https://felinediabetes.com/FDMB/threads/7-9-newman-amps-242-2-0u-pmps-274.265306/ Good morning. I understand that the numbers so far are flat on 2.0U and an increase will probably be in order, but I am seeing so much of the "before" diabetic Newman. So good to see.
Shooting from new vial this morning but holding on 2.0U. I did notice when reviewing his spreadsheet that the days I got blue numbers on this dose, started with the highest yellows. (says the perfectionist always looking for logic) LOL
What times are best to test to be most helpful for your analysis? +4 and +7 ? I can't guarantee that he will be available to me, but I can try. He is spending less time under the bed. I wonder why 2 units were less productive than 1.75 units. Is it time to increase? I'm not sure what to do. @Frost @Suzanne & Darcy
Not time for an increase just yet. Tonight will be the 14th cycle on this dose. After that you can increase by .25 if he’s still in higher flat numbers.
We are off schedule this morning because Newman barfed up his breakfast immediately, into his bowl. I did notice that the vomit seemed to contain more liquid, perhaps a clue as to what causes these occasional early morning barfing episodes. Anyway, he did not come back right away, as usual, to eat again so I had to wait for him. I ended up serving it to him on my desk where he ate the heaping tablespoon of food I measured for him. Problem is, he is out of reach under the bed so no insulin yet. I will try to entice him with shaking the treat bag and hopefully he will not wait too long. Question: When he does come out should I give the full dose and run the day behind schedule or is it better to make some adjustment to accommodate delay? Thanks @Suzanne & Darcy @FrostD
Good morning, Linda. I guess that depends upon how late it is when he comes out. I mean if it’s 11 am that would really mess things up!
Also, what time will your son or grandson get up? Can one of them help get Newman out from under the bed?
They are not home. Both leave very early in the AM. Should have included fasting BG at 6:50 am. was 250, eat, vomit. Ate measured food and retested 7:40, BG 274.
O This is funny…. not you…. me! Here’s the thing. Can you tell I am on vacation and can’t tell what day it is!! For me, it’s just a very long weekend. Lol. Since I am sitting here in my pajamas and drinking coffee, it feels like Saturday!
I’m sitting on a screened in porch at a cabin in the woods of Pine Mountain looking out at the lake and just enjoying the morning. It’s only 74 degrees. Very peaceful.
LOL......Maybe it's a good thing that time becomes blurred on vacation. I am affected by that confusion when my son or grandson alter their routine schedules! I hope that you are feeling fully recovered after being sick.
Anyway, so I was about to say …. Wow they get up early for Sunday to go to work? I really don’t know what day I thought it was … just the weekend.
Wow. He really goes up a lot in that first hour after eating. You did great! We have to live in the real world where everything is not ideal, right? Did he eat a little more? I hope so because it seemed like he only ate about a tablespoon after he vomited? You can work your way back to your regular schedule by shooting at +11.5 tonight.
BG at 6:50 am. was 250, eat, vomit. Ate a heaping tablespoon measured food and retested 7:40, BG 274. He got under the bed for about one hour. Came out for treats so I tested, got 290 and shot 2.0. Thirty minutes after shot, he ate approx. 1/4 can Fancy Feast.
Sorry, it is hectic around here lately. It seems every day somebody has an appointment, or school, or "extracurricular"...or I have to try to keep up with the yard, groceries, or house Liquid hmm. Let's see what the next few vomits look like I guess, because if that's stomach acid I wonder if some pepcid might help...but it's not like he's doing it all the time. Is there any hair in it?
Sometimes a little hair but usually not. I haven't been giving him the temptations treats for hairball control as much as I used to and when I do, it seems to produce more stool (normal in appearance) so I have wondered if hairball could be a factor. His appetite is not affected and usually he is ready to eat immediately after barfing. And always keeps that food down, but I do reduce the quantity I give him. That is probably how grazing develops. I suspect this morning he had had a big drink right before eating and he was just too full. No apologies necessary. I know you have your hands full.
I do have cats who will drink too much water and will vomit. Usually those are my kidney disease cats though who drink too much water. Does Newman drink a lot of water?
If he vomits clear foamy liquid it may be excess stomach acid. Usually that’s before eating though, i.e., vomiting clear foamy liquid before breakfast.
Honestly, I do not monitor the amount of water he drinks but I would have answered that he drinks an average amount, enough and not too much. Before he was dx with FD, his use of the litter box was the same as Ozzie in frequency and amount based on the size of the pee clump. Both of the cats only visit the litter box once a day. He never just throws up clear liquid or anything having a foamy appearance. Usually if he throws up, it is immediately after eating and the vomit appears exactly like the pate he has eaten. I only commented today, because it was more watery than usual, prompting me to think perhaps he has just had a big drink right before eating. I'll keep an eye on it, but I don't expect any additional issues.
