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Zoey & Carol

Zoey & Carol

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Can someone please look over Zoey's spreadsheet? I'm concerned that for the last month and a half she has had many really high numbers. The ones that say 600 are probably actually higher because the tester just said "HI". In looking back over the spreadsheet, she seems to have been doing much better over the summer. Do you think her dose is just too high and she is bouncing? Lately, a few of her preshots have been too low to shoot! But some of her nadir numbers haven't been too bad. I'm really confused. It doesn't seem that what I'm doing is working!

Is it time to try a new insulin? This is my third type: Novolin, Vetsulin, ProZinc.

Thanks for any advice you can give me!
 
Last night, between the 183 and the 395, did Zoey eat?
 
Yes, she is all over the place but I see some encouraging signs in there. Her pmps numbers the last few cycles have been encouraging. I think you have enough data to shoot a 180, as long as you can monitor her early on, and as long as she is rising. So instead of stalling, I'd shoot those. Her amps this morning was a nice change.

Maybe a little tweaking of your sliding scale? Or, if you are about out of ProZinc, it might be that a depot insulin would flatten out those curves. You are shooting small doses which is encouraging. Zoey is like several of our kitties here - their numbers aren't bad but it is so hard to pick out patterns in their spreadsheet. A dose one cycle does something completely different the next. The 1.4 for those pinks looks pretty good , except for the occasional 400 bounce.

I don't know, Carol, she seems to respond pretty well but she also has some odd responses scattered in there. We could ask @Merlin to tweak your sliding scale?

When does she eat and how much?
 
Carl & Polly & Bob (GA) said:
Last night, between the 183 and the 395, did Zoey eat?
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Yes. She ate about 1/2 can of Fancy Feast.


Sue and Oliver (GA) said:
Yes, she is all over the place but I see some encouraging signs in there. Her pmps numbers the last few cycles have been encouraging. I think you have enough data to shoot a 180, as long as you can monitor her early on, and as long as she is rising. So instead of stalling, I'd shoot those. Her amps this morning was a nice change.

Maybe a little tweaking of your sliding scale? Or, if you are about out of ProZinc, it might be that a depot insulin would flatten out those curves. You are shooting small doses which is encouraging. Zoey is like several of our kitties here - their numbers aren't bad but it is so hard to pick out patterns in their spreadsheet. A dose one cycle does something completely different the next. The 1.4 for those pinks looks pretty good , except for the occasional 400 bounce.

I don't know, Carol, she seems to respond pretty well but she also has some odd responses scattered in there. We could ask @Merlin to tweak your sliding scale?

When does she eat and how much?
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She has food available most all of the time, except for the 2-3 hours before her shot. She usually eats about 3 cans of Fancy Feast a day, sometimes 4. She still weighs about 8 pounds, so I have been letting her eat as much as she wants, except right before shots. She eats Fancy Feast with occasional Special Kitty and Purina Pates.
 
Okay, I thought so. I am guessing that is why you shot 1.2 on that number instead of what you would normally shoot on a 395?

I agree that maybe your scale needs tweaking. My thinking is that the .2u increment steps are not significant enough to show you definite results.
 
Carl & Polly & Bob (GA) said:
Okay, I thought so. I am guessing that is why you shot 1.2 on that number instead of what you would normally shoot on a 395?

I agree that maybe your scale needs tweaking. My thinking is that the .2u increment steps are not significant enough to show you definite results.
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Yes. That is why I shot less than what I normally would. I didn't want her to bounce too high again. Maybe I'll increase the jumps to .4 instead of .2?

This is the scale I've been using:
Less than 150 0
150-220 1.0
220-320 1.2
320-400 1.4
400-500 1.6
Over 500 1.8

So should I try increasing each dose by .4 instead of .2?
 
What I was thinking, .4u steps. And then being able to try to test for nadir to see how it works whenever possible.
See what others think?
 
Carl & Polly & Bob (GA) said:
What I was thinking, .4u steps. And then being able to try to test for nadir to see how it works whenever possible.
See what others think?
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So is this what you're thinking?
Less than 150 0
150-220 1.4
220-320 1.8
320-400 2.2
400-500 2.6
Over 500 3

I'm a little hesitant because I've never given her over 2 units. But I'm up for trying anything at this point.
 
