6/8/18 New Question/Answered- Dose (jaxa)

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Kris & Teasel said:
Hard decision to make without quite a bit of daytime data.
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Unfortunately I don't know how that will change any time soon as long as I am working. The times I do get day time tests it always seems to be pretty flat, though it was interesting to see her +8 lower than the +6 this last weekend. I worry that she is getting too low during the day, or that her bg continues to drop in the afternoon because she eats primarily at shot time and then not again until pm shot time. Her biggest food time is the evening when she eats almost once every other hour until 11pm, once again around 2am, and then food is usually up 2-3 hours before AMPS depending on when I wake in the middle of the night. I know she is eating enough over all, but her pattern is uneven.
 
Glassgoblin said:
Unfortunately I don't know how that will change any time soon as long as I am working. The times I do get day time tests it always seems to be pretty flat, though it was interesting to see her +8 lower than the +6 this last weekend. I worry that she is getting too low during the day, or that her bg continues to drop in the afternoon because she eats primarily at shot time and then not again until pm shot time. Her biggest food time is the evening when she eats almost once every other hour until 11pm, once again around 2am, and then food is usually up 2-3 hours before AMPS depending on when I wake in the middle of the night. I know she is eating enough over all, but her pattern is uneven.
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I didn’t mean to sound critical. I know it’s hard when you’re away at work all day.
 
Kris & Teasel said:
I didn’t mean to sound critical. I know it’s hard when you’re away at work all day.
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I don't think I was taking it that way- I'm more critical of myself than anyone else seems to be. After going through the pancreatitis when I had to watch her calories like a hawk, it feels like I should be able to do more for this too. All the guessing goes against my comfort zone; I like things to be stable and routine and every day is different. Jaxa doesn't care as long as she gets fed.
 
Glassgoblin said:
I don't think I was taking it that way- I'm more critical of myself than anyone else seems to be. After going through the pancreatitis when I had to watch her calories like a hawk, it feels like I should be able to do more for this too. All the guessing goes against my comfort zone; I like things to be stable and routine and every day is different. Jaxa doesn't care as long as she gets fed.
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I totally get that! I crave stability and routine too. Teasel sure won't let me have it though ... ;)
 
Glassgoblin said:
All the guessing goes against my comfort zone; I like things to be stable and routine and every day is different.
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This made me smile. :D Ah, wouldn't it be nice if things were 'stable and routine'. Not gonna happen! I was just telling someone yesterday that this is just so 'dynamic'. Every time there are a few days where things look great and consistent.. BAM.. there is a crazy drop or confusing high numbers.
 
Djamila said:
Why don't you lower the daytime dose down to 4u and see if that gives you PM number you're more comfortable with?
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I might try that tomorrow. We did our normal shot this morning because she was close to 300, and she is at 204 for our PMPS so I gave another "normal" shot at 4.25u- we've been kinda doing a fat 4.25/4.33 for some of the shots lately, and I've given it at that number for the AMPS. Will test later and see how she is doing- she just ate a bunch of Orijen regional and tundra treats (she is getting as enthusiastic about those as she has always been for the high carb treats) with her usual dinner.

Next week it might be time for another bottle of insulin- we are not too low but I want the back-up since I've almost forgotten it out twice now, and only just barely caught myself.
 
As long as you can give the regular dose, that's ideal. Eventually you'll be shooting on lower numbers and it won't be so scary. My suggestion to lower to 4u was for your peace of mind so that you can hopefully give two fairly equal doses per day.

So glad she's enjoying the treats! Sam is constantly trying to convince me that treats should be used as meals. :rolleyes:

I agree about getting a new vial before the last one is used up. I like to keep a little back-up in the fridge too.
 
Djamila said:
As long as you can give the regular dose, that's ideal. Eventually you'll be shooting on lower numbers and it won't be so scary. My suggestion to lower to 4u was for your peace of mind so that you can hopefully give two fairly equal doses per day.

So glad she's enjoying the treats! Sam is constantly trying to convince me that treats should be used as meals. :rolleyes:

I agree about getting a new vial before the last one is used up. I like to keep a little back-up in the fridge too.
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I kept it at 4.25u for this morning; we seemed to be getting some pretty good numbers on that before though it was a little flat some days, which is why we went up a little. Will have to see how her PM numbers shape up. I feel like we do a curve almost every weekend.

