I think I blew it!

[Bobbie And Bubba]

Man am I frustrated. On 6.23 Bubba AMPS was 410! So I raised his 1u of prozinc 1.25. He had 3 cylcles with the increase. Then yesterday's PMPS was 197. So I waited 20 mins. without feeding him and retested and got 215. I reduced his insulin back down to 1.00. This morning he was 397! Should I have left his insulin at 1.25. I will do a mid-day reading today. How often should I do a mid-day check?

 

[Sue and Oliver (GA)]

No, you learned something. This dance is all about collecting data and then interpreting it. Every number and every cycle gives you information you can use. So, yes, the 1.25 May be a good dose. If you get a pmps that is a little lower, like the one last night, stall and retest like you did, and then shoot.

If you can, a mid day test daily is wonderful. It will tell you how the insulin is working - how low it takes him. That helps you figure out how the dose is working. With ProZinc, the pre shot number also tells you if the dose is safe to shoot. So both numbers are important.

If it helps, think of this early period as data collecting. You are gathering information. A number is just one number: a cycle is just one cycle. It's the overall patterns and trends that give you the whole picture.

As someone wise on this forum once said, "this is a marathon, not a sprint"

 

[Bobbie And Bubba]

No, you learned something. This dance is all about collecting data and then interpreting it. Every number and every cycle gives you information you can use. So, yes, the 1.25 May be a good dose. If you get a pmps that is a little lower, like the one last night, stall and retest like you did, and then shoot.

If you can, a mid day test daily is wonderful. It will tell you how the insulin is working - how low it takes him. That helps you figure out how the dose is working. With ProZinc, the pre shot number also tells you if the dose is safe to shoot. So both numbers are important.

If it helps, think of this early period as data collecting. You are gathering information. A number is just one number: a cycle is just one cycle. It's the overall patterns and trends that give you the whole picture.

As someone wise on this forum once said, "this is a marathon, not a sprint"

Thanks Sue! I am really trying to wrap my mind around the mid-day number compared to the pmps number. Today I will test at around the 6+ mark. If that number is 50% less than the AMPS, then I should just keep him at 1.25 is the PMPS is 200 + and shootable. What happens if the PMPS number does not rise to 200 after I retest in 20 mins? Do I just skip that dose? Oh what a dance this is! I went to bed last night thinking Bubba was going into remission........

 

[Sue and Oliver (GA)]

So, I would consider anything above 60/70 to be a safe nadir. The low 100s would be fine at this point. You don't want him dropping lower than 50. Or, dropping 50% from a higher pre shot number would be a nice drop also. There is no set number (just above 50) you just want to note how the dose worked on that particular pre shot number.

If you get a number far below 200 and retest and it still is low (I am thinking in the 160 and below range) you have several choices. Skip and plan to shoot a little less the next cycle, even if the number is high(which it will be because he will be 24 hours since the previous shot). The thinking is to shoot a lower dose as the previous one gave you an unshootable number. Or if you would rather not skip (which isn't ideal) wait an hour or so, see if the number has sure risen and shoot a reduced dose (maybe half). This may throw off your 12/12 schedule but with ProZinc, there are ways to adjust for that.

It does seem really complicated, but the more numbers you get, the more info you get about what dose did what. And before you know it, you are looking back at your spreadsheet and figuring the best dose. Meanwhile, just keep asking questions and post when you are unsure. The biggest and best thing is that you are testing, so you can keep him safe. You won't be guessing about whether he is too high or too low. A simple poke will give you the answer.

 

[Bobbie And Bubba]

So, I would consider anything above 60/70 to be a safe nadir. The low 100s would be fine at this point. You don't want him dropping lower than 50. Or, dropping 50% from a higher pre shot number would be a nice drop also. There is no set number (just above 50) you just want to note how the dose worked on that particular pre shot number.

If you get a number far below 200 and retest and it still is low (I am thinking in the 160 and below range) you have several choices. Skip and plan to shoot a little less the next cycle, even if the number is high(which it will be because he will be 24 hours since the previous shot). The thinking is to shoot a lower dose as the previous one gave you an unshootable number. Or if you would rather not skip (which isn't ideal) wait an hour or so, see if the number has sure risen and shoot a reduced dose (maybe half). This may throw off your 12/12 schedule but with ProZinc, there are ways to adjust for that.

It does seem really complicated, but the more numbers you get, the more info you get about what dose did what. And before you know it, you are looking back at your spreadsheet and figuring the best dose. Meanwhile, just keep asking questions and post when you are unsure. The biggest and best thing is that you are testing, so you can keep him safe. You won't be guessing about whether he is too high or too low. A simple poke will give you the answer.

Thanks again Sue, you are like my angel I just tested him at 5.5 hours after am shot, he was 208. AMPS was 397. So, he's close to the 50% mark. Should I increase a wee bit, or keep the same?

 

[Sue and Oliver (GA)]

That's a nice drop. He could still go down a little. I'd see where he is at pmps and then decide.

 

[BJM]

As you collect data, you may find that you can use a sliding scale with him, where knowing how much he drops with a given dose and pre-shot, you can adjust the dose based on that data.

