Cadmium BG March 2023: PMPS: 465, +2: 412

apollonia-artemisia

apollonia-artemisia

Active Member
Previous thread: https://www.felinediabetes.com/FDMB/threads/cadmium-bg-thread-cont-amps-383-4-108-pmps-438-7-5-189.273200/

(Adding in the other days of March that were in the previous thread)

03/01/2023
AMPS: 451, 0.75F, whole can
+6: 295
PMPS: 267, 0.75F, whole can
+5: 94

03/02/2023
AMPS: 424, 0.75F, whole can
+3.5: 135
+6: 215
PMPS: 471, 1S, whole can. Tweaked his dose because I do not like that preshot.
+3: 364

03/03/2023
AMPS: 414, 1S, whole can
+5.5: 353, thats concerning...
PMPS: 403, 1S, whole can
+3.5: 163
+5.5: 81

03/04/2023
AMPS: 416, 1S, whole can. He did jump while getting insulin, so hopefully it was injected into the right spot.
+5.5: 169
PMPS: 474, 1S, whole can. This might have bounced up so high bc of separation anxiety.
+2: 399

03/05/2023
AMPS: 383, 1S, whole can. I will start a new thread soon because I realize its getting rather long to read this main post!
+4: 108
PMPS: 438, 1S, whole can
+7.5: 189

03/06/2023
AMPS: 482, 1u, whole can. My impression from his really high preshots are that he is either rebounding from what his body thinks is a low, or he is needing his insulin dose tweaked to be a bit higher. I am going to see how he responds to 1 unit flat for now, as thats not as intense of a dose change.
+6: 393. At first after his dose he was zoomy and chatty, then got tuckered out and sleepy (which is pretty normal so I didnt think anything of it) and now I'm wondering if that was him dropping too fast and I didnt realize it.
PMPS: 365, 0.75F-1S, whole can. Returned to lower dose because I dont like how he was acting on 1u.

03/07/2023
AMPS: 388, 0.75F-1S, whole can
+1: gabapentin dose
+3.5: 291
+5: vet appointment
PMPS: 458, 1S, whole can. Today at the vet he got his rabies vaccine and a urine sample taken in order to prepare him for his dental cleaning. I am thinking for now the plan should be to hover around 1S and see if his cyclical bounces clear up with time, and go from there.
+4: 287, still eating

03/08/2023
AMPS: 438, 1S, whole can
+6: 177
PMPS: 443, 1S, whole can. Theory to test: see if his readings are lower if I don't need to squeeze his ears
+3: 330, still eating

03/09/2023
AMPS: 394, 1S, whole can
+6: 341, woken from a nap, I suspect this as a bounce while I was running errands.
PMPS: 425, 1S, whole can
+3.5: 374. Maybe his insulin went bad after all.

03/10/2023
AMPS: 364, 1S, whole can
+8: 296
PMPS: 232, 1S, whole can. Looks like his insulin was fine, and he was just bouncing a lot!

03/11/2023
AMPS: 285, 1S, whole can
+1: zoomies
+4.5: 267, just finished eating his food not too long before this reading
+6: 297 :/
PMPS: 428, 0.75F, whole can. I'm thinking it kicked in around AM+2, and then made him bounce hard. Trying reduced dose tonight and will check at PM+2
+1: zoomies
+2: 381
+4: 299

03/12/2023
AMPS: 441, 0.75F, whole can
+3.5: 250
+6: 253
PMPS: 468, 1u, whole can
+2: 415
+5.5: 353
+8: 367

03/13/2023
AMPS: 401, 1u, whole can. Vomited his food shortly after insulin dose, likely scarf and barf. After that he used the litter box and seems to still have mild constipation but was able to pass stool, then got ridiculous levels of zoomies. All of this happened in short succession. He was given a half can to make up for the food he lost.
+4: 261
+6: 217
PMPS: 167, whole can, asking for advice on dose.
+1.5 after food: 238, 0.75F and keeping an eye on him
+2: 284
+5.5: 116

03/14/2023
AMPS: 162; 15min later: 173, 0.75u, whole can
+2.5: 302
+4: 306, looks like this dose might not be enough to help him process his food
+7: 344
PMPS: 395, 1S, whole can
+3.5: 244

03/15/2023
AMPS: 322, 1u, whole can
+2: 313
+6: 144
PMPS: 287, 1u, whole can. PM dose may have been a possible furshot, I had difficulty aiming it right tonight.
+3: 331

03/16/2023
AMPS: 353, 1u, whole can
+2: VERY zoomy
+6: 325, how.... confusing.
PMPS: 335, 1u, whole can. Dose of dasuquin in food, as he might be having an arthritis flare
+3: 197!!

