I'd like to understand

[AlphaCat]

My question today is, what does this mess mean?

Over the last 5 days Fabby has only been able to receive her PM shot (due to human issues). Her testing times are not consistent as usual either.

When I look at the consistent timeframe of testing and shots versus the last few days of inconsistent testing and only one shot what I take away from the numbers confuses me.
We got our lowest tested number ever during this week.
Our numbers weren't high/low like we've seen with previous bouncing.
The numbers stayed consistent (or within expected realm for her) like when she was on regularly scheduled insulin, even when she's not getting the insulin.
We've had higher numbers on consistent insulin, than now without.

So what does all this mean? Is the insulin we're on not really doing anything anyway?

Only one other change that should be noted when looking at this whole picture. Fabby doesn't appear stressed due to this week's changes. She has had more inconvenience and difficulty this week than over the previous 3 weeks. Some of the potential stress changes. She got a roommate in quarantine (which she tolerates, but doesn't love). Her schedule is not dependable. Her food schedule isn't consistent as previous. (I've tried to leave out wet food so she can regulate herself since I couldn't give insulin dependably. Normally she only has access to food 4x a day at feeding.)

 

[Lisa and Smoky]

You may want to post this on the vetsulin forum as well. I'll tag @JanetNJ and see if she can help. Her kitty went into remission fairly early and you could be headed that way too.

 

[JanetNJ]

Can you get a curve in this weekend?

 

[AlphaCat]

You may want to post this on the vetsulin forum as well. I'll tag @JanetNJ and see if she can help. Her kitty went into remission fairly early and you could be headed that way too.

JanetNJ always comes and finds me! She's been amazing at helping Fabby and I so far!
I'm amazed you might be thinking a remission direction and here I was thinking the insulin wasn't working at all...

@Yong & JanetNJ have been my guiding forces on this journey through the last month. The whole board is a blessing.

Can you get a curve in this weekend?

I can try. Seamus should be off quarantine tomorrow, and the spouse should be healing a little more each day. I will shoot for Sunday to do 2 tests every 2 hours. How long of a curve? 12 hours, 24? And with still one more day before I can get to it, should I go back to regularly scheduled insulin 1.5 - 2x a day, or should I let her go without for one more day and get the curve and then refigure the insulin plan?

Tomorrow will be heavy spouse care day, as well as litter and some cleaning, and I need to go get more strips and food for both Fabby and spouse. But Sunday... I should be able to slow down on Sunday to pay attention to things that have been a bit de-prioritized. (Sorry Fabby... OMG!)

 

[JanetNJ]

JanetNJ always comes and finds me! She's been amazing at helping Fabby and I so far!
I'm amazed you might be thinking a remission direction and here I was thinking the insulin wasn't working at all...

@Yong & JanetNJ have been my guiding forces on this journey through the last month. The whole board is a blessing.


I can try. Seamus should be off quarantine tomorrow, and the spouse should be healing a little more each day. I will shoot for Sunday to do 2 tests every 2 hours. How long of a curve? 12 hours, 24? And with still one more day before I can get to it, should I go back to regularly scheduled insulin 1.5 - 2x a day, or should I let her go without for one more day and get the curve and then refigure the insulin plan?

Tomorrow will be heavy spouse care day, as well as litter and some cleaning, and I need to go get more strips and food for both Fabby and spouse. But Sunday... I should be able to slow down on Sunday to pay attention to things that have been a bit de-prioritized. (Sorry Fabby... OMG!)

12 hours is fine. No reason to not sleep. Lol

 

[JanetNJ]

JanetNJ always comes and finds me! She's been amazing at helping Fabby and I so far!
I'm amazed you might be thinking a remission direction and here I was thinking the insulin wasn't working at all...

@Yong & JanetNJ have been my guiding forces on this journey through the last month. The whole board is a blessing.


I can try. Seamus should be off quarantine tomorrow, and the spouse should be healing a little more each day. I will shoot for Sunday to do 2 tests every 2 hours. How long of a curve? 12 hours, 24? And with still one more day before I can get to it, should I go back to regularly scheduled insulin 1.5 - 2x a day, or should I let her go without for one more day and get the curve and then refigure the insulin plan?

Tomorrow will be heavy spouse care day, as well as litter and some cleaning, and I need to go get more strips and food for both Fabby and spouse. But Sunday... I should be able to slow down on Sunday to pay attention to things that have been a bit de-prioritized. (Sorry Fabby... OMG!)

I I think the 1.5 may be too much. It looks like she's dropping more than 50% from the start. When that happens it can trigger bouncing which keeps them in high preshot numbers. You haven't been home at all in the morning? How long is that going to be the case? Only getting dosed once a day really isn't ideal.... Although I know sometimes things are out of our control. It's hard to give dosing advice when it's unclear what is happening. If a curve is not feasible... Try to get a +5 or 6.

 

[AlphaCat]

I I think the 1.5 may be too much. It looks like she's dropping more than 50% from the start. When that happens it can trigger bouncing which keeps them in high preshot numbers. You haven't been home at all in the morning? How long is that going to be the case? Only getting dosed once a day really isn't ideal.... Although I know sometimes things are out of our control. It's hard to give dosing advice when it's unclear what is happening. If a curve is not feasible... Try to get a +5 or 6.

Hey, good morning.
Yea, the last few days have been doozies. I've had to leave the house at 4am and returned somewhere about 9pm.
My doozie days are done. Today is the first morning I am home, but I should be able to go back to consistently monitoring as of today. I'm just unsure how to proceed. I can't commit to a curve today, as I have too many other responsibilities, but I will do it tomorrow for sure. But I'm not sure where that leaves me with doing what about insulin today... (I will get in my usual 4x tests, and can do 2 shot times today, just not curve.)