 

[Bobbie And Bubba]

So, I would consider anything above 60/70 to be a safe nadir. The low 100s would be fine at this point. You don't want him dropping lower than 50. Or, dropping 50% from a higher pre shot number would be a nice drop also. There is no set number (just above 50) you just want to note how the dose worked on that particular pre shot number.

If you get a number far below 200 and retest and it still is low (I am thinking in the 160 and below range) you have several choices. Skip and plan to shoot a little less the next cycle, even if the number is high(which it will be because he will be 24 hours since the previous shot). The thinking is to shoot a lower dose as the previous one gave you an unshootable number. Or if you would rather not skip (which isn't ideal) wait an hour or so, see if the number has sure risen and shoot a reduced dose (maybe half). This may throw off your 12/12 schedule but with ProZinc, there are ways to adjust for that.

It does seem really complicated, but the more numbers you get, the more info you get about what dose did what. And before you know it, you are looking back at your spreadsheet and figuring the best dose. Meanwhile, just keep asking questions and post when you are unsure. The biggest and best thing is that you are testing, so you can keep him safe. You won't be guessing about whether he is too high or too low. A simple poke will give you the answer.

 

[Bobbie And Bubba]

Thinking ahead: If the PMPS is too low (160 and below) and I wait an hour and retest, do I go ahead and feed him? And still shoot a half dose?

 

[Sue and Oliver (GA)]

Hmmmm. So if we look at the spreadsheet and try to see a pattern to help us figure him out, he has a lower pmps than amps And his cycle lasts longer than usual. With ProZinc we want to see a smile pattern - higher at preshots with the lower number in the middle. Yesterday he was at 176 at +5 and then 179 7 hours later. I wonder if he was flat that whole time or whether he went lower around 8/9. And he is a lot lower at pmps than amps. Is he dropping low overnight and bouncing back up?

I think, if he were mine, I would give him a lower dose at pmps than amps and see if he has preshots that are more even. So if he is near 200 tonight (do the stalling if you need to, making sure he is rising not falling and that he is close to 200) maybe give one unit. And see if the next amps is lower. (This is what Bj is suggesting giving different doses for different pre shots. It's called a sliding scale and works well with some ProZinc cats)

If you possibly can, you might set the alarm overnight (or test when you are up anyway if you are my age) and get a mid cycle number to see what happens at night. Does he drop pretty low? That info would help fill in the picture.

If he is near 160, I'd do the stalling thing. If he still isn't close to 200, then you could feed him and test again an hour or so later. If he is in a shootable range, maybe give what we call a chicken $&@? dose - maybe .5? to keep him out of high numbers that he might get into without a shot at all.

Does he have any food at night? That might help him stay up mid cycle overnight and avoid a bounce (if that is what is happening)

Clear as mud?

 

[Bobbie And Bubba]

Hmmmm. So if we look at the spreadsheet and try to see a pattern to help us figure him out, he has a lower pmps than amps And his cycle lasts longer than usual. With ProZinc we want to see a smile pattern - higher at preshots with the lower number in the middle. Yesterday he was at 176 at +5 and then 179 7 hours later. I wonder if he was flat that whole time or whether he went lower around 8/9. And he is a lot lower at pmps than amps. Is he dropping low overnight and bouncing back up?

I think, if he were mine, I would give him a lower dose at pmps than amps and see if he has preshots that are more even. So if he is near 200 tonight (do the stalling if you need to, making sure he is rising not falling and that he is close to 200) maybe give one unit. And see if the next amps is lower. (This is what Bj is suggesting giving different doses for different pre shots. It's called a sliding scale and works well with some ProZinc cats)

If you possibly can, you might set the alarm overnight (or test when you are up anyway if you are my age) and get a mid cycle number to see what happens at night. Does he drop pretty low? That info would help fill in the picture.

If he is near 160, I'd do the stalling thing. If he still isn't close to 200, then you could feed him and test again an hour or so later. If he is in a shootable range, maybe give what we call a chicken $&@? dose - maybe .5? to keep him out of high numbers that he might get into without a shot at all.

Does he have any food at night? That might help him stay up mid cycle overnight and avoid a bounce (if that is what is happening)

Clear as mud?

 

[Bobbie And Bubba]

Thanks so much, sorta clear as mud. Bubba does not graze, he eats everything up quickly and then stalks his brother cat for his leftovers. Which maybe is contributing to this discrepancy in numbers. I am being diligent in taking away Forrest's food that Bubba tries to finish. He does not have food over night, probably the last time he eats is around 10ish if there is any more Young Again pellets in his bowl. Thinking maybe I should divide his calories over 3 feedings a day. Is 250 calories for a 17.5 lb cat reasonable? Plus he goes outside and yesterday he got a mouse mid day. How many calories do they have?? Thanks for the info about tonight's numbers and I will try an test him tonight around 12 am.

 

[Bobbie And Bubba]

Good morning Sue. I meant to post here and did it in the main forum thread. When you get a chance, please look at it and tell me what you think. Thanks so much.

 

[Sue and Oliver (GA)]

Well, yesterday's cycle was more of a smile shape, with a lower number in the middle and the same range for both pre shots. That's headed in a good direction. And it looks like he stayed in a decent range overnight. Today's amps is a little lower.

If you are home today, you might get a few more numbers to help fill out the picture - a number 3-4 hours after the shot, then 5-7, then 8-9. That'll help you see what his cycle really looks like.