9/13 Sushi - #s <45 Sat-Tues - +4.5~311|PMPS~179|+2~141

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Sushi (GA 5/05-3/14)

Sushi (GA 5/05-3/14)

Member Since 2011
Good Morning!
We're starting the day with a 202, and a full night's rest for this bean! Yeayyyyyyy!! :-D :-D It's AMAZING what a night's sleep will do for you!! I desperately needed it.

I'm going to repost yesterday's condo:
Sushi said:
last condo - Sunday
Sooo I've been up half the night pulling Sushi out of low #s for the past 4 nights in a row. I'm EXHAUSTED!!! I desperately need a good night's sleep. Work is super stressful right now, I'm to the point to where I had a migraine last night. This bean needs sleep!! I sure hope we're not in for another long night tonight. :cry:

I wasn't able to come home and check on Sushi at lunch Monday and Tuesday, so who knows what may have gone on then... :-|

I'm not sure what the heck is going on. Can anyone advise?
And I find it really strange that he dips so low so quick! As early as +2!

Also, I'd like to re-post some of what I asked/said in my last condo--
What if low #s happen while I was at work or something? Like if I came home for lunch, checked him and he was super low? I would just break open a can of high carb and leave it out for him?

I feel like no matter how many times this happens, we always end up at 3+ units again anyway. I feel like we just go back and forth, back and forth, and can never land on a dose that really works. I feel like I'm playing checkers, don't see any moves I can make, so I just move a piece one way, then back over and over again. No moving forward. Ugh. :roll:

Here's a recap:

SUNDAY - 3u
+3.75 47 - VitaGravy & a few kibbles of Purina Indoor Cat
+4 47
+4.5 53
+4.75 61
+5 55
+5.5 65
+5.75 70
+7 115

MONDAY - 2.75u
+2 44 VitaGravy & a few kibbles of Purina Indoor Cat
+2.5 45
+3 49
+3.5 41 1 tsp high carb
+3.75 49
+4 61
+4.75 69
+5.75 92
+10 163

TUESDAY (bean had migraine!) - 2.5u
Sooo vocal & hungry @ PMPS!
+2 58 a few kibbles of Purina Indoor Cat
+3 36 1 tsp high carb
+3.5 44
+3.75 39
+4 46 1 tsp high carb
+4.5 47
+4.75 56
+5.5 57 VitaGravy
+9 eating sister's food
+11 sooo vocal & hungry!
+7 133

TODAY - AM 2.5u / PM 2.25u
Click to expand...
 
Re: 9/13 Sushi - #s <45 Sat-Tues - AMPS~202

I'm glad you showed back up. I worried about you when you signed off the other night.


You earned a dose decrease the other night (9/11) with that 36.
Why didn't you take it?
I don't see anything to indicate that you should go up.
I think Sushi is telling you he needs less.
You've been getting lower numbers. I don't see why you aren't decreasing by .25. You have to let new doses have time to settle in
unless they earn another decrease.
I think you are having that "move forward" and missing it. This is a complicated dance and Sushi is leading you.


And since you aren't home during the day, I would always lean on the conservative side with dose changes. No big jumps.
If you come home to a low number, you need to watch him eat it, not set it down and run.
You may have to hold it for him but you need to know he's getting it in.
 
Re: 9/13 Sushi - #s <45 Sat-Tues - AMPS~202

Um, it looks like she did take a reduction on Monday and Tuesday and Wednesday. After they have been ill, things can really change. Now that Sushi is over the stress from being boarded and all the aftermath, he is needing less insulin. We usually try to let a dose settle before doing a second reduction, sometimes the shed really needs to drain. But that 36 was a big demand for less again and I don't blame you for the second reduction. Keep a close eye on him though, you may need to go back a little.
 
Re: 9/13 Sushi - #s <45 Sat-Tues - AMPS~202

I just saw lots of waffling that I wasn't sure which one was the dose for today. She's added a number since then.

I didn't like the chatter about thinking she was going to wind up back to 3u.
Marje should be back on some today and will hopefully make it over to your condo.
 
Re: 9/13 Sushi - #s <45 Sat-Tues - AMPS~202

I just looked at Sushi's SS, back up to 2.5u this morning??? Why? It was a beautiful green cycle last night or was that a typo?

I noticed you said he was straining in the LB too. Maybe add a little Miralax to his food, 1/8tsp. I do that for Tess when she has hard poo.
 
Re: 9/13 Sushi - #s <45 Sat-Tues - AMPS~202

Thanks for your responses! I'm typing on my phone real quick at work--I gave 2.25u this morning. If my spreadsheet says something else, it's a typo. I'll type more when I get home later! : )
 
Hi!

Okay, now I'm at a "real" computer and can type a better response. I have been decreasing in increments of .25u. Ann did a great job of explaining my situation and why I've taken the decreases I have.

If anything, I think I should have decreased Saturday night (lowest was 41), but I wasn't sure if that was a good move with all the changes we're going through right now (that Ann explained). With everything going back to normal, I figured he's just re-adjusting. Even with Sushi dropping to 47 Sunday, I waited until Monday to give a decrease.

