Jack 6/23 Blues today

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Darlene & Jack

Darlene & Jack

Member Since 2011
Went with a small increase up to 1.2 yesterday and got a lot of nice blues today!

I was off from work and now my son is out of school so we could get more readings. He seems to be eating more just in the AM and PM with a little in between rather than eating all day as he used to. At first I thought he wasn't eating much, but I am thinking maybe now that his readings are a little lower consistently maybe his appetite is going back to a normal amount. He seems to be eating more like my civvies now. :-)
 
Woohoo! You're getting closer to a good dose!! Look at that, nice and dramatic and nadir almost exactly where it should be - +7, got a little surfing in (the 103 to 111 over 3 hours).

People ask "what am I looking for with a good dose" - THAT IS IT!! Might be a little wonky yet, but stick with 1.2U for a while and see what happens. He may have that nice curve but then level off a little higher, that would mean another very small increase to no more than 1.3U.
 
Thanks ladies! Blue does look nice on Jack, but he preferred yellow today. :-) I notice that when I increase he usually gets better numbers on day #2, then a bit higher the next day as you predicted Vicky. I was still happy with the 218 PMPS tonight.
 
Not sure about today...is this dose too high maybe and he's still rebounding a little?

He dropped nicely to 79 @ +7 during the day, but now tonight he is rising still, up to 350 at +7.

Keep the same dose? increase? Decrease? just when i think we are doing so well!
 
I would hate for you to loose the progress he's made if you lower dose, and yes that cycle yesterday from the high AMPS to the 72 and back up again sure looks like a rebound but let's look at what's happening overall, not just the bounce itself.

If you think about the body wanting to maintain a normal state, his normal state is mostly higher numbers. This is probably the point at which you should stay with the 1.2U in order to shoot through the higher numbers. The mid cycle 100s look very very good because they hang for quite a while so if we can get more of those then the normal state will become those lower numbers.

I haven't used the term "hangtime" in quite a while, but that is when they get several hours at steady numbers. The 23rd and yesterday are good examples. The dose is good when that happens, but the body doesn't always realize that, the liver is still playing tag and wants to be IT!

Staying with 1.2U has a good chance of getting him through this period. The thing to watch for now is a real low of 40 or below. That's when you want to lower dose a little.
 
Thanks Vicky. I ended up giving the 1.2 this morning, seeing the higher numbers today. He seems to like to alternate a low day with a high day!
I will stick with the 1.2 for now and see what happens.
 
So, as the pattern is lately...today was a low day....for half the day!

179 @ AMPS Gave his usual dose as he is almost always higher at +3
127 @ +3
58 @ +5 called home to check on Jack and asked my son to check him now since he had dropped at +3. Had my son put him in front of the food to eat (his usual FF, not anything
high carb
61 @ +5.5
86 @ +6
98 @ +7
142 @ +9
491 @ PMPS!!!!!!!!!!!!!!! ugh!!! not sure what to do...gave 1 unit as I needed to make a decision and get somewhere

The day looked beautiful until that PMPS. :-(
 
Oh my goodness! That is never pleasant to see. Yeah, he rebounded hard off that 58. From this point stay with the 1U till this rebound clears (up to 3 days when it's this hard and cat is unregulated) then re-evaluate whether to creep him back up.

Jack may be a case where you have to go up one drop at a time. I have had to do that with Gandalf before I saw progress and he stopped reacting to lows like this. There probably really isn't much difference between a fat 1U and 1.2U, so that's alright, but stay with the progression as 1U, fat 1U, 1.2U etc. Not sure how you determine one drop MORE rather than less, but when we're speaking in .1U changes, that's basically only 1 drop.

Now what some people are doing is feed those low numbers to bring them back up that way rather than allow them to rebound so hard. I'm not convinced that works because some cats are going to rebound regardless whether they get a little extra food or not. I don't mean high carb food, just more food.

Does he have food available at all times, or is it just when someone puts it in front of him? ECID 'cause some cats eat all at once and whenever they are presented with food, always eat it all. Gandalf is the opposite, he eats when presented with food, but leaves plenty for later and he snacks throughout the day. I'm not sure which is better for a diabetic because the piggy eater can be food scheduled easier. I never know if Gandalf will eat it all or not. He has a timed feeder and it helps encourage him to eat when I want him to. If your kids can check Jack and feed him when he's in greens like that, you might see the bounce lessen.

Just an idea. The Lantus board does some version of this (feeding the lows) and I'm not entirely fond of it because that manipulates the blood glucose rather than allowing the insulin to do what it does, but there may be some cats which that can help in these situations, rather than do it like that all the time.

Give it some thought and maybe we can get Jack over this hump. but something like this rather than having to monkey with his doses all the time and get no where.

