8/12 Pumbaa PMPS/52 - skipped this shot!

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Pumbaa

Pumbaa

Member Since 2012
Pumbaa cleared his bounce from yesterday, hit 70 at AM +6, and just hit 50 at AM +7! Good going, little guy!

Depending on his numbers the rest of the AM cycle, I don't know if I'll drop him down just a hair to a skinny 2.50U, or take him down to 2.25U. Suggestions, based on his past history, are welcome!

Oh happy day!!!!

Yes, I'll be testing him in another 15 minutes to make sure he doesn't drop too low, since he went down 20 points in one hour.

+7.5 = 51

+8 = 56

+9 = 43 (I opened a can of gravy food and let him take a couple of licks. Then gave him more LC food.)

+9.25 = 46

+9.5 = 54

+10 = 58

+11 = 58 (Big worry. He's not going up. I can't shoot him tonight if he's still this low. Yikes!)

PMPS = 52 (I'm skipping this shot.)

+1 = 86 (Better, but who knows since his nadir's keep getting later and later! Will someone please invent a spigot for our cat's ears...and a nadir alarm clock to warn us in advance of the lowest number of the cycle?) :lol:

+2 = 210 (I was so hopeful that Pumbaa would stop bouncing and diving. Then again, the night is young and anything could happen.)

Question:
It's nearing +10, when I would normally pull his food. But if he's still low, I want to prevent him from having a Lantus double-dip. So, unless he bounces, his PMPS number is going to be affected by food. What do I shoot? *LOL* (Caregiver info: I'm on a very tight deadline and this testing him every 15 minutes is very difficult. Good thing I'm charging a flat rate for this work, instead of by the hour or my timesheet would have constant starts and stops.)



Suze
 
Re: 8/12 Pumbaa earns a dose reduction!

Congratulations Pumbaa, you win the contest hands down! While Chip is back mired in flat pink.

But according to Roomp Rand I don't think it's a dose reduction unless he goes below 50. If you wanted, you could fudge that if you really think he needs a reduction, but my hunch is he doesn't yet. Chip hit 50-even on Lantus and I took the reduction but it was a big mistake. Since Pumbaa's bounce was over 200 he also has an increase coming so maybe they cancel out? Those are both in the "Holding the dose" section of Roomp Rand.

I think I would hold the plain 2.5 to fill the shed and see if he can surf another 17 hours? I'm pleased he returned to green right away. Hopefully you got some Zzzzzzzze during the blue surf? :cool:
 
Re: 8/12 Pumbaa earns a dose reduction!

Pumbaa just hit 43. He truly earned his reduction. :)

Chip: Pumbaa wants some company down here! Time to give your dad a workout and make him stay up all night! ;)
 
Re: 8/12 Pumbaa earns a dose reduction! +9/43 Questions

These nadirs at AMPS and PMPS are for the birds. Kind of like a triple witching hour. You have the bounce still clearing, you have nadir coming, and now PMPS.

Maybe he will be on the way up by then? I would pull the food at least by 10.5?
 
Re: 8/12 Pumbaa earns a dose reduction! +9/43 Questions

Dale 'n' Chip said:
These nadirs at AMPS and PMPS are for the birds. Kind of like a triple witching hour. You have the bounce still clearing, you have nadir coming, and now PMPS.
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Not to mention the fact that I'm still not caught up on sleep and I'm on a very tight deadline! I need to be triplets right now! :roll:

Dale 'n' Chip said:
Maybe he will be on the way up by then? I would pull the food at least by 10.5?
Click to expand...
He's coming up very slowly, and I hope he doesn't have a Lantus double-dip between now and the PMPS. I don't know if the numbers are now due to food, or if he's coming up on his own.

I guess the numbers will determine when I pull the food...he's eating a little every time I test him, otherwise he's laying low in the living room.
 
Re: 8/12 Pumbaa - HELP ... 58 at +11 and not rising

Bumping this up in case anyone is around on Sunday night.
 
Re: 8/12 Pumbaa earns a dose reduction! +9/43 Questions

Seems he's surfing not falling, so see if that holds true? I know it's scary to shoot below 60, but you do know the drill.

