6/13 Samba PMPS 350 +2.5 287 +3 288 +4 267

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Sarah Mc

Member Since 2017
http://www.felinediabetes.com/FDMB/...81-5-5-76-6-5-73-7-5-64-8-5-85-11-110.179166/

I had to bring Samba to work with me today because I was too worried about leaving him home alone with his numbers the way that they are... he is refusing to eat his LC food here. It's not needed yet, but I am hoping he would respond differently to MC food since he seems to like it better. Worst case scenario, I have honey with me, which I have never given him before. I will try to test him as frequently as I can here. I do crisis work and am on call for the Police. Some days are busier than others. If the Police call me for an emergency though, I will have to go, so I am hoping that he does all right today.
 
Wow..Samba!!!!:cool::cool::cool: Exciting but you need to eat!!!!

I'm glad you could take him with you. The stress of a new place might keep him from wanting to eat but if his numbers drop much, it should entice him to eat.....hopefully. Smart move taking the syrup.

Paws crossed he will just have a great surf and it will be quiet there today. Thanks for posting.....I saw his SS first thing and wondered what you did.
 
Wow..Samba!!!!:cool::cool::cool: Exciting but you need to eat!!!!

I'm glad you could take him with you. The stress of a new place might keep him from wanting to eat but if his numbers drop much, it should entice him to eat.....hopefully. Smart move taking the syrup.

Paws crossed he will just have a great surf and it will be quiet there today. Thanks for posting.....I saw his SS first thing and wondered what you did.
I just ran to the store to grab his favorite flavor (fish & shrimp feast), which I believe has 0% carbs, and he ate a teeny tiny bit of it, so that's progress :) this is the 3rd time I've brought him to work, and he has refused to eat every time. Happy to know that lower numbers might spark his appetite...that's a relief! Thanks so much for checking on us.
 
It's great that LC food is giving him this flatter curve.

As you can see, when they start flatter, they have less drop. Less drop means less bounce. This is looking like a great dose for him right now.
 
Awww....you're welcome and thanks for the thanks!
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He's definitely looking better. There have been cats that have made some remarkable progress just with a change in feeding strategy. Let's hope that, long term, he is one of them.
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Awww....you're welcome and thanks for the thanks! View attachment 29007View attachment 29007View attachment 29007View attachment 29007

He's definitely looking better. There have been cats that have made some remarkable progress just with a change in feeding strategy. Let's hope that, long term, he is one of them. View attachment 29008
He's down to 58 now. He dropped 22 points in the last hour. I will try a teaspoon of LC unless you think I should do something different. He might not eat it.
 
He's getting past midcycle. Did he eat or is he holding steady without food?

ETA: I saw he is coming up with the 0% with a bit of his regular food. Not a bad day with 0% carbs.
 
He's getting past midcycle. Did he eat or is he holding steady without food?

ETA: I saw he is coming up with the 0% with a bit of his regular food. Not a bad day with 0% carbs.
Yeah it was honestly the tiniest bit...I hope that was okay. I got nervous when I saw the 58. Would you have held out on feeding? He likes that 0% flaked fish & shrimp feast better than his regular food, but I save it for days like this since I read they shouldn't be getting mercury every day(?)
 
His BG was 62 at +9, so I wonder if the 65/69 were a little bit of a food spike. Headed home with home now, hopefully in time for a +10
 
Yeah it was honestly the tiniest bit...I hope that was okay. I got nervous when I saw the 58. Would you have held out on feeding? He likes that 0% flaked fish & shrimp feast better than his regular food, but I save it for days like this since I read they shouldn't be getting mercury every day(?)
Probably not....I would have fed. You've got stuff going on tonight and you don't need him hanging out around 50.

What a great day he had! Looks like he might let you go out tonight (paws crossed). It will be interesting to see if he gets a second dip.
 
Probably not....I would have fed. You've got stuff going on tonight and you don't need him hanging out around 50.

What a great day he had! Looks like he might let you go out tonight (paws crossed). It will be interesting to see if he gets a second dip.
PMPS 350 :eek:
I will be back for +2
 
Sarah

You are likely gone but I'll post this now as your +2 will probably be while we are walking.

