Dosing Advice

It looks like he’s bouncing from the lower numbers. On 3/30 you documented a blue of 104. His Pmps was pink and we don't have tests until the next morning when he was in the red. On 4/1 he started out in the yellows and went to green during the middle part of the cycle and by evening was in the pink (beginning the bounce) and by morning was in the black. I’m sorry. His body isn’t used to those lower numbers and panics!
 
Do you feel the 1.5 units is a good dose? I almost reduced it when he had yellow AMPS but held it there. When he is in the black should I increase?
 
Please, please don't be tempted to increase the dose because of higher pre-shots due to bouncing. We know it's frustrating, but, all we can do is be patient, wait it out and give Freddie a chance to clear it. And, don't look at just that one number, look at the big picture, look at how the cycles flow, he drops at least 50% to nadir from those higher preshots - that's awesome movement in the cycle! Some cats stay really high and flat for days through a bounce.
 
I don’t think you have much room to increase- the way things stand right now anyway- because you have seen green and lower blues on this dose. Those higher preshots are hard to see. But I don’t think it’s necessarily safe to shoot an increased dose on those days. You don’t know when he’s going to break his bounce - especially since Freddie doesn’t seem to stay up there very long. It’s possible he’s also dropping lower at night, resulting in the high morning preshot numbers. If things start to settle a bit, you may have some wiggle room to tweak the dose, but right now it seems to be working fairly well for him.
 
Oop, just missed ya!

At first glance he does appear to be sneaking up, but, wonder how often he's dropping lower at night cuz he's got such good movement during the day. You caught that 144 from a high red AM preshot and he zoomed back to high red at PMPS that cycle. And, wondering what happened in the PM cycles before you got those yellow AMPS's - late bounce break or maybe going too low?

Can you do a curve today or a few extra tests & would love to see more PM tests if/when possible.
 
Freddie had a yellow AMPS this morning and I reduced his dose to 1.5 instead of 1.75. I am thinking maybe I should have reduced it even more?
 
Hi. I hope next time you get a preshot of about 266 you can get some mid-cycle tests so we can see if the full dose of 1.75 is okay at that dose. I hope things are going all right :-)
 
Hi. Just looking at his SS. I see some good blues. Sorry about the high preshots though. Write us when you can and let us know how he is doing.
 
I just did his PMPS half an hour earlier and it was 7.3 (blue) so I am skipping his Insulin tonight. I am getting ready for a family get together later this week so wanted to change his dose time slightly.

Freddie is doing fine by the way. He still has quite the appetite and is his old self!
 
I would not have skipped his insulin entirely but would have given a token dose - like a half dose - as long as I could do my usual monitoring. You will have another opportunity to see how he does when he has a blue preshot. I thought maybe last night you were saying that you were not able to check his BG. I looked at his spreadsheet and was worried about how high he would go by the morning with no insulin. Oh well, today is another day :)
 
I've been peeking in on you and Freddie, don't like seeing more and more blacks showing up :(.

Black (almost) always means bouncing, but it's a bit of a mystery what he might be bouncing from. It could be from fast drops, we've seen those in the past - he could still be sometimes diving fast & early in the cycle and on his way back up by the time you do your AM+5 or +6, but the bigger concern with limited testing is you're not catching if he's going too low somewhere.

Most kittys go lower at night and there's alot of data missing there.

You shoot late, does a before bed test every night work to get a PM+2 or later? Or, what time do you get up in the morning? Could you grab a first thing in the morning test, even if it makes it a PM+8, +9 or +10, might help us see what's going on. We've had kittys go from red or black at PS, tree green or lime mid cycle and back to red or black by the next PS, I'm concerned you might be missing something like this. If he's been dropping below 90 (5mmol) somewhere he would have earned a reduction following SLGS. (You don't test enough to follow MPM like your spreadsheet indicates, along with the bit of dry it looks like you're still feeding - it really does make a difference).

I know test strips are stupid expensive in Canada (been there, done that). I just want to make sure Freddie is staying safe and the only way to know is with a bit of extra testing if possible.
 