Maybe before messing with your scale, more info would explain some of the confusing results. What I see is

1.4 for 338 was perfect = 192 pmps
1.4 on 350 gave you a 462 pmps
1.4 on 375 gave you 166 pmps

IMHO, upping the dose won't improve things. This is a puzzle that may need some time and finesse. What is the relationship of food to the pmps numbers? Did she eat closer to the 462 than the 166? Where is the nadir? Is it at +6 or earlier or later? Is that 462 related to a low nadir or not?

You hold the syringe; you decide. I think we need to give this some time, some more eyes and all the data you can get in the next few cycles.
 
Or, maybe the ranges can be adjusted to provide fewer adjustment ranges. Let me ponder it a bit.
 
Her nadir doesn't seem to be consistent. Sometimes it's +5, +6, or +7. I've been picking +6 because it's in the middle, and I can't check a lot except on weekends. She eats pretty much whenever she wants, except for 2-3 hours before her shot. She seems to eat about 1/2 can at a time. I usually leave 2 cans (3 oz. each) mixed with water for the daytime, and do the same at night. It's usually gone by the time I get home, which is usually 2 hours before her shot. She isn't gaining weight and seems otherwise pretty healthy.

I'll do a curve this weekend and keep her dose the same until I post it.
 
Something else that will help, Carol, is to get numbers whenever you can. So if you're home 2 hours before pmps, get a test then. Is there a time in the am when you could get an extra test - maybe as you go out of the door? A before bed test?
 
Carol
Good idea. That might let others weigh in as well.

Unfortunately, I don't think Sue and I will ever agree on how to read a spreadsheet, because my take on the cycles she listed is not the same as hers. For example, I don't see the first one as "perfect" in and of itself. It was long duration to my eyes, and might have been taken advantage of and kept a run of better numbers going.

I'd say the AM cycles on 11/8, 11/12 and 11/14 are more representative of what a 1.4u dose normally does.
 
To me, it looks like the reactions to doses are wildly inconsistent. 1.4 has taken you to blue PMPS, yellow PMPS, pink PMPS, and red and black PMPS. It's just hard to figure out why sometimes it does one thing and sometimes another. If it was a too long duration issue, I don't know why it would only do that occasionally and other times cause a much higher number. Remember, this is just my opinion...not trying to argue, just stating what I see.

I think some more data is really the key. I hate to be a broken record, but I think the best thing to do is get tests when you can. I used to get the occasional midnight test that just happened because I was up...or anytime overnight when you happen to be up.
 
Rachel said:
To me, it looks like the reactions to doses are wildly inconsistent. 1.4 has taken you to blue PMPS, yellow PMPS, pink PMPS, and red and black PMPS. It's just hard to figure out why sometimes it does one thing and sometimes another. If it was a too long duration issue, I don't know why it would only do that occasionally and other times cause a much higher number. Remember, this is just my opinion...not trying to argue, just stating what I see.

I think some more data is really the key. I hate to be a broken record, but I think the best thing to do is get tests when you can. I used to get the occasional midnight test that just happened because I was up...or anytime overnight when you happen to be up.
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Because (just my opinion) ECID really stands for Every CYCLE is different. Because there is a lot more going on each cycle than just the amount of insulin given.
The long duration doesn't happen all the time, but really, I am starting to think that a long cycle is exactly what you'd want to happen on a regular basis. You just need to figure out and understand how to manage it when it does happen.
 
Good news today! Zoey was 220 at AMPS and I was able to test her at +5 when she was 94 and at +6 when she was 98. However, I'm sure that won't last long! I will try to get as many numbers as I can this weekend and post them on Monday. However, I agree with Rachel that she is "wildly inconsistent". That is what is making me crazy!

Thanks to everyone for your advice. I really appreciate it!
 