He went up so fast at the end of the cycle because he lost duration. There could definitely be some bounce in that but when I see it go up that fast, it looks like a duration issue. Which means that if it's not a bounce, he could come back down tonight. No way to know until he gets there.

But I wanted you to be aware that it's a possibility.

Have fun!!!!
 
Sarah

You are likely gone but I'll post this now as your +2 will probably be while we are walking.

He went up so fast at the end of the cycle because he lost duration. There could definitely be some bounce in that but when I see it go up that fast, it looks like a duration issue. Which means that if it's not a bounce, he could come back down tonight. No way to know until he gets there.

But I wanted you to be aware that it's a possibility.

Have fun!!!!

Looks like Samba has reached the magic dose! Go Samba!

What is the fix for a "duration issue"?
 
Sarah

You are likely gone but I'll post this now as your +2 will probably be while we are walking.

He went up so fast at the end of the cycle because he lost duration. There could definitely be some bounce in that but when I see it go up that fast, it looks like a duration issue. Which means that if it's not a bounce, he could come back down tonight. No way to know until he gets there.

But I wanted you to be aware that it's a possibility.

Have fun!!!!
Thanks for this info. I have the same question...what can be done so that he doesn't lose duration before the 12 hours is up? You know so much about this!! I feel like I have already learned so much from you; thank you. I hope that you've enjoyed your night
 
Thanks for this info. I have the same question...what can be done so that he doesn't lose duration before the 12 hours is up? You know so much about this!! I feel like I have already learned so much from you; thank you. I hope that you've enjoyed your night
Thank you...excellent teachers, esp my Gracie
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And @MJW
Duration can be affected by several things: dose, absorption, food, the way the insulin was injected, where it was injected, etc.

Obviously, some things can be controlled like finding the right dose, not feeding too many carbs, perfecting injection technique. But absorption can vary up to 50% from one shot to the next at the same dose.

Having said all that, I'm not really sure why he lost duration today. The dose looks good, he didn't get anything but LC. But, I would suggest you not focus on an isolated cycle here or there where he might lose duration.

Insulin is a hormone so it doesn't act like a medication would. Therefore, we can get unpredictable results sometimes.

We typically recommend if you get a number that seems unexpected, either high or low, that you're retest to be sure. I just wanted to be sure it was really that high since you were going out.


 
Thank you...excellent teachers, esp my Gracie View attachment 29017View attachment 29017View attachment 29017

And @MJW
Duration can be affected by several things: dose, absorption, food, the way the insulin was injected, where it was injected, etc.

Obviously, some things can be controlled like finding the right dose, not feeding too many carbs, perfecting injection technique. But absorption can vary up to 50% from one shot to the next at the same dose.

Having said all that, I'm not really sure why he lost duration today. The dose looks good, he didn't get anything but LC. But, I would suggest you not focus on an isolated cycle here or there where he might lose duration.

Insulin is a hormone so it doesn't act like a medication would. Therefore, we can get unpredictable results sometimes.

We typically recommend if you get a number that seems unexpected, either high or low, that you're retest to be sure. I just wanted to be sure it was really that high since you were going out.
Thanks for this info. When I try to switch up the location of his injection and shoot somewhere other than his scruff, he might handle that okay 1-2 times, but then he starts getting aggressive with me, and if I even pinch the skin on his body, he starts growling, tries to bite me, etc. There was one day back in March that I had to skip his shot because he was really mad at me, and I realize now that part of it might have been because I had started trying to shoot in other areas on his body than his scruff. Explaining this because I believe I shot the side of his chest on Monday evening before he had that good cycle. Then, yesterday morning, I tried to do that area again, and he got a bit upset, so I shot the scruff. Then, last night, I tried to do a different area than the scruff, and he got really combative (like reminiscent of the day in March-I had to take a break and let him calm down), so this morning, I just did the scruff to avoid trouble. I've noticed when I stick the scruff, the needle sometimes goes in effortlessly, but other times, it feels like it might be tearing the skin-hard to explain but not as smooth. I wonder if that is scar tissue? I try to not shoot the exact same place every time, but the vast majority of his injections have gone there, so I do think that my shooting technique is in need of improvement. I wonder if times that his curves were good were after I shot his belly, flank or side of the chest instead of the scruff? I will start keeping track of where I shoot and welcome any other suggestions..thanks again for everything. I'll start a new condo for today now.
 
