6/25 Mazi AMPS 197, +2 168 +4.5 85 +5.5 100 +6.5 103 PMPS 117 +1 132 +2 119 +3 115

Mazi's Mom

Mazi's Mom

Active Member
https://felinediabetes.com/FDMB/thr...shot-4-200-8-110-pmps-95.291172/#post-3187028

Morning! Mazi & I have been missing in action over the past couple weeks.

I graduated nursing school in December & earned my WI state license in March about 2 weeks before Mazi was diagnosed with DKA, DM, & then 12 hours after bringing him home a severe episode of Hypoglycemia. Needless to say, I was traumatized & terrified to leave him home alone until he was regulated, on a safe dose, and till the boyfriend & I had a good regimen down to keep him safe while gone at work. So I stalled on my job search.

Fast forward to now & I just got offered a RN position on my dream unit, Cardiac and Neurology. I'll be working 12.5 hr days 7:00 am till 7:30pm, luckily the hospital is close to home & just a 12 min ride. I start on 7/15/24.

Mazi and I have come a long way since we joined the group thanks to @Wendy&Neko and @Diane Tyler's Mom for holding my hand thru this journey. And I am forever grateful.

We have gotten Mazi regulated, on a safe dose (range), and have developed a game plan that I can now feel safe leaving Mazi home alone so I can start my new career.

However, since our short absence, Mazi was on 0.5U of Lantus & he developed this new pattern where he likes to take a steep drop from his preshot to about +3, & because of that Wendy and I thought he possibly could be bouncing, as evidence by him hitting a green nadir and then right after the green nadir increasing back up to blues right after, instead of surfing in greens most of the day, as he used to do. Plus a cycle or 2 where he was having a bounce clearing cycle.

I've tried giving LC snacks at +1/2 to slow the drop, didn't work. Then I tried MC, wasn't really working. Plus I was conflicted on when to give the snacks, bc some days his insulin wouldn't kick in till +2/2.5, and other days it would seem to kick in immediately and by +2, he dropped by 80 points already.

I made the decision to try lowering his dose to 0.25U (against the TR rules) a few days ago to try to see if could see a difference in onset & how steep he drops. Its a little too soon to make any judgements. However, what I have noticed thus far, is his drops have only been 40 some points or less, he hits a green nadir, but goes back up to blue soon after just like on the 0.5U dose. Preshots have been in the upper 100s on both 0.5 & 0.25U doses.


Yesterday I did a curve. It was the first day in a few weeks that I was able to give him a full day of checks.

For the past 2 months I haven't been able to get him on a consistent dose. It seems to me his sweet spot is somewhere between 0.1U to 0.5U. He is regulated, and stays in safe numbers which I am thankful for.

At this point, I dont know if he needs an increase, decrease, or what? But I'm willing to wear my patience pants and really buckle down & figure this out.

My goal is to get him on a consistent dose that works for him by the time I go to work. That way maybe ill be able to identify some consistent patterns with that set dose, and hopefully predict his cycles better, which in turn will help me better plan for my days at work and feel better leaving him alone.

My schedule is pretty open now till July 15th, where I can really work on finding a good dose for Mazi and can really put in the time doing lots of testing and curves.

@Wendy&Neko im in need of your expert guidance!
 
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Congrats on getting the new job exactly where you want to be too. :joyful::joyful:

You've only been on this dose for 2 days. We hold doses that see green for 10 cycles, though yesterday's green could still have been from the 0.5 unit depot. Even then, a 98 means you have room for an increase. In truth, the 0.5 wasn't enough either. You'd like his nadirs to ideally be in the 50-80 range on the Relion. Which they weren't consistently on 0.5 units either.

Remind me, what is the latest in the cycle that he is getting food? I want to double check that he's not just losing duration - which causes higher preshots and those possible resulting dives. What does "snack" consist of that you feed when he hits green?
 
Hi @Wendy&Neko!

I know I prolly shouldn't have decreased, now im lost..Thats what I get for thinking after only 3 months into this journey, that I have the slightest clue on how to analyze his SS and to make a good judgment on when to increase or decrease his dose. Lol, I have been humbled by this journey.

The latest in his cycle that he recieves a snack is +6. I make sure not to feed him after that bc I know the concentration of insulin in his blood is starting to wear off from +6 to +12. Except on 5/28 and 6/4, he recieved a snack at +8, I have no idea why I did that. More than likely I was rewarding him with a cheat day due to his good numbers.

All his AM snacks have been LC up untill 6/18.

All his PM snacks are LC, unless im being cautious due to a low preshot, steep drop, or a reading in the 70s or 80s near nadir.

His AM snack times are anywhere from +3 to +6, but mostly +3, 4, & 5. And his PM snack times are always +3/+4, unless im up till +5, rarely.

Recently, his SS will show that he was getting snacks at +1,2, or 3 due to me trying to slow down his steep drops on onset, which I struggled with bc they would occur at different times and I was having a hard time catching them.

His snack size is a 1/4 of pate from a 5.5oz can. It roughly comes out to be able 1.5 tablespoons to 2 tablespoons of pate for a snack. If I give a second snack its only 2 teaspoons.

His Meals are 1/2 can of LC Friskies pate and that has been consistent for 2.5 months. He recieves the variety pack and the carbs range from 3 to 6% carbs.

Hope that helps!
 
Food experiments can take a couple weeks, so a couple days worth of data might not be enough to see if a strategy is working. I only see one cycle of an MC experiment. I'd also try consistent snack times for a while, and see if that helps.

I'm not seeing a lot of data where you test then give an LC snack, then test again an hour or two later, to give you an idea what the LC snack did for him. Ideally you'd get to the point where you could say - if I give him LC at this point of the cycle, he will (pick one of stay flat/bump up x points/slow the drop). Same with MC and even HC. Think of feline diabetes as at Etch a Sketch (maybe dating myself?). You have one control knob that is the insulin dose, and the other is food both quantity and carbs.
 
Ok, so more consistent checks at +1 and +2 and when I give a snack make sure to recheck an hour or two later to see how the snack affected his numbers.

To start, ill go back to what I usually did and just give LC and if I'm not seeing the LC slowing his drops over a period of 2 days, ill then try MC, and if that doesn't help ill try HC. I will keep the test times and the amount of snack size consistent, and only experiment with the carbs.

Now what are your thoughts on going back up to 0.5U?

Im kicking myself in the butt for lowering his dose, my intention was I thought maybe that would help with his drops, I know silly me. Insulin is going to do what it wants to do, and the only way to fight against it is snacks with carbs. Now his preshots are higher and nadirs are higher.

Do you think it is safe to boost him back to his 0.5U?

If he's going to end up needing an increase, I'd rather do it now or soon while I'm home to monitor all day. Plus, with the possibility of him maybe needing an increase after a minimum of 5 days (10 cycles) of 0.5U to 0.75U (since his nadirs weren't that great at 0.5U from 6/9 to 6/22), I ideally would like to make those changes between now and 7/15 before I start work, since now im home to monitor closely. Mazi hasn't been on a dose higher than 0.5U since April 11th and I have no idea what to expect from a 0.75U dose.
However if you don't think its safe, I can wait. I definitely don't want to compromise Mazi's safety.

Thanks wendy!!!!
 
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