So far so good tonight; 2 nice blue #s! I could get used to this! It looks like I may get some sleep tonight as well! Yessss!!

Any other dose advice?

I still don't feel confident that I know what to do if Sushi's #s seem to be dropping when I'm not able to be around to care for him (ie: while I'm at work). I think the answer is to give him high carb food and leave some out for him. Right or wrong?

Thanks! ;-)
 
I still don't feel confident that I know what to do if Sushi's #s seem to be dropping when I'm not able to be around to care for him (ie: while I'm at work). I think the answer is to give him high carb food and leave some out for him. Right or wrong?
Click to expand...

Right! I would reconsider the use of the dry food, though.

Ann was alluding to the point that we usually don't encourage taking what amounts to back-to-back reductions. There's a reasonable chance that dome of the drops were a result of the insulin depot not having caught up to your newly reduced dose. If it doesn't look like the lower numbers are holding, don't hesitate to increase Sushi's dose.
 
HIP HIP HOORAY TO SLEEP!!!!!! YAY Sushi on some LOVELY numbers! Keep up the lovely blues (for now...nothing higher or lower...at the moment!) :-D

Sleep well, Ashley!
 
Sienne and Gabby said:
Ann was alluding to the point that we usually don't encourage taking what amounts to back-to-back reductions. There's a reasonable chance that dome of the drops were a result of the insulin depot not having caught up to your newly reduced dose. If it doesn't look like the lower numbers are holding, don't hesitate to increase Sushi's dose.
Click to expand...

Hello Ashley

Sushi is giving you some really great numbers - that's wonderful! I thought I'd reiterate the point Ann and Sienne made above, just to make sure you realize what it entails: When a cat throws several sub-50 dips at its bean in a few consecutive cycle, it's sometimes a toss-up between responding to each single sub-50 dip with its own reduction, and allowing the shed (the indulin depot) to "catch up" to the current dose. You know, I'm sure, how the insulin depot/shed works, but it's easy to lose sight of some of the core aspects especially when one's cat is being all dramatic, so here's a little refresher:

QUOTE from INSULIN DEPOT Sticky:
"Have you ever wondered why, when you are giving the same amount of insulin every time, the response is different in each cycle? Sometimes the numbers go up for the whole cycle, sometimes they go down, sometimes they stay flat, and sometimes they actually “curve.” The answer often lies in the depot. Did you skip a shot or give a partial shot at some time in the past few days? That can result in higher numbers for several days as the depot replenishes some of its lost stores. Did you increase the dose? This can result in a change in the size of the depot and can lead to a temporary adjustment in the amount of insulin available for use. Did you decrease the dose recently? A dose reduction will usually result in a need for less stored insulin. The excess may be released into the bloodstream faster than usual, especially if several dose reductions are done back-to-back."

The shed mostly can't catch up to a dise change instantaneously - it needs a few days to adjust. So when your cat earns a decrease by dipping to sub-50, the shed itself is still overly full the cycle(s) *after* you decreased, until it has "caught up" to the current dose. This means that a subsequent drop to sub-50 may not stand for "I need even less insulin", but may instead stand for "I need to let my shed catch up". It's tricky to manoevre through this, because it can be hard work to keep a cat out of the low numbers while the shed is playing catch-up. I think that this is what you've been going through.

If it is, you may find Sushi needing a bit *more* insulin after all - because by flicking through the doses (reacting, understandably, to the sub-50 dips in quick succession), you may have flicked *past* the dose that would have helped Sushi stabilize a bit, before making more progress and earning his next reduction. Should you see this happening, try not to be discouraged - it's something we see a lot when back-to-back reductions were taken, and it's just a way of taking a break and allowing the cat the chance to show which dose is the current "good dose."

Looking over Sushi's SS, I wondering about your previous approach to dosing - I see quite a number of lanreg dose changes, as for instance between the 4th and 6th of September. May I ask what your reasoning was behind those large dose changes? (I'm also wondering if you might consider posting a Profile for Sushi? It would help tremendously in learning a bit more about his and your FD history.)

I hope this makes sense to you. Please do keep asking your questions! It's wonderful to see such a dedicated bean caring for her cat and wanting to be sure to understand all the finer points of what we do here in TR Lantus Land :smile: You're doing well, and once Sushi has had a chance to demonstrate which dose he likes for now (and that may be the one he's on, with luck), I'm sure you'll be able to make progress that will help you feel more confident that both you and Sushi are doing great!

Hugs
Jane
 
Okay. And I will know to give an increase when Sushis #s get to what?
I feel dumb asking but apparently I just don't get it, and have been doing it wrong for a while now...

Thanks for the responses & great info! :smile:
 
You needn't be sorry for asking, Ashley. I would try sticking with your current dose for a few days (barring any extreme development) to see what Sushi will do with this dose. With luck, he will do well on it. If you did inadvertently slip past a good dose, you would see his numbers creeping up. Let's re-assess tomorrow when he's had another couple of cycles on this dose. How does that sound to you?

Anything else unclear?

Jane
 
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