Hi Carol. I love torties. I have one and her name is Kita. I live out in the desert in North Phoenix. About three years ago, I woke up (around 5am) and two of my cats were on the window ledge looking out on to our back porch and growling. What the heck? I went out there and there was this little skinny, matted hair, scabby, scratched up, 4lb kitty. She was the sweetest thing and right a way, came up to me with a little meow. I checked her out and she looked like she was in a war battle. I then noticed that she had kittens (she was approximately 8-12 months old) and just recently nursed that morning. Omg, I frantically started checking and searching for her babies. I checked in the washes, out in the desert, near my barn, under trees, etc. What I think happened is that she had her kittens and that a coyote got to them, in the meantime, she must have put up a good fight. I kept her out in the porch for about 3-4 days before I brought her inside and then, of course, the rest was history. Right away, she was not using the litter box but would go in there scraping around. I took her to the vet to get checked out and found out she had a UTI. I am figuring that her previous owners must have booted her out once she started peeing on the floor. After some antibiotics, she had no problem peeing in the box. She literally is the best cat I have ever had with the best personality.

Ok so enough about Torties. If you like, I would be happy to look at your SS to see if we could create a sliding scale. You are already using one but maybe we can tweak it some. What would help me if I could get some more nadirs; which it sounds like you are already working on getting some. Just let us know if you have any more questions. BTW great day today!
 
Merlin said:
Hi Carol. I love torties. I have one and her name is Kita. I live out in the desert in North Phoenix. About three years ago, I woke up (around 5am) and two of my cats were on the window ledge looking out on to our back porch and growling. What the heck? I went out there and there was this little skinny, matted hair, scabby, scratched up, 4lb kitty. She was the sweetest thing and right a way, came up to me with a little meow. I checked her out and she looked like she was in a war battle. I then noticed that she had kittens (she was approximately 8-12 months old) and just recently nursed that morning. Omg, I frantically started checking and searching for her babies. I checked in the washes, out in the desert, near my barn, under trees, etc. What I think happened is that she had her kittens and that a coyote got to them, in the meantime, she must have put up a good fight. I kept her out in the porch for about 3-4 days before I brought her inside and then, of course, the rest was history. Right away, she was not using the litter box but would go in there scraping around. I took her to the vet to get checked out and found out she had a UTI. I am figuring that her previous owners must have booted her out once she started peeing on the floor. After some antibiotics, she had no problem peeing in the box. She literally is the best cat I have ever had with the best personality.

Ok so enough about Torties. If you like, I would be happy to look at your SS to see if we could create a sliding scale. You are already using one but maybe we can tweak it some. What would help me if I could get some more nadirs; which it sounds like you are already working on getting some. Just let us know if you have any more questions. BTW great day today!
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Thanks! I would love some help with her scale. After a good day yesterday, last night her PMPS was 465 and this morning it was 141, so I didn't shoot. I just went home for lunch (+4 1/2) and she was 565! I gave her 1.6 units and one hour later she was coming down to 515. See what I mean about crazy? She's sleeping off the roller coaster ride now. And yes, I do love torties. She is the sweetest, most lovable cat I've ever had (and I have had plenty of them)! I also have a tuxedo Maine Coon cat named Marley who is a big snuggle bug.
 
Oh Marley sounds so sweet. Well a very interesting day/night. So, again, we will need to see more +5, +6 or +7 tests in order to tweak so hopefully you can get a few in this weekend or on your lunch time. What time do you normally shoot?
 
Merlin said:
Oh Marley sounds so sweet. Well a very interesting day/night. So, again, we will need to see more +5, +6 or +7 tests in order to tweak so hopefully you can get a few in this weekend or on your lunch time. What time do you normally shoot?
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I usually shoot at 8 and 8 because both my husband and I travel a lot for work. That time usually works best for us. One of us is usually home by then. If not, I have a friend who does the testing and shooting.

I will work this weekend on getting lots of numbers. I'm not sure how well it will work out with her strange behavior today. Since I shot her at +5, I'm assuming I should wait 12 hours to shoot again. Thay will be about 12:30 am for us. Is that what you would advise? And if so, how am I going to get her back on track with 8-8?
 
When we are off schedule, we usually suggest start shooting early about 15-30 minutes but that might take you a while to get back to your regular schedule of 8am/8pm. I bet you probably need to get back to that schedule by Monday morning too. What you want to do is make sure the number is rising. For the majority of the time, by +11, you are able to tell if that the number is rising. I have shot an hour earlier before if Merlin gives me a shootable number. Since he runs high in the am, I typically can always shoot one hour early however the pm number is usually low, so that is sometimes when I can't shoot before 12 hours (most of the time, Merlin is on a 12.5/11.5 schedule).