I think I would shoot the plain 2.25 reduction and just keep testing? Or if you are too scared you could repeat the chicken shot?

Good job Pumbaa you are doing great! :thumbup
 
Re: 8/12 Pumbaa - HELP ... 58 at +11 and not rising

Thank you for being there for me, Chippendale's! Much appreciated!

Yes, he's holding at 58.

My brain knows that yesterday's BCS didn't affect him in the daytime cycle, and I shouldn't be afraid to shoot him just now. Then again, had I shot his full dose, would his numbers have been even lower yesterday? I don't know...

I just know that I have so much work to get done, quickly, and can't be staying up with Pumbaa 24 hours right now. So what do I do?

I guess I'll figure it out when I see his PMPS number. Maybe I'll post that number, then stall the shot until someone helps me reason this out.

Why couldn't Pumbaa have done this when my work wasn't on such a tight deadline? Hahahahahahaha!!!!!!
 
Re: 8/12 Pumbaa - HELP ... 58 at +11 and not rising

You could just shoot the chicken shot.

It didn't hurt much last time.

He's doing great. :cool:
 
Re: 8/12 Pumbaa - HELP ... 58 at +11 and not rising

The other option is to skip the shot.

MammaDale seems to be skipping everything under 70.

It would be a just this weekend thing?
 
Re: 8/12 Pumbaa - HELP ... 58 at +11 and not rising

Pumbaa said:
Thank you for being there for me, Chippendale's! Much appreciated!

Yes, he's holding at 58.

My brain knows that yesterday's BCS didn't affect him in the daytime cycle, and I shouldn't be afraid to shoot him just now. Then again, had I shot his full dose, would his numbers have been even lower yesterday? I don't know...

I just know that I have so much work to get done, quickly, and can't be staying up with Pumbaa 24 hours right now. So what do I do?

I guess I'll figure it out when I see his PMPS number. Maybe I'll post that number, then stall the shot until someone helps me reason this out.

Why couldn't Pumbaa have done this when my work wasn't on such a tight deadline? Hahahahahahaha!!!!!!
Click to expand...

I don't know where everyone is ... what do you want to shoot, how late can you delay? A skip is the safest, no matter what anyone says.... you can make it up later but always side with safety.

You got good numbers from the 2.5u, so you shot a 1.5u then went back to 2.5u which put you in this low string of green... so you definitely got yourself a reduction.... you may want to wait till the numbers are rising, you did shoot a 66 the other day with 2.5u, but with that 43 and the current surf, I would maybe think of going with a 2u then in the morn, decide if you want to stick with the 2u or go up to 2.25u.

If you are feeding the numbers at all, and you decide to shoot, be sure you check the numbers after about an hour or so, you don't want the numbers falling once the food wears off and you are in bed.
 
Re: 8/12 Pumbaa - HELP ... 58 at +11 and not rising

I don't want to skip entirely at this point and really screw up the shed. I don't know if the BCS yesterday morning has come into play yet.

Going to test Pumbaa now. He's getting 7% carb food tonight, although he doesn't seem to be carb sensitive.

Unless he bounced since the +11, I'll probably do a 1.50U BCS.

At least I work from home. What do people do who are gone at jobs all day??????
 
Re: 8/12 Pumbaa - HELP ... 58 at +11 and not rising

PMPS = 52.

I like what Blue said, err on the side of safety. I am skipping this shot. Whew! Feels better now that the decision is made. Thank you!

Blue, yes, I'll still be testing him all night until he bounces or his numbers go up to the high 100's at least.
 
Re: 8/12 Pumbaa - HELP ... 58 at +11 and not rising

Not that many people shoot a 52, at least not when it's not rising.

Good choice.
 
Re: 8/12 Pumbaa - HELP ... 58 at +11 and not rising

Dale 'n' Chip said:
Not that many people shoot a 52, at least not when it's not rising.

Good choice.
Click to expand...
Pumbaa said it was a good choice, too, 'cause he's really tired of me poking him lately. And he hates getting his injections. :)
 
Re: 8/12 Pumbaa - HELP ... 58 at +11 and not rising

Too often, people are afraid to mess with the shed, but why push it if you don't have to push?
Keep your cat safe, above all else, and worry about things like shed later on.

