bart 8/9, 1.6u 2nd cycle +7 164

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bartcat

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Hello !
I'm new to the board (about a month) and been posting on the main health, where Carl and Sue have been trying to teach me. Hi Guys!

Thought I should come over here now where I can get more prozinc experienced eyes on the Bart-ness.

I (now) understand it's more the magnitude of the numbers and not the actual numbers that are important during a cycle i guess? And it looks like today Bart is in a bounce? He's on a pretty high 2.4 units, but he was on 6+- units for 8 yrs before finding you guys and switching to lc can. I still can't really tell if the current dose is too much or too little - hard for me to adjust too low since he's been on so much for so long....

Here's the thread (I think) from the main forum:
viewtopic.php?f=28&t=75807

And I have no idea where to go from here - should I keep him on the 2.4 for awhile for the bounce to finish bouncing or adjust my dose down - and how long should i let a dose ride before i can be sure that the responses are stabilized for that dose? When i previously tried 2.0 units, he was very sugary and not feeling good, high pu/pd, but did i not tolerate the high sugar from the lower dose long enough?

Are there any particular patterns in here that jump out at any of you guys - maybe someone has had a kitty similar to Bart?

Thanks so much,
Bart and Cat
 
Re: Hello! New and dancing with Bart (prozinc)

Hi Cat!
If you look around the forum, you'll see not all PZI kitties fall into the low dose class. Yes, there are some who only need 1u or less, but there are others who are currently in the 4u+ range too. Ellen's Robbie was up as high as 8u the first time he went through this, and went into remission, but recently relapsed I think Ellen is shooting 5u or so. Angela's Henry gets 4u at times.
Anyway, they'll have some input I'm sure, but I just wanted to roll out the red carpet for you and Bart!

As you said, I am one of the people who are somewhat familiar with your recent adventures, and I've seen some "bouncing" in Bart's cycles recently. I agree that when you have shot low doses, they don't seem to be effective, but then the higher doses seem to cause higher PS numbers later.

The whole time, until very recently, like when he was on 6u, he was eating both dry and wet food, correct?

I just checked the SS to see how he did on 1u last night, and it looked great and then went sour sometime after +8 and gave you the red AMPS today.

This is sort of what happened four days back. He went low overnight, had a low preshot in the morning, went down into the 60s that cycle, and then right back up by the next shot time. Same pattern to me. Two nice cycles with green nadirs, and then high and flat day. Looks like today is turning into one of those.

To me, it looks like the 2.4 is working and it's doing one of two things. Either it pushes him nice and low and he bounces, or it keeps the BG down more than 12 hours and gives you a lower PS number which ends up with you needing to reduce the dose.

We have to find a dose that stops that from happening. Personally, I'd rather see the green nadirs and the bounces that follow, because at least you can keep the dose about the same. The long cycles with lower preshots at the end of the cycle cause too much dose adjusting.

I want to hear what other people think, but maybe if you try 2.2 for 3 or 4 cycles? It isn't much of an adjustment down, but maybe it'll lessen the drop in BG enough to avoid the bounces and/or the long cycles?

Carl
 
Re: Hello! New and dancing with Bart (prozinc)

Hi Carl and thanks for the welcome!

Carl & Bob said:
The whole time, until very recently, like when he was on 6u, he was eating both dry and wet food, correct?
Click to expand...

He was mostly on dry and got can now and then as a treat - both were the DM prescription food. When I monkeyed around with his food to see how that might help him - he seemed to do better on the dry. Surprise surprise since he was on 6 units bid. And that 6 units was determined at the vets office. If only I had known then what i know now....

Your observations on his numbers and trends and suggestion to reduce dosage a smidge make good sense to me. And today he did the high and flat like we've seen before, so a bounce from yesterday just like you predicted. So for tonight's shot I took him down to 2.2 units and we'll give it some time to see what it does.

And thanks for letting me know that Bart is not necessarily a total anomalie with higher doses - I hope some other folks with the higher dose kitties stop by to take a look at our numbers and share their experience too.