I'm paranoid that I will drop the bottle, and if I did it would probably be on a weekend when the vet office is closed and I can't get instant shipping to rural MN. I think I will use the last from the first bottle (our current backup) and then get the new one.
 
Glassgoblin said:
I kept it at 4.25u for this morning; we seemed to be getting some pretty good numbers on that before though it was a little flat some days, which is why we went up a little. Will have to see how her PM numbers shape up. I feel like we do a curve almost every weekend.

I'm paranoid that I will drop the bottle, and if I did it would probably be on a weekend when the vet office is closed and I can't get instant shipping to rural MN. I think I will use the last from the first bottle (our current backup) and then get the new one.
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Many people wrap the bottle with something to protect it if it falls. That thin, "mini" bubble wrap would work well.
 
Kris & Teasel said:
Many people wrap the bottle with something to protect it if it falls. That thin, "mini" bubble wrap would work well.
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I should try that- I probably have some.

Every day is an adventure. Tonight we are at 137 when I tested a little early, and I'm stalling atm.

*Whenever we stall we seem to go down rather than up - 24 min after first test and she is at 121mg/dl.
*Had stalled again -26 min between tests- and she was at 102mg/dl (this was 12 hrs and 10min past her AM shot). I'm feeding and not giving a shot, unless someone has a convincing argument.
 
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Glassgoblin said:
I should try that- I probably have some.

Every day is an adventure. Tonight we are at 137 when I tested a little early, and I'm stalling atm.

*Whenever we stall we seem to go down rather than up - 24 min after first test and she is at 121mg/dl.
*Had stalled again -26 min between tests- and she was at 102mg/dl (this was 12 hrs and 10min past her AM shot). I'm feeding and not giving a shot, unless someone has a convincing argument.
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I think a no shot tonight is the right decision.
 
I almost never say "no shot", but I actually would agree with that decision tonight. I'm curious what Jaxa is trying to do with the insulin right now, and giving her a clear cycle might help. I'm curious where she'll be in the morning, and how the next few cycles will look.

As a side note for going forward: you've tried it enough to know that stalling doesn't work with Jaxa. It never worked with Sam either. Stalling is the strategy that is recommended, but when you've collected enough data to "prove" that it doesn't work for your cat, then it's safe to try what I think of as "Kris' strategy" (because she's the one who did it the most around here for awhile. :)). Do the PMPS test, see it's too low, feed the cat their regular food, wait 30-60 minutes after the PMPS and test again. Most likely the food will have caused the number to rise and you can shoot at that point. (Did I get that right @Kris & Teasel?)
 
Djamila said:
I almost never say "no shot", but I actually would agree with that decision tonight. I'm curious what Jaxa is trying to do with the insulin right now, and giving her a clear cycle might help. I'm curious where she'll be in the morning, and how the next few cycles will look.

As a side note for going forward: you've tried it enough to know that stalling doesn't work with Jaxa. It never worked with Sam either. Stalling is the strategy that is recommended, but when you've collected enough data to "prove" that it doesn't work for your cat, then it's safe to try what I think of as "Kris' strategy" (because she's the one who did it the most around here for awhile. :)). Do the PMPS test, see it's too low, feed the cat their regular food, wait 30-60 minutes after the PMPS and test again. Most likely the food will have caused the number to rise and you can shoot at that point. (Did I get that right @Kris & Teasel?)
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I'm really curious about what is going on too- I just did a +4 (from her usual shot time) and first I didn't have enough blood so all the meter said was Lo, which just about stopped my heart. Then I got a decent drop of blood and it was at 135mg/dl. She has been eating this evening- at least three times that I have seen, but then I gave her a couple Orijen treats between her earlier tests this evening and she was still going down in number. I'll probably give her a few more treats right now and encourage some more food.

I can't wait to see what her AMPS is going to be.
 
Djamila said:
I almost never say "no shot", but I actually would agree with that decision tonight. I'm curious what Jaxa is trying to do with the insulin right now, and giving her a clear cycle might help. I'm curious where she'll be in the morning, and how the next few cycles will look.