 

[JanetNJ]

Hey, good morning.
Yea, the last few days have been doozies. I've had to leave the house at 4am and returned somewhere about 9pm.
My doozie days are done. Today is the first morning I am home, but I should be able to go back to consistently monitoring as of today. I'm just unsure how to proceed. I can't commit to a curve today, as I have too many other responsibilities, but I will do it tomorrow for sure. But I'm not sure where that leaves me with doing what about insulin today... (I will get in my usual 4x tests, and can do 2 shot times today, just not curve.)

What are you unsure about? Get the am reading and see what it is. If it's high enough give 1.25-1.5.

 

[MrWorfMen's Mom]

I have a feeling 1.5u may be too much too! If Fabby were mine, I think I might try giving 0.75u twice daily and see what happens for a few days. I think Fabby is perpetually bouncing. While it's hard to tell for sure given the one shot per day for the last five days, Fabby's numbers didn't seem to change much despite skipping the morning shot and her PMPS for the past two evenings has come down which suggests to me, less may be more in her case.

 

[AlphaCat]

We are 454 AMPS
Also, b/c I was going to be home and back on track there was no option of food left out.

 

[MrWorfMen's Mom]

That's fine. Am I safe to assume you gave 1.5u last night or was that a missed shot? There is nothing on the SS. If you did give 1.5 last night, perhaps she is bouncing. If the shot was missed, that also would explain the higher AMPS. Being conservative until you can get back to monitoring regularly will keep Fabby safe. Dosing should be based on pre-shots and nadir and Fabby has been dropped more than 50% in 15th evening cycle so backing off the dose for a few days should help settle things down and level off.

 

[JanetNJ]

I have a feeling 1.5u may be too much too! If Fabby were mine, I think I might try giving 0.75u twice daily and see what happens for a few days. I think Fabby is perpetually bouncing. While it's hard to tell for sure given the one shot per day for the last five days, Fabby's numbers didn't seem to change much despite skipping the morning shot and her PMPS for the past two evenings has come down which suggests to me, less may be more in her case.

I'd probably do 1 twice a day for a few days then raise it up a bit once the bouncing settles.

 

[AlphaCat]

Thanks to both of you.
Should I wait to do the curve until after a few days of steady 1u. 2x a day? Or go ahead as scheduled on Sunday?

 

[JanetNJ]

Thanks to both of you.
Should I wait to do the curve until after a few days of steady 1u. 2x a day? Or go ahead as scheduled on Sunday?

do it whenever you want. as often as you want. the more data the better.

 

[AlphaCat]

That's fine. Am I safe to assume you gave 1.5u last night or was that a missed shot? There is nothing on the SS. If you did give 1.5 last night, perhaps she is bouncing. If the shot was missed, that also would explain the higher AMPS.

I did miss all of yesterday. I have it on my list to go update the spreadsheet with all my zeros and get back to normal today.

Due to civvie cat emergency, and spouse surgery, I haven't been taking care of me and my illness has been neglected, which in turn has spilled onto both Fabby and civvie cat with er issue, and even my crystals boys. I was in survival mode and it peaked yesterday. Today will be better. Today I can get things back to normal with schedule and monitoring.
When it rains it pours... I'm just hoping the fall-out from my neglect doesn't keep the downward spiral going.
Today... Today is my turn around day.

 

[Yong & Maury GA]

After she settles from bouncing, I'm curious to see Linda's suggestion and trying 0.75U first before increasing again. As you've gotten to 1.5U her numbers seem a little higher.

Yes you have to take care of you too so you are well enough to keep taking care of everyone else

 

[MrWorfMen's Mom]

My motto and that of a most folks around here is that you have to look after you first so you keep yourself in good shape to look after all your significant others including Fabby. You've had a lot of very stressful stuff on your plate and Fabby has weathered the routine change without any problem. You never know....skipping those shots may turn out to be a blessing in disguise...it has after all given you a whole new picture of what the insulin is doing for her. Get back into your routine when you are able and in the meantime, do what you can. Sounds like you may need a bit more recovery time!

 

[AlphaCat]

I don't know if that's a universal thing, but there's a reason people have to be told they must strap on their mask before assisting others. Bottom was yesterday. Today is a new day. All week all I kept saying was make it to today. I do need some personal downtime and recuperating, but that's not in the cards just yet. Thing is, my illness is always there whether I get rest or not, so I know I can get through this difficult spot.
Fabby will too. She's stubborn like her mama.

It does help that all of you are so helpful and willing to help!
Thank you so much for the support, for the advice, for the love of cats!

 

[AlphaCat]

So curve was able to be completed today.
And back on track with 2 doses of insulin every day.
I had gone down to 1 unit 2x a day, but now having the curve info, should I be going down to .75 units 2x a day?

Does the curve say anything helpful?

 

[MrWorfMen's Mom]

Fabby is still dropping more than 50% on the 1u. If she were mine, I'd back down to 0.75u and see how she does with that for a few days. Is there any way you can get some random evening cycle tests between +1.5 and +4 to see what she does at night? Many cats go lower at night and sometimes those evening tests can fill in pieces of the puzzle and make the picture a little clearer.

 

[AlphaCat]

Fabby is still dropping more than 50% on the 1u. If she were mine, I'd back down to 0.75u and see how she does with that for a few days. Is there any way you can get some random evening cycle tests between +1.5 and +4 to see what she does at night? Many cats go lower at night and sometimes those evening tests can fill in pieces of the puzzle and make the picture a little clearer.

I can get night tests. My previous routine before the massive craziness was to get a +3 or +4 after the PM shot. I tried to feed 4x a day and test before each meal.
I'll begin the lower dose insulin with her next dose.
Her pattern before the craziness was she dropped very similar overnight as she did in the day, both with meals around/just before nadir in day and night.