Crossing my fingers for a little settling down of the BG!!!! Thanks again for all your help - I hope my constant questions and screw-ups don't end up frustrating you too much :dizcat
Cat
 
Re: Hello! New and dancing with Bart (prozinc)

Cat,
They only are frustrating because I wish I had all the answers. It's way more frustrating for you and anyone else that's having to "live it" 12 hours at a time. It was so relatively easy for me with Bob (ignorance was bliss), and the fact that he went OTJ in 10 weeks despite my not really knowing what the heck I was doing for most of that time. So don't worry about asking questions! And sometimes it is the "screw ups" that educate all of us the most.

Hoping the reduction shows us something good!
Carl
 
Re: Hello! New and dancing with Bart (prozinc)

Hi Cat!

Glad you made it over here! It is a much smaller forum than Health so you probably won't get as many responses to each post. If you ever have an emergency, be sure to post here and on Health to get more eyes on your thread.

You might look at bookworm's (Lisa and Cassie) spreadsheet. He tends to do the higher flatter numbers after a low nadir thing. (I think it is comforting to see that someone else's cat does something similar to your cat) It would be good if we can see an actual pattern; that makes the whole thing easier.

Interested to see how the new dose works.
 
Bart - 8/6 pmps 37, NS&food +0.75 65, NO HYPO???

Hi Carl and Sue,
Don't freak out - NOT A HYPO! He was acting more normal than he has in a while actually - happy as a clam, social, purring, grooming. Did not eat his afternoon meal (see notes on ss), did not act hungry till dinnertime at low bg - but zero (not even mild) hypo symptoms. (I was away from house between the +6 and +9.5 am tests, during blue numbers it appears).

So, I guess the new lower dose of 2.2 just provides more puzzles? I'm at a complete loss.....

He has no underlying pacreatitis so is it possible that now on just lc can for over a month, his pancreas is trying to work?? I'm thinking drop down to 1.0 units tomorrow am if he's got a shootable number? I will be out of the house for the whole day after his am shot tomorrow - +12 full hrs. My son will get home maybe around +9 to +10 and he knows hypo signs and can call me and administer sugar boost if necessary. What do you guys think??

Right now I'm also thinking NS tonight, but his bg might spike
Is there a scenario at all where i should even consider a low dose - like if he's over 200 at +2 - (after eating at 0)? That's coming up in just about 30 min and I will be here all night, until am shot time. I plan to NOT shoot at all unless I hear back from you guys definitely.

I'll also update as soon as I get the +2 bg. What the heck could this pattern be?
Cat ----> :dizcat
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

Update:
pm +2 is 202, jumping up like i expected.
Should we just ride out the bounce with no insulin at all? Or do i give a little to help cushion it and his organs?

And should i consider no insulin tomorrow morning? Or should i plan to further reduce dose, maybe down to 1 unit - start over??

I'll check back here tonight before I go to bed and and again in the a.m.
Please advise - Thanks!
Cat
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

Hmmmm, I think I would give one unit tonight to keep him from climbing. Then you can "experiment" with it overnight when you are at least around. It would make me nervous to try a new dose - even a lowered one - if you won't be home the whole cycle.

Well, the 2.2 is too much. It will be interesting to see what the one unit does and we may have a better idea about the am dose?
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

Ok, wow. At +2.5 up to bg 303, so gave 1 unit.
But still don't know the best course of action for in the am when I'll be gone for that entire cycle .....
Suggestions???
Thanks, Cat
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

I missed all of this....brb, looking at the SS.

Carl
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

Wow.

So, I guess the new lower dose of 2.2 just provides more puzzles? I'm at a complete loss.....
Click to expand...
Not a puzzle. Some things just can't be explained (which is just what you DON'T want to hear, lol). I don't think it was so much the dose, but more to do with some pancreas activity going on? His pattern sure isn't like this on the days you have a +9 on the SS, except once before when he was on a 2.0 dose, and with higher number back on July 13th. I don't know, however, what caused the drop today. He didn't eat at +9, so in theory his pancreas wouldn't have a reason to put out insulin. Puzzle for sure.

Regardless, I think you did the right thing by giving the 1u tonight after the climb to 300. Some of that was food, but not all of it.

In the morning....depends on what he does tonight. What did you have in mind for testing tonight? The 3 hour late shot tonight will also come into play, because if you want to shoot on time in the morning, it'll only be 9 hours past this shot.

What's your schedule like until you leave the house in the morning. I'm assuming you need some sleep at some point? LOL.