Enjoy the nice green surf, and you can shoot on time in the morning, and give some thought to the dose...
The 1.5u BCS did nothing to drain the excess shed, if that was the issue, so it was more than just an overfilled shed; you also earned a reduction, so 2.25u may be good, but keep an eye on Pumbaa in case you see another drop into the green zone again... and that would tell you maybe a 2.0u or s2.25u would be better.
 
Blue and Chippendale's:

Thank you for the hand-holding tonight. (((HUGS)))

Blue, while I don't want to "mess with the shed" and have Pumbaa have a set back, I'd rather have him have a set back than go hypo, so I totally agree.

Suze
 
Pumbaa just hit 210 at PM +2.

Once tonight's numbers play out, I'm going to need and want some help analyzing Pumbaa's SS data. :)

At this point, I'm wondering if that 210 is the start of a bounce, or if it is a reaction to my BCS for the 8/11 AM shot. I hated skipping his shot tonight (as I hated giving the BCS yesterday morning), but due to all that is going on in my life right now, and all that Pumbaa has been going through, I just could not shoot a declining 52 PMPS number. Not even a BCS. I simply was not brave enough since I have no backup here, in my house, to test and watch for hypo signs if I crash due to too many work hours and not enough sleep hours. And even the skipped shot tonight doesn't guarantee that Pumbaa won't dive to dangerous low numbers again, due to the shed.

Anyway, I'm not great at analyzing SS data to help predict the future, or even analyzing it to figure out what caused what happened to happen in the past. So all input is welcome!

SuZzzzze <--Yes, we are back to this. My body needs 7 hours of good sleep per night, and I don't think I've had that since Pumbaa was diagnosed. :roll: I got about 4-1/2 hours last night (plus a 1-hour nap before Pumbaa's +6.5 reading), but have no time for naps these days to help make up for missed sleep.
 
I should be in bed, but I just had to check on you. I'm so glad Pumbaa bounced early tonight, and you are getting some sleep.

I think that you did the right thing, of course. I feel that you have to work up to shooting below 100 and then below 90 and then below 80, etc., not for the cat or for the progress toward remission, but just for you. Plus, when you are exhausted . . . well, I have slept through some tests I should have done for Max because I was that tired, and I just couldn't get out of bed. That's not good, and I've been lucky that he either ate on his own or his BG just didn't go that low.

I think you will, eventually, have to shoot some low numbers to make progress. That has been my (limited) experience.

More importantly for the short term, I also think that if you can get Pumbaa down below renal threshhold, and keep him there for a while in safe numbers to let yourself have some time to catch up on your sleep, you will be much, much better off. Aren't there some sort of sticks you can buy to put in his urine stream that will tell you if he's dumping glucose into his urine? Maybe you could find his renal threshhold and try to hold him there below it for a week or two while you get some time to heal yourself? Anyone else think this is a reasonable course of action?

Goodnight.
 
Dale:

Thank you for checking in before bedtime! :)

I would love to just have Pumbaa stabilize below renal threshold, and never bounce and never dive! That was my goal when I started him back up the dosing ladder, and why I was only increasing by drops, instead of by the full .25U that is normally recommended. So if you know who has the magic wand to make this happen, let me know! *LOL*

The keto sticks I have check both for ketones and blood glucose, but I never pay attention to the BG reading because it was my understanding that that's not an accurate guide to anything, or maybe I misunderstood and it's just not an accurate guide to dosing since the sugars in the urine accumulate over the last several hours. I'll have to look into that.

I've shot low numbers in the past, fearlessly. But that was when Pumbaa was on a lower dose and wasn't getting greens regularly, and when his nadir's were more predictable then they are right now. I have to take that into account as well as my ability to test him non-stop to catch his unpredictable nadir, and be able to catch small naps here and there.

I hate giving BCS's and really hated skipping his shot last night, because I don't want to mess with the shed and decrease our momentum getting him into good numbers more regularly. But you do what you gotta do.

Suze
 
I think you are right about the test strips for urine. The glucose in the urine doesn't show up for several hours. So, that level showing on the strip doesn't help you dose or decide whether to shoot because the BG that corresponds to that urine test is hours old. The idea is, of course, trying to figure out what is the highest BG that your cat can handle without dumping sugar into the kidneys.

