Dose reduction? 2.75u or 2.5u? 12/26 AMPS 154 /+5.5 79 /+10 151 /PMPS 307

Deb & Wink said:
If Nico is too low, and you have to leave, you can always leave out some MC (medium carb) food for him.
He might bounce a bit on the higher carb food. But the alternative, a hypo, is not something you want to see.
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I should be home in about 15 minutes. I did leave some food out for him before I left, just in case. I’ll pull it up once I’m home for his fasting bg PMPS (which he didn’t eat any of anyway). Will let you know!
 
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@Deb & Wink @Shelley & Jess @JanetNJ UPDATE: we’re on the way up +12.5 116. +13 138.

(side note: he gets “poke treats” —Dr Elsey’s dry food, chicken— about 5 kibble per poke so I think this may be influencing his rises when his pre-shot tests are initially low. How can I overcome this? I’m nervous we aren’t getting accurate tests for him for those pre-shot +12.5 & +13 values.. thoughts??)
 
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Shelley & Jess said:
After the stall cycles are you shooting at your regular times the next cycle? I'm thinking you are, but want to be sure.
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Yes, we are still shooting 7am & 7pm (PST) if we stall that hour per-shot. But if it surpasses one hour then I’ll usually ask then adjust his schedule accordingly. The past few days have all been as given in his ss (noted if given @+13). What are we thinking we need to reduce to? I gave his full this morning, well a smidge under so closer to 2.5u. Let’s connect @Shelley & Jess @Deb & Wink @JanetNJ later today.
 
Things are changing quite quickly the last few days. Want to rule out any anomalies. Don't know if what I'm thinking came out the right way when I worded it. Hoping Janet or Deb can read my mind and what I'm trying to say....as my husband would word it "Are you picking up what I'm putting down?" o_O:)
 
There’s a note in his ss, but in case you missed it I should probably call attention to the fact that previous to Saturday we had him on Friskies pates, he was transitioned to FF pates fully by Sunday morning. Could also be contributing to the drastic changes we’ve been seeing in the past ~3 days.. ?
 
@Shelley & Jess perhaps the insulin being shot at +13 is effecting that later nadir. I just did a +5/6 (not sure if on the ss it should be put under +5 or +6, given the delayed am insulin dose) and he was 266. I’m planning to grab a +9/10 as well to see where we go from there. I doubt he’s hit his nadir yet. I’ll try to get back with you before his PMPS. Let me know what you guys have come up with.
 
The + entries on your spreadsheet should be recorded as the actual amount of time from when the insulin was shot.
If you stall and shoot 1 hour late your 'usual' +6 test is really +5 and should be recorded as +5 (or 5 hours after you shot insulin.)

If you shoot 1 hour 'early' to get back on schedule after a stall cycle your +11 becomes your AM/PMPS - the number you actually shot on.
 
Shelley & Jess said:
The + entries on your spreadsheet should be recorded as the actual amount of time from when the insulin was shot.
If you stall and shoot 1 hour late your 'usual' +6 test is really +5 and should be recorded as +5 (or 5 hours after you shot insulin.)

If you shoot 1 hour 'early' to get back on schedule after a stall cycle your +11 becomes your AM/PMPS - the number you actually shot on.
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Okay. I’ll try to change it this evening when I get back home. Just did a +7 on him, 264. So pretty much the same.
 
Emily Tuomey said:
There’s a note in his ss, but in case you missed it I should probably call attention to the fact that previous to Saturday we had him on Friskies pates, he was transitioned to FF pates fully by Sunday morning. Could also be contributing to the drastic changes we’ve been seeing in the past ~3 days.. ?
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Definitely! Those Fancy Feast (FF) pates are lower carb than the Friskies pates. So yes, even that food change could be contributing to the drastic changes in the BG numbers.

I think it's time to try Nico back on the 2.5U dose. Especially since you completed the food change on Sunday morning to the lower carb FF.

I would not worry too much about those yellow range BG numbers at mid-cycle today. BG levels can be a bit erratic, especially when your cat has had some lower green or blue BG numbers. That is Nico to a T right now. Erratic. Doing his own thing. Making your life complicated.
 
