back up the scale...

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RobbiesMom

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I'm going back to 3.00 - my gut is telling me somewhere between 3 and 4 will get us some results that aren't red, purple or yellow. 4 appeared to be too much - I gave the 1.5 a good go, and tried to transition to 2.0 but looking at the numbers on his SS and watching how he feels I really think he's going to be responding at 3+ somewhere along the road. I know low and slow is sound advice but I also have to follow my gut and remember that our vet wanted him to start out on 4.00. We'll see where this goes - it's an odd weekend but I've re-arranged a few things so I can check up on him more so after much consideration decided to go back to 3 and hope something pops to attention this time around.

He clearly knows somethings wrong - he's talking to me all the time, rubbing my face and licking my forehead which normally he only bestows these actions on special occasions. He cries almost any time I walk up to him - not a painful cry but just a "MEEAAA" like "what's going on mom?" - he's not playing with the dog much at all which he always loved to do and he's sleeping even more than normal and drinking a TON - lots of water, lots of big pee clumps. He paws the ground around his water bowl every time he drinks - so odd - he did this the last time he was DX than stopped when he was OTJ and now he's doing it again. So strange. Last night he wasn't as hungry as he's been - not crying for food as much - just sleeping. He cleaned himself this morning with a bit more effort than he has been lately and it made me realize I almost never see him grooming for those long sessions he normally would do - he's clean and he gets started but than just stops. None of this is making me feel good about his condition.
 
I would only increase by 1/2 unit increments. Increasing by whole units at a time is a huge increase.

But you hold the syringe so it is up to you.
 
I'd look at the percentage of increase. 2 to 2.5 is a 25% increase. 2 to 3 is a 50% increase. I'd go with the 25% increase, tops. It's easier to increase in smaller increments, actually the highest increase I'd advise anyone to do is a .25u bump at a time. Going up slowly reduces the risks, IMO. 2.0 might not look like enough right now. But if 3.0 is too much, and he dives deep and fast all of a sudden, you can't get the insulin back out once it's in.

My cat went up way too fast because I didn't know better. If he ever goes back on the juice, I'm starting him at 1u and going up by .25 per increase. His top dose was 4.0 bid when he was on insulin, and I wasn't "here" at that time. Looking back, I'd bet the farm that his "ideal dose" was less than 4, and that I was really lucky I didn't mess him up bad by going that high that fast.

But like Robin said, you hold the syringe, and you are there watching him day and night. It's easier to advise from afar than it is to "live with it" right there in front of you, and you know your kitty better than anyone else possibly can.

Carl
 
Carl I appreciate what both you and Robin are saying and I wasn't home last night and my husband was nervous from having heard the comments about going too high too fast and didn't feel comfortable shooting 3 so I said fine shoot 2.50 which he did. Would you look at the SS and tell me your thoughts? I know these are just your thoughts and I hold all responsibility - I'm looking at his 7:30 pm shot with much confusion. He just tested 290 at AMPS +10. He's eaten a less than normal amount today but he's had it spaced out throughout the day as we were out for Easter with family and weren't here to take it away and give it back later (which I do if he doesn't finish it - although 9 times out of 10 he finishes whatever I put in front of him unless it has the metimucil in it.)
Thank you for your kind consideration of our journey here -
 
Hi Ellen,
What I have seen in the time I have been here is that when a dose might be too high, it does one of two things. It either causes a deep drop to a normally timed nadir (sometimes the drop will also seem to happen early and quickly), or, it causes a "longer than normal duration" with not as much drop until later in the cycle.

However, this doesn't really look like too much. It looks like it might give you a lower PMPS number, because he isn't climbing up as fast as usual. Yesterday's AM cycle, he got a good curve, then rose more towards the end. Same thing happened last night on the 2.5 dose.

I'm thinking that somewhere in between that 244 and the 290 today, he went into the lower 200's, which means about a 50% drop. That's a reasonable drop in terms of percentage, especially if it doesn't cause a "bounce" into a red number the next PS time. His number at PMPS tonight will tell you if he went "too low" today (at least as far as he thinks "too low" is).

The spacing out of food might also have been helpful if he managed to just eat enough to balance what the insulin might have been doing during the course of the day. I know human diabetics are best off if they eat multiple small meals than fewer large ones. Same seems to be true with sugarcats.

Carl
 
Thank you Carl as a Type II Diabetic human I know the small meals throughout the day are the best - and Robbie did best that way too - so I'm trying to keep him on that but he gets very hungry at times now - and just screams for food. I am hoping to get our timed cat feeder working or buy a new one that might help. He was 344 at PMPS - I shot 3.00 - tonight is one of the last nights I can be up and testing him this week - so I figure I'll see what happens. He gets so sluggish and clearly not feeling well when he gets into the 400's I just hate to see him heading there - I still don' t have my brain wrapped around the whole bouncing and too much insulin not just pushing the BG down but making it stay flat and all that - I really have to focus and read more so I understand what this is all about.
355 @PMPS+2 - hoping that is due to the food at PMPS and right after.
 
Yea it is a balancing act. I made the BIG mistake of going too high too fast one time and i payed for it. I restarted over and finally have found a closer dose, although still not completely there. Every day reacts differently on a too higher dose or if their bodies "precieve" they went too low. You will see a pattern the more data you collect. Even then it sometimes is a mystery.

Hang in there....

lori
 
I don't know Robin I've about given up on my thoughts and gut instinct - today he's running all in the purple - he's VERY demanding about food - so I give him small amounts of the Shrimp, Cod etc. FF which is the lowest carb/calorie they offer that I can find, mix it with water and give him maybe 1/4 between meals when he gets very vocal - today I fed him his regular "breakfast" (full can of FF with metimucil) at 6:30 am (PMPS +11) because he was SCREAMING tested him first and he was 315 at 7:30 (shot time) he was 413 (ok he had that food in him) shot the 3.50 I'd mentally committed to and he's been in low 300's all day NO movement out of that range. I'm really getting pretty despondent about this - I'm heading into my busiest time of work when I will be in the office for 10,12 and 14 hour days - not able to test frequently and I really was hoping to get him to some solid point where I wasn't worried about him constantly. He's drinking like a fish and peeing HUGE amounts, now today he has dandruff (which he hasn't up till now) other wise he's pretty much his old self except he knows somethings up with all the attention and the testing and the treats for testing. I'm just heartsick over this cause at the same time my father is not improving either and it's just starting to be more than I can process.
 
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