Carl
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

Hi sue, thanks for confirming the one unit. I think bart will be bouncing tomorrow from the low numbers. I think eating is the confounding factor. He loves to eat and never used to turn anything down ever. Now that Im trying to get him better regulated i pretty much free feed all can - he gets 15 oz food per 24 hrs, split up and fed every 3 hrs (1 can FF at 0 and fed+12, half a can at and+3 +6 +9 both cycles.

Well, now that his bg is better under control (sometimes) he's getting flavor picky and less hungry, so he skips a meal and the bg drops. Does that make sense? Of course then he bounces which makes him ravenous again. It's looking to me like his long cycles and late drops come when he skips a meal because he is cruising near normal bg. Perhaps i should cut back his volume of food? But most of what I've seen on the board says unregulated should eat alot. Bart is big boy - slightly overweight but not seriously obese. Well proportioned, about 17 lbs, tall, does have a waist, can leap tall dressers in a single bound...

Have you ever heard of something like that and how do we break that cycle?

Have i exceeded the number of questions allowed in a single post ?! LOL
thanks ! Cat
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

Hi Carl and welcome to the party !
It's past my bedtime now actually. I normally get up at 4:30 EST, which would be +8 from the 1 unit . I don't do well with the nighttime up and down, but could squeeze one in if you think the data would be important .... Wont the bounce/ post-low cycle be somewhat invalid?
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

If you are going to get up at +8, then I agree, tests earlier than that won't be that helpful. I was more concerned with late in the cycle. You get up at 4:30, and what time are you leaving the house? I'm trying to figure out if/when you would be able to shoot in the morning, or whether skipping would be the best strategy for the morning.

Carl
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

LOL I can answer a couple of the too many questions above!

5 cans of FF a day, right? Hmmm, roughly 80 calories per can, so 400ish per day. The theory is that a cat needs between 20-30 calories per pound of ideal weight, per day. At 17 lbs, that would be 340 to 510. 400 fits right in there. So although it might sound like a lot, if it isn't causing him to beef up and get heavy, it probably isn't too much. I'll have to think about the timing, but it sounds good to me. It should make for flatter cycles since you're spreading it very evenly during the cycle. The +9 serving might be confusing things. You'd figure it would make him climb towards +12, because the insulin should be loosing steam that late in the cycle. Have to ponder that some...

Carl
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

I can leave a little late- which will be at + 10. I think bart will be high and flat tomorrow. Also take a look at notes on Ss when he went long and low late cycle - he's usually skipped a meal or two while in the blue - not sure why.
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

Yeah that makes your morning schedule sort of messed up.
If you want to shoot in the morning, you have to be able to test him twice, like an hour apart, and make sure his number is rising without food being the reason. Because it would be a "short cycle", he must be rising and high enough to shoot, and even then you would want to shoot a reduced amount.
You don't want a long cycle like today, and shoot a 2nd dose on top of the first one. The 2nd dose might start acting before the first dose is completely gone, and you won't be home to check him if he drops low. That's the dilemma...

Carl
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

Ok, so should keep his 3 am feeding?(feeder moves to empty at 4 am)
test him at 5 and 6 am (+ 8.5 and +9.5 which would be 1 and 2 hrs after feeder closes)
or cancel the feeding and then it'll be 5 and 6 hrs after his last meal....
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

If he eats at 3, and doesn't scarf it, it'll be there as part of the 5, and maybe the 6am tests....
But if he doesn't eat, his number may not be rising.

This is tough.
What time will you be home tomorrow?
I'm thinking that skipping in the morning is going to be the best thing to do...

Carl
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

I won't be home till 6 pm, +12 from amps& shot time.
My son will be home around +9 to +10 and knows hypo signs but can't bg test...
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

I could bump up the feeding by 1 hr,which means the two am tests would be after he's cut off from dish by 2 and 3 hrs respectively....
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

It's not probable, but is possible, that someone will be online in the morning to help if you get a shootable number. If PZI is silent, you can post a "Need quick dose advice" on Health.

I mean, it's possible you'll wake up to a 350, and you could shoot 1u and not have too much to worry about. I'm more concerned that you'll get a "what should I do with this 180 AMPS when it's only been 9 hours since PMPS??? In which case I would definitely skip. You can catch up after skipping and be back on schedule tomorrow night.