:nailbiting:
Deb & Wink said:
Definitely! Those Fancy Feast (FF) pates are lower carb than the Friskies pates. So yes, even that food change could be contributing to the drastic changes in the BG numbers.

I think it's time to try Nico back on the 2.5U dose. Especially since you completed the food change on Sunday morning to the lower carb FF.

I would not worry too much about those yellow range BG numbers at mid-cycle today. BG levels can be a bit erratic, especially when your cat has had some lower green or blue BG numbers. That is Nico to a T right now. Erratic. Doing his own thing. Making your life complicated.
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It seems the erratic continues... +11 (PMPS) 350. :banghead: 2.75u given. Should I look to change his dosage to 2.5u in the morning?? :nailbiting:
 
@Shelley & Jess @Deb & Wink @JanetNJ I know it’s barely a day left until Christmas (and tomorrow is my birthday :joyful:) and hopefully y’all have wonderfully, cheery things to look forward to in the coming few days. I just wanted to tag you today, so as you have time you can follow Nico’s progress. This morning he tested just under 150, AMPS 133 (then after stalling 30 mins tested 143), I gave him his full dose. We just did a +6 and he’s just under 100 at 99. So we are doing GREAT, after a not so fun night last night, poor guy looked so sad— but his snuggles were top notch! I’ll continue to update as I am able. As of right now I plan on getting a +8 and his PMPS then will go from there. Merry Christmas Eve eve!!
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Nico does not want to let your hand go! How cool is that?!?!?

That mid-cycle 99 was low, but not too low.
In my mind, it's a bit of a tossup, to stay at the 2.75U dose or lower to 2.5U.
You say that Nico didn't look so good, per the Remarks on your SS.
So I'm thinking you should stay at the 2.75U for now.
It's your call Em, as you are there to observe Nico's behavior.

Happy Holidays to you both!

p.s. Big storm coming my way Thursday into Friday. Predictions of widespread power outages with the high winds. Hope that doesn't happen, but if it does I won't be able to sign on to the message board and respond. Otherwise, I'm "Staying home for the holidays."
 
Not a great start to our day over here today.. AMPS 451 :( Do we think this is some sort of bounce, or is his body just being wonky?? I’m continuing him on 2.75u as much as I am able. Not sure what to anticipate later in the day, but gonna try to enjoy my birthday as much as I can today— here’s hoping Nico feels much better a little later today!
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Emily Tuomey said:
AMPS 451 :( Do we think this is some sort of bounce, or is his body just being wonky??
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Bounce, big, ol' bounce. Could be from the green during the AM cycle 12/23 but I'm guessing he went low overnight. It's going to be really important to get a test or two in the PM cycles from now on, now
that he's showing you greens. Cats generally go lower at night. At the very least try and get a before bed test every night, he may be earning dose reductions in the PM cycles and we won't know if you don't test.

Try not to fret too much when he gives you higher than ideal numbers because of a bounce - that's why we need patience, to wait out those bounce cycles to see how the insulin is actually working when the bounce finally clears. And, we do know for a fact that the insulin is working, look at all those lovely greens popping up on your spreadsheet! It's going to take time for Nico to get used to those low/normal numbers. Think of it this way, the highs (bounces) are not because the insulin is not working but rather the opposite. It will take time for his body to relearn that the lower numbers are safe. As Nico gets reacquainted with a more normal BG he won't bounce as high and those higher readings will lessen. Remember, a bounce is simply a natural reaction to what the cat's system perceives as a BG value that is "too low".
 
