Eukanubo 3/29

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hbs60

hbs60

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AMPS very good at 228 this morning. I shot only 0.6 because yesterday morning I shot 0.8 into a 337 and he went all the way down to 138, in the evening his PMPS was only 224 so I shot only 0.6, he seems to have stayed in the 200s all night, although I slept through most of it. +8 reading at 2 AM was 208 and this morning he's only up to 228. Things are looking mighty fine!

I have to go away for the weekend in a couple of weeks, so I'm setting him up for boarding. They do give the insulin shots, but I need to come up with some guidelines, otherwise I fear they will be too aggressive. So, this is what I'm thinking:

>300: 1 unit
250-300: 1/2 unit
200-250: 1/4 unit
less than 200: feed, retest and shoot if over 200 by the above guidelines.

I'm writing it as 1/2 or 1/4 unit increments instead of 0.2 increments because I want to minimize the possibility of errors that could happen if they have to use U100 needles and conversion charts. I think it's easier if they stay with the U40 syringes and follow these guidelines, keeping the guidelines as simple as possible. Of course, as he progresses over the next 2 weeks, I may modify the guidelines.

Thoughts?
 
It's +4 and I just got a reading at 138, wonderful number but I worry he'll keep dropping through the day. I can stay for the rest of the morning but I have to work part of the early afternoon, around the +7 to +9 when I'm concerned he'll have his lowest. He is eating right now and I think we'll be OK if he eats at +6 before I go off to work.

Should he be on a different insulin?

Thanks!
 
Sorry to be so blunt, HB, but with these kinds of numbers you're getting, you're thinking you want to change insulins? Are you kidding? Where did that come from?

If you were seeing no significant changes, no blue numbers or barely a yellow number for extended periods, as I have, after ruling out every other possibility, then I would consider a change in the insulin. But I'd have to be pretty convinced that Prozinc was not doing anything whatsoever before I'd even go there! And I've been waiting and watching for a change without much response... for a long while... and I'm not even there yet!

You might want to explore other peoples spreadsheets and re-evaluate how good Euk's numbers really are! Of course there are gonna be some blips on the radar.... but personally, I would stay the course.
 
I don't think you need to change insulin. It Euk looks like he is responding very well to PZI. PZI is one of the slowest acting insulin. The others I think tend to drop BG faster & tend to raise BG once it wears off.
You want him to go into normal feline BG ranges 80-120. The longer the insulin keeps him in those ranges the better. It helps support the pancreas. Which exactly what you want to do. Support helps repair if possible. Repair means the pancreas working, functioning on its own. Functioning on its own means remission. Remission is the ultimate goal of treatment.
So when you feed in mid cycle it raises BG. I now is very nerve racking to see the lower BG but it's really a good thing if it's between the ranges. I know it's very hard to not be scared, but see how low BG the PZI will take him with in safe numbers. When you have the time feed once, take the food way & test +4-+9. Almost every hour. This will help you know what the insulin is doing during those times. It will also help you build trust in PZI & Euk BG numbers. It gives a bigger picture.

Around +7-+9 is when some cats been to raise. Unless they are late nadirs...like Baxter.

What weekend are you going to be gone?
 
To Lu/Grayson: it's not that I'm complaining or that I don't think the PZI is not doing the job, I worry about it doing it too well. I'm also concerned that I notice that every day he keeps getting lower numbers, and late nadirs, so if he's already low at +4, would he be hypo at +7?
As far as the feeding, it's also tricky because he's always been a free-feeder so his eating is always erratic and unpredictable. I will consider withholding midcycle food if I didn't have to go back and forth from work.
The weekend I'll be gone is April 13th-15th, but I won't be able to pick him up at the vet until Monday the 16th.
 
I would stop, take a big breathe.....Euk is fine. Those 100's are not too low, and I wouldn't worry about intervening with massive amounts of food. If you have to leave before nadir today test at your latest opportunity and feed him if you need to as he is lower earlier in the cycle today. Stay with the normal food unless you get down low (not above 60). No need for Karo unless you have a real crash.

Reduced doses that do more and last longer each cycle? That's great, the goal is remission as was previously stated, and that is exactly what you'd be looking for!
 
You are doing a amazing job! Its only natural for you to worry. Euk is your best friend & your companion. You want to do the very best for him.
PZI is doing its job. This is exactly what you want to bring the BG down & to have lower safe numbers everyday. Lower AM & PMPS. You want to adventually have lower cycles. In order for that to happen you need lower numbers longer...
I always leave food for Baxter when I go to the store or need to be somewhere. That way if he goes low he can kind of help himself.

So you ask the question if he is low at +4 wouldn't he hypo at +7? Maybe not. He could go lower to a safe number & then slowly rise towards the end of that cycle. Which is very normal.
Do you have data from pervious cycles at +4, +5, +6 & +7? I know this is a weekend thing. I would do it before you leave on your trip.
You have a couple more weeks before your trip. Where you going? Some place fun I hope. Between now & then. I would collect the data from the +'s I suggested. See how low he will go. Once you have that then start making a dosing scale for the vet. They are going to test him before each shot?

Just one quick think about one of the other insulins. Lantus....they do what I think is crazy protocol. From what I have read the take the BG super super low. To almost hypo range low. I could be wrong. If you are nervous on PZI then Lantus might make you crazy. @-)
 
Thanks for all the supportive comments. Not that I should be unique about it, but I do have a rather obsessive neurotic streak, which is probably good as it results in good care for kitty but it may result in his caretaker going bananas... :mrgreen:

Just did a +6 which is a beautiful 114, lower than the +4 but doesn't seem like that steep of a drop. So I'll breath easier.

I'm going to South FL for my niece's wedding. It will do me a lot of good to get away and not worry (me, not worry???? HA!) about glucose readings, hypos, insulin doses, or getting up in the middle of the night, plus I can catch up on my sleep.
 
That +6 is great! My guess is you're gonna start getting greens soon, just let them ride as long as they're not super low without major food intervention and monitor him, Jenn is correct that this is exactly what you want to see, hopefully it will continue!

I think we're all neurotic...btw.

*if you want to see low curves, check out my ss. I never used anything but low carb food and careful testing.
 
Just wanted to chime in here and say you are doing a great job with Euko. Looks like you are getting good results with PZI and the dosing. Just stay with the dose. Sometimes it takes a week or two to settle in and adjust to there body. I've noticed with my copper that when i just be patient and stick with the dose that he eventually will settle nicely.

Good luck!!! And it's ok to be neurotic a bit. Otherwise, we wouldn't be able to handle all this testing.

Lori
 
Just got home for a +9 check which is at a beautiful 136, absolutely fantastic!
I don't know how I'll dose tonight for his PM shot, I'm anticipating it may be around 0.4 unless he bounces back too high.
 
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