As a side note for going forward: you've tried it enough to know that stalling doesn't work with Jaxa. It never worked with Sam either. Stalling is the strategy that is recommended, but when you've collected enough data to "prove" that it doesn't work for your cat, then it's safe to try what I think of as "Kris' strategy" (because she's the one who did it the most around here for awhile. :)). Do the PMPS test, see it's too low, feed the cat their regular food, wait 30-60 minutes after the PMPS and test again. Most likely the food will have caused the number to rise and you can shoot at that point. (Did I get that right @Kris & Teasel?)
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That’s right. It was a useful tool and didn’t backfire. Sometimes I reduced the dose a little.
 
A little high (324) this AM, but I expected that- gave 4u to see if she will go low for the PMPS, though I'm not sure if it is a good day to test that with no shot last night.

I'm might have to save for one of those microchip food bowls- her food is locked in the bedroom so the dog can't eat it during the day, and lately she wants to be out of the room (and outside if possible) almost all day, so she eats in the morning but then not again almost all day long. I still take the food up 2 hrs PS but she often hasn't eaten for at least four hours before the test. Or has only eaten grass and bugs. She isn't an easy cat to encourage to eat when she doesn't want to eat, but maybe if the food was protected and still available she would snack a little more in the day.
 
Glassgoblin said:
A little high (324) this AM, but I expected that- gave 4u to see if she will go low for the PMPS, though I'm not sure if it is a good day to test that with no shot last night.

I'm might have to save for one of those microchip food bowls- her food is locked in the bedroom so the dog can't eat it during the day, and lately she wants to be out of the room (and outside if possible) almost all day, so she eats in the morning but then not again almost all day long. I still take the food up 2 hrs PS but she often hasn't eaten for at least four hours before the test. Or has only eaten grass and bugs. She isn't an easy cat to encourage to eat when she doesn't want to eat, but maybe if the food was protected and still available she would snack a little more in the day.
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It's their mission to make things difficult for us! :confused:
 
Kris & Teasel said:
It's their mission to make things difficult for us! :confused:
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I just wish I could take several days off in a row and get daily daytime tests (at different intervals) - but the most I can have this summer is a three day weekend over June 15-17. Even daily tests don't seem to show too much when things are constantly in flux though. Today she is eating more because it is raining and I am home, so she wants to be close and every time I pet her she goes to eat a little right away. Tomorrow it will be sunny and I have to mow the lawn, so she will be in and out of the house a lot, and probably eat less. I sometimes wonder if I should keep track of the weather on my spreadsheet too, it might make a difference or maybe it is just coincidence.
 
That 324 this morning was higher, but not terribly higher. And the 135 looks good. Hopefully the reduction will help balance the cycles a little so the dosing can be more consistent.

It is hard when we have to be at work and can't get as much data as we'd like. You're doing fine though, and getting enough evidence to make good decisions. It might be interesting to track the weather and see if there is any impact. It could be related to Jaxa's activity level based on the weather, more than the weather itself, but that might still help you to make predictions if you know that she's more or less active on different types of days.
 
Djamila said:
That 324 this morning was higher, but not terribly higher. And the 135 looks good. Hopefully the reduction will help balance the cycles a little so the dosing can be more consistent.

It is hard when we have to be at work and can't get as much data as we'd like. You're doing fine though, and getting enough evidence to make good decisions. It might be interesting to track the weather and see if there is any impact. It could be related to Jaxa's activity level based on the weather, more than the weather itself, but that might still help you to make predictions if you know that she's more or less active on different types of days.
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I think her nadir has shifted too- it had seemed to be around +5 during our first month, but looking at some of her more recent numbers from +6 to +9 it seemed like she goes down further after +6 and is rising again by +9 (except the day we had the big bounce). I just don't have a lot of days with those tests during the daytime. We are in some good greens today, but if she is 88 at +9 maybe that is why were are so low at PMPS. This is the time when she is eating less and pretty soon the food comes up.

Almost a month without a red number makes me happy. I like sending the vet my spreadsheet instead of bringing in Jaxa and she likes that better too.
 
