Bud AMPS 485 0.75u

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eeraby

eeraby

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12/30 9:00 pm 181 0.5u +4 281 +8 381 12/31 +11 481 (AMPS - 8:00am) 0.75

I almost shot 1.0

Told DH last night NOT to shoot at his normal 5am, so he didn't. He didn't know to shoot a 381

Pulling hair.
 
I'm not surprised that she's so high today. She dropped 400 points yesterday and I'm sure her liver panicked and thought she was too low and dumped sugar to protect her from what her liver preceived as a hypo, even though it wasn't, it was just a steep drop. Another ride around on the roller coaster.

That is why I suggested to pick a lower dose and stick to it and let the roller coaster come to a stop.

If Lori is right about her getting a longer duration a lower consistant dose will still be needed to stop the spikes.

Any thoughts?
 
I probably would have gone with .5u.

Look at yesterday, you had a very similar AMPS and shot .75u just like you did today, so today you can expect the same type of day that you had yesterday.

Joanna is right, every day is a data gathering experiment, trial and error, keep looking back at the last few days and the results that you got on a PS and dose XX and make adjustments, if it was too much insulin than the next time you lower your dose a hair, if it was not enough insulin than you increase your dose a hair (by a hair I mean .05u or .1u).
 
I did look at yesterday and that's why I shot 0.75. She had a late nadir and @ +10 was 88

I debated with myself to shoot 1.0. I'm missing something, I think.

Leaving for the day in 30 min ///10.30 EST..

Again... any and all comments welcomed!!!!!! I'll read 'em the minute I walk back in the door.

Thank you Rob!
 
I guess I thought you wanted to get on a 12/12 schedule.

+10 88 is a good nadir, but the 400 point drop is the problem, a nadir of 88 would be perfect if your PS was 180 to 200.
 
You can't freak out on a bounce # of 481, just know that it is a bounce and it will clear. I know it sounds counter intuitive.

When I started and got a 400ish bounce the veterans would tell me to put on the hand cuffs and not shoot the bounce (meaning not to increase the insulin because of the higher bg), to just stick with his regular dose and let the bounce clear on it's own.
 
I am surely no expert, but my impression is that any time you have a large fast drop, the body may react by protecting itself and dumping sugar into the blood (as if it feels it is going down a rollercoaster and is afraid if it doesn't stop the plunge it will hypo). So while you want those lower numbers, you want to get to them more slowly.
 
Interesting, I would have expected a little more action from the 0.5u. Could be right what others are saying that it's some bounce from the steeper drop & lower #s yesterday. I probably would have gone with 0.6 today, but after reading the thread, 0.5 makes sense to me as well.

The thing that stands out to me is that yesterday's pattern was not a nice U-curve to a "normal" nadir (+4 to +9 say), so unless you have a cat who typically nadirs late (which I don't see from earlier data, there is often a much earlier nadir), *something* is up. There are several possible explanations, but to me the first line of approach (regardless of the explanation for the curve) is to lower the dose a hair and see what happens. If the 88 had come at a +6 and you had something like a 60% drop from PS to nadir, then I'd be saying the dose was perfect. When the pattern doesn't match that (barring a cat with a history of a different pattern), then I start to question the dose.

Don't tear your hair out though, I don't think 0.75 is unsafe or anything like that, at least not on this kind of PS. If it isn't making sense to you and you are still having dreams of shooting 1u though, let us know exactly what part isn't making sense.
 
Just dawned on me too that the 0.5 was shot at +16, so another theory (just to confuse you, sorry! :roll: ) is that the dose got less "oomph" b/c it was a late shot, and that could be an alternate explanation of the higher #s overnight. If that is the case, then you would expect to see better #s off of a 0.5 dose shot at 12/12. So don't despair! I would try 0.5 again when you get the chance.

And if you are tearing your hair out, might be a good day to take a break from spot testing. We can all get kind of tunnel visioned looking at each data point & of course it's always interesting to have more data, but in most cases IMO there's no need to get extensive data every day. I'd take the day off, leave some food out, go out & have some fun and not worry about it.