I think he just eats too fast and throws up. I am not suggesting he has any other condition. He may have just had a drink, that’s all….. and it just coincided with one of his usual vomits.
Oh, no, I didn't think you were suggesting. I thought you were offering information and I actually appreciate learning these things. He is here on the desk, waiting for his evening treat and test. I am planning to shoot close to 8 PM to move toward our regular schedule.
@Suzanne & Darcy @FrostD Fasting BG this morning 156, retested after 10 minutes to verify got 175. I will stall for another 20 minutes and retest. Please check in on this one if you can. Thanks Retest result 173 going to feed
Do you want to shoot a slightly reduced dose this morning? I think he’s on his way up and will get a food bump. But since you may not be able to get a hold of him, I understand if you want to reduce a little. Do you think 1.75 for today would be okay?
I definitely think I should reduce the dose but I'm not at all certain by how much. I fed him less than usual this morning on the outside chance he would throw up, so about 2 tbsp of food. He was fine all day yesterday after the events in the AM.
Test 90 minutes after eating, got 241 so I shot 1.75U. Thanks for checking in while on vacation. You know I am nervous about making these decisions so I really appreciate your help.
Yes, he has eaten a full can of FF over the morning period finishing right after I poked him at 3.5. I just posted on the SS he is 187 @ 3.5.
I think that was from a later nadir last night, but you did the right thing. This is really where your comfort level comes in. After the retest, knowing he's rising, I probably would have suggested a half dose given your situation. That way he wouldn't climb too high, but also should be a pretty safe dose knowing he's rising. But waiting again for a more comfortable number is also fine! I do think it's time for another increase though.
Looks like your reduced dose worked just fine today so far anyway, some beautiful blues for Newman and I hope each of those two tests gave him the opportunity to eat some food each time.
It looks real good to see a string of blue. I will try to test again at +9 (6:15) then hold food aiming to test for PMPS at 8:15 and shoot at 8:30. Always good to have a plan. lol
Newman is @347 for PMPS. I think I should shoot 2.0U as I had been. Is there reason not to use that dose? @Suzanne & Darcy @FrostD
Yep! Not quite sure if he's bouncing, or it's the effect of delay and slightly reduced dose, but you may end up in a similar situation tomorrow morning. Bounce breaks tend to have later nadirs.
Okay, so I'll shoot the 2.0 and then if he is low again tomorrow morning I will stall and retest and if he is coming up on his own I can probably go ahead and feed him but maybe shoot half the dose, or 1.0 U. I think that is what you were telling me earlier. Have I got that right?
Yep - though see changed suggestions below based on how he did today. The important thing is that he's flat or rising. As long as he is, it's generally ok to shoot at least some sort of dose. I would skip anything below 150-ish for now. In the 150-174 range probably more like 0.25U, 175-200 then 0.5U-0.75U. Those should keep him in a safer range in case you can't get to him for testing. Target nadir is still 90-120, just given those preshots, those doses are what I think will help get nadir in the upper end of that range.
Also if you are comfortable with it, it may help if you add something like "Cannot always reliably test" to your signature. Just in case you're in a pinch and someone else pops by, you don't have to go through the whole rigamarole.
Thanks so much for the guideline. This is so helpful to me as it brings the numbers into focus. I also appreciate your suggestion to add a comment to my signature. I will certainly do that!
Fasting BG 294 will feed and then since he is so close to 300, but still under 300, I will shoot 1.50U (75% of the current dose) I will check back with you guys, should you comment before I shoot. @FrostD @Suzanne & Darcy Shot 1.50U fat Note: I have a dental appt today and will leave the house at 4:00pm so I will be away for about 2 hours I also need input on the dose increase we were looking at before the disruption when he barfed at breakfast, which may have led to the low fasting BG 156, yesterday (Thurs) morning.
I don't think that was due to the vomiting. Even the smaller dose yesterday brought him down quite a bit so I think better to hold. We'll see how he does today, I'm hoping you'll be able to shoot full doses over 250.
He was 147 @ +6 He then ate some of his FF pate, groomed and came back for more. I gave about 1 tbsp, he ate it and vomited. The only thing different was that I used Pure Bites chicken for bait and treat for testing. He has vomited those bites in the past but not always. He is acting fine so I will get ready for my appointment, try to test him before I have to leave and if he is lower, I can give him some med carb Friskies 14%. I haven't been able to find high carb to purchase short of a case of it. No cans at the grocery store. Hopefully he won't go too low, +6 is pretty far into the cycle. Fingers crossed. I wish I didn't have to go out. @FrostD Add: 139 @ +7 not bad. 151 @ +8
@Linda and Newman I really cannot comment much on this “sliding scale” as I believe that consistency is key to getting a cat regulated. Of course, in your situation, some adjustments will occasionally have to be made (like yesterday and even today since you would be away from home) but I believe those tiny doses mentioned will not do much for Newman. He had a beautiful cycle yesterday on the 1.75 unit dose after a lower than your comfort zone preshot (and a little stalling.). I think the stalling was good so you could see he was rising. If you had given him only a .5 unit dose according to that sliding scale that would not have helped get him anywhere near blue numbers. I see he’s seeing some nice blue today as well, but that was with a 1.5 fat which was similar to yesterday’s dose. Anyway, that’s my take on it, and I look forward to seeing how Newman will do on this new sliding scale. Surprise me, Newman!