03/17/2023
AMPS: 174, 1S, whole can. I am trying a slight dose reduction to see how he responds while in blue numbers.
+4: zoomies!
+5: finished rest of food
+6: 213
+10: 295
PMPS: 392, 1u, whole can, ketones- negative
+4: 130

03/18/2023
AMPS: 394, 1u, whole can
+3: zoomies!!
+4: 323, finishing his breakfast.
PMPS: 181, 1u, whole can. I'm trying out 1u to see if it'll keep him in the right range after food
+2.5: 217

03/19/2023
AMPS: 215, 1u, whole can, dose of miralax. He's been getting doses at least once every other day, but sometimes I forget. If I notice he is still having difficulty, he gets additional doses.
+6: 97!!
PMPS: 412, 1u, whole can. Boing!

03/20/2023
AMPS: 279, 1u, whole can, cuddles
+7: 251, zoomies
PMPS: 329, 1u, whole can
+5: 155

03/21/2023
AMPS: 329, 1u, whole can
+6: 254
cleaned his ears
+7: zoomy
+7.5: 257
PMPS: 296, 1u, whole can

03/22/2023
AMPS: 187, 1u, whole can
+6: 91
PMPS: 394, 1u, whole can, very zoomy
+4.5: 190

03/23/2023
AMPS: 176, 1u, whole can
+6.5: 120
PMPS: 416, 1u, whole can
+3: 283

03/24/2023
AMPS: 301, 1u, whole can
+3.5: 216
PMPS: 152, 1u, whole can
+3: 177, only halfway done with his food so im not too worried

03/25/2023
AMPS: 248, 1u, whole can
+6.5: 100
PMPS: 374, 1u, whole can

03/26/2023
AMPS: 145, 1u, whole can
+7: 82, he hasn't been finishing his cans lately, did the recipe for chicken feast pate recently change?? EDIT: yes it did, its to remove artificial flavors and preservatives!
PMPS: 125, stall 10 min: 128
+1: churu to stimulate appetite, zoomies
had to hand feed him. sometimes when his separation anxiety is high he avoids eating, but hand feeding tiny pieces at a time helps.
+9: 217

03/27/2023
AMPS: 290, 1u, whole can
+6: 93
PMPS: 197, 1u, whole can
+2.5: 115

03/28/2023
AMPS: 211, 1u, whole can
+8: 119
PMPS: 175, 1u, whole can
+3: 91, has half of his food left still so i am not too worried
+6: 86

03/29/2023
AMPS: 150, 1S, whole can. Gave "skinny" dose because I want to see how he responds to it when his preshot is in the mid 100s.
+6: 78, after reading I gave him some churu.
+7: 134
PMPS: 275, 1S, whole can. temp reduction due to AMPS and AM+6
+5: 109

03/30/2023
AMPS: 175, 1S, whole can
+6.5: 64, churu and freeze-dried chicken
+8: 111
PMPS: 216, 0.75F, whole can
+4: 54, given two spoonfuls of 12% carb food
+5: 90
+5.5: 108

03/31/2023
AMPS: 431, 0.75u, whole can
+5.5: 150
PMPS: 161, 0.75u, whole can
+5: 69

04/01/2023
AMPS: 180, 0.5F, whole can. I will start a new thread once I have more awakeness energy-
+4: 49, getting out his 12% can to get him back up. He put off eating for so long that once he felt low he scarf and barfed his normal food.
20m later: 74, giving him two more spoonfuls.
+5: 90, letting him finish the rest of the can (approx 1 spoonful)
+5.5: 120
+6: 225
+7: 348
PMPS: 465, 0.5, whole can. Changed to salmon fancy feast, will update signature.
+2: 412
 
Last edited:
New thread @Suzanne & Darcy @FrostD ! Current concerns are if I am giving him too much insulin causing him to rebound up so high, or if I was not giving him enough. I tweaked his dose to be slightly higher as 1u flat instead of 1S as that wasn't as intense of a dose change, and I will keep a close eye on him today.
 
This doesn’t look like bouncing to me; it looks like lack of duration of the insulin. He just doesn’t stay high long enough for it to be bouncing. Some days he starts pretty high, gets his shot and, within a few hours, he is back down into blue. That’s not a typical bounce pattern where the hormones will keep a cat high despite the insulin.

He had previously gotten some better cycles with lower preshots when he was on the 1fat dose. That may be too much if he starts out with a low yellow preshot, of course, (like February 13) but most of the other times it worked well.
 
Suzanne & Darcy said:
This doesn’t look like bouncing to me; it looks like lack of duration of the insulin. He just doesn’t stay high long enough for it to be bouncing. Some days he starts pretty high, gets his shot and, within a few hours, he is back down into blue. That’s not a typical bounce pattern where the hormones will keep a cat high despite the insulin.

