7/22 Herman AMPS 115 SKIP DOSE +4 124 +6 220

Amy & Herman

Amy & Herman

Member Since 2022
From yesterday and this am:
https://www.felinediabetes.com/FDMB...102-11-5-133-amps-115-skip-dose-2-110.266132/

Yesterday was scary, perplexing and exhausting! In a nutshell Herman did a scarf n' barf after his pm shot, ate only a small amount an hour later, then refused to eat anything more or move from his bed for the next almost 12 hours while hovering in low numbers (for him) for the bulk of that time period. He showed outward signs of nausea in the morning once I finally got him out of bed (lip licking, smelling food but not eating).

With a AMPS of 115 and no appetite, I skipped the shot.

After a morning walk, grass eating (and I assume a subsequent vomit that I did not witness) he slowly came around to his usual self staying in the blues (low for him at this stage of our treatment and part of cycle especially given we skipped the shot) till +6.

The odd scarf n barf and morning grass eating pukes are not unusual for him. Complete lack of appetite is, although on 7/19 he went in to the greens and lost his appetite at shot time causing me to stall for an hour. After the greens he also had diarhea which is uncommon for him. I realize these things are likely unrelated but I do find he thrives in the comfort of the yellow and fuchsia and is out of sorts in the low blues and greens. I realize this can affect his appetite and he probably doesn't have that starving feeling at those levels. I understand it will take time for him to adjust.

Thanks to to those who helped this extremely anxious cat mom through a sleepless night, especially @Suzanne & Darcy !

I have a few questions:
  • Can I move pm shot forward to 430pm (an hour early) safely since I skipped am dose? I had to stall an hour on the aforementioned 07/19 and I am trying to decide if I should go back to 430 and if so if this might be the easiest time to make that adjustment in one go vs 15 min increments.

  • Do people ever adjust PM dose based on the fact that the particular cat is much less active and eats far less than the daytime?

Also a note about why I gave FF 15% gravy at +11, he was still essentially unresponsive to me (would not get out of bed) and hadn't eaten in 9 hours (nothing tempted him even his fave contrabands) at that point and I was trying to stimulate his appetite with something he likes and could be syringe fed. It was less about bumping up the BG at that point. Next time should I try to wait it out longer or try to syringe something other than 15% gravy? I didn't think it was time for karo....

THANKS TO ALL!
Amy and Herman
 
Since you did a skip today, you can move the shot forward by an hour. Under normal circumstances it should not be more than 30 minutes either way per day, but it’s okay with the skip.
 
With depot insulin, consistency in dosing is very important so, no you should not shoot a different dose in the p.m. if he’s dropping too low at night then that would be taken into consideration for the overall dose, since doses are based on nadirs.
 
I’m trying to think how to explain why the need for consistency. Think about the depot. Every time you shoot a lower dose, the depot is depleted a bit. Then you shoot a little more and the depot starts to rebuild- then at night you shoot a little less again— but the depot still influences at least the first part of the cycle anyway. So you really can get some wonky numbers, and it also could make dosing decisions about whether to increase or reduce almost impossible. It also would detract from the ability of the depot insulin to give nice flat cycles, which is the beauty of the depots to begin with. Now, I know you don’t feel like you are seeing flat cycles yet, but you are dealing with bounces as well right now and that can’t be completely controlled. But you will get there. I hope this makes sense.
 
Suzanne & Darcy said:
I’m trying to think how to explain why the need for consistency. Think about the depot. Every time you shoot a lower dose, the depot is depleted a bit. Then you shoot a little more and the depot starts to rebuild- then at night you shoot a little less again— but the depot still influences at least the first part of the cycle anyway. So you really can get some wonky numbers, and it also could make dosing decisions about whether to increase or reduce almost impossible. It also would detract from the ability of the depot insulin to give nice flat cycles, which is the beauty of the depots to begin with. Now, I know you don’t feel like you are seeing flat cycles yet, but you are dealing with bounces as well right now and that can’t be completely controlled. But you will get there. I hope this makes sense.
Click to expand...
Thank you yes makes sense!
 