Djamila said:
Interesting...curious what the PMPS is tonight....?
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Just did the test and she is at 132mg/dl, so I'm going to feed and test again in 30-60 min and see if I can give a shot, reduced, shot, etc. Not sure how I should note that on the spreadsheet; I just put in the test so far.
 
I had a feeling. Tomorrow I would suggest lowering the dose again. For tonight, I think maybe 2.25 or 2.5u? You gave 2u on a similar PS a few nights ago, and she ended a bit high in the morning, so I'm thinking a little more than that tonight. What do you think?
 
Oops. I read your post too quickly. Yes, if she rises enough for the full shot tonight, that's fine too, although for "full shot" I would still recommend a little reduction from the 4u.
 
Will see what she does- I think I will give her close to that hour before testing, and give lower than 4 (3.75 if she is high enough or half if at least 150)?
 
Djamila said:
Sounds like a good plan. It's nice to see her insulin need going down a little. :)
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An hour later, after eating she is still only at 146. I gave her 2u on 156 once before, but I still hesitate.
*I gave her some treats and a 2u shot while she was eating them- will keep watching tonight to see what direction she is moving.
 
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I think she is bouncing because of the PM lows- a little high this AM, though not over (technically) 300; 294mg/dl probably means I could get a 300+ on the same blood drop though. Gave 3.75u and will see if her PM test is any different.
 
Glassgoblin said:
294mg/dl probably means I could get a 300+ on the same blood drop though. Gave 3.75u and will see if her PM test is any different.
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lol...I totally did that just the other day (5/30 PM cycle), but in the opposite direction - I tested and got a 203, and then since there was a big blood drop, retested the drop to get the 197 because I didn't want to put a yellow on the spreadsheet. :smuggrin: So silly, i know!

My hunch is that the 294 isn't a bounce; instead it's because there wasn't quite enough insulin at 2u and so the duration was short. So basically the insulin ran out before AMPS leaving her in higher numbers for the morning. It's possible it was a bounce, but you can see the same pattern on your other 2u shot - the next morning was a 292, so almost identical.
 
Djamila said:
lol...I totally did that just the other day (5/30 PM cycle), but in the opposite direction - I tested and got a 203, and then since there was a big blood drop, retested the drop to get the 197 because I didn't want to put a yellow on the spreadsheet. :smuggrin: So silly, i know!

My hunch is that the 294 isn't a bounce; instead it's because there wasn't quite enough insulin at 2u and so the duration was short. So basically the insulin ran out before AMPS leaving her in higher numbers for the morning. It's possible it was a bounce, but you can see the same pattern on your other 2u shot - the next morning was a 292, so almost identical.
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I wish I could get by on less sleep- I was watching her every time I woke up last night but she seemed normal and was eating so I didn't test again when I should have at +7 or so. I'm never sure, when she has a 104 at +3 how much lower is she going later in the night. Just got a +3 at 135 a little while ago and that was after she ate four times from her dish, had treats and ate her b12/bisque. The Orijen treats don't seem to impact her bg much, which is nice. I got some Young Again Immune and Digestive support supplement (probiotic and nucleotides powder) that is supposed to go over her food and she tried it this morning- loved it. It doesn't seem to be carby either.
 
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And now she is actually under 50... +6 was 45mg/dl. I gave her some temptations treats and will test again soon. She is acting normally, but I hope she is going up right now.
*@+6.5 was at 59 (64 from same drop of blood), +7 was both 66 and 75 from same drop of blood- I feel like I'm wasting test strips but I always want to know (when there is enough blood) how different two readings might be and if the second will be higher or lower).
 
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Yes!!! Go, Jaxa!!! She is really determined to get herself on a lower dose, isn't she?

Don't drive yourself crazy over-testing. Those numbers are all in the same range from each other, so precisely which number is right isn't that important. Although if you're having fun and not driving yourself crazy, then keep at it ;):bookworm::smuggrin:

Whenever they hit a lime green, you lower the dose again, so try 3.5 or 3.25 tonight.
 
PS When they hit a low number around nadir, you can usually raise them with just regular food instead of introducing carbs. The carbs can make them a little wonky for a few cycles.
 