If I were in your shoes, I would just make a decision to try a certain dose for a day or two on a 12/12 schedule if possible (maybe 0.6 (?) and of course adjusting if you got unexpected low #s or something) and collect data and then reevaluate. No need to solve all the problems today or tomorrow (assuming Bud is feeling moderately well and you don't have any ketone problems). Sorry if I have contributed to your feeling like you should, as I'm sure I have. :-D
 
I'm stuck in perpetual newbie-ville, so I don't like to give dose advice...but I have to say that I agree with Joanna's last paragraph. Try a slightly lower dose for all your doses on a 12/12 schedule. The slightly lower dose may not get you as low of nadirs as you've seen, but it may help to keep him on a consistent dosing schedule so that you're not skipping shots or shooting several hours late. Not that there is a problem with doing those things if you can stand it, but I think it would drive me crazy staying up all night waiting for a shootable number! You're doing great!! Every day you'll learn one or two new things and eventually it will all start to make sense.
 
Just chiming in to say I'm sorry you're having such ups and downs. Since I stopped testing Sam except for PSs, I have to say I'm much happier and he seems to be slowly leveling down. Maybe it's time to give yourself a break, you know? Let things even out on their own. Seems to have worked for Sam, although I know ECID.
 
Thank you ALL for all the thoughts!

Joanna... hon, you've not contributed to me thinking I *have* to do anything. ALL of ya'll are giving me your thoughts and opinions... which is exactly what I've asked for.

So.... The general consensus is to shoot 0.6u every 12 hours for several cycles no matter how PS HIGH she goes?

At what LOW PS do I shoot less than 0.6? I for sure ain't shooting greens... Blues?
 
eeraby said:
So.... The general consensus is to shoot 0.6u every 12 hours for several cycles no matter how PS HIGH she goes?
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Pretty much correct. My input would be pick a number like .6u and try it for a few cycles. If no "improvement" then up a hair more like Robin said to .65u or .7u for another few cycles. If too much improvement then you may need to back off on the dose a hair. High numbers for short periods of time are generally not bad for most kitties. DO make sure to add water to your kitties wet food. It should be much softer but not soupy. This will help with hydration and potentially lesson any issues that can come with higher numbers.

It looks like in the past you have gotten traction with .5u when she was regularly getting insulin but I'm not sure if that would be true still. You could try starting with .5u too and see if that gets you anywhere then maybe move up to .6u if no improvement in a few cycles.

eeraby said:
At what LOW PS do I shoot less than 0.6? I for sure ain't shooting greens... Blues?
Click to expand...
My opinion would be that if you are at less than 200 for now you would want to reduce a little perhaps. Maybe .3u for anything between 150 and 200? Maybe the others will have some input on that.

And like Robin is alluding to it really depends on what is going on at the time to make the best judgments.
 
I agree you should keep a no-shoot level that you are comfortable with. I would say 150 for an absolute bottom, and like Gator said if it's between 150 & 200 try a lowered dose. I would probably stick with 0.4 on a 150, and 0.5 or 0.6 on 200 or higher. I'm probably at the more aggressive end of the opinion spectrum, having done my fair share of being a chicken and undershooting for my cat (not saying you are doing that).

One thing you can do is sit down with your spreadsheet and make notes on what makes sense to YOU, if you haven't already done that. For instance where you've shot before on a 150 or a 180 or whatever, see what dose you gave and what the results were. If you got a nice U-curve with a 60%ish drop, and the beginning and ending PSs about the same, then that's a dose that might be a good one. If the #s never went to a passable nadir, and then went steadily up to a higher +12 for the next shot, then the dose was probably too low. If you got an overly green nadir and gave HC, the dose was probably too high. Of course the cycles often aren't super-easy to read like that, but you start by sort of mapping out what worked & what didn't, and build your ranges & shooting strategy from there.
 
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