9/25 Nelli PMPS 169 +2.5 174

While we are waiting, I’d like to do a recap. When I was working, we called it an “after action report” which details what we did and what we could have done so we could learn from it. So....this is provided as an opportunity to learn, not as a critique. Ok? And it helps others learn.

Remember back when I was nagging you about always getting a +2? Now you see why. I guarantee that at +2 today, she would have been lower. Then you could have given her a little LC to help slow the drop and even her out (hoping she would have eaten). By waiting until +3.5 to test, the locomotive was headed downhill fast.

When, at +3.5, you got the 65, I absolutely would have fed that with a higher LC food or a larger helping and I would have retested in 30 mins...not 1-1/2 hours. If you had to leave for an appointment at that 65, I would have fed her a large helping of the w/d right then and left some out for her to eat. Moral of the story.....if you must go out for a work appt and she’s safe but lower, feed HC food and leave some out. Better that she go high than low.

And I will add that we’ve all been in your shoes on this. The first time Gracie gave me a 30, and it was early on, I fed her as usual and figured she couldn’t drop that much in two hours that I’d be gone for a golf lesson. Wrong. She could and did and so do alot of cats.

And a reminder that you’ll want to drop the dose tonight. I’d like to see how this cycle plays out before we decide by how much, ok?
 
Yes, I agree on the +2, I'm always harping on that test also. I call it my "favorite test"

Also, unfortunately, when you had asked in post # 11 if it were okay to test again at+5, I had answered it in post +12 but my answer got hidden in your quote box so I am not sure if you saw it where I had said to get a +4 because she was beyond onset.

You are doing great Krystina and all though it is very stressful to see them dropping , it is also a very good thing that she has hit a dose that is getting her into better numbers and she earned a reduction. :)

I will be watching later to see what dose Marje advises for tonight.
 
+3.5 65
+5 39 fed 1.8oz can w/d (25% carb)
+5.5 38 fed 1.8oz can w/d (25% carb),
+6.25 53
+7 71

I’m still confused about when you gave the syrup. In one place, you said you gave it at +5.25 and in another, you said you gave it when you fed at +5.5.

Why is this important? Because it needs to be put in the remarks on her SS so you and we know exactly what you did when and what worked. It would be rare if this never happened again so you want to know how to react especially if it’s in the middle of the night and you are on your own because the board is quiet.

Please be sure you read my post #54 and @Bobbie And Bubba post #55.

Normally, at 6u, we would drop the dose back to 5.5u. However, my reservation is because she was just starting to look good and the numbers today could have been because she didn’t have enough food to offset the drop. We must reduce but I worry that reducing her to 5.5u is going to leave her in high numbers.

Do you think you could consistently draw a 5.75u dose and will you have enough availability to test her over the next six cycles? The reason I’m asking is because a 6u depot could drop her lower again the next 4-6 cycles and if we just drop her to 5.75u, you could see more low numbers in those six cycles before we can clearly see what 5.75u does.

The option is, if you have a tough schedule the next few days, reduce to 5.5u and drain the depot more. You can always take her back up.

Thoughts?
 
Marje and Gracie said:
While we are waiting, I’d like to do a recap. When I was working, we called it an “after action report” which details what we did and what we could have done so we could learn from it. So....this is provided as an opportunity to learn, not as a critique. Ok? And it helps others learn.

Remember back when I was nagging you about always getting a +2? Now you see why. I guarantee that at +2 today, she would have been lower. Then you could have given her a little LC to help slow the drop and even her out (hoping she would have eaten). By waiting until +3.5 to test, the locomotive was headed downhill fast.

When, at +3.5, you got the 65, I absolutely would have fed that with a higher LC food or a larger helping and I would have retested in 30 mins...not 1-1/2 hours. If you had to leave for an appointment at that 65, I would have fed her a large helping of the w/d right then and left some out for her to eat. Moral of the story.....if you must go out for a work appt and she’s safe but lower, feed HC food and leave some out. Better that she go high than low.

And I will add that we’ve all been in your shoes on this. The first time Gracie gave me a 30, and it was early on, I fed her as usual and figured she couldn’t drop that much in two hours that I’d be gone for a golf lesson. Wrong. She could and did and so do alot of cats.

And a reminder that you’ll want to drop the dose tonight. I’d like to see how this cycle plays out before we decide by how much, ok?
Click to expand...
Thanks. I am clear ;). I have learned ‘how to’ save post that are important references for me now, too. This is definitely a keeper... this single post alone from you.
I do want to understand and be able to make intelligent decisions, moves. I am frustrated that I cannot see what you and others (who have graciously guided me), see. I don’t even pretend to remotely understand what is happening, what is getting ready to happen most likely, at each new day.
Thank you again so much for this clear understanding of what transpired today… So far :facepalm:. They have often been times when remembered I got ‘the’ answer to a question or, a move to make. But where God would I dig this back up? I’d become lost. Lost no more :D:p:smuggrin:!
 
