? BG still erratic, help needed please

This too shall pass! Go get some chocolate to soothe the frustration! It could be worse.....he could be running low and making you hold a PJ party with him! When you get lemons make lemonade. ;)
 
I’m greedy today, I got a whole chocolate cake and I want some blue/greens from Perlutz :D

Could 3.5 be too high for him? Sometimes I wonder if 3.25 would work better?
 
Yes I'd back him off to 3.25u. He got down to 4.2 today and I'd usually reduce for a reading 5 or less. Right now he's bouncing and lowering the dose won't necessarily stop that although it might make it a little less dramatic.
 
PMPS 6.8

Currently stalling without food to see if he goes up but still unsure what dose to give if he goes up a little. Anyone around with suggestions?
 
Can you monitor a bit tonight? Your goal is to get him surfing in high green to low blues and the more time he spends there the more his body will learn those are normal numbers and you might be fine with his regular dose but since it's a night cycle and the lowest PMPS you've shot, how about knocking him down to 3.25u? If you need sleep and /or can't monitor for a few hours, then you could knock him back to 3.0u for tonight.
 
MrWorfMen's Mom said:
Can you monitor a bit tonight? Your goal is to get him surfing in high green to low blues and the more time he spends there the more his body will learn those are normal numbers and you might be fine with his regular dose but since it's a night cycle and the lowest PMPS you've shot, how about knocking him down to 3.25u? If you need sleep and /or can't monitor for a few hours, then you could knock him back to 3.0u for tonight.
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We're staying in so I can monitor him until late/overnight if I have to. But I think I'd be more inclined for 3.0u. We were saying earlier that maybe I should lower to 3.25 so I guess I'm thinking given it's quite a low PS for us, maybe 3.0u would be better?
 
I only wish I did have some suggestions for you Georgiana but every time I look at a ss my eyes literally glaze over. Linda might be around to help, but if not, can you see any patterns in bg on different doses? What have you dosed before when it looks as if he's getting long duration - have you given the current "usual" dose and has he clearly bounced? Or have you given a reduced dose and he's gone high anyway? Or has a reduced dose actually kept him in better numbers for a while but then he's gone up again at pre shot? It really does need someone who's good at analysing a ss to know what to do for the best, and sadly that's not me - however hard I try :(

I do wonder though if he's going to be surfing the blues for a while if you could consider dosing late, testing hourly, see what happens, and catching him just when you sense he's about to rise... could be late evening but as it's the weekend you might be able to adjust shot times again to get back into the usual cycle. That may be crazy.

The other thing I've been wondering about is trying eight-hourly dosing for a couple of days, eg at a weekend, just to see if you can keep those numbers down for a bit longer and get him more used to them... I know TID isn't really ideal and is not sustainable, but sometimes a little experimentation might get somewhere.

Sorry - slightly off the wall, not really suggestions as much as musings, but throwing them out there (Linda, please feel free to chuck bucketloads of water over all this!!)
 
No drowning you today Diana.:woot:...it's always worth considering potential options, but I wouldn't try TID dosing with Perlutz because that's usually a consideration when lack of duration is an issue, more common with Vetsulin than ProZinc and Perlutz doesn't seem to be having that issue. I don't think those higher AM pre-shots are lack of duration but rather bounces from lower numbers Perlutz just has to learn are not a threat. He's definitely getting better. There is also the problem that TID dosing is a recipe in most cases for driving the CG a bit crazy.

Georgina, if you are more comfortable with 3u tonight that it fine. You hold the needle and have to be comfortable with what you are giving.

What is the food schedule with Perlutz? SOmetimes you can steer the cycle with food timing/more or less carbs. Wondering if that might be something to explore a bit with your furry kid.
 
If Linda decides to go for the bucketloads of water, I’ll get some too, Diana :joyful: I went for a fat 3.0u.

Whenever I get a low PS, I check the SS for previous similar situations and see what I’ve done then and how it worked out. But I think we can all agree Perlutz is nothing but full of surprises!

Here’s a pic of him just earlier waiting for his 2nd test :cat:
C29E69B1-3123-4F1E-9ACE-C2DC9FF0BCCD.jpeg
 
Georgiana & Perlutz said:
If Linda decides to go for the bucketloads of water, I’ll get some too, Diana :joyful: I went for a fat 3.0u.

Whenever I get a low PS, I check the SS for previous similar situations and see what I’ve done then and how it worked out. But I think we can all agree Perlutz is nothing but full of surprises!

Here’s a pic of him just earlier waiting for his 2nd test :cat:
View attachment 47819
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He is SO gorgeous!

Thank for your comments on mine, Linda, make perfect sense ;) and I specially like the bit about steering the cycle... Perlutz is doing better, even I can see that, but we'd all like to see some more consistency so looking at all sorts of avenues seems to be something that might just make that bit of difference.
 
