4/22/11 jack

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Darlene & Jack

Darlene & Jack

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So looking for dosage advice. Jack's numbers are creeping back up...well, except for this afternoon where it went through the roof. Today:

376 @ AMPS
286 @ +3
199 @ +6
561 @ PMPS

I just gave the 0.6 un, but wondering if I need to go up again based on the last few days? yesterday looked pretty good, so I thought we going in a good direction. I thought maybe I should stick with 0.6 for another day to see what happens? but I'm not sure. can you folks look at his spreadsheet and let me know what you think? Thanks so much!
 
Hi Darlene,

I would try 0.7 or 0.8. You haven't seen a low blue or a green in a few days, as you said it looks like he is creeping up. Generally I would say if the nadirs are above 120 (so in diabetic #s) there's usually room to increase the dose a hair. (Does NOT apply for those kitties getting overly steep curves!)
 
Darlene, I have to tell you, everytime I see Jack’s pic he looks so soft and I just want to pet him and give him a squeeze. Do that for me, will you? :smile:

Good luck on the dose increase. Hopefully this will bring things back in line for ya.
 
Awww, thanks Donna. He is very soft and so squishy to hug! Will give him a squeeze for you, he will appreciate that. :-)

Joanna, thanks for the advice on the dose, I was figuring I probably need to increase a bit. Will try that in the morning.

Just checked him at +3 and he came down to 235 from the 561 on the .6 dosage.
 
Thanks, not quite sure what to do with him at this point! Numbers were pretty good this morning. just checked a +9 to see if he was rising a lot and got 443. This is such a roller coaster!
 
Hmmm that looks awfully much like rebound, but I don't see any cause for rebound, and I don't think he is in liver training. Anything out of the ordinary today that might explain it? Got into the dry food? Something really stressful?

In the absense of anything else to explain it I would say it's a sign the dose is too high. I don't see that in the numbers, but that would be the baseline explanation I think in this case for rebound. Maybe he is extra sensitive to drops (although it doesn't look steep to me, but could be an unseen drop between the +3 & +6?).

Maybe try 0.7? Let's see what others think.
 
No dry food out at all, all the cats are on wet food now. Nothing else he could have gotten into, no snacks or treats. Nothing stressful, he's just been relaxing and playing this morning. Napping this afternoon. A very nice day for him.
I'll be home tonight so i will try to check more frequently after his shot tonight to see what his numbers do and if he is dropping in between the +3 and +6.
 
ok, today is a complete anomaly. did i see she went up and then came down by herself? hmmmm.
i have a question for you...what meter are you using? does it require coding?
when the number is lower at the end of the cycle than somewhere in between it is a good idea to wait 15 or 20 minutes and retest. we don't want to shoot a dropping number kwim?
that, shall we call it the red night, was just maybe an anomaly too.
 
I am using the ReliOn meter, codes automatically with the strips. I just double checked it and it matches up. It was just checked against the vets machine last week and gave the same reading.

Yes, he did go up at +9 and then was lower at the PMPS, which totally confused me. So you are saying that since the PMPS was lower than that +9, I should have rechecked and waited to see what happened? What if I rechecked it and it was lower again? Just trying to figure these things out so i know what I am doing here!
 
well yes, i don't think it's a good idea to shoot a falling number. i'd rather skip a shot than shoot a dropping number. you never know how far the pancrease will take it....and it is unusual to have a dropping number at that time so you would want to pay attention to it. will you be getting a number tonight?
 
Yes, i will check him a few more times tonight to see what his numbers are doing. So back to the PMPS reading, if he was still dropping, and I rechecked a few times, then he started rising, I would shoot at that time? What if it was a few hours later? Then do you get on schedule and give the AM dose at the usual time?

Any ideas on dosage? .6 vs .8?
 
So just fyi, that is the classic rebound pattern - shooting to a high at +9 or so and then dropping back down to a lower +12 (next PS). Normally with PZI you never shoot a falling number b/c you want to be sure you are past nadir, otherwise if the #s are still coming down and the next shot kicks in, you can get a double nadir so to speak, and could get unexpected lows. It's more of a concern with early shooting than with shooting at +12, since most of the time they are past nadir by +12 and the insulin in most cases will have worn off by the time the next shot kicks in. Still better to have a rising # of course, but I wouldn't worry about it too much in this case since the #s are so high, and I think the falling # is due to rebound wearing off rather than to an actual nadir from the insulin.

You might want to add a +9 spot test every few days to your repetoire - maybe get your +3 one day, and a +9 the next, mix it up a little that way, now that you have seen this pattern. There's no way to know for the past few days if you have been seeing this every cycle or not. Sorry not to have thought to have that checked before suggesting a dose increase :oops: . I'm really glad you were able to get that today, so now you know. If for instance, that was part of the pattern on the 0.6 the past few days, then I would say the 0.6 might be too high a dose. For now I would probably stick with the dose you are on (barring lows that require a dose decrease), and try to get a +9 spot test in the next day or two. If that pattern is continuing, I'd back down further on the dose (assuming ketone tests are negative).
 
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