Emily Tuomey said:
@Shelley & Jess @Deb & Wink @JanetNJ I know it’s barely a day left until Christmas (and tomorrow is my birthday :joyful:) and hopefully y’all have wonderfully, cheery things to look forward to in the coming few days. I just wanted to tag you today, so as you have time you can follow Nico’s progress. This morning he tested just under 150, AMPS 133 (then after stalling 30 mins tested 143), I gave him his full dose. We just did a +6 and he’s just under 100 at 99. So we are doing GREAT, after a not so fun night last night, poor guy looked so sad— but his snuggles were top notch! I’ll continue to update as I am able. As of right now I plan on getting a +8 and his PMPS then will go from there. Merry Christmas Eve eve!! View attachment 58816
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How sweet and pretty he is. He's doing so much better than a month ago. He's lucky to have you.
 
Shelley & Jess said:
It's going to be really important to get a test or two in the PM cycles from now on, now
that he's showing you greens. Cats generally go lower at night. At the very least try and get a before bed test every night, he may be earning dose reductions in the PM cycles and we won't know if you don't test.
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Thank you for this. I realized this morning that I haven’t tested overnight in a few days, I think mostly because I felt like we all needed the rest, but I will do better going forward. I know his lows do usually happen in the middle of the night, and are generally lower than his daytime cycle lows. I think my biggest problem though is that he (as Janet says) “likes his late nadirs,” and it can be hard to be up that late with him every night. +6, 7, or 8 depending.. especially when I have to be up just 2-3 hrs later to pull up the food, then 2 hrs after that for amps routine/work. I guess it can just seem like a lot, especially when you’re tired. Anyway, may you have tips that I haven’t thought of and could pass along. But, I will do better. I promise.


JanetNJ said:
How sweet and pretty he is. He's doing so much better than a month ago. He's lucky to have you.
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Awe thank you. But, I think maybe that’s backwards— I’m lucky to have HIM. <3
 
Just a quick update @Shelley & Jess @Deb & Wink @JanetNJ tested a +5 for Nico and he’s dropped to 199, which is quite large considering he’s coming from 450+ just a couple hours ago. I’m planning on getting a +8, so will be bank then. — looking like okay need a new thread tomorrow too!


Deb & Wink said:
Big storm coming my way Thursday into Friday. Predictions of widespread power outages with the high winds. Hope that doesn't happen, but if it does I won't be able to sign on to the message board and respond. Otherwise, I'm "Staying home for the holidays."
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Hoping this isn’t the calm before the storm for you— power outages suck! It’s BEAUTIFUL here today, crisp and sunny. Already been out for two walks, gonna do a bit of baking now. Thankful for al of you, and such a good day with my sweet babies.
 
Emily Tuomey said:
I guess it can just seem like a lot, especially when you’re tired. Anyway, may you have tips that I haven’t thought of and could pass along. But, I will do better. I promise.
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I am in no way saying you're not doing an excellent job. I've got 'slept thru alarm' notes and many nights when I should have tested but didn't. We've all been there. We know exactly what you're going through.

A before bed test is a good habit to get into, as he settles in and you learn his patterns you'll have a better idea if you need to set an alarm to get a test later in the cycle. Take care of yourself and test when you can on a schedule that works for you. :)
 
JanetNJ said:
Why do you think he will go low? That's a bouncy boy you have there.
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I’m not sure, I guess I just figured higher highs mean lower lows (though again I realize it’s unpredictable..). No? Maybe I don’t need to test that much then. I guess I just figured if he was pretty high at PMPS then I didn’t need to test for a nadir overnight, but then heard that’s precisely why you would want to test for a nadir overnight.. to look for a bigger bounce. Maybe I misunderstood..
 
Emily Tuomey said:
I’m not sure, I guess I just figured higher highs mean lower lows (though again I realize it’s unpredictable..). No? Maybe I don’t need to test that much then. I guess I just figured if he was pretty high at PMPS then I didn’t need to test for a nadir overnight, but then heard that’s precisely why you would want to test for a nadir overnight.. to look for a bigger bounce. Maybe I misunderstood..
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I think he will be fine. Get some sleep.
 