He is eating 1x can/sachet before insulin AM and PM, 1/4 can/sachet around +3, then 1/4 to 1/2 can/sachet around +7.5. Whatever he eats from the autofeeder is at approximate times, the feeder has a dial rather than a digital timer. In terms of carbs, his food has around 6%.

I'm not sure what TID and CG stand for :oops:
 
Georgiana & Perlutz said:
He is eating 1x can/sachet before insulin AM and PM, 1/4 can/sachet around +3, then 1/4 to 1/2 can/sachet around +7.5. Whatever he eats from the autofeeder is at approximate times, the feeder has a dial rather than a digital timer. In terms of carbs, his food has around 6%.

I'm not sure what TID and CG stand for :oops:
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TID = three times daily dosing
CG = caregiver

Any more? ;)
 
Georgiana & Perlutz said:
If Linda decides to go for the bucketloads of water, I’ll get some too, Diana :joyful: I went for a fat 3.0u.

Whenever I get a low PS, I check the SS for previous similar situations and see what I’ve done then and how it worked out. But I think we can all agree Perlutz is nothing but full of surprises!

Here’s a pic of him just earlier waiting for his 2nd test :cat:
View attachment 47819
Click to expand...
What a beautiful kitty, he sure is handsome
 
How about trying 3.25u for a few cycles? You are getting more pre-shots when you have to stall to make sure it's ok to shoot and some nice lower numbers. Technically should have reduced the other day when HRH went down to 4.2. Might even out those pre-shots a bit.
 
He was getting irritated with not being fed so I tested him 15 min later and BG went up to 7.0. Dosing ideas? I’m wondering if a 2.75 would be better, maybe he won’t bounce (so bad)?
 
It's entirely up to you and what you are comfortable with but if you want to reduce more how about 3u? HRH is doing well but still have some room for movement and you don't want to lose the momentum. Dropping the dose too much might slow you down and won't necessarily stop the bouncing. Bouncing will stop when he gets used to those nice lower BGs.
 
MrWorfMen's Mom said:
I'd would test at +2 as well as before bed. If HRH is dropping you can bump him up with some food. Want to keep him in those healing numbers as much as possible.
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I went with 3.0u and will test at +2 and before bed. He is fed up with my testing, as soon as I get ready for it, he runs under the dining table. But comes out and behaves the second he sees food :D
 
HRH’ AMPS was 3.7 :woot: :woot: :woot: Did NOT see this coming!

Bf was awake an hour- an hour and a half before testing and said Perlutz was acting absolutely normal. He was fed immediately after testing and 25 min later BG went up to 5.7.

I will test him again before I leave to work.
 
Yikes - whatever next. He really is giving you the runaround isn't he. Interesting though as his AMPS have usually been stubbornly high, whereas PMPS numbers haven't been too bad at all recently. So a lower AMPS than expected would in itself be a change, but that low is certainly a surprise. Maybe he's decided to flick a switch and go into a different phase just to keep you guessing.

Yes, test again before you leave and post here if you get a minute in case anyone looking in has anything to offer!
 
Diana&Tom said:
Yikes - whatever next. He really is giving you the runaround isn't he. Interesting though as his AMPS have usually been stubbornly high, whereas PMPS numbers haven't been too bad at all recently. So a lower AMPS than expected would in itself be a change, but that low is certainly a surprise. Maybe he's decided to flick a switch and go into a different phase just to keep you guessing.

Yes, test again before you leave and post here if you get a minute in case anyone looking in has anything to offer!
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He loves to keep us guessing, doesn’t he! I don’t know what he’s got up his sleeve this time, but I’m hoping it’s similar AM and PM preshot numbers (blues and yellows only, please!:smuggrin:) Realistically, I’m expecting a black PMPS tonight...
 
Georgiana & Perlutz said:
+2 14.9 so it does look like we’re heading for a black coloured pmps
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Sigh...
Are you popping home at lunchtime and if so and he's still rising, I wonder if there's any value in giving just a tiny smidge of insulin...? I think this issue has been raised elsewhere before and I can't remember the expert responses... if it was me doing this without the help of members here, that would be my instinct, but I can see that there might be problems with it of course.
I'm sure Linda will make a sensible comment!
 
Diana&Tom said:
Sigh...
Are you popping home at lunchtime and if so and he's still rising, I wonder if there's any value in giving just a tiny smidge of insulin...? I think this issue has been raised elsewhere before and I can't remember the expert responses... if it was me doing this without the help of members here, that would be my instinct, but I can see that there might be problems with it of course.
I'm sure Linda will make a sensible comment!
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Definitely going home lunch time to test him but I’m not sure about giving insulin. I don’t really know how giving a little insulin at +7 would work and I can’t make any changes in shooting time (I start work earlier than usual tomorrow to Friday). But I’ll look into it, I can see how it might work.
 