I shoot Yum right when I put her food plate down. She sometimes tries to move away from me, but she doesn't get very far because she never brings her mouth up from the food.
Do you shoot Samba while he is eating?
Sometimes I feel the needle break the skin, sometimes I don't. I don't know if that depends on the angle I get the bezel going in or not. I used to recap the syringe after I filled it, often hitting the needle against the cap. After I saw pictures of the deterioration of bezels just due to repeat use, I no longer recap the syringe---the bezel is very easily damaged.

I know you read my recent thread re shooting location and cycle numbers. I had a theory that the difference in her AM and PM curves was due to my rotation of shot location. At first the data supported my theory, but then it did not. I haven't gone back to shooting her flank in the PM, but I might in the future.
 
Thank you...excellent teachers, esp my Gracie View attachment 29017View attachment 29017View attachment 29017

And @MJW
Duration can be affected by several things: dose, absorption, food, the way the insulin was injected, where it was injected, etc.
It takes me a long time to try and understand all these things. After reading your excellent "duration issue" notes here, I also found an @Wendy&Neko post where she says feeding after nadir can shorten the duration. I am trying to get rid of Yum's high AMPS numbers. If they are a "duration issue", I shouldn't feed her after PMPS+6, assuming that is her nadir. Other people advocate feeding every 3 hours 24/7, to gently stimulate the pancreas. And for kitties nearing remission, people advise a PMPS+9 snack---why is that? Several conflicting strategies. Confusing.
 
Thanks for this info. When I try to switch up the location of his injection and shoot somewhere other than his scruff, he might handle that okay 1-2 times, but then he starts getting aggressive with me, and if I even pinch the skin on his body, he starts growling, tries to bite me, etc. There was one day back in March that I had to skip his shot because he was really mad at me, and I realize now that part of it might have been because I had started trying to shoot in other areas on his body than his scruff. Explaining this because I believe I shot the side of his chest on Monday evening before he had that good cycle. Then, yesterday morning, I tried to do that area again, and he got a bit upset, so I shot the scruff. Then, last night, I tried to do a different area than the scruff, and he got really combative (like reminiscent of the day in March-I had to take a break and let him calm down), so this morning, I just did the scruff to avoid trouble. I've noticed when I stick the scruff, the needle sometimes goes in effortlessly, but other times, it feels like it might be tearing the skin-hard to explain but not as smooth. I wonder if that is scar tissue? I try to not shoot the exact same place every time, but the vast majority of his injections have gone there, so I do think that my shooting technique is in need of improvement. I wonder if times that his curves were good were after I shot his belly, flank or side of the chest instead of the scruff? I will start keeping track of where I shoot and welcome any other suggestions..thanks again for everything. I'll start a new condo for today now.
Have you read my post on Testing and Shooting Tips? There might be something in there that will help you with your shooting technique. It's really important that the bevel is up. I preferred the roll method instead of the tent method.

If you look on Gracie's SS, you'll see I rotated shot sites and kept track of them (see Units column). Some cats will only allow scruff shots and if he's one, just try to rotate around the scruff as much as you can. Think of a box around his shoulders and make a pattern that you keep. For example, left top, left bottom, right top, right bottom.

If you think the syringes are not sharp enough, you might also think about changing syringes. I wasn't crazy about the Walmart syringes but a lot of people use them.

PS. Thanks for all those AT2 vs human meter numbers on your spreadsheet.
If you look on Gracie's SS, you will see a tab where I also kept comparisons of AT/Micro numbers, if you are interested. It's important to note that one cannot extrapolate my data to other meters. This comparison was valid for the two meters I was using and that's it. The value of the data is that it shows the difference between the two is not always the same.