I prefer consistency as well. The goal is always shooting the same dose AM and PM above 200, then hopefully lowering that number over time - still shooting same dose. Some cats don't cooperate like that. I suppose I should have clarified - the scale I gave is more for when he's lower than usual, and you want to shoot *something* instead of stall for awhile. I'm not recommending it as a standard thing (like I am for Spike if you've been reading, he's a cat that benefits from a true sliding scale approach for now). Eventually the hope is they level out nicely to get a consistent dose and/or you find you can shoot higher doses at lower numbers. And I suppose I disagree - and this is the same point I'm currently making for Maggie on this forum - 0.5U at 150 is the safe option. Newman seems to give better clues that he's going to bounce, in which case it's better to shoot a higher dose. But when you're not sure if a bounce is incoming, it's better to go with a safe dose to avoid hypo. I'm a little torn here. Had you shot the full dose yesterday and today like we'd normally say, I'm fairly certain he'd have earned a reduction. So in this case I leave it up to you, the options as I see it: Go back to 1.75U and shoot that any time he's above 200. I'm not a fan of this because I feel like it's a step backwards. Before the last two days, we were considering an increase, so I'd hate to decrease. Hold the 2U for a little longer to see if the last two days were more of a fluke, especially with the vomiting factored in. Give it any time he's above 200. This does run the risk of some sub-90s (I don't think below 60 though), so you have to weigh your situation vs your goals for his BG.
Quote: Had you shot the full dose yesterday and today like we'd normally say, I'm fairly certain he'd have earned a reduction. So in this case I leave it up to you, the options as I see it: Quote — I agree with this. But we did not shoot a full dose - to prevent too low numbers. —— Quote: I suppose I should have clarified - the scale I gave is more for when he's lower than usual, and you want to shoot *something* instead of stall for awhile. I'm not recommending it as a standard thing Quote —— okay, good. I was not sure about this. Although I don’t think I have a problem with stalling when Linda is at home - but that’s up to Linda. I understand. I would rather shoo a higher dose after stalling like yesterday as opposed to shooting a really lesser dose. But sometimes this may not be possible. ————- Quote: I'm not recommending it as a standard thing(like I am for Spike if you've been reading, he's a cat that benefits from a true sliding scale approach for now). Quote ———— Yes. I understand about Spike, who is a whole different ball game! He really does need a sliding scale. I don’t see Newman as being like Spike. There’s kind of a similarity though, not so much between the cats but in the caregiver’s situations. Linda may not be able to test Newman if she can’t get her hands on him and Lee cannot if he’s at work all day.
It was not my impression that I would be using a sliding scale as an ongoing plan. It very much followed the "How to handle a lower than normal preshot number when following SLGS" Otherwise, I don't feel experienced or knowledgeable to add to the discussion. I do think and want to find a dose that is consistent for both morning and evening, based on preshot values, if possible.
I agree. If a CG can stall, and after the stall it's fairly indicative a bounce is coming, my preference is always to shoot a higher/full dose. When I give a "sliding scale" it's typically only for sub-200 numbers. That way in a pinch, a CG has some loose guidelines if nobody is around. The sticky lists anything from a skip to 50% and that's a wide range and can be scary/confusing. Perhaps sliding scale is the wrong phrase for that situation...
Quote… the options as I seeit: Go back to 1.75U and shoot that any time he's above 200. I'm not a fan of this because I feel like it's a step backwards. Before the last two days, we were considering an increase, so I'd hate to decrease. Hold the 2U for a little longer to see if the last two days were more of a fluke, especially with the vomiting factored in. Give it any time he's above 200. This does run the risk of some sub-90s (I don't think below 60 though), so you have to weigh your situation vs your goals for his BG. ———- I Also agree with these as being the options.
@Suzanne & Darcy I got the email notification that you had posted, "Bouncy Newman", but I can't find the post to reply! I click on View this thread and it brings me to this point, but I don't see that most recent comment.
Yes, back to normal posts, and I checked and also got the email notification. Thanks. I'm also glad about the step away from pink.
So far, so good. I started a new thread, I guess our posts crossed in the process. Here is the link. https://felinediabetes.com/FDMB/threads/7-17-newman-pmps-232.265948/