Corduroy's numbers

[blove7]

Hi everyone,

Again, haven't been on here in a long time...just updated his SS though in order to get an overview on his numbers to see if there are any trends. I set up a consultation with Dr. Lisa Pierson in early March and she formulated a new recipe for Corduroy because she says that his bloodwork shows he could be in the early stages of CKD. I've been feeding them this since March 7th. However, I feel that his numbers have been wild lately and am just wondering if it could be due to the change in diet (I also started giving them both Miralax on March 7th on a daily basis and that is helping with the bathroom problems). We've also had to up his dosage to .75 a lot more.

When I look at the SS, I think that there are a lot more fushias and yellows...also more reds thrown in there randomly too, unfortunately...but just not sure that I'm seeing it correctly. Is there a calculated way that any of you might know that will give me a true reading of his trends, instead of just "eyeballing" it?

I hope everyone is having a good Thursday and that your kitties are having an even better one!

Thank you,

Brigitte

 

[rhiannon and shadow (GA)]

Morning Brigitte,

My own take on your ss is that Corduroy is quite the travelin' man. He easily swings 200 up or down during a cycle.
I think when you see those red numbers, it means he's seen a green number..... for example, on 4/03 he went down to 39 and then bounced right on up to 423.
I wonder why you didn't take a dose reduction because of that 39.
There are gaps in other places where Corduroy could have done similar drops.... just yesterday , he went from 271 to 171 to 72 in just a few hours.
You can't make assumptions with him being in yellows that he stays yellow in a unknown area.

You might want to stay around and get a little more input from more eyes watching your ss.
You need to be consistent in the dosing and not react by dropping or raising the dose in response to one cycle.
Try to think of the shot you gave last night showing you the numbers this morning. ( that's an awkward sentence) :roll:

I'm going to tap on a couple of shoulders to come weigh in.

 

[blove7]

Hi Rhiannon and Shadow,

Thanks for replying! The reason why I didn't reduce his dosage on 4/4 after that 39 is because in the morning, his number was so high that I thought he still needed .50 (shooting through the bounce I think I've heard it termed). Then, last night, I kept setting my alarm to get up and check him, as we do when we feel that we need to, but when I saw that it went back up to 100 after being 74, I thought it safe to get some sleep for the night. We check him at 9/9 everyday, so his +4s and +6s are pretty late into the night/morning...no sleep! @-)

We change his dose (and I know we're not supposed to) because he's so unpredictable. And I don't like to keep his blood sugar up high for too long at a time nailbite_smile

Thanks for inquiring further into this with other members. I really appreciate it!

 

[Marje and Gracie]

Hi Brigitte

Welcome back! Rhiannon asked me to pop over and check out Corduroys SS.

She has made some really good observations that I agree with.

--you've done a lot of dose hopping from cycle to cycle between 0.25u and 0.5u; it looks to me like you are worried about shooting lower Preshots but to benefit Corduroy, you need to learn to shoot PSs above 50. For experienced members (inc you), we shoot low to stay low as long as the BG is above 50 and you have supplies and can test. By shooting a reduced dose almost every time he's low blue or high green, you are missing opportunities to get him to flatten out.

There is usually someone experienced around most hours of the day and late into the night who can help you shoot those lower numbers above 50 and stay with you if numbers drop.

--when he earns a reduction, I'd suggest you only shoot through the bounce once and then take the reduction. If you feel he's not holding reductions, you could allow him to go between 40-50 on three separate days before taking a 0.25u reduction. And if you could manage his food curve, you could prevent him needing a reduction so he could stay in healing numbers longer.

--when it's evident he's clearing a bounce, like on the a.m. Cycle of 4/3, I'd be more vigilant with the testing and try to catch low numbers before they happen.

--I'd get a +2 test every single cycle that it is possible to do so because it will tell you where he might be headed for the cycle. If it's the same as or much lower than the PS, you should expect an active cycle. And if he's coming down, please don't stop testing until he starts back up and stays up without food. If he's coming down, like on 4/22 and you have to leave, feed him HC before you go and leave some out for him. Bounce clearing cycles can be especially active.

--I don't know if, on 4/22, a low number number or a fast drop (or both) triggered that hard bounce. Be aware that they both will. If my Gracie is coming down fast, I slow her down because she bounces harder from a fast drop than a low number.

--on the food, it depends on how Dr. Lisa formulated the diet. She is very well versed in FD and so I'm assuming she also knows that many FDs do better on a diet with carbs in the 4-10% range as opposed to zero carbs. I will say that in looking at his SS, I can't tell from the numbers when you switched his food. You might want to make more remarks on his SS. Perhaps put an asterisk in the boxes when you feed him. That helps us more than you know.

--I would hold this 0.75u dose now until he earns a reduction.

I hope this has helped. Please let us know if you have questions.

 

[julie & punkin (ga)]

Hi Brigitte! Great to see you and Corduroy!

You've already gotten lots of good advice, so I will just second the encouragement to learn to shoot lower numbers. I think of that lower preshot as a gift - it is an opportunity to lower the entire range of his numbers. You can do it gradually if it makes you nervous. Shoot a 140, then a 120, then 100, etc., until you're shooting 50's. I think you'll be thrilled with Corduroy's response to it.

In the beginning, i thought that if a dose could drop punkin from 300 to 100, and i then gave him the same dose at 100, he'd go hypo and die from it. But it doesn't work that way. When you shoot lower numbers the whole range flattens out very nicely and can literally become a "line" instead of a curve. Always get a +1 and +2 when you've shot a new-to-you lower number, just to make sure he doesn't dive.

For a little encouragement to see how this works, take a peek at Davidson's spreadsheet. Start with February and notice what happens as she begins shooting blue numbers and then green numbers. His OTJ party is coming - Shawna's been shooting lower numbers since Feb as Davidson has worked his way down the dosing scale. Those green numbers allow a kitty's pancreas to heal and begin producing its own insulin. It's pretty amazing - cats are able to heal and become diet-controlled and be in remission.

So go for it!

julie

 

[Sienne and Gabby (GA)]

I agree with Marje's very thorough post. The only point that I'd add is that when you make frequent dose changes, the result can be wonky numbers. In effect, you end up with the situation that you're trying to prevent. I'd also not get too focused on the amount of insulin you're shooting. The dosing may go up or down -- the dose is what Corduroy needs. If your finding that his nadirs aren't where you want them to be, then he needs a larger dose.

 

[blove7]

Thanks everyone for the responses! I'm going to try to stay with the .75, even when he's lower, including this morning (he's AMPS is coming up at 9). What you've all said DOES make sense and I appreciate the explanations (I'm the kind of person that if I don't know why, it's hard for me to do it).

The only problem we run into is at night it can be extremely difficult to stay up to check him every hour when he goes low since his PMPS is at 9 (that time seems to work the best for both of us however after playing around with it). We definitely DO stay up if we need to, but sleep deprivation really gets the best of you!

Thanks again and I'll try not to be afraid of shooting low. :smile:

Have a great Friday and a great weekend!!! :mrgreen: