Josie 3/12 & 3/13

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Holly and Josie

Holly and Josie

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For the past few days Josie's numbers have been very confusing! One thing that keeps happening, that I don't understand, is that her numbers appear to be lower at the pre-shot than they are at what has normally been her peak (+5 - +7). This has happened 4 times since Friday, including this afternoon's PMPS.

These numbers are low enough (between 100-180) that I don't feel comfortable giving her insulin. What happens is that we keep waiting and keep testing and wind up giving her shot anywhere from +2 - +6. This has caused us to get off schedule, get back on schedule and get off schedule again.

It happened again today:

Her AMPS (11pm) was 148. Too low to shoot. Fed, waited 2 hours
+2 - 388. Gave .75 units.
+5 was 200.
+10.5 - 148. We're testing her again in a few minutes, but I think she'll be too low to shoot again.

The weird thing is, I don't think she is dropping way low between +5 and the PMPS. (Although I don't know that for sure.) I feel like she is just gradually getting lower even though the shot is wearing off.

Does anyone have any insight on this? Is her pancreas picking up the slack when the insulin wears off?

I'm not sure if I should go ahead and give her a small dose, to support her pancreas, rather than waiting for her to rise again (and getting completely off schedule?)

I am glad she is getting these lower numbers, but I am very confused!
 
Re: Josie 3/12 pre-shot lower than nadir?

I looked at the SS, but today and yesterday are not filled in--so, I am going to resond based on the numbers in your post. It appears to me, that what you are calling +2 is really your AMPS. Your AMPS is the reading you are giving insulin into. So, this morning she was too low to shoot at your normal AMPS time (+12 since her last shot). So, that cycle appears to have lasted 14 hours and now your AMPS is 388. Then your 200 is +3 and your +10.5 reading is really +8.5. It is not unusual to have a nadir at +8. IF I am following this correctly, she should not be due insulin again for 3.5 hours.

If I am correct in the times-- she could very easily be high enough to shoot in 3.5 more hours.

Am I missing something or reading the post incorrectly?!
 
Re: Josie 3/12 pre-shot lower than nadir?

kse said:
I looked at the SS, but today and yesterday are not filled in--so, I am going to resond based on the numbers in your post. It appears to me, that what you are calling +2 is really your AMPS. Your AMPS is the reading you are giving insulin into. So, this morning she was too low to shoot at your normal AMPS time (+12 since her last shot). So, that cycle appears to have lasted 14 hours and now your AMPS is 388. Then your 200 is +3 and your +10.5 reading is really +8.5. It is not unusual to have a nadir at +8. IF I am following this correctly, she should not be due insulin again for 3.5 hours.

If I am correct in the times-- she could very easily be high enough to shoot in 3.5 more hours.

Am I missing something or reading the post incorrectly?!
Click to expand...

I just realized my spreadsheet isn't filled out -- I'm going to go fix that here in a minute.

No, the +10.5 is really 10.5 hours post shoot. Let me add the actual times and that might make it more clear.

AMPS (11:30 pm) - 128 - too low to shoot, fed and waited 2 hours
+2 (1:30 pm) - 388 - gave .75 units
+5 (6:30 am) - 200
+10.5 (12:00) - 148
+11.5 - (1 pm) -161
 
Re: Josie 3/12 pre-shot lower than nadir?

I think I get it. So you are getting a long duration sometimes, with a preshot too low to shoot. That usually means the dose is too high, but it can also be that the pancreas is helping out.

I wouldn't give her any insulin until she is close to 200 and sure rising. People do shoot mini doses at numbers like 180, but her data is all over the place so I wouldn't be comfortable doing that yet. At 200, I think I would reduce the dose by a bit - maybe a little less than .5 and see what it gets you. We would be hoping for a shootable preshot and some good numbers overall.

I know this messes up the schedule. Mini dosing basically means chasing the numbers until she is where your target it and then shooting - whether it is at +12 or +16. Difficult but it usually doesn't last long. The hope is that she is headed off the juice at that point..
 
Re: Josie 3/12 pre-shot lower than nadir?

OK, I updated my spreadsheet. It is pretty confusing though, because I keep having to delay her shots. It's even confusing to me, and I was there!
 
Re: Josie 3/12 pre-shot lower than nadir?

Sue and Oliver (GA) said:
I think I get it. So you are getting a long duration sometimes, with a preshot too low to shoot. That usually means the dose is too high, but it can also be that the pancreas is helping out.

I wouldn't give her any insulin until she is close to 200 and sure rising. People do shoot mini doses at numbers like 180, but her data is all over the place so I wouldn't be comfortable doing that yet. At 200, I think I would reduce the dose by a bit - maybe a little less than .5 and see what it gets you. We would be hoping for a shootable preshot and some good numbers overall.

I know this messes up the schedule. Mini dosing basically means chasing the numbers until she is where your target it and then shooting - whether it is at +12 or +16. Difficult but it usually doesn't last long. The hope is that she is headed off the juice at that point.
Click to expand...

Sue, yes, this is exactly what is happening!

What's bothering me today is that my husband is getting ready to leave for work and I won't be home for work for another 3 hours. By that time she'll be at about 3.5+ hours. If last night is any indication, she'll be pretty high by then. Of course, if Saturday morning and Sunday morning are any indication, then it'll be the perfect time for her shot. I wish I could have my husband give he a little bit before he leaves, but you're right, it's probably too risky. Plus, having just eaten at 1pm, she'd still be on a food high, so who know how accurate her number would be. I think I am going to have to quit my job to stay home and take care of my cat! :-D
 
Re: Josie 3/12 pre-shot lower than nadir?

I know! Particularly when they are needing less and less insulin, it becomes more demanding.