I just hope she is high enough tonight; Sundays are the day I leave around her shot time for a few hours- family obligations- and I might just tell them I'll be late tonight.
 
Djamila said:
PS When they hit a low number around nadir, you can usually raise them with just regular food instead of introducing carbs. The carbs can make them a little wonky for a few cycles.
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I tried getting her to eat the regular YA first, even added some dried duck liver to it, but she didn't show interest. She is at 222 for the PMPS though, so gave 3.25 and will test when I get home again.
 
Again (ha) we are under 200 for PMPS- 153mg/dl tonight. I've shot on that before- feeding and giving straight 3u. First test said 87 and I was like, no way- I retested the other ear and got 147, wasn't sure which I trusted and thought maybe not enough blood on first test so tested that first ear again and got 153. The two tests are close so I am going to go with the not enough blood theory for the first test. As usual, will watch and test again later.

I just don't know where these low numbers are coming from all of a sudden- did we hit the magic dose and she got triggered? Is the better weather helping? Is it finally long enough that any residual prednisolone is completely out of her system finally? I need to go in for the new insulin and needles later this week so I might ask the vet to review her more recent numbers (he said he had never had anyone share a spreadsheet like that before and I got the impression he was used to people just giving up and putting their kitties down instead of trying).
 
Yes, you've hit the "breakthrough" dose. It doesn't happen for all cats, but some will climb up and up the doses and then all of a sudden they reverse directions and head back down again. Some head all the way down, others head down for a while and then stall at some level and hang out there for a looooooooong time.

Basically you just keep doing what you're doing. Little reductions when the data asks for it. And lots of guessing.
 
I always tell people about this and they never believe me until suddenly it happens! I'm glad you've hit it...it's stressful, but it's lovely too!
 
At 100mg/dl for PMPS, so feeding and will test again in 30-60. We will see how much she jumps in that time, and maybe this will be another NS if little to no rise. She was outside all afternoon, so she is scarfing that food down like there is no tomorrow but the low carb food doesn't seem to affect her bg very much nor do the Orijen treats. I worry that if she is at 100 now, she was too low earlier. I may try 3.0u tomorrow morning and see if it helps get us to a number we can shoot at right at food time.

*She ate, we waited 45 minutes, and I tested again (while eating a second time) and she was at 97mg/dl, so I'm skipping the shot tonight. Will get another test in 3-4 hrs and then see how her AMPS is tomorrow. She wants to go out and play again now.
 
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It is a little weird that she hasn't gone up yet- eaten three times so far tonight. Almost at +5, so we will see if she has gone up since her +3, which was 91.

*+5 test was 104 mg/dl. So she has been pretty flat all night, but in good numbers. Glad we skipped the shot.
 
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That's a very good sign! Often when we see that they stay flat in low numbers or go down after eating and NS, that means that the pancreas are kicking in. It doesn't mean they work all the time, but more like they're kind of sputtering on and off. Beautiful numbers!
 
AMPS was not too bad either; gave 3u and will see if the slight reduction this morning makes a difference for her PM. I don't want to take anything for granted at this point; she seems to feel good, want to play, be social, eat her food, beg for treats, and go outside to eat butterflies, all of which are signs that she feels as good as she did a few years ago.
 
Djamila said:
Is your mom around to give her some extra food during the day?
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The food is out all day; but the door is closed so the dog can't eat it. So when Jaxa decides to go outside she doesn't have access then, but she has never been much for eating during the day time, even before we had this dog (our last dog didn't jump onto beds, he was too stocky). My mom usually tries to get Jaxa to eat before the food goes up, but that is usually when Jaxa wants to be outside and won't willingly come inside. She doesn't even eat the orijen treats unless I give them to her- but when the dog is getting friskies and temptations in the day she is probably mad she isn't getting those too.

I am considering spending the $ to get a microchip food dish so she has another food in the dining room that won't open for the dog.
 
I was wondering since Jaxa seems to be moving down in dose right now - just to make sure if she needed something during the day your mom would be able to get her some food. Many cats will ask for food if they start to go low - they are pretty good at taking care of themselves. So I would imagine if Jaxa got hungry enough she would come inside -- or catch something outside (? Does she ever do that?)
 
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