It takes me a long time to try and understand all these things. After reading your excellent "duration issue" notes here, I also found an @Wendy&Neko post where she says feeding after nadir can shorten the duration. I am trying to get rid of Yum's high AMPS numbers. If they are a "duration issue", I shouldn't feed her after PMPS+6, assuming that is her nadir. Other people advocate feeding every 3 hours 24/7, to gently stimulate the pancreas. And for kitties nearing remission, people advise a PMPS+9 snack---why is that? Several conflicting strategies. Confusing.
I also posted on one of your condos and suggested you stop feeding at +9 as that is a technique just used for cats about to go into remission and whose pancreas is already working. It takes about three or so hours for the endogenous insulin produced by the pancreas to bring down the BG. By feeding a +9 snack to a kitty where the pancreas is working, then the PS is lower. Because the AMPS is often the last number to come down as a kitty progresses towards remission, feeding at +9 can help that issue.

When the beta cells of the pancreas are damaged or destroyed, they cannot produce insulin. You can feed a cat every three hours and if the beta cells aren't working, it isn't going to stimulate them. What allows the pancreas and the beta cells to heal is time spent in normal numbers. Even as the healing starts, the beta cells are still fragile and can be easily damaged.

For nondiabetic cats (and humans), small meals throughout the day is a good thing for the pancreas because it's much easier for it to regulate the BG with smaller meals than with a huge meal. If you took your BG immediately after eating an enormous meal, you might find it is higher than usual so that is more work for the pancreas to do to bring it back down. After a while (sometimes a very long while, sometimes not) if large, high carb meals continue, it stresses the pancreas to the point where diabetes develops.

In a diabetic cat that is not near remission and whose pancreas is not working, it's the exogenous insulin that is dropping the numbers. With Lantus, after the peak action of the insulin (nadir), the effects of the insulin start to wane. More carbs use more of the insulin and so it can impact duration.

Think of it like your car approaching a stop sign. If you are 100 feet away from the stop sign and you slam on the brakes, you aren't going to make it to the stop sign but if you take your foot off the accelerator, you'll glide to the stop sign.

On active cycles and especially bounce clearing cycles, we sometimes have to feed after mid cycle to keep the numbers from dropping. Because you want to minimize the impact on duration, it can be wise to just use LC food and see if that will keep the numbers up if feeding is absolutely necessary.

I will admit that one of the mistakes we made with Gracie early on is we didn't let her liver learn to surf the greens. We were afraid she would drop and so we would feed more, albeit LC, than we probably needed to. In hindsight, for her, it would have been better if I had pulled the food after mid cycle and when she had flattened out and stopped dropping so her liver learned to surf. It can be a :nailbiting: thing to do especially with a cat, like Gracie, who thought nothing of dropping into the 20s out of nowhere. Thankfully, we were testaholics :rolleyes:

Does that help with the confusion? A peer review forum is excellent so you get lots of opinions but sometimes those opinions are urban legends....like feeding a +9 snack to cat that is nowhere near remission. It won't help.
 
If you look on Gracie's SS, you will see a tab where I also kept comparisons of AT/Micro numbers, if you are interested. It's important to note that one cannot extrapolate my data to other meters. This comparison was valid for the two meters I was using and that's it. The value of the data is that it shows the difference between the two is not always the same.

@Eric Minor you recently asked about AlphaTrak vs Human meter numbers. I just found today that @Marje and Gracie has a large number of past comparisons on Gracie's spreadsheet. @Sarah Mc also has many recent comparisons on Samba's spreadsheet. I find them very useful, even though they do not support accurate conversions.
 
I shoot Yum right when I put her food plate down. She sometimes tries to move away from me, but she doesn't get very far because she never brings her mouth up from the food.
Do you shoot Samba while he is eating?
Sometimes I feel the needle break the skin, sometimes I don't. I don't know if that depends on the angle I get the bezel going in or not. I used to recap the syringe after I filled it, often hitting the needle against the cap. After I saw pictures of the deterioration of bezels just due to repeat use, I no longer recap the syringe---the bezel is very easily damaged.

I know you read my recent thread re shooting location and cycle numbers. I had a theory that the difference in her AM and PM curves was due to my rotation of shot location. At first the data supported my theory, but then it did not. I haven't gone back to shooting her flank in the PM, but I might in the future.
Yes, I always shoot right after laying down the food and agree with you that it is really the only way! Haha. Even so, he gets a little fussy sometimes and gives this quiet little growl when I pinch his skin even before sticking the needle in like he knows what's coming. Things had improved tremendously due to a few minor improvements, but he got fussy again just yesterday. Poor boy is probably sick of how much I've been poking him...he's been a very good sport.