Anyone else have a thought? Lori, I know you've worked with food scheduling/issues, what do you think?
 
Jack is free fed, and ate well this morning. When Brady checked him and he was 58 the food in the regular dish had all been eaten (i have 2 other cats as well) and the auto feeder was scheduled to go off soon. I had Brady pop it open and put Jack in front of it to eat, and he did. That was about 11:15 or 11:30am. The feeder went off again around 2, then I got home at 5 and there was still some left. Fed with his shot at 6. Brady said he had food available but didn't eat too much through the afternoon, but as I mentioned last week Jack seems to not be eating quite as much during the day. If Jack is given a bowl of food, he will generally eat some, walk away, go back later, etc. He isn't a piggy eater. :-)

As far as dosing and the fat 1 unit vs. 1.2, I do the drops and measure them and count them out. For the fat 1 i just go a little over the 1 unit. When I do the 1.2 I draw up the 1.5 then let off 3 drops. I'm sure it's not always super accurate, but it's the best I can do. It was so nice when he was on that flat 1 unit dose...so easy to measure! haha
With Jack it does seem that one drop makes a difference, that's why i have just been trying to stick with those drop increases.

Interesting about the feeding, though I'm not sure what it entails and if I could keep the other cats from eating at Jack's time, or eating all the food, etc. But it might be good to hear more about it. I'm lucky to have my helpers at home to check Jack when I'm at work!
 
Well then, I know it's frowned upon to change doses all the time, but I wonder if giving him 1U in the mornings and maybe a fat 1U at night would help if he eats less during the day.

I still swear that Lev is more flexible than it is given credit for.
 
I'm willing to try anything! I'll let him settle from yesterday's events then see if that might be something I need to try.
 
Hi Darlene,
After thinking about this this morning, I decided I might have it backwards.

Part of the challenge with Lev is that it has this "shed" thing which is simply carryover where one dose can continue affecting the next cycle. As you get closer to a good dose, that effect becomes even more evident.

So I might have it backwards - if he's not eating as much during the day, then the PM shot is the one to give less of, say 1U, then the AM shot would be a fat 1U. That way the PM shot has less effect on the AM cycle. Does that make sense?

Overlap is also one of the reasons starting at too high of dose is such a problem.

Such a small difference should not cause a problem (like a low) but after thinking about it, I realized it might if we did the larger dose on the wrong cycle so it would end up affecting the cycle where he doesn't eat as much and has lower numbers.

Maybe someone else will check in this morning and give their 50 cents (inflation), as I am off to work, but I don't want to cause a problem for Jack, so wanted to explain this to you. :smile:
 
So Jack had a nice day today, nice gentle curve on 1 unit. I guess I'm just not sure what to do from here with a few different opinions. I assumed the numbers yesterday were rebound and that he was on too high of a dose. but it was also explained that his body is not used to low numbers and to hold the dose.

I've had a few suggestions offered, from lowering to the 1 unit or staying with the 1.2 units and letting Jack's pancreas get used to the lower numbers (panicky liver or sputtering pancreas?). maybe the split dosing also. I can see each point of view and this is what confuses me! As was said a day or 2 ago, I hate to lose any ground we gained with the increase to 1.2 and I wonder if I just should go back to that now, or do i need to start all over again with increasing? This week we are good for getting testing during the day with my son checking him, but next week I am off and we will be taking day trips and plan on being out during the day.

Any further explanations are appreciated! confused_cat
 
I think it might help if someone else puts their 50 cents in on this. He did not have a breakthrough till you hit the 1.2U, so 1.2U is worth trying again. However, his BGs today don't look too bad at all so with being gone next week if you want to stick with 1U because it's safer, that might be worth staying with for the time being.

Sorry if I confused you.
 
Thanks Vicky, I was thinking maybe I should go back to the 1.2, but today does look like a good day and he was just 154 @ +5 tonight. I guess I'll see how he is in the morning and decide from there. I would feel better with a safer dose for next week but I still have a few days to get ready for that. Once we know a bit more about our plans I might need to check in for advice about delayed shots. I know one day we will be going to NYC and will probably not be home in time for 6pm.

No apologies needed.
 
Darlene & Jack said:
Jack is free fed, and ate well this morning. When Brady checked him and he was 58 the food in the regular dish had all been eaten (i have 2 other cats as well) and the auto feeder was scheduled to go off soon. I had Brady pop it open and put Jack in front of it to eat, and he did. That was about 11:15 or 11:30am. The feeder went off again around 2, then I got home at 5 and there was still some left. Fed with his shot at 6. Brady said he had food available but didn't eat too much through the afternoon, but as I mentioned last week Jack seems to not be eating quite as much during the day. If Jack is given a bowl of food, he will generally eat some, walk away, go back later, etc. He isn't a piggy eater. :-)

As far as dosing and the fat 1 unit vs. 1.2, I do the drops and measure them and count them out. For the fat 1 i just go a little over the 1 unit. When I do the 1.2 I draw up the 1.5 then let off 3 drops. I'm sure it's not always super accurate, but it's the best I can do. It was so nice when he was on that flat 1 unit dose...so easy to measure! haha
With Jack it does seem that one drop makes a difference, that's why i have just been trying to stick with those drop increases.

