.

Worse case scenario is when you over fill the shed/insulin depot... get very low numbers... then empty out shed by dropping dose too much... or having to skip the shot. Then you'll see high numbers from the combo of the effects of rebound and an empty storage shed/insulin depot. Most react by bumping the dose back up which overfills the shed/depot again resulting in a roller coaster ride to nowhere. Not the way to work this insulin.

~ written by jojo and bunny(GA) and Y

 

[Jay]

+22 BG 260, shed action most likely.

Shed is depleting so you would likely* shoot your 2.75u in the AM if you see blue.

Just to claify "shed", its the shed that creates the duration as even though there has been an infusion of exgoenous (external insulin) insulin is being drawn from strorage. Sort of? Right?


*I use the word "likely" because I don't like saying what someone should do 12 hours from now -- things can change, my likely means yes provided things don't change drastically.

Completely understood., I was just attempting to plan ahead. This isnt so much about this dose (right now) but a cycle or two ahead, so that I can be prepared for any eventuality as opposed to coming here and frantically looking for help at 5 AM EST. (as if there arent a whloe lot of folk up at that ungodly hour


On spreadsheet, I think it might be confusing down the road to have it the way you do now. How about putting the n/s next to the AM BG and then BG 260 2.75u at the PM spot with an asterix, keep note saying +22. Where you have it now we haven't gotten to yet.

Ahhh..I get it. Was a bit confusing at first.


Shed:
There's a storage shed/insulin depot under your cat's skin. It has first dibs on the insulin. Once it is filled, the insulin that you shoot doesn't have to go into the shed. It can be used. The shed HAS to be filled before the Lantus or Levemir gets to use the extra on cat's BGs. So by skipping shot, or waiting too long to shoot, or giving a fur shot... the cat starts dipping into it's shed and the next shot or shots have to partially go to refilling shed before they can work on BGs.

"got it"

When you get impatient and overfill the storage shed by upping the dose too fast, you get into a situation where at first it looks like nothing is happening because the shed is still filling up. Then you reach the point where it is totally full and yet you are still giving a dose that's too high. Now suddenly none is going into shed, because that is full. It is all working on the cat... and the numbers drop out on you.

Worse case scenario is when you over fill the shed/insulin depot... get very low numbers... then empty out shed by dropping dose too much... or having to skip the shot. Then you'll see high numbers from the combo of the effects of rebound and an empty storage shed/insulin depot. Most react by bumping the dose back up which overfills the shed/depot again resulting in a roller coaster ride to nowhere. Not the way to work this insulin.

Handling Rebound with PZI Vet was exactly the same, I would drop the dose if I suspected there was a rebound at play.

~ written by jojo and bunny(GA) and Y