I am thinking that because your would have typically shot a 1.4 for that number, 395; but you gave a reduced dose of 1.2 instead, you may be able to test at 11:30pm and shoot then if the number is shootable and rising. You really don't want to shoot anything different than you normally would for this weekend because this is when you were planning to get data. We will just have to keep that under consideration. It still make take you 3-4 days to get back to your 8am/8pm schedule.

The other option you could do is just skip the shot tonight (may still want to test just to see what it is) and shoot again Saturday morning at 8am. It would almost be like a fur shot and it is only one cycle.

Edit Update: Another option is to give a token dose (a very reduced dose like 0.4u) tonight at 12:30am and then shoot eight hours afterwards but I am not familiar with how you would do that or how much. I just have seen that happen before. Maybe someone else can chime in and provide their thoughts on this option.
 
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Thanks. I will check her about every hour tonight and see where she is before bedtime. Then I can make a decision. Since I usually don't go to bed until late, it won't be a problem.
 
You probably don't have to test every hour but maybe once before the PMPS and at PMPS before you shoot if you decide to.
 
I just checked her at +6 and she is down to 257. I'll check again in a couple of hours to see if she is coming up. Thank you for helping me through this!
 
Well, I tested Zoey as much as I could through the weekend. Again, she was very inconsistent. She totally got off-schedule because of the no-shoot on Friday morning. I finally did shoot her at +5 because she was up to 587. Then I had to spend the whole weekend trying to get her back on schedule. I hope the new numbers help somewhat in formulating a new schedule. Until then, I'll just keep with what I've been doing.

Thanks for any help you can give me!
 
@Carol & Murphy, @Likameow and @Louise & "Abby" I hope you don't mind me tagging you but I thought you might be interested in the conversation below regarding sliding scales. Carol and Zoey is currently collecting data to create a formal sliding scale. So since you all have recently been utilizing a sliding scale, I think this information would be of interest.

Carol, you did the best that you could under the circumstances. How about this and you may already be doing this. So when you test and get a number, check a previous number that is close to the one that you just got, and use a dose that gave you a previous good nadir. This is what you need to do anyway when you create a sliding scale. It is a good habit to get into i.e. always check previous numbers/doses to confirm desired results.

For example, say if you got a 200 like you did on 11/14. You gave 1u and that dose gave you a nice nadir of in the 90's. Another example on 10/10 you got a 358 and you dosed 1.6u and that dose gave you a nice nadir of 71. Another example; on 8/2 & 9/5 (a little while ago), you got 268 & 255, respectively, and you dosed 1.4u and got a nice nadir of in the 70's. So in the future, as you get similar numbers, you go back to these numbers and see what dose you gave. From there you decide what dose you should give. See how I keep looking at previous numbers to confirm doses?

So here is a little different example. On 11/21, just this weekend, you got a 335 and you dosed 1.2u and got a 218 nadir. I will look for a similar number like on 11/13 & 11/14 where you got 338 & 350 (close to 335), respectively and you dosed 1.4u and that dose gave you 103 & 198 respectively. Nice numbers but not quite in the green. When you got the 335 on 11/21, you may have considered a 1.6u. If you look further up on your spreadsheet, you would have found a 358 on 10/10 where you dosed 1.6u and got a 71 nadir. Bingo! So it looks like a 1.6u would have worked for you in that mid-300 range. Do you see how I came up with that dose of 1.6u?

So what you want to do is look for previous successful data and dose accordingly. Of course you will want to "test" that dose at or near nadir to make sure that the previous data is still valid. Zoey can start changing like either needing more or less insulin but that is why you check and continually test nadirs. Anyway, that is how you build your sliding scale - from previous, successful data and slide that number and corresponding dose into your scale. Hope that helps.

Even though I would like a little more data, I think you have some data for some numbers that will help guide you to dose and base decisions on. Does that help for now?
 
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@Merlin I do sorta get this now My only question is what to do when Murphy is going through some sort of clearly abnormal cycle (like now for instance) How to count those numbers and use them when they are probably outliers
 
I get it! That was an excellent explanation. We will be going out of town for Thanksgiving, and my friend will be doing the preshot tests and shots, so I will wait until I get back and can try this. It does make sense, but I agree with Carol & Murphy about the outlier numbers. (Maybe the wild inconsistencies in their numbers has to do with the name of the bean...Carol!) Also, I had a wonderful dog named Murphy until a couple of years ago...he was a real sweetie!
 
