Beau - 7/31 - post hypo dosing advise needed

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alicia.1771

alicia.1771

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Good morning everyone! Beau and I survived a hypo episode last night thanks to all the support and guidance here :-D

His 7am BG is at 303 and I will test again in 30min just to make sure there is no crazy change before his shot.

We generally dose at 7:30am/pm but delayed yesterday morning to 8:30am pending the vet's decision on his lower dosage. Last night was shot at 8pm so I'm hoping to shoot at 8am today and move up to 7:45pm tonight so we can get back to schedule tomorrow for 7:30am.
 
Good morning Alicia and Beau
don't fear the 300. It's.a lot less scary than the 40s or 50 s! The advice last night was to go with the .8 and I think that's.still good advice. Will be looking forward to seeing the results of Beau's curve later today.
Carl
 
His 7:30am BG is 336 so definitely rising.

From yesterday's discussion it seems 0.75-0.8U is a safe and good dose for him. Just want to double check with everyone this morning giving his BG readings.

I will be using the U100 syringe to day so I can get a better dosage reading --> so it will be at the 2.0 mark for 0.8U or a "skinny" 2.0 for 0.75U?
 
Hi Alicia,

Good job last night. Looking back at your last 3 cycles you have 2 inverse curves indicating too much insulin and a perfect curve at the vet clinic which is very unusual, with vet stress you would expect those numbers to be much higher.

Your 303 this morning is probably due to the higher carb food fed last night and some liver panic from the lower numbers, that will clear his system by itself.

Kitties can be more sensitive to insulin after going low so you will want to lower your dose. Please come back and post your next bg number but I think I would drop down to .75 unit for this morning.

You are doing an awesome job.
 
Alicia
Yes that would be just on the skinny side of 2 on your u100 syringe.
carl
 
Hi Rob - when you say inverse reading does that mean his post-shot BG was higher than pre-shot? The higher reading on 7/29 am after shot was taken at the vet's office so it's possible his BG is elevated due to stress. His 7/29 pm post-shot reading was taken after feeding. I did not learn about wait and test until 2 days ago so I just test, feed, then shoot. But I am putting this to practice now to give me more accurate info on his BG curve.
 
Alicia
has beau eaten a good breakfast?
Carl
 
Not yet, but he seems hungry so I am going to feed then shoot. Ha..I was so focused on his BG #'s I forgot to feed him....
 
Hi Alicia,

An inverse curve is when your numbers arch up and then back down instead of a smile curve.

Example: Inverse curve: AMPS 211, +4 235, +6 275, + 8 259, PMPS 220.

A good curve looks like the curve done at your vet clinic.
 
An inverse curve is when your midcyle test are higher than your preshots....but, your test/bgs come back down at the next preshot. Imagine it as a hill or speedbump--it curves up. An inverse curve is a signal for too much insulin. In determining if a curve is inverse, it is key to see it curve back down at the end of the cycle. If it didn't curve back down, it could signify too little insulin. Your curve definitely came back down--inverse!

You are doing great!
 
A good curve is a "smile" an inverse curve is a "frown"
carl
 
Thank you Robin and Kelly for the explanation! Looking at his curves again it sure appeared Beau had 2 inverse curve at 1.0U so that would indicate too high a dose even at 1 for him.

Can you believe it's actually raining here in Cali in the mist of summer?
 
The pm curve on the night of the 29th was hard to call inverse until last night! The inverted test you had, looked like they could have been a reaction to the greens you saw at the vet. But, when you put the pm cycle on the 29th with the am cycle on the 30th together--it seems to support that the 29th pm cycle most likely was inverse, due to too much insulin also.
 
In simple terms, would you say that two consecutive frowns could have been caused by excess insulin? And then last nights exaggerated smile was beau's liver saying "hey! Knock it off!"?
Carl
 
off topic but yeah alicia, what's up with this weather. fiance just got home and asked me when did we move to florida?? LOL!! we've had some thunder, lightning, steady rain with several downpours so far this morning out in xxxx. oh, and the humidity! personally i don't mind it having grown up in the midwest but california boy here is crying. :lol:

good job last night. sorry i too wasn't around. tend to go out to dinner on friday nights

when you get a chance you could go back to the post on health and edit it and take out the 911 icon now since the crisis is over.
 
Carl - hahaha...I like your analogy! He is definitely trying to tell me something.

Beau's +2 is at 346, about 10 higher than his rising AMPS #. Hopefully that's due to food and not the beginning of an inverse curve. I will continue to monitor his BG today an post here.

Questions:

1) Is there a big chance I'm going to see an inverted curve again today due to his low #'s last night (lowest tested was 40)?

2) If I do get a "frown" today and PMPS continues to fall but stays > 200 I should still skip his PM shot or give a reduced dose say 0.5U?

3) For ProZinc, what is a safe time variation to give a shot? +/- 2 hours on a 12/12 schedule? If I see a rise say around +14 do I give a reduced dose?

