Cliff Notes, pt 3

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Sure like the pinks midcycle rather than the reds today. And his pre shots continue to look nice. Have to admit his cycles are among the most unusual I have seen. I notice today that his midcycles are lower with the lower dose today. We used to think cycles with an upside curve were indicative of too much insulin. Part of the reasoning is that the the preshots are coming at the tail end of theinsulin potency and they are the lower numbers.

I know you have increased carefully and slowly, but wonder if a quick trial with a lower dose might be worth a try? Having said that, I do not understand why his evening cycles are lower on the same dose....

I am not confident in this advice particularly - just looking for an explanation.
 
Thanks for taking a look at Cliff's spreadsheet, @Sue and Oliver (GA)! I've been happy with his evening cycles lately, but still pretty confused as to while his daytime curves look different.

I have been thinking abt a lower dose test, but I might wait until the end of the week. My vet wanted another curve soon, so I don't want to change much between now and then.
 
+11 was 215, so fed and gave insulin an hr early to try and get closer to our old schedule.

6.75
 
+11 337
6.75
Gave shot early to try and make up time.

Going to the movies again tonight, will be home by +4. Will leave food. Seeing=Lion.
 
+7.25 426

Running a little high today. :(

Trying to figure out when it would be best to do a curve for the vet. His PM cycles are so different than his AM cycles. I'm thinking maybe tomorrow night, since I'll be around and it's the weekend.

After that--I'm not sure how I'll approach his dosing. I don't like these REDs creeping back into the daytime cycle. Might experiment with a lower dose, but I'm just not sure about that.
 
+7.25 426

Running a little high today. :(

Trying to figure out when it would be best to do a curve for the vet. His PM cycles are so different than his AM cycles. I'm thinking maybe tomorrow night, since I'll be around and it's the weekend.

After that--I'm not sure how I'll approach his dosing. I don't like these REDs creeping back into the daytime cycle. Might experiment with a lower dose, but I'm just not sure about that.
What factors specifically are different during the day that might account for the differences between day and night BGs?
  • activity level
  • home alone
  • feeding schedule
  • other?
 
These are all great questions, many of which I've been asking myself! Please see my answers below:

What factors specifically are different during the day that might account for the differences between day and night BGs?
  • activity level--he definitely seems more lethargic during the day. I'm not home M-F during the day to see, but on the weekends, he pretty much just sleeps and eats. In the evenings, we see him walking around more, being more active.
  • home alone--yes. with the exception of lunchtime, when I come home from work to feed them.
  • feeding schedule--his schedule is pretty similar day and night. they are fed 3 small meals each cycle, for a total of 6 small meals a day. This may seem like a lot, but I've experimented with fewer meals, and it usually results in the Civvie puking (she does this when she goes without food too long) and if I feed fewer meals with larger portions, neither cat seems to eat enough.
    Daytime feeding schedule normally looks like this: (1st meal) before AM insulin (2nd meal) +3 or +4 (3rd meal) +7 or +8
    Nighttime feeding schedule normally looks like this: (1st meal) before PM insulin (2nd meal) +4 (3rd meal) +7 or +8--before bed
    Another reason I am reluctant to feed fewer meals, is that I really want him to have food available when I leave the house for work, or go to sleep overnight, so that if he happens to dip low, he has food available. I am open to feedback on this though.. perhaps I am feeding too frequently? But it is the same schedule morning and night.
  • other? I really can't think of anything else. Even when I'm at work, he's never alone longer than 4-5 hours between when I leave for work and come home for lunch, and then Dave gets home about 4 hours after I leave the house from lunch. The only thing that is different from AM/PM is that Dave shoots him at night, I shoot in the morning, but I draw all the insulin. Hm, maybe a test on the weekend where Dave does all the shots to see if he is doing something different?
 
These are all great questions, many of which I've been asking myself! Please see my answers below:
Sounds like things are quite similar AM and PM. What a mystery! I wouldn't change the feeding schedule if it's working for Cliff and civvie.
 
Last night's #s were ok.
Amps=240
6.75u
+4 303
+8 329

Gonna switch to alpha tracker tonight for curve. Also gonna give 7units, I think
 
Yesterday's curve was not great. All 400's. I will update SS when I'm home tonight.

Today's #s already better. I deceased dose by 0.25 and switched up injection site to be lower in scruff.

Amps=379 relion
6.75u
+3.25 288
+6.5 276
+8.25 235
 
What can happen after you break through the built up insulin resistance is that they become more responsive and the dose has to be decreased carefully. That might be what's going on.
 
AMPS=238
6.5 units -- trying a slight decrease in dose

+3 285

I'm not ready to give up on ProZinc yet. We are finally starting to see a response--I just need to figure out what dose he's asking for!
 
Updated his SS with last night's #s and today's #s:

Amps=194, stalled 20min, 204
6.5 u
+3 335
+8 318

Drew 6.5u for Dave to shoot tonight. Thinking about bumping tomorrow back up to 6.75 because last time I did that he saw some yellows during the day! What a curious little bug. I wish he could talk.
 
Updated his SS with last night's #s and today's #s:

Amps=194, stalled 20min, 204
6.5 u
+3 335
+8 318

Drew 6.5u for Dave to shoot tonight. Thinking about bumping tomorrow back up to 6.75 because last time I did that he saw some yellows during the day! What a curious little bug. I wish he could talk.
I agree - it would be SO much simpler if they could talk. Interesting how he goes up in the middle of the cycle when the dose is decreased. That's his pattern I guess - for now ...
 
+5.5 211

Now I'm a little :nailbiting:
Was hoping to test and go to bed, but I'll probably test in 1.5 hrs to see where he is.
 
I had fed him 1/8 5oz at +5.5
He's 252 at 6.5

Gonna retire for the night. Did give another 1/4 5oz (his normal bedtime snack)
 
Last night, I woke up around +11 and Cliff was 314

This AMPS=313
6.75
+4 460 !!! :mad:

Not sure what is up with that! I increased his AM dose by 0.25. I'm really not sure if I need to increase or decrease with this one during the day time.

Gonna stick with 6.5 at night, because that seems to be working. Might increase that a little on the weekend, to see if I can see some blues at night again.

I also have a new bottle to open soon, probably tomorrow.
 
+8.25 he was 480

I drew up 6.5 for PM cycle. I have a feeling I need to be dosing down during the day.
 
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