He had previously gotten some better cycles with lower preshots when he was on the 1fat dose. That may be too much if he starts out with a low yellow preshot, of course, (like February 13) but most of the other times it worked well.
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Yeah, I agree... Maybe on those days he would get a 1 unit or 1 skinny dose? But overall, slightly above the 1 unit seems to help him a lot. He's gotten pretty zoomy today after his 1 unit!
 
Suzanne & Darcy said:
Now yesterday March 5 and today March 7 really does look like a bounce to me. Let’s see how long it lasts. He’s trying to be tricky! :cat: He is going to the vet today?
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I think its partly due to insulin overdose making that bounce, but we will keep an eye on him! He's going to the vet and got a dose of gabapentin.
 
Hi. Maybe you should try a straight 1 unit. I am uncertain why you are thinking that he is overdosed? I don’t see it. @FrostD what do you think? I don’t mean that in any unkind way either, because I really have developed an affection for you and Cadmium! I don’t think that he is being overdosed and it’s causing bounces. I think he is bouncy because he is still not accustomed to being in lower glucose numbers. He probably has some glucose toxicity because of being in high numbers a fair amount of time. That makes it harder to break through. If you really want to do fine dose changes, you might want to get some digital calipers. There are people who do that. I only mention this because on your spreadsheet there is a 1 s dose and then a .75f dose. Those two doses are really hard to distinguish between, I think. I also don’t think that it is best to keep changing his dose quite so frequently. Of course, with a very low preshot you would make adjustments. If you think he is overdosed, you could choose a lower dose and stick with it for a little while.

Could you maybe try a 1 unit for at least 6 - 10 cycles and see what kind of nadirs you get? Honestly, I think it looks like he needs a little more than 1 unit but you could try it and see.
 
I can maybe try, I was just really paranoid about the times he would drop too quickly in the past I guess! He also still gets zoomy after his shots, so thats why I was partially led to believe he might have bounced and I just missed it... Thank you though for that, it means a lot!

For the 1S I had been measuring instead of to the bottom of the line, I measure to the top of it. For 0.75F, I go to 0.75 and just pull a tiiiiny bit farther. But considering how hes been with his insulin and how extremely sensitive he gets, he likely needs something like calipers for sure!
 
As for dropping fast, I was going to ask you about that because fast drops can trigger a bounce as well, as I am pretty sure you know. Even today I noticed it was a pretty steep drop initially and then he leveled off. Is he willing to eat a +2 snack? If he’s already getting a +2 snack then maybe the carbs in that snack need to be increased a little bit. It may slow him down just a bit in the first few hours and may help reduce bouncing.
 
Suzanne & Darcy said:
As for dropping fast, I was going to ask you about that because fast drops can trigger a bounce as well, as I am pretty sure you know. Even today I noticed it was a pretty steep drop initially and then he leveled off. Is he willing to eat a +2 snack? If he’s already getting a +2 snack then maybe the carbs in that snack need to be increased a little bit. It may slow him down just a bit in the first few hours and may help reduce bouncing.
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He kind of already does that, where he eats half of his can on his own before receiving insulin, has a tiny bit more, and the saves the rest for around the +2-3 mark. I think its because he can tell his glucose is coming down fast, and then he remembers he has leftovers!

I guess we will see what his PMPS will be? I gave it at 11:15 this morning because of daylights savings, and will gently scoot it back to 10:30.
 
I agree with Suzanne and trying 1U. You may get stuck in a cycle of increasing to break through toxicity, followed by a reduction, followed by a creep back up into some toxicity, repeat.

My cat also fed his own curve essentially. Works great when regulated! But doesn't help those steep dives. Worth trying a higher carb % there.
 
It’s not at all uncommon to have numbers go up after and increase. It’s what we call new dose wonkiness. Hang in there! We have to try. This used to happen to me a lot, although with my cat he usually went up on the second day after an increase and then went back down. Maybe it was because he was on a depot insulin (we started with vetsulin, then prozinc, then lantus then levemir.)
 
Suzanne & Darcy said:
It’s not at all uncommon to have numbers go up after and increase. It’s what we call new dose wonkiness. Hang in there! We have to try. This used to happen to me a lot, although with my cat he usually went up on the second day after an increase and then went back down. Maybe it was because he was on a depot insulin (we started with vetsulin, then prozinc, then lantus then levemir.)
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He's being a bit of a nightmare today, check the notes for the full reasons why. He got half a can to make up for the food he lost. I'm running on four hours of sleep because I had really early labs to get done at my doctor's office, so today has been really hard so far :'( On top of that, the brat tried to steal my glazed apple fritter!!!! He didn't get any of it but he wanted it so so so badly.
 