4) Feeding - currently I am feeding him several times throughout the day since he's a grazer and eats a little bit at a time, but I read somewhere it's not recommended to feed between nadir and next shot. How are you guys feeding your cat?
 
Thanks Cindy for the reminder, I removed the 911 icon.

I was quite surprised to wake up to the rain this morning, but looks like it's a short storm passing and the sun is breaking through a little bit :)
 
I will answer number 4.......

I feed Kitty after checking her preshot.....then, my only "rules" are....no food within two hours of her insulin injection or her next preshot. So, on a 12 hour cycle, there are 8 hours she can eat. A lot of people say small meals throughout the day, like you are doing, are actually very supportive of the Pancreas.
 
alicia.1771 said:
Carl - hahaha...I like your analogy! He is definitely trying to tell me something.

Beau's +2 is at 346, about 10 higher than his rising AMPS #. Hopefully that's due to food and not the beginning of an inverse curve. I will continue to monitor his BG today an post here.

Questions:

1) Is there a big chance I'm going to see an inverted curve again today due to his low #'s last night (lowest tested was 40)?

2) If I do get a "frown" today and PMPS continues to fall but stays > 200 I should still skip his PM shot or give a reduced dose say 0.5U?

3) For ProZinc, what is a safe time variation to give a shot? +/- 2 hours on a 12/12 schedule? If I see a rise say around +14 do I give a reduced dose?

4) Feeding - currently I am feeding him several times throughout the day since he's a grazer and eats a little bit at a time, but I read somewhere it's not recommended to feed between nadir and next shot. How are you guys feeding your cat?
Click to expand...


Your +2 is probably food spike, that is pretty typical.

As for your questions.

1. There is not way to predict the future, he is a cat after all. The bounce from the low numbers and higher carb food can take a few cycles to clear out, we just have to wait and see what he does today and go from there.

2. If over 200 I would give a reduced dose, if under 200 an even lower dose if at all depending on the number.

3. Yes, you would want to give the insulin when his bg is high enough but that will put your next shot later also. You want to stay with the 12/12 schedule as close as possible but there are always "except if's" so it is always good to come and ask someone at the time. You can get back on schedule a little at a time.

An early shot = a dose increase. A late shot = a dose decrease.

4. ECID some feed twice a day, some free feed you need to find out what works best for you. I free feed, but pick up the food dishes 2 hours before my PS test, the dishes are usually empty by then anyway.

Keep asking questions, that is the only way we will be sure to cover everything.
 
Oh wow, just tuning it, looks like you had a big night! :shock: Great job getting through it, looks like you handled it really well! Hopefully it was not an actual hypo - looks like good numbers, and by feeding higher carb you averted a hypo.

On the inverse curve question, it is normal that their numbers will go up until the insulin starts working (onset) which is often somewhere around +2, plus or minus. So that is normal, and some cats can rise quite a bit around +1 and +2 before the new shot starts working. From there you want it to drop down to a nice nadir, and then rise back up for the next PS at +12.

It can be hard to determine what is truly an inverse curve and what is natural variation - we have seen cats with mild inverse curves that are actually on too little insulin. If it goes up into red numbers or such then it is clear cut, but when it is muddling around in yellows, it is hard to say whether it is truly inverse or not. That is where you will get conflicting advice here :-D as different people will draw different conclusions when it's in a gray area.

I think you may be seeing signs that his pancreas is healing and starting to come to life, which is great (though it can be scary!). 1u looked to be slightly low for a dose a few days ago, and now is clearly looking too high. Scary, but going in a good direction!

My apologies if my advice contributed to the low numbers. We have had so many cats underdosed here lately, and trying dose reductions that were not needed, that I may have gotten a little too far thinking in the other direction. Anyhow, looks like you are doing great... great job!!!
 
Hmm... we are at +7 and his BG is still hovering in the 300's although it is SLOWLY coming down. I will continue to check at +9 and +11 and will need some advise on what to do if I don't get a rising # by PMPS.

7:00am - 303
7:30am - 336 --> fed 1 can FFC
8:00am - gave a skinny 0.8U --> fed 3/4 can FFC
10:00am - 346
1:00pm - 331 --> fed 3/4 can FFC
3:00pm - 314
 
Looks like his BG is starting to come down now. At +9 (5pm) his BG is at 270. If anyone will be around please keep an eye out for my PMPS #'s, I plan to test at 7pm, 7:30pm, and 8pm in case I still don't get a rising # cuz it looks like he's just coming down.
 
How about starting a new thread in PZI and put something like....Going to need PM dose advise ....and see if you can catch some eyes and alert the group at what time you will be testing.

You might want to go ahead and post the same in health.
 
I'll be on late again tonite. I just got off work and I'm on my 2nd cup of coffee, AND tomorrow is my Saturday so no alarm in the AM for me. All I need to do tomorrow is run to town and pick up some cat food and supplies. I was thinking about cutting the grass, but oh darn, it's supposed to rain... :-D
I'll keep an eye out for your posts.
Carl
 
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