I wish it were black and white, but 6am isn't all that far away, and you have no idea what sort of number you'll be looking at.

Carl
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

Ok Carl. Sounds like a good general plan. I'll plan on being very conservative. I cancelled the 3 am feeding so we'll have no food influence on the morning numbers to be safe. I'll post if the numbers aren't clear cut in the am.
Thanks for all the time tonight !
I have to crash now or I'll be useless tomorrow at work.
I'll update tomorrow evening at the latest.
C ya soon,
Cat
 
Re: Bart 8/6, pmps 37, NS&food, +0.75 65, NO HYPO!???

Hi guys
just a quick update - bart was in 300's this amps, gave one unit. Tonight pops in hi 200s. Gave only 1 unit because it looked like the 2.2 was too much. He was probably high and flat all day, water bowl says so.
Im considering keeping him on 1 for a few days to let the bounce clear and see if he adjusts to the lower dose. Seems like every dose I've tried from 2 to 3 units is too much and gives a late low cycle once settled in.
Long day today so im going to crash. I plan to try to get a late+6 tonight if i can, but exhausted so is iffy.

What do you think about the one unit plan? If its not enough insulin and he doesn't go into all red and black it should nt be too bad? If he starts acting really poorly I'll revise. And I'll check for ketones first chance too - though he is sneaky and hard to catch in time...

Is there a better course of action considering his limited but kinda weird number history ?
Thanks for all you do!
Cat
 
Re: bart 8/7 keeping on 1 u, waiting out bounce

Hi Cat,
When you gave him insulin this morning, how many hours was it since last night's shot? Just curious. I was up at 4:30 this morning to get ready for work, and checked to see if you posted your tests... In between this morning's shot and tonight's shot, was iit 12 hours? Just trying to get a feel for the timing and the numbers.

I think you made a good call for both shots, and the 1u trial might be enlightening. Try it for a couple of days, and we'll see what sort of numbers you get.

Carl
 
Re: bart 8/7 keeping on 1 u, waiting out bounce

Hi Carl
the morning shot was at +10 and then last nights was at +11.5 , he's back on regular schedule by job necessity. Also, got a+6 last night and it was almost 400 - 396 i think. Don't know if he's still high and flat or if he had one of those early nadirs. Tried to get a +3 earlier but he wouldn't bleed for me. Will try to post updatd ss tonight.
Cheers, cat
 
Re: bart 8/7 keeping on 1 u, waiting out bounce

Sorry I have not been around around (family medical issues) but you and Carl are doing fine. Yes, please update the spreadsheet - it helps so much to see what is happening. I am thinking one unit is too little and 2.2 was too much so an small increase is a good idea? Maybe 1.5 for a few cycles to see how he does.

The nice thing about moving up from the one unit is that you can systematically increase based on his numbers, instead of giving the larger dose and having to react to it when it causes low numbers and guess how much to reduce. (did that make sense? :mrgreen: )

You are doing fine. Just think of this process as data collecting and mutter that to yourself when you are puzzled by the numbers.....
 
Hi Carl and Sue,

Sue - I agree that Bart probably belongs somewhere between 1 and 2 units, so I increased his dose to 1.6 units (using u100 syringes). First cycle he stayed high and flat, but in the second cycle today his +7 is 164, which i think is pretty good, especially since he ate at +6? His spreadsheet is updated now and I'll get a few more numbers this cycle to add. He tested ketone negative this morning too. Tonight I will try to get some, but can't do too many because i have a long drive tomorrow.

Unfortunately, I have to go out of town tomorrow and won't be back until Monday. My teenage son will be shooting and feeding Bart, but cannot do BG testing. He does absolutely know the signs of hypo and how to treat it though and he'll be keeping a close eye on Bart and staying in contact with me via phone. I know it's not ideal, but it really is the best I can do and it's only a few days.

Bart is doing good - feels good and decreased pu/pd and alert happy and eating good - on the 1.6 and I plan to keep him on that, barring any issues tonight or while i'm gone. I know there's not alot of data for it, but based on past experience and his current condition, I think he's not too high or too low on this dose - fine tuning will have to wait till i get back in a few days.....
 
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