I was previously capping the needle after drawing the insulin and actually sticking it under my arm like a thermometer to warm it, one of the "improvements" that I made after the incident in March. I didn't even think that it might damage the bevel! I did not cap it tonight, so thank you so much for that suggestion, and hopefully it helps...I've seen with this and other things in life that little changes can really lead to big changes, so here's hoping :)
 
Have you read my post on Testing and Shooting Tips? There might be something in there that will help you with your shooting technique. It's really important that the bevel is up. I preferred the roll method instead of the tent method.

If you look on Gracie's SS, you'll see I rotated shot sites and kept track of them (see Units column). Some cats will only allow scruff shots and if he's one, just try to rotate around the scruff as much as you can. Think of a box around his shoulders and make a pattern that you keep. For example, left top, left bottom, right top, right bottom.

If you think the syringes are not sharp enough, you might also think about changing syringes. I wasn't crazy about the Walmart syringes but a lot of people use them.


If you look on Gracie's SS, you will see a tab where I also kept comparisons of AT/Micro numbers, if you are interested. It's important to note that one cannot extrapolate my data to other meters. This comparison was valid for the two meters I was using and that's it. The value of the data is that it shows the difference between the two is not always the same.


I also posted on one of your condos and suggested you stop feeding at +9 as that is a technique just used for cats about to go into remission and whose pancreas is already working. It takes about three or so hours for the endogenous insulin produced by the pancreas to bring down the BG. By feeding a +9 snack to a kitty where the pancreas is working, then the PS is lower. Because the AMPS is often the last number to come down as a kitty progresses towards remission, feeding at +9 can help that issue.

When the beta cells of the pancreas are damaged or destroyed, they cannot produce insulin. You can feed a cat every three hours and if the beta cells aren't working, it isn't going to stimulate them. What allows the pancreas and the beta cells to heal is time spent in normal numbers. Even as the healing starts, the beta cells are still fragile and can be easily damaged.

For nondiabetic cats (and humans), small meals throughout the day is a good thing for the pancreas because it's much easier for it to regulate the BG with smaller meals than with a huge meal. If you took your BG immediately after eating an enormous meal, you might find it is higher than usual so that is more work for the pancreas to do to bring it back down. After a while (sometimes a very long while, sometimes not) if large, high carb meals continue, it stresses the pancreas to the point where diabetes develops.

In a diabetic cat that is not near remission and whose pancreas is not working, it's the exogenous insulin that is dropping the numbers. With Lantus, after the peak action of the insulin (nadir), the effects of the insulin start to wane. More carbs use more of the insulin and so it can impact duration.

Think of it like your car approaching a stop sign. If you are 100 feet away from the stop sign and you slam on the brakes, you aren't going to make it to the stop sign but if you take your foot off the accelerator, you'll glide to the stop sign.

On active cycles and especially bounce clearing cycles, we sometimes have to feed after mid cycle to keep the numbers from dropping. Because you want to minimize the impact on duration, it can be wise to just use LC food and see if that will keep the numbers up if feeding is absolutely necessary.

I will admit that one of the mistakes we made with Gracie early on is we didn't let her liver learn to surf the greens. We were afraid she would drop and so we would feed more, albeit LC, than we probably needed to. In hindsight, for her, it would have been better if I had pulled the food after mid cycle and when she had flattened out and stopped dropping so her liver learned to surf. It can be a :nailbiting: thing to do especially with a cat, like Gracie, who thought nothing of dropping into the 20s out of nowhere. Thankfully, we were testaholics :rolleyes:

Does that help with the confusion? A peer review forum is excellent so you get lots of opinions but sometimes those opinions are urban legends....like feeding a +9 snack to cat that is nowhere near remission. It won't help.
Thank you for this incredibly helpful info!! I reread the shooting tips you posted and will try rolling his skin and see if that works out. Which syringe brand is the best in your opinion, Terumo? Your description of rotating around the scruff was also really helpful.
 
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