Georgiana & Perlutz said:
Definitely going home lunch time to test him but I’m not sure about giving insulin. I don’t really know how giving a little insulin at +7 would work and I can’t make any changes in shooting time (I start work earlier than usual tomorrow to Friday). But I’ll look into it, I can see how it might work.
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When in doubt, don't do it! I was only thinking about a very small amount - if anything - that might just stop a stratospheric rise and tide him over till this evening. But it is only a thought!
 
Diana&Tom said:
When in doubt, don't do it! I was only thinking about a very small amount - if anything - that might just stop a stratospheric rise and tide him over till this evening. But it is only a thought!
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I tried to find something about giving a dose like this mid cycle but no luck :( I just don't know how his body will react to something new (time wise) and he is nothing short of full of surprises! I still have an hour before I go see him
 
Georgiana & Perlutz said:
I tried to find something about giving a dose like this mid cycle but no luck :( I just don't know how his body will react to something new (time wise) and he is nothing short of full of surprises! I still have an hour before I go see him
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I know... it's probably not a good idea in practice even if it seems sort of logical (to me, anyway) in theory. I know messing with shot times is generally a bad idea, but as he had no insulin at all this morning, plus knowing his tendency to shoot up and trying to find ways to keep him in reasonable numbers, a tiny half-unit or something might possibly do something useful. But as you say, he is full of surprises so who knows, he might be surfing nicely in the yellows at lunchtime and even beyond - which could present another dilemma as you'd be wondering what to shoot tonight!

But whatever happens for the rest of the day, you will have some interesting data on what he wants to do without insulin for a lengthy period. I'm sure you must be tearing your hair out wondering what else you can do to try and get him into better numbers so any variation on the usual - in this case, 24 hours without insulin - could be useful!
 
I do see logic in giving him a tiny dose now, it's just that I don't know how that would work for him. It wouldn't surprise me if it gave a low PMPS and if that would be the case, I wouldn't have any wiggle time with the shooting time. So despite him being 30.6 just now :confused: I won't give him any today but it's something I might try one day when I have some flexibility with shooting time and maybe be able to keep an eye on him.

It will be interesting to see PMPS, I wonder if mr pancreas will come out for a little play today...

As for tearing my hair out, not yet :D I think the better numbers we've seen lately have something to do with that. While they're still not good, consistent numbers, it's an improvement and like you said not long ago, it's not all about the diabetes! He's still my lovely, cuddly kitten! (12 yo and 6 kg kitten :smuggrin:) He doesn't seem in pain, he eats, plays, cuddle so I try to focus on enjoying him. This morning I was running late because I was starring at him sleeping and playing with his cheeks :D I'll add a picture of how cute he was napping
 
Georgiana & Perlutz said:
I do see logic in giving him a tiny dose now, it's just that I don't know how that would work for him. It wouldn't surprise me if it gave a low PMPS and if that would be the case, I wouldn't have any wiggle time with the shooting time. So despite him being 30.6 just now :confused: I won't give him any today but it's something I might try one day when I have some flexibility with shooting time and maybe be able to keep an eye on him.

It will be interesting to see PMPS, I wonder if mr pancreas will come out for a little play today...

As for tearing my hair out, not yet :D I think the better numbers we've seen lately have something to do with that. While they're still not good, consistent numbers, it's an improvement and like you said not long ago, it's not all about the diabetes! He's still my lovely, cuddly kitten! (12 yo and 6 kg kitten :smuggrin:) He doesn't seem in pain, he eats, plays, cuddle so I try to focus on enjoying him. This morning I was running late because I was starring at him sleeping and playing with his cheeks :D I'll add a picture of how cute he was napping
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Great post Georgiana, well done you!
 
WHOA! What a surprise that must have been this morning. Looks like Perlutz bounced and the bounce broke overnight. Your clue that there might be a low coming is the drop Perlutz had last night between PMPS and +3. While it wasn't a huge drop, it was substantial given that ProZinc usually onset roughly +2 or so. If you get a before bed test that is the same or dropping, feed Perlutz a snack and set an alarm to retest a bit later.

As for giving a small dose mid cycle, it can be done but it would put your schedule off. Normally with ProZinc you have an hour of leeway but if you shoot even a tiny dose mid cycle, you'd be dealing with 2 nadirs and that could get dicey. You're better off to employ the stall technique. If you get a low at pre-shot, stall without feeding and retest 20 to 30 minutes later to see if BG is coming up on it's own. If it is rising, then you can consider giving insulin (either full or reduced dose depending on BG).

I'd drop his dose down to 3.25u and keep it there. He earned a reduction with that 3.7 this AM. Hopefully there will be more lovely greens showing up but let's try to keep them in the dark green. :D
 
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