Interesting about the feeding, though I'm not sure what it entails and if I could keep the other cats from eating at Jack's time, or eating all the food, etc. But it might be good to hear more about it. I'm lucky to have my helpers at home to check Jack when I'm at work!
Click to expand...

I think food plays a huge part in getting these cats regulated. I think it is really hard though with diabetic cats in a multiple cat household to achieve this.

I know pretty much exactly how much Tigger eats every day. And if he doesn't feel like eating his whole preshot meal, we pretty much urge him on until he is done or shortly thereafter (maybe it will take an hour or more sometimes). But in the end he gets pretty much that 3 ounces of food at shot time.

After that he is then given a small cooked chicken treat somewhere at mid-cycle, after plus four, but usually a little later. Easy, since he is an only cat.

So again, with other cats possibly eating Jack's food during the day since he is free fed, the insulin doesn't have any food to counter-act it at times. Maybe he gets enough food one day, but not the next. Consequently he rebounds from going too low at times (not enough food).

My thoughts on this, but would like to hear yours. I know you are frustrated. I would be too. And I am sorry I don't have any answers as to how you can change this in a multiple cat household. I know there are lots of people that advocate free feeding in multiple cat households, but I just don't see how this can work on a consistent basis to keep numbers steady or to know when to lower or raise the dose.

I am not much help here (again). And I am not sure what you could do about it anyway. I am going to have two cats staying with me in a couple of weeks and I will have a challenge there as well.
 
Random thoughts here:

- I think that even (flat) numbers, even in the upper 100s/lower 200s are better than a swing from 50s to 500s.

- The 500 is definitely rebound, which I usually say reduce the dose to stop the swing.

- Lev does seem to like percentage dose changes - so less change amount in units from lower doses. i.e. 10% of 100 is .1u, but 10% of 2u is .2u (almost .25u) - he is in the range where making .1u changes will have a noticeable effect.

- Therefore, maybe 1.1u or .9u needs to be considered?

Yes, let him settle off this rebound before making any more dose changes (stick with 1u for now).

Regarding the Health thread, I would never aim for a 60, but if I see one I don't worry about it. I think a better aim point is 80-100 which leaves some wiggle room. He was getting in that range on .8u, but also still going to 58. It may be the case that he needs .7u, so keep that in mind if the 1u or .9u isn't working.
 
Pamela...it is a challenge making sure Jack gets to eat without someone else (his friend Tucker) nosing his way in while he's eating. But for the most part I do not think Jack is ever left without food available. I probably put out a can more than needed in the auto feeder during the day and rarely do I come home at 5pm and find all the dishes empty. I do set the feeder to go off once overnight and the morning is the only time I find the dishes empty. I hate to overfeed, on the other hand, but I wonder if I put out one more can overnight if it would make any difference. Maybe I will try tonight. Good luck with your extra kitties coming to visit!!

Thanks for the thoughts Sheila...I agree that I would rather see a day like 6/28 rather than that huge swing on 6/27.
As far as doses, in my thinking, and pretty much measuring, my fat 1 unit = 1.1 unit. I do understand that the change in .1 makes a huge difference so that's why I've tried to keep the changes small. I guess the hard bounce kind of scared me into the .2 drop down to 1 unit. Will sit with this dose for a bit and see what happens.

340 AMPS this morning, a little higher than he has been, but maybe he dropped lower last night. He was 154 @ +5...and I was sooo tired and didn't have the energy to get up at 1am to check a +7! So he might have bounced up a little from an overnight lower number, maybe.
 
Thank you, ladies.

Darlene, I do the same thing with food - probably put out too much. I come home and usually it's all gone in Gandalf's feeder. But there might be some in the other bowls. I use a taste enhancer supplement called F-Biotic to encourage Gandalf to eat, but his buddy Leahpold loves it and she will nose him out of the way. Not because she's mean but because he is so mild-mannered he'll let her do that. I wish he would have kept that spunkiness he had as a kitten - I remember trying to remove his bowl when he was eating after I first brought him home, 'cause I didn't want him to have too much and he put his paw on my hand with this little bitty nails biting in! And he growled. I think that's the only and last time he ever growled about food!!

If you read the post I made in Melissa and Celle thread, I have to agree the best thing you can do now is pick a dose and stick with it for a few days.
 
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