Krystina & Nelli said:
Thanks. I am clear ;). I have learned ‘how to’ save post that are important references for me now, too. This is definitely a keeper... this single post alone from you.
I do want to understand and be able to make intelligent decisions, moves. I am frustrated that I cannot see what you and others (who have graciously guided me), say. I don’t even pretend to remotely understand what is happening, what is getting ready to happen... most likely at each new day.
Thank you again so much for this clear understanding of what transpired today… So far :facepalm:. They have often been times when remembered I got ‘the’ answer to a question or, a move to make. But where God would I dig this back up? I’d become lost. Lost no more :D:p:smuggrin:!
Click to expand...
You’re welcome.

Also....a few other things to add which is for future reference because I know the first time you see these numbers, it’s all out panic and adrenaline. You aren’t expected to keep track of everything.

When we are working low numbers, in between testing and feeding, it’s imperative that you (a) keep the SS up-to-date and accurate so what you post in the condo and what you post in the SS are exactly the same and (b) keep the subject line up-to-date. Even now, your subject line is telling members she’s at 38. That means that members are going to stop what they are doing and check in. That takes up their time that they don’t need to spend on this condo because it’s all under control. It’s standard practice here that when one member is helping another member with low numbers, others don’t get in the mix and post because it becomes too stressful for the member dealing with low numbers to have to keep up with all those posts. But check out your views...106 right now. So members are taking time to check in on you.

The other helpful thing with low numbers is to keep a summary of it in the condo as we are doing it. By that I mean:
+3.5 65
+5 39 fed 1.8oz can w/d (25% carb)
+5.5 38 fed 1.8oz can w/d (25% carb) with two pearl sz drops agave
+6.25 53
+7 71

When I’m helping a member, I’m not looking back at their subject line because I’ve got the condo open constantly. I’m also probably not looking too much at the SS because, even if you update it immediately, there is a time delay in what we see from the SS link in FDMB. The person helping you will help you do the summary. Long ago, we did not do this but some where along the line, we started doing it and it really helps all concerned. And if you’re in a frazzle and the numbers drop back down again before you’ve entered everything into your SS Remarks on feeding, you can scroll back up and see what we did when.
 
I didnt see this Bobbie. That’s weird how it got put in that yellow box? Regardless, Nelli’s dental appointment on October 8 is with a dental veterinarian whom she saw a few years back. Which 0BTW he was thrilled at her age she had all of her teeth :) hasn’t had an extraction... yet :bookworm:
How his procedure works is that she gets the greenlight for anesthesia, she’s anesthetized, dental exam and cleaning and... any thing else she might need. So, the exam is done under anesthesia :).
Without thinking I had heard anything other about testing +5 I stayed on that track.
 
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Marje and Gracie said:
You’re welcome.

Also....a few other things to add which is for future reference because I know the first time you see these numbers, it’s all out panic and adrenaline. You aren’t expected to keep track of everything.

When we are working low numbers, in between testing and feeding, it’s imperative that you (a) keep the SS up-to-date and accurate so what you post in the condo and what you post in the SS are exactly the same and (b) keep the subject line up-to-date. Even now, your subject line is telling members she’s at 38. That means that members are going to stop what they are doing and check in. That takes up their time that they don’t need to spend on this condo because it’s all under control. It’s standard practice here that when one member is helping another member with low numbers, others don’t get in the mix and post because it becomes too stressful for the member dealing with low numbers to have to keep up with all those posts. But check out your views...106 right now. So members are taking time to check in on you.

The other helpful thing with low numbers is to keep a summary of it in the condo as we are doing it. By that I mean:
+3.5 65
+5 39 fed 1.8oz can w/d (25% carb)
+5.5 38 fed 1.8oz can w/d (25% carb) with two pearl sz drops agave
+6.25 53
+7 71

When I’m helping a member, I’m not looking back at their subject line because I’ve got the condo open constantly. I’m also probably not looking too much at the SS because, even if you update it immediately, there is a time delay in what we see from the SS link in FDMB. The person helping you will help you do the summary. Long ago, we did not do this but some where along the line, we started doing it and it really helps all concerned. And if you’re in a frazzle and the numbers drop back down again before you’ve entered everything into your SS Remarks on feeding, you can scroll back up and see what we did when.
Click to expand...
Thanks, I appreciate you.
 
