7/16 Jean Luc Thinking about Blue...

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snorton

snorton

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After a rough night Saturday, he decided to drop back into the blue region on Sunday. He woke us up one hour early. I tested him and he was at 630 (no ketones) so I went ahead and gave him 2.5U insulin one hour early. It lasted ~14 hours. He was at 301 at 6:30pm after eating a little bit. I then gave him 1.75U which didn't seem to be enough to hold him until this am. Tested during the night and he was at 398 and 352. He was at 530 at AMPS. I was surprised by that.

He slept until normal time this am. Fed him, gave him 2.5U, left more food, and had to go to work. He was happy and social this am. He was eating more food as we walked out the door... Hope he enjoys the quiet time today.

Is this normal?? If he doesn't require insulin until 6:30pm again, can I give him 2U.
 
The idea that he will bounce from that nice green is certainly logical. It is difficult that he is lasting so long with the 2.25 and but not reponding as well to the 2 unit dose previously. I liked that you shot early this am. Maybe the longer cycle (+13 if you stay with the usual pm time) will give a shootable number tonight.

This is difficult for me to figure out because he is clearly bouncing and our usual advice is to lower the dose for a number that reflects a bounce. But he doesn't seem to respond to that reduced dose.

I'll see if Carl will weigh in......
 
Yesterday was 325 at PMPS. Was at 331 at +4. This am was at 280. Gave what I think was 2.5U, but smelled a little insulin smell. Fur wasn't wet and smell went away very quickly. I'm thinking it was a little extra on needle.

Crossing paws it will be a good day. Last night he was playing up a little storm. Chasing the string down the hall with bright, bright, eyes.
 
Very nice, Shannan. Can you get a nadir? He is moving around so much with numbers that it is hard to know what to shoot and you want to catch a low number if he throws one.

Carl and Robbies's mom were up all night with low numbers. Maybe he will check in after work tonight.
 
Can try to do this evening? Had to go to work and too far to travel back and forth for lunch. Gave him plenty of breakfast (3oz FF Turkey) which he didn't eat of all. Has food for +1.5 (1/4 3oz can); +4.5 (1/4 3oz can); +7.5 (1/4 3oz can). Yesterday, he ate every bit. Last night, he ate 1 can between PS and +3 plus he had ~1/8 can snack at +5 and 1/4 can at +7.5. He turned his nose up last week on the Wellness Turkey and Merrick 96% Chicken. FF Turkey is still a go. I did catch him eating the Merrick Sunday night though. He must have been hungry and decided okay it's not that bad.. Perhaps, food boredom or just messin' with me. He ate the same dry food for years. I vote just messin' with me and trying to push my buttons. Spoiled.... :) ohmygod_smile
 
This is just a guess, because there aren't numbers to prove it happened. But I think the 2.5 was a little too much this morning, and he went low enough today to cause a bounce. That doesn't mean "hypo-low". Kitties can bounce from blue numbers too.
What I see that past couple of days....

The .5 dose wasn't enough to keep his numbers down, and he had a black AMPS Sunday morning. The 2.5 on that number was plenty, and he gave you a green number you couldn't shoot. You had to wait, and shot 1.75 when he came up. It looks like the next morning's black number was NOT due to "not enough insulin". I think it was his reaction to that green number, so it was a bounce.
So on Monday morning, you shot a good dose. It gave you a lower PMPS number. Then you gave him 2.5, and again, you got a lower number 12 hours later. That means the dose was good, or maybe just a bit too much. I'm thinking "too much". Because what I think happened again today is that he went low enough to cause another "bounce", which is where your higher PMPS number comes from.

What I think I would try is to draw a line in the sand at 350. If he's higher than that, AND it doesn't look like the higher number came from a bounce, then shoot 2.25. IF his number is below 350, shoot no more than 2.0. ( of course you would reduce even more if his number was well under 350) What you are trying to achieve is to get his AMPS and PMPS numbers closer together, so that you can shoot a consistent dose, and not cause bounces. If you can get to that point, then it will be easier to tell if Jean Luc needs just a little more, or a little less insulin to maintain good consistent numbers.


Carl
 
Thank you for your thoughts Carl and Sue. The suggestion sounds reasonable.

Last night was a very low night. It started high at 421 so I shot 2.5U normal time. At 7:45pm he was 385 with Relion (the alphatrak was getting quite expensive). After cleaning up a misplaced urine episode in our dining room, I was planning to go to bed a little early and set alarm for +6 +7ish. Went to bed early, but couldn't sleep (tossed,turned). Got up at +6 and tested he was 48 was Relion. Tested again about 8 minutes later and he was 48 with Relion; 66 with AlphaTrak (same sample). Gave him what I thought was maybe .25oz Merrick 96% Chicken with a little bit of FF Turkey mixed in. He gobbled it up. I then realized "oh Crap", he wasn't able to eat his +4.5 snack. Perhaps, that explains the drop. I was a dumb, dumb. I had the feeder set to 9:30am not 9:30pm. I had put it on hold early in the evening. Stupid Mom!! I tested again at 7.25 and he was 169 on Relion. He then ate about 1/8 can ff at 12:30pm. Obviously, I gave him tooooo much food or he is very, very, carb sensitive or an early bounce, or I don't know what. At AMPS he was 506, I was planning to give him 2.25. That didn't work out either it ended up a big, flat, fur shot. Fur wet.... He did not have any ketones.

