Crackerton...partial curves...upped dose. Thoughts?

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Jen+Crackerton Spunky(GA)

Jen+Crackerton Spunky(GA)

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well here it is. I was gone the 10 days and my husband did an excellent job tracking him. He clearly doses not have enough insulin during the day...but gets better numbers at night. He still has NO TOLERANCE for lower numbers. As instructed today I shot even when he was in 200’s. He seemed ok but as you can see by his numbers tonight he did a huge bounce. I am leaning toward a sliding scale...I think his sensitivities warrant it. I have tons of experience with prozinc and a sliding scale...but not at these dosages...he is on a teenie tiny .2 unit dose using a u100 syringe. So for the dose increase how much? I think there should be a scale for at least a skinny dose when he is under 250..thoughts? He is acting well. I swear his neuropthay is better after not seeing him for 10days. Thanks for your help...
Note he was on lantus before and I found at these small dosages the shed was too unpredictable....
 
Hmmm...that is an extremely odd number tonight. I'm not convinced it's a bounce...I'm not convinced he went low today. My guess is he's just not getting enough insulin. I think if it was me, I'd be tempted to bump him up to 0.4 for both AM and PM shot because really he isn't getting low enough at night either. He's sitting in yellows at +5 and he probably isn't dropping into greens later.

If you wanted, you could also say maybe do 0.2 for under 200...like say down to 170 or so if you can monitor? Then we can move that no shoot number down further over time and hopefully help get him into even better numbers.
 
I agree with Rachel, it looks like too little insulin, not a bounce. The increase is a good idea.
 
I think it was a bounce....did it again today...what should I do? We return to work tomorrow...I was too afraid to do more than .3...hard to measure...air above the 1 unit Mark....
 
I suggest 0.5 u. He has a lot of room to drop before hitting the "take action" number of 50 on a human meter. If that makes you nervous, try 0.3 u again or a "skinny" 0.5 u. Draw up 0.5 u and release a drop.
 
I'm also wondering about food impact for those PMPS numbers. Can you tell us a little about what times, how much, and what he is eating? Many cats benefit from some careful arranging of their snacks to avoid those giant spikes at the end of a cycle, so if we can see what you're currently doing we might be able to make some suggestions to even it out a little.

And the insulin increase should help as well.
 
Djamila said:
I'm also wondering about food impact for those PMPS numbers. Can you tell us a little about what times, how much, and what he is eating? Many cats benefit from some careful arranging of their snacks to avoid those giant spikes at the end of a cycle, so if we can see what you're currently doing we might be able to make some suggestions to even it out a little.

And the insulin increase should help as well.
Click to expand...
I did .3...per you guys hold a dose 3 cycles/days
He eats only fancy feast classics...not 2 hours before a shot. He eAts a lot..i leave it out because we are gone 7-1 daily. None2-5pm pre shot and none3-5 am preshot. Sometimes he will eAt a whole can at one sitting. Give half can at shot time then leave him with a can 7-1, offer another 1/2 can at pmps...then 1/2 can at bed...sonetimes he pesters for more
 
Hmmm....okay, I'm going to throw both of these out there, and you can see if either seem worth trying.

Some cats need food withheld after nadir. So in your case that would be no food after around 11am/pm. If he eats his food fairly soon after you leave, then that probably isn't an issue anyway, but if he saves it to eat later, then you might consider getting a timed feeder that will close around +6 and see if that helps. For cats in this category what happens is that they are getting giant food spikes and after +6 there just isn't sufficient insulin to hold the BG down anymore.

The other option is that some cats need a late cycle snack (my cat is in this category). If he doesn't eat around +9, then by the time +12 rolls around, he's higher. If he gets a late cycle snack, his numbers will hold stead(ier) until the end. They still rise at the end, just not as much. So yesterday you can see we got a higher PMPS, and the reason for that is he didn't like the food I left in the feeder for him and refused to eat when it opened for his snack. So in your case, maybe give a quarter of a can or so right when you get home (sometime between 1-2:00).

So one of those strategies will likely help, and the other one will make it worse. It's a bit of a guess which is which at this point, and may take some trial and error for a few days in each direction.

Of course, if the insulin is just too low, neither of these will help much until the dose gets closer to what he needs, so if they don't make a difference now, you can just file them away for when he's better regulated and consider them at a later time.
 
I agree. I think it was a very good decision...and exactly what I'd have done if he was mine.
 
So I wasn’t going to shoot 125. So tomorrow morning as long as I shoot an upward number in the 100’s do you think .3 is ok? Not willing to push to .4...afraid of hypo and under personal stress....at least we saw 100’s...and it explains why he was sitting on my head continually from 2am...note to self sitting on head means low...
I learned how to change the title of the thread to update..wooohooo
 
I think 0.3 would be fine. If he is at a low number in the morning, do try the stalling and waiting thing to see if he comes up. It's reassuring sometimes to just see that the number is rising when you hit those lower numbers.

The sitting on your head thing is cracking me up! At least he knows how to communicate. :)
 
I know I am supposed to wait but I hate the numbers he has had...and the first dose sent him low...any chance this dose is too high?
I stopped giving him access to food all the time. He only got a half can to last the Morning after shot yesterday. 1/2 can PMPS . Can overnight.... Today he got 1/2 can post amps, 1/3 can + 6 and then He just got 1/2 can with dinner. Will keep,trying this...
 
Hi Jen - I dont' see any cycles where he went low. Is there some data missing from your spreadsheet?

Also, how much to feed really depends on the food and the cat, so I can't really comment on that part other to encourage you to make sure that he's getting an appropriate amount of calories - a little less if he needs to lose weight, a little more if he needs to gain weight. Especially when they are in high numbers like you're seeing, they often need more calories to compensate for what they are losing. There are calorie calculators on the internet that can help you get a ballpark for how much he should be eating, and then you can adjust from there based on ideal weight, activity level, and BG level.

It doesn't look to me like too much insulin. It looks to me like too little. Will you be able to do a curve one day this weekend though to check?
 
II agree with Djamila. f you can do a curve today or tomorrow at his current dose it might make things clearer.
 
Great job! That really helps to see what's happening during the cycle. And it does look like he's got a moving nadir, so scattering the tests around as much as you can on non-curve days will be helpful.
 
I am getting no where with pzi....I plan to go back to lantus in the morning...his numbers have been horrible during the day...and just getting worse...thanks for all your help..
 
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