Krystina & Nelli said:
I didnt see this Bobbie. That’s weird how it got put in that yellow box? Regardless, Nelli’s dental appointment on October 8 is with a dental veterinarian whom she saw a few years back. Which 0BTW he was thrilled at her age she had all of her teeth :) hasn’t had an extraction... yet :bookworm:
How his procedure works is that she gets the greenlight for anesthesia, she’s anesthetized, dental exam and cleaning and... any thing else she might need. So, the exam is done under anesthesia :).
Without thinking I had heard anything bad about testing +5 I stayed on that track.
Click to expand...
Yeah I am not sure why my response to your question went into the yellow quote box. The only think I can think of is that the last Quote bracket ( ] )got erased and made you post and my post as one. When I caught up with Nelli dropping I went back to make sure I had answered your next test question and found out that had happened. I am sorry that it happened as it could have saved you some anguish and , mental note to self to make sure my response looks correctly after it is sent.
 
Krystina & Nelli said:
Thanks, I appreciate you.
Click to expand...
Especially when I’m not nagging you :woot::woot::p:p:p:D:D:D

Krystina & Nelli said:
Ok, now for God’s sake... when would you test next?
Click to expand...
I would test at +8. She had a lot of HC food and it’s going to wear off. Let’s be sure it put the brakes on her a bit as the duration of the insulin is waning.

And I’d still like your thoughts on the dose for tonight after you read my post #57 because my answer depends, in part, on your ability to test.

Thanks for fixing that subject line. See....members always care even if they don’t post. It’s just the etiquette here to not post when we are working low numbers.
 
Marje and Gracie said:
+3.5 65
+5 39 fed 1.8oz can w/d (25% carb)
+5.5 38 fed 1.8oz can w/d (25% carb),
+6.25 53
+7 71

I’m still confused about when you gave the syrup. In one place, you said you gave it at +5.25 and in another, you said you gave it when you fed at +5.5.

Why is this important? Because it needs to be put in the remarks on her SS so you and we know exactly what you did when and what worked. It would be rare if this never happened again so you want to know how to react especially if it’s in the middle of the night and you are on your own because the board is quiet.

Please be sure you read my post #54 and @Bobbie And Bubba post #55.

Normally, at 6u, we would drop the dose back to 5.5u. However, my reservation is because she was just starting to look good and the numbers today could have been because she didn’t have enough food to offset the drop. We must reduce but I worry that reducing her to 5.5u is going to leave her in high numbers.

Do you think you could consistently draw a 5.75u dose and will you have enough availability to test her over the next six cycles? The reason I’m asking is because a 6u depot could drop her lower again the next 4-6 cycles and if we just drop her to 5.75u, you could see more low numbers in those six cycles before we can clearly see what 5.75u does.

The option is, if you have a tough schedule the next few days, reduce to 5.5u and drain the depot more. You can always take her back up.

Thoughts?
Click to expand...
 
Marje and Gracie said:
Do you think you could consistently draw a 5.75u dose
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Now you are stressing me out :eek:.
I have half mark syringe- in past how I would do it would measure rubber stopper in between the half Mark and the whole mark? I hope I have/do it consistently correct but who knows without having a calpiler, which I do need to invest in one.
My schedule can be flexible enough to be properly attentive over next six cycles. The only day which is nearly impossible for me is a Friday night through Saturday afternoon.
 
Krystina & Nelli said:
Now you are stressing me out :eek:.My schedule can be flexible enough to be properly attentive over next six cycles. The only day which is nearly impossible for me is a Friday night through Saturday afternoon.
Click to expand...

Krystina & Nelli said:
I am all over avoiding this possibility!
Click to expand...

Ok. Let’s see how the cycle plays out. The normal reduction from 6u should be to 5.5u just for the same reason we went up 0.5u. At this dose, a 0.5u reduction would be like at 0.25u reduction at a lower dose. My gut, from a safety standpoint, tells me it’s best to give the full reduction and take her up to 5.75u if she stalls.
 
Marje and Gracie said:
a 6u depot could drop her lower again the next 4-6 cycles and if we just drop her to 5.75u, you could see more low numbers in those six cycles before we can clearly see what 5.75u does.
Click to expand...
I’m ready to roll on a .25 reduction. I will need guidance on test timing for PM especially. What I’m getting ready to say may not sit well with you and some others… if so, just virtually spank me with a wet noodle (he-he).
Here goes:
To me it doesn’t make sense to wake Nelli up and poke her every two hours if not crucial. I know I have been told numerous times “if pm +2 is higher (or lower) than PMPS shoot ____, otherwise you can break until + ___. As I understand the more test the better (Gracie SS exp.).
Marje and Gracie said:
Ok. Let’s see how the cycle plays out. The normal reduction from 6u should be to 5.5u just for the same reason we went up 0.5u. At this dose, a 0.5u reduction would be like at 0.25u reduction at a lower dose. My gut, from a safety standpoint, tells me it’s best to give the full reduction and take her up to 5.75u if she stalls.
Click to expand...
not following you? Shoot 5.75 or 5.5 PM?
 