One thing you can try is to test, feed and test again in 40 minutes or so. If she goes down, not up, it means the pancreas is helping out. Depending on what you find out, you can steer the numbers up or down by giving her snacks.
 
Re: Josie 3/12 pre-shot lower than nadir?

Sue and Oliver (GA) said:
I know! Particularly when they are needing less and less insulin, it becomes more demanding.

One thing you can try is to test, feed and test again in 40 minutes or so. If she goes down, not up, it means the pancreas is helping out. Depending on what you find out, you can steer the numbers up or down by giving her snacks.
Click to expand...

Unfortunately, my husband left for work a few minutes ago, so we can't do anymore testing. I sure wish we had an extra hour! Normally, we would but we got off schedule last night, so we didn't have any extra time today. That's kind of why I tested at 10.5+, so I could get an idea of if she was going up or headed down. But her numbers were 148 and 161, so that was inconclusive!

What makes me more nervous is that she really only eats twice per day, sometimes a small snack or two in between. So not only did she NOT receive insulin, but she just ate a big meal. This is not ideal! But since she only eats twice per day, I felt that we couldn't withhold food from her.
 
Re: Josie 3/12 16+ - 192

I just got home and checked her, fearing a high number, but to my pleasant surprise she's at 192!

I'm not going to shoot yet. She was at 161 at 11.5+ but had a big meal afterwards. We weren't able to test her after that, so at this point I'm not sure if she's slowly on her way up, or if she went up and now she's headed back down. I think I am going to test her in an hour and see.

If anyone has any advice as to what point to shoot and how much (not sure if I should reduce the dose, or keep to .75) I would love your input!
 
Re: Josie 3/12 +16 - 192

Wow quite a ride you've been on.

One thing you could try is dropping the dose down to .5u at 200 or above and see if that gets you back to having shootable PS's.
 
I wasn't able to get back on here last night, but Josie's awesome numbers didn't last much longer. I tested her at +17 and she was at 315. For some reason, I had a hard time believing the reading. Looking back, I probably just didn't want to believe that the great numbers were over, but at the time, I thought she seemed stressed and that maybe the reading wasn't accurate. I retested twice, getting figures of 345 and 275, further convicing myself that I wasn't getting accurate readings . I spent some time cuddling and brushing her, hoping to "calm" her and by the time I was done she was at 415! I felt SO bad for not having given insulin immediately. I quickly gave her .75 units.

At +4 she was at 298. A little before +7, my husband woke me up to tell me that Josie threw up a little. She is definitely not a puker and usually only does so in reaction to medicine. She is taking an antibiotic and it hasn't made her sick so far, but last night she did take it at a different time in relation to when she eats. I don't know if that was the problem or it was something else. We tested her immediately afterwards and she was at 129. We offered her some food and she gobbled up at least half of it. Could she have gotten sick from being hungry?

She woke me up this morning (about 10.5+) begging for food and I fed her a little. She was at 183 at that point.

Her PS number this morning was 240 and we gave .50 units.
 
Re: Josie 3/12 +16 - 192

Rob & Harley (GA) said:
Wow quite a ride you've been on.

One thing you could try is dropping the dose down to .5u at 200 or above and see if that gets you back to having shootable PS's.
Click to expand...

That's exactly what we did this morning. (We didn't do that last night because her numbers got so high.) We'll see how that works out!
 
Re: Josie 3/12 +16 - 192

This possibility of the pancreas working again is not an either/or - unfortunately. If you check Kitty's (Catannc) spreadsheet, it was sputtering for a while before she finally got some consistent low numbers.

The trick is to support it with small snacks when she gets a long duration or lower numbers, and then be ready to shoot as soon as it sputters out. Wrecks havoc with the schedule and bean's sleep patterns.

She could have vomited because she felt herself going low, but it could have been just because she is a cat. :mrgreen: Regardless, you guys are doing great and her numbers are looking good. Just hang in there!
 
Re: Josie 3/12 +16 - 192

Sue and Oliver (GA) said:
This possibility of the pancreas working again is not an either/or - unfortunately. If you check Kitty's (Catannc) spreadsheet, it was sputtering for a while before she finally got some consistent low numbers.

The trick is to support it with small snacks when she gets a long duration or lower numbers, and then be ready to shoot as soon as it sputters out. Wrecks havoc with the schedule and bean's sleep patterns.

She could have vomited because she felt herself going low, but it could have been just because she is a cat. :mrgreen: Regardless, you guys are doing great and her numbers are looking good. Just hang in there!
Click to expand...

I have a question about this... so I should be feeding her snacks if it seems her pancreas is working? I was thinking that the less she ate, the longer her numbers would stay low. Maybe that's wrong? We would never withhold food for her if it was time to eat, but I hadn't thought to feed her extra snacks.

I am also wondering if I should be testing more frequently during these times. I waited a little over an hour last night and I definitely feel like I waited too long! Maybe I should test every half an hour?
 
If her pancreas is working, snacks can bring her down. So small infrequent meals can be helpful. Once the pancreas fades out, food brings her up. Sorry, complicated, huh? It is a balancing act. If it looks like her pancreas is working, then small frequent can continue supporting it. Once it is tired and quits helping, they are less important. ( I love the way we talk about Mr. P as if he is a living, ornery person. :mrgreen: Much easier than getting into the science of the pancreas. At least for me...)

Check out Kim's thread (kse) yesterday. She supported Chewy's pancreas with small snacks and Chewy continued to move down, not up. Today, after 50 hours, she is looking at higher numbers and considering shooting.

Once you get up into the range where you think you could shoot (150+?) more tests can be helpful. Anytime you can catch him before he shoots up is best.
 
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