Needless to say I am frustrated, tired, confused, and very mad at myself. I've been giving shots for several weeks without fur shots. Why now? I know he is getting less and less loose skin, but this isn't right.

Crossing fingers and paws he will not go into cat coma today..
 
Don't beat yourself up Shannan. It happens. If he continues in the high ranges, you could possibly shoot early? Or would that mess up your whole schedule?

I wonder, if it is the food, you can use that to manipulate the numbers. What is your feeding schedule now? How much/how often? Maybe he is getting too much food and that is keeping him higher? If skipping a snack really did contribute to a low nadir, we should pay attention. Course it could also be he decided to settle into that dose and respond. Either way, it's encouraging to see a double digit.
 
Since last Friday, I've been feeding him 1 3oz can ff classic at AMPS. Then 1/4 - 3oz can at +1.5, 1/4- 3oz can @ +4.5, and 1/4 - 3oz can @ 7.5. These are in the feeder.
At PMPS, he is offered another 3oz, which he usually grazes on until +1 - +1.5. Food is then held until +4.5 at which time there is roughly 1/4 can and then another 1/4 can at +7.5
He seems happy. Has been playing more in the evenings.

I am just thinking I have no idea what I'm doing ....

Shooting early AM may be difficult, but it can probably be done. The PM shot cannot be moved earlier. My work schedule doesn't allow for that. If we can get something to work with the 5Am / 5PM ish, that would be prefered.
 
Sorry, I think I confused the situation. I just meant today, with your fur shot, if you wanted to shoot early. Not as a usual thing.

This is HARD and truthfully Carl and I are just guessing the best we can. The L insulins have a protocol so you have a gameplan, but it is very similar to PZI. Be patient through the bounces, continue to raise by .25 every couple of cycles until you see movement.

I think I am going to figure we are close to a dose he will continue to respond to. I'd just take the day off because of the fur shot and start again tonight. He will be high but that is because of the 24 hours since a shot, so I'd stick with your dose. The food sounds reasonable - about 3 cans total for a 24 hour period. That's what I gave Oliver when he was unregulated; once he got regulated, I reduced it to 2. He was a 16 pound Maine Coon who needed to lose a couple pounds. (which he did once he got regulated and then OTJ)

I know the fur shot is discouraging, but the nice number at nadir is encouraging, Shannan.
 
Oh.... His shot this PM will be at regular time. Can't get away from work early.
By "L" insulins, do you mean Lantus? I haven't switched yet. Still using PZI. I do anticipate having to give a full 2.5U. I am hoping he will not be super sky high.
Thank you for the encouragement. I also got excited about the NADIR, but really frustrated with the bounce.
 
Hi Shannon, I'm Robin and I've been on a hiatus for the past few months and am just now catching up with everyone here.

Don't beat yourself up about a fur shot, it happens to all of us, it is only one shot, one cycle in the grand scheme of things. I would still give a fur shot every once in a while after shooting for a year. Be sure to tent the skin and shoot at a 45 degree angle into the tent. I found that the skin by his shoulder/flank was thinner and looser so that is where I shot.

I'm going to agree with Carl, it looks like shooting a higher dose into a bounce is giving you the low numbers and starting another bounce. While some think shooting through a bounce is ok I was never able to find a balance chasing the numbers, like a roller coaster ride you go up and down over and over again. The bounce hormones will clear out of his system by themselves in a few cycles.

I think that if you back off the dose like Carl suggested Jean Luc will even out his bg's and show us the true picture.

You can pick whatever schedule works best for you, if 5am/5pm works that's great.

You are doing great, really, it's only been a few weeks. The learning curve is very steep in the beginning of this dance but once the steps become more comfortable things seem to fall into place.

When Harley was dx I went into a hyper adrenalin overdrive and stomped around here yelling "I want him regulated and I want it now" :lol:

Hang in there.
 
Yes, I meant Lantus and Levemir. I know you are using PZI. I was just commenting on the fact that it's frustrating to use because it is sort of a "do it yourself" insulin and doesn't have a protocol like the L insulins.

Hey Robin, nice to see you. I know Shannan will appreciate more eyes on her ss.
 
Thank you all. Tonight he will get 2.25U. I suspect he will be well over 500, but I might be surprised.... :mrgreen:
 
Surprise me!!! We got 491 on relion at pmps. Gave 2.25u. With big fur shot it could've been worse. Maybe he got some after all.
 
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