Thank you for looking in on us! I could try to get a before bed test - it would be +2 . I don’t know if you noticed but I had to skip his dose twice in late April. I will also be leaving the house at 7:00 am on Wednesday so will, after a BG test, be administering his Insulin early if the test warrants it.
 
MimiG said:
Thank you for looking in on us! I could try to get a before bed test - it would be +2 . I don’t know if you noticed but I had to skip his dose twice in late April. I will also be leaving the house at 7:00 am on Wednesday so will, after a BG test, be administering his Insulin early if the test warrants it.
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There’s no BG test recorded for the two evenings that you skipped in late April. What were the preshot test numbers that caused you to skip? How early will the shot be on Wednesday? How many minutes?
 
As per the notes, I skipped because I had to go out of town so no BG preshot numbers. The shot will be 2.5 to 3 hours early on Wednesday.
 
MimiG said:
As per the notes, I skipped because I had to go out of town so no BG preshot numbers. The shot will be 2.5 to 3 hours early on Wednesday.
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Oh, I'm sorry! I missed that in the notes. I was looking at your spreadsheet on my phone and I didn't see that.
 
And wow! 2.5 to three hours is really too early to shoot. I don't think I would do it -- and you don't have time to make much of an adjustment. Insulin shots generally should not be adjusted by more than 30 minutes per day (either 15 minutes at either shot -- or 30 minutes at a time.) It could really mess you up for the PM shot.

But I know you will be careful with Freddie and take the BG into account.
 
So my OneTouch Verio Reflect meter is not reading Freddie’s blood this morning so I had to give him Insulin blind. The meter says Apply blood and I do and it does not give a reading.. I tried 3 strips and the message doesn’t change it just reads apply blood. I called customer service and as soon as they found out I was using it on a cat they would not troubleshoot or send a replacement. Very frustrating…. I guess I will pick up another meter today. Just wanted to vent.
 
Hmm I wonder if it is the battery. I’m not getting any reading at all but can still view the logs and summary. How long before the batteries got low on yours @Shelley & Jess ? Mine is 6 months old.
 
Just checking in as it’s been awhile. Freddie has begun to exhibit neuropathy in his back legs, I would say over the last week or two. I live in a 1 bedroom apartment but am currently house sitting at my sister’s house so really notice it with him on the stairs here.
I have ordered Zobaline via Amazon and it should get here in a week or so. What is the dosage for Zobaline?
 
Based on the fact that Freddie has neuropathy now and he is rarely getting in the greens mid cycle, do you feel I should increase his dose by 0.25?
 
MimiG said:
Based on the fact that Freddie has neuropathy now and he is rarely getting in the greens mid cycle, do you feel I should increase his dose by 0.25?
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Yes. I was looking at his spreadsheet and I think you should try an increase. He’s still eating the same foods? And same feeding schedule? I hate seeing those reds and blacks on his spreadsheet.
 
If he doesn’t get into green, then let’s look at increasing his dose after 7 days. Holding doses for too long can make it more difficult to get into better numbers.
 
He’s been at 2.00 for quite a while now, so I take it I should increase now? I’ll give him 2.25 this morning. He’s due for his am shot in 10 minutes. Yes he’s still eating FF and Dr Elsey’s cans as well as dry Dr Elsey’s. But mostly the canned.
 
So Freddie seems to be responding well to his increase. In fact I’ve had to shoot lower doses due to low PMPS on 3 evening occasions including tonight and one morning low AMPS. I wonder what this means going forward?

I forgot to add that I have been giving Freddie 5000 mcg of B12 every night for a week now. His Zobaline has not yet arrived.
 
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Is there any change in his neuropathy? You are doing well. Is there any way you can test at night? I've been studying his spreadsheet and there are just so many gaps in the p.m. cycles, it's very hard to see what is happening. I'm happy that we are seeing some green from time to time.
 
Yes, I’m happy that he seems more comfortable. :)His Zobaline arrived today but I think I will continue with the nightly 5000mcg of B12 until I run out, then start the Zobaline.
 
So Freddie had a green Pmps, so I skipped his Insulin tonight. First time in ages I have skipped a dose! Fingers crossed he doesn’t go too high tomorrow morning!
 
Sadly, I see he did go higher. I think you should have given a reduced dose. I think it’s good he had a green PMPS though.
 
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