Krystina & Nelli said:
I’m ready to roll on a .25 reduction. I will need guidance on test timing for PM especially. What I’m getting ready to say may not sit well with you and some others… if so, just virtually spank me with a wet noodle (he-he).
Here goes:
To me it doesn’t make sense to wake Nelli up and poke her every two hours if not crucial. I know I have been told numerous times “if pm +2 is higher (or lower) than PMPS shoot ____, otherwise you can break until + ___. As I understand the more test the better (Gracie SS exp.).

not following you? Shoot 5.75 or 5.5 PM?
Click to expand...
I don’t know that anyone has told you to poke her every two hours if not crucial. Where the difference might be is your definition and our definition of “crucial”. You can’t compare Gracie because she was on Levemir so the cycles are totally different.

All we can tell you is what we know from experience. If she’s the same as or lower at +2, she’s likely to have an active cycle and “might” require more testing. It’s up to you to whether you how much you want to test her but you might want to look around at SSs of lantus users and see what happens when the +2 is lower than the PS. Remember ECID but it just gives you an idea.

IMHO, I’d reduce to 5.5u and if she needs more insulin (she does not come back down into green after any bounce has cleared), then you’ve got something to take her up to as the “last good dose” is not the dose that got her into the 30s (in other words, 6u is not a good dose right now; later, we might find she needs to go back up to 6u but for now, she’s telling us she needs less insulin).

Having said all that, you hold the syringe.
 
Definitely, if I see based upon +2 that she quite possibly will have an active night... I will test until she starts rising to AMPS.
Thanks :)
Was +8 # to be expected; how does it look?
 
Krystina & Nelli said:
Definitely, if I see based upon +2 that she quite possibly will have an active night... I will test until she starts rising to AMPS.
Thanks :)
Was +8 # to be expected; how does it look?
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Looks good!

We are headed out...hiking day. I won’t be back by your shot time but I’ve given you my thoughts. You’ve got time to query others if you’d like other opinions.

Good job today!!!!
 
Sue and Luci said:
I don't know if someone has already mentioned this - have you tried the blender/food processor and adding water or broth to liquify her food? Just wondering...poor thing...she needs her fuds...but that was a nice start this morning! Good for her for showing you 'she can do it'...!:bighug::bighug:
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I used a ( magic bullet o_O) blender to pulverize Nell Rad Cat for dinner. It worked brilliantly, thanks for the sugest’ she ate all at one sitting- didn’t watch but don’t think she went thru her chop, chop, chop-chopping mouth behavior tonight :D.
 
I will feel relieved, one way or another when Nelli has her BP checked late tomorrow late afternoon is appointment.
Asked... Vet uses “digital BP meter not Doppler. Is one better than another?
 
She has developed little bitty bumps on her little ear flaps from pokin’ :oops:
and
Asked... Vet uses Digital not Doppler BP check. One over the other? You opinion :) please.
 
Not regularly- when I put aloe or Silver first aid, etc, it interferes with next poke unless I clean/wipe away completely? I’ll try the Neosporin :) question to @Bobbie And Bubba whould you and Bubba s.l.e.e.p tonight or shoot some more?
+2.5 was just about same as PMPS :-|
 
Are you poking her ear flaps? You should be poking higher than that.

The digital one should be fine to measure BP. Good luck tomorrow and good luck with the dose reduction.

On the dose reduction, if she bounces, we want to be sure the BG comes back down to green or we need to increase to 5.75u. You don’t want to sit on a dose that isn’t working after a reduction.

Paws crossed 6u was the dose that got her going!
 
Krystina & Nelli said:
pulverize Nell Rad Cat for dinner. It worked brilliantly, thanks for the sugest’ she ate all at one sitting-
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Did not work this morning :-( I am playing phone tag with dental office should know something here shortly… Waiting for a callback. She is so hungry but cannot finish her breakfast. I waited about 45 minutes and then set down the rest of it for her, she finished it gobbled it up but then went through her mouth exercise.
 
Krystina & Nelli said:
Did not work this morning :-( I am playing phone tag with dental office should know something here shortly… Waiting for a callback. She is so hungry but cannot finish her breakfast. I waited about 45 minutes and then set down the rest of it for her, she finished it gobbled it up but then went through her mouth exercise.
Click to expand...
Poor thing...hope someone can look at her soon...
 
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