I wonder if anyone here has tried to use the test strips to determine what his/her cat's individual renal threshhold range might be, and get the chance to keep the damage to a minimum while keeping the risk of hypo low, too. It would seem worth looking into for someone who goes to work everyday, and can't monitor his/her cat. For you, I think if it was useful, and could work out the way I am wondering, that it would let you get some rest just in case you are in for a wild ride when you are ready for it.

Now, keep in mind, that some people feel remission is very, very important, and that risking the chance it won't happen is a very bad idea. For you, the period of time your cat has had diabetes is a consideration. Let's face it, not only for the cat, but for you, remission would be really great. When I wrote:
I feel that you have to work up to shooting below 100 and then below 90 and then below 80, etc., not for the cat or for the progress toward remission, but just for you.
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, I wasn't taking into consideration the period of time since your cat was diagnosed or whether you have to be more brave (and more self-sacrificing) if time's a-passin.'

Nonetheless, when I came here I had no expectations of remission - all I wanted was for my cat was for the BG to stay between 100 and 200. I had no idea how difficult that goal was going to be to reach nor did I realize that it's probably pretty difficult to keep a cat in that range every day. I was naive in that I thought that if 100-200 was the range recommended then it was probably chosen because it was possible for most cats. I took another look at that recommendation: the operative words are: "the majority of the time" or something to that effect. That makes sense if 230 is the lowest renal threshhold in most cats, and 80 is close enough to hypo for most people's tastes.

The fact that Max suddenly starting getting BGs in the Green, and that I have (barely) the time and freedom to try TR at the same time . . . totally unexpected for me. I'm thinking that there are so few cats that can go into remission and that if mine is one that can, I should give him (and myself) that chance.
 
Dale:

My ultimate goal would be for Pumbaa to also go into remission. But I don't think that will happen as long as he still bounces and dives, which is why my short term goal is more and more days of even numbers, like that 17 straight hours of good greens.

With the numbers Pumbaa is getting today, I really feel bad for doing a BCS Saturday morning and skipping his shot last night, but you can't rewrite history and can only forge ahead. At least your Max isn't still bouncing like Pumbaa still is. The highest you've had since 7/29 are a few yellows lately. You're SOOOOOO lucky in that respect. :) But I don't envy your wild ride down the dosing ladder with him. That was intense...even sitting here reading what you were going through! *LOL*

2.50U might still be Pumbaa's ideal dose for a while, and I might have to take him back up there. Maybe until he does stop bouncing and diving. Maybe 2.50U is where his body needs to be to keep healing his pancreas. I don't know.

I wish it was as easy as saying, "I'm going to give this dose and keep my cat below the renal threshold until Friday" or something like that. But, as you know, it's not. It's a huge guessing game and balancing act and decision making process that we still have no control over the outcome on, in the end. Although it's frustrating at times, it was enough to cause me to bawl when Pumbaa had that wonderful 17 hours of greens for the first time. :)

Suze
 
I don't know if Pumbaa won't suddenly start seeing progress even if he bounced just the day before.

Look at Max's July 18 through 26. I thought we were just going to keep bouncing. Look at the AMPS on 7/24. That 400 which is Pink but should be Red. He only had about 8 days of 2.75u, and then fur shot after fur shot gave him Pinks for both am and pm, but yet his journey into Greens started right there.

It was a darn good thing I had the sitter giving him 2.5 because I wonder: if she had been giving him 2.75 might he have started diving while I was gone!!!!?
 
Dale,

The difference I see between your Max and my Pumbaa from your Max's July 18-26 is that both Max's pancreas and liver kicked in big time, right then, with the pancreas saying, "Hey, I'm working now, stop sending in the Lantus scab to do my job!", and with the liver saying, "I'm going on vacation now, 'cause we're getting used to these lower numbers and you've worked me too hard the last couple of months." If that was the case for Pumbaa, he wouldn't have the high numbers he's currently having, after my BCS on Saturday and skipped dose last night.

If this 2.25U doesn't get him back to good numbers, I am ready to take him back up to 2.50U and get his pancreas back to work and give his liver a vacation. :)

Suze
 
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