So um, his PMPS was 167! Partner already went ahead and fed him so stalling is not an option. With a preshot that low, what advice do y'all have for his evening dose?
 
What I wound up doing was following dosing advice in the guide re: low preshots and waited 1.5 hours, which is when he started acting really tired. At that number (238) I felt like it was safe to give him a dose, albeit a reduced one, and that I would keep an eye on him.
 
Bron and Sheba (GA) said:
@apollonia-artemisia sent me a PM to look at this thread.
I'm not a prozinc user so will tad @Suzanne & Darcy and @FrostD to have a look for you.
When you waited and got 238 I think you could probably have given the full dose as waiting that long after the preshot was due, is a bit like a dose reduction anyway. But it was fine to do what you did. Sorry no-one was here for you:)
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I figured that was the case but I was just wanting to make sure he would be safe if I was more asleep than usual (was running on four hours of sleep!) especially because he has a tendency to drop lower during the night.

It does seem like something worked out today, as his +5.5 was 116! Yay!
 
You did fine. His spreadsheet is looking good. Sorry I was not well at all last night by the time I finally got home. Hopefully today he will do great. You may have to get used to more lowish preshots. Gradually.
 
Suzanne & Darcy said:
You did fine. His spreadsheet is looking good. Sorry I was not well at all last night by the time I finally got home. Hopefully today he will do great. You may have to get used to more lowish preshots. Gradually.
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I hope you're feeling better!!

Hoo boy, with low preshots, how much am I supposed to reduce his dose? Is that when token doses come in?
 
It appears that he was on his way up this morning when you were stalling without food, or least stable if we consider meter variance.
 
Suzanne & Darcy said:
Yes, vets always will advise to keep your cat in higher numbers. I believe they fear their clients will let the cat hypo.
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The vet wasn't wanting him to stay in the 200s-300s. She was hoping for staying level in around the same range as his preshot.

Suzanne & Darcy said:
It appears that he was on his way up this morning when you were stalling without food, or least stable if we consider meter variance.
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Yeah, I was thinking it was possibly meter variance because ~10 points is not a lot, or subtly going up because he was getting impatient for food!
 
I am actually proud of you for shooting the 1 unit this morning. I do not think that 82 at +7 is a problem- although I hope he was having snacks before that. I wish I knew where he was a bit earlier in the cycle.
 
Suzanne & Darcy said:
I am actually proud of you for shooting the 1 unit this morning. I do not think that 82 at +7 is a problem- although I hope he was having snacks before that. I wish I knew where he was a bit earlier in the cycle.
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He was doing alright based on behavior though yeah I probably should have done another test earlier- he was rather chatty and energetic! He was being rather picky about his food changing its recipe (apparently its to remove artificial preservatives and flavors?), but he did finish it all.
 
Yeah, whenever I see a green number I am usually prepared to accept that his PMPS will be a high bounce! But I do agree that hes getting used to the lower numbers, especially with how his behavior has been :) His bounces have been getting less severe too, now they typically go into the 300s instead of the 400s!
 
apollonia-artemisia said:
Yeah, whenever I see a green number I am usually prepared to accept that his PMPS will be a high bounce! But I do agree that hes getting used to the lower numbers, especially with how his behavior has been :) His bounces have been getting less severe too, now they typically go into the 300s instead of the 400s!
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I know! Real progress is being made. I remember how sluggish and sleepy he would get in the lower blues and higher greens. You have been very patient and have been taking great care of him.
 
apollonia-artemisia said:
He's doing okay! His reading just now was 217, so he might be experiencing a delayed bounce or went into the greens again. We shall see what his AMPS does later to figure out next steps.
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Yep. Either is a possibility. Don’t feed him within two hours of shot time so that you will be able to make the best decision for shooting - although if he’s already yellow now at +9 it should be easy.
 
You had some excitement yesterday, didn't you! Nothing in the danger zone, but still lower than the SLGS protocol calls for in terms of target BG. So he earned a reduction. I see you gave the .75 f last night. You may want to try a straight .75 going forward and see how it goes. He is making progress so maybe the reduction will hold. I think it's really good that he seems to feel well now in the lower numbers.
 
Suzanne & Darcy said:
You had some excitement yesterday, didn't you! Nothing in the danger zone, but still lower than the SLGS protocol calls for in terms of target BG. So he earned a reduction. I see you gave the .75 f last night. You may want to try a straight .75 going forward and see how it goes. He is making progress so maybe the reduction will hold. I think it's really good that he seems to feel well now in the lower numbers.
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I went ahead with the 0.75 considering he had a rather hard bounce this morning of 431. Lets see if the reduction holds!!
 
bumping, he fell to 49 because he put off eating his food for so long. he hates the recipe change that much. I am going to get him different food once I'm not as worried about his glucose levels.
 
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