@Shelley & Jess @JanetNJ @Deb & Wink we aren’t having a great day over here today— my first clue was Nico sleeping on the kitchen floor by his water fountain. We had an alright amps of 235, but now at +5 we are pretty elevated at 345. I’m nervous for the second half of his cycle today.. hope it doesn’t go the way I think it’s gonna go— don’t want to see him in the blacks by nightfall. We shall see. Hope you all are having a wonderful holiday.
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Wait I think I caused it!! His holiday Purebites contain sweet potato!!! Fudggggggge. Pulled them up, no more(!), fasting two hours and retest to see. I can’t believe I did that!!!
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Well H E double hockey sticks!
At least you traced the problem to those new holiday treats.

Even if Nico is higher in the red or black range at PMPS, you know that you can keep him at the higher 2.75U dose that he has been on for 9 cycles now.
If you thought you would be able to monitor more tonight, you could try giving him 3U if he's really high.
 
Deb & Wink said:
Well H E double hockey sticks!
At least you traced the problem to those new holiday treats.

Even if Nico is higher in the red or black range at PMPS, you know that you can keep him at the higher 2.75U dose that he has been on for 9 cycles now.
If you thought you would be able to monitor more tonight, you could try giving him 3U if he's really high.
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PMPS 417. So high, but not sure it warrants 3.0u. I gave 2.75u. His behavior is already markedly better (though his numbers are lagging a bit behind that it seems), so I’m hopeful his numbers will follow suit shortly. I plan to get a +4 for him around 11pm PST, and go from there. I was just happy to see him perk back up about 3 or so hours ago, preen himself, eat well, and CUDDLE. Such a difference from mere hours before when he looked terrible and was sleeping in strange places, which for him screams “I feel like crap, mom.” — I can see it in him now, (with some training) it was extremely odd that he, almost immediately after eating some of those holiday treats early this morning, was sleeping on the kitchen floor right next to the water fountain and didn’t move for nothing! Even at the time I remarked how weird it was. I guess hindsight is always 20/20... Hope your holiday was lovely. Hoping you’ll check in again at some point tomorrow in case we are in need of a dosing adjustment. Thanks for all you do!
 
Emily Tuomey said:
All’s right in the world this morning. AMPS 154. 2.75u given.

@Shelley & Jess @Deb & Wink @JanetNJ UPDATE: +5.5 79. :D
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Yeah! Nico did come back down. It can take time to get the BG levels back down after they spike, but you waited and the BG's are looking good right now.

Again, don't be surprised if Nico bounces up high at PMPS tonight, 12/26/20, after that low green at mid-cycle today.
 
Deb & Wink said:
Again, don't be surprised if Nico bounces up high at PMPS tonight, 12/26/20, after that low green at mid-cycle today.
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He’s certainly one bouncy, little boy! Will the bouncing end at some point? Or, how do we know changes need to be made to his current dosing? Just curious (for the not so distant future)..
 
Emily Tuomey said:
Will the bouncing end at some point?
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Some cat's bodies do learn to adjust to the lows, and not bounce so much.
Some cat's bodies never learn to adjust, and bounce and bounce and bounce.

Emily Tuomey said:
Or, how do we know changes need to be made to his current dosing? Just curious (for the not so distant future)..
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You kind of get a feel for the waves of action of the SS readings noted on the SS. Looking at the trends over several cycles, looking at what happens over several days to a week or longer.

Right now, it's looking to me like Nico may be due for a dose reduction soon.

After seeing that low blue AMPS on 12/26/20, then the low green at +5.5, Nico will probably bounce.
But I'm getting the feeling that he could do ok with a dose reduction to 2.5U soon. Very soon. Perhaps tonight, if he doesn't bounce.
 
Hey Em! @Emily Toumey
This thread is getting super long. It's about to go to a second page.

Would you start a new thread here, in the Prozinc forum and link this old thread in at the top? Please.
 
Deb & Wink said:
Hey Em! @Emily Toumey
This thread is getting super long. It's about to go to a second page.

Would you start a new thread here, in the Prozinc forum and link this old thread in at the top? Please.
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I’ll get that going at PMPS tonight, thanks for the reminder!
@Deb & Wink UPDATE: we bounced (PMPS, 307), so staying at 2.75u tonight. Fingers crossed for tomorrow!
 
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