Yeah that is a bit of a hard one to figure out when they get a few cycles that are inconsistent. It is like you do the best you can to try to get them back on track. I pretty much shoot the dose to the number unless it is a really weird number such as huge bounce. When I was first starting out with sliding scales, there were a few times where I had to take a break and go back to consistent dosing. I was looking at my 2014 ss and it looks like after a month on this site, I started a sliding scale (April 2014). Then my first vet wanted to try consistent dosing of 1.4u, 1.2u and then 1u. Then about three weeks of that I slowly got back to the sliding scale. If he started to get a little wild, I would go back for a few days to a consistent dose but soon that wouldn't work because he started to become really sensitive to his doses i.e. a 0.2u difference would send him too low or not low enough. So I have stuck with the sliding scale for about 18 months. So sometimes, it is not too bad to go back to consistent dosing if that is what you think your kitty needs and yes, sometimes, it does help those wild, inconsistencies.

Carol - When I go on vacation and I have a friend or brother come in and do the test/shots, I usually lower my dose 0.2u. They may run a little high while you are gone but at least they are safe.
 
Thanks. I agree that a lower dose is better if I'm not around to check on her. But last night was another roller coaster! After a relatively normal number at AMPS, she was down to 68 at PMPS! I don't know how low she went during the day, if she did, but that was scary. She seemed fine, and after one hour she was up to 74. I checked her again at +3 and she was up over 500, so I gave her a smaller dose of 1.2. This morning at +8, she was up again to 303. At +9 she was 314 and I had to go to work, so I gave her 1.2 again. I don't know what's going on!
 
Zoey & Carol said:
Thanks. I agree that a lower dose is better if I'm not around to check on her. But last night was another roller coaster! After a relatively normal number at AMPS, she was down to 68 at PMPS! I don't know how low she went during the day, if she did, but that was scary. She seemed fine, and after one hour she was up to 74. I checked her again at +3 and she was up over 500, so I gave her a smaller dose of 1.2. This morning at +8, she was up again to 303. At +9 she was 314 and I had to go to work, so I gave her 1.2 again. I don't know what's going on!
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Zoey & Carol said:
Thanks. I agree that a lower dose is better if I'm not around to check on her. But last night was another roller coaster! After a relatively normal number at AMPS, she was down to 68 at PMPS! I don't know how low she went during the day, if she did, but that was scary. She seemed fine, and after one hour she was up to 74. I checked her again at +3 and she was up over 500, so I gave her a smaller dose of 1.2. This morning at +8, she was up again to 303. At +9 she was 314 and I had to go to work, so I gave her 1.2 again. I don't know what's going on!
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Oh Carol - I so feel your pain - look at Murphy's SS - I have gone through the same thing Let's see what the wise ones say, but it looks like the 1.8 units was too much and it lasted a long time - did Zoey eat after the 74 reading?
 
She did eat, but only what she normally eats: low carb canned food. I'm trying to think if there was anything else she could have gotten into, but I can't think of anything!
 
Zoey & Carol said:
She did eat, but only what she normally eats: low carb canned food. I'm trying to think if there was anything else she could have gotten into, but I can't think of anything!
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just the regular even no carb can make BG rise for a while , and probably right then any insulin she had in her system vanished - I try not to test for 2 hrs after Murphy eats because it is difficult to know if the reading is due to the food
 
I agree. I usually don't feed her for 2 hours prior to her test, but she was so low and had already not eaten for 3 hours. I thought the food probably had something to do with the high number, and that's why I only gave her 1.2 instead of what I would normally shoot for a number that high. She's such a little kitty and I'm such a sucker! I just wish I could figure this out!
 
Hey Carol! It does look to me like yesterday the dose may have been too much. With such a low number after such a high AMPS, it's very surprising. I'm really not sure what's going on here, but that low number to me says the dose is too high since we want 2 shootable preshots. The only problem is that Zoey doesn't always throw us the same things...so we'll just keep having to try! :)
 
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