Instead of Fancy Feast gravy food, you might want to explore an alternative high carb food. I discovered Neko was allergic to wheat (not uncommon), so had to get some of the canned foods with potato in it. Weruva Cats in the Kitchen pouches have some in the low end of high carbs range, and Grandma's Chicken Soup (canned) is over 20%. First Mate, a Canadian brand, is mostly HC cause they use potatoes in their foods.

It's not usual for cats to feel best in numbers they are most used to. In the beginning, I could tell Neko was in the low 300's when she went over to her toys and started playing.:rolleyes: Her first greens she hid under the bed. I was so happy when over time that switched around and high greens/low blues became play time and she moped around when over 300. The analogy I use is that high blood sugar is like caffeine. When you are used to it, you need that caffeine and feel miserable without it. Over time, as you cut back, you feel better with less.

With out dosing methods, we definitely see that consistent dosing is best for AM and PM. Also, due to the nature of the depot, what you shoot one cycle can heavily influence the next. Last night's shot kept him in blues this AM. And skipping this morning has resulted in pinks and you getting a good night's sleep.
 
Wendy&Neko said:
Instead of Fancy Feast gravy food, you might want to explore an alternative high carb food. I discovered Neko was allergic to wheat (not uncommon), so had to get some of the canned foods with potato in it. Weruva Cats in the Kitchen pouches have some in the low end of high carbs range, and Grandma's Chicken Soup (canned) is over 20%. First Mate, a Canadian brand, is mostly HC cause they use potatoes in their foods.

It's not usual for cats to feel best in numbers they are most used to. In the beginning, I could tell Neko was in the low 300's when she went over to her toys and started playing.:rolleyes: Her first greens she hid under the bed. I was so happy when over time that switched around and high greens/low blues became play time and she moped around when over 300. The analogy I use is that high blood sugar is like caffeine. When you are used to it, you need that caffeine and feel miserable without it. Over time, as you cut back, you feel better with less.

With out dosing methods, we definitely see that consistent dosing is best for AM and PM. Also, due to the nature of the depot, what you shoot one cycle can heavily influence the next. Last night's shot kept him in blues this AM. And skipping this morning has resulted in pinks and you getting a good night's sleep.
Click to expand...
Great explanations. Thank you.
 
Wendy&Neko said:
Instead of Fancy Feast gravy food, you might want to explore an alternative high carb food. I discovered Neko was allergic to wheat (not uncommon), so had to get some of the canned foods with potato in it. Weruva Cats in the Kitchen pouches have some in the low end of high carbs range, and Grandma's Chicken Soup (canned) is over 20%. First Mate, a Canadian brand, is mostly HC cause they use potatoes in their foods.

It's not usual for cats to feel best in numbers they are most used to. In the beginning, I could tell Neko was in the low 300's when she went over to her toys and started playing.:rolleyes: Her first greens she hid under the bed. I was so happy when over time that switched around and high greens/low blues became play time and she moped around when over 300. The analogy I use is that high blood sugar is like caffeine. When you are used to it, you need that caffeine and feel miserable without it. Over time, as you cut back, you feel better with less.

With out dosing methods, we definitely see that consistent dosing is best for AM and PM. Also, due to the nature of the depot, what you shoot one cycle can heavily influence the next. Last night's shot kept him in blues this AM. And skipping this morning has resulted in pinks and you getting a good night's sleep.
Click to expand...
I will purchase some Weruva. Is it correct that I want some in the 15-20% range to bump him up if he gets to the greens steeply? I also see they have some in the 4-8 % range. It’s been mentioned to me a couple times that Herman might do better on a few more carbs (for a week or so I was pretty strict with the 1-2%FF and 0%tiki varieties and I’m not sure that was a great fit) and I actually find that’s a hard range to nail down. I tried some Beyond in 3-5% range. He liked them one day and not the next but weruva seems to have lower phosphorus so might be the better choice. Thanks again for sharing your experience with Neko in the greens. Herman really does seem weird in those zones and knowing this is not completely unheard of helps me forge through and stay the course!
 
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