Josie AMPS = 107 (stalling)

Jenna Josie

Jenna Josie

Active Member
Here we are again! :rolleyes:

AMPS is 107. I am thinking that she’s having another looooong cycle and that this is the “overlap” @Djamila decribes. Will retest and post it in a few, but if it’s right that she’s now coming up from last nights dose, do we stall again and retest once more?

Current dose is 1.5. Saturday night when she did this, shot .75 and appears we could have done 1u ?
 
Are you home today to monitor? From the cycle a few days ago, I agree that giving 1u might be worth a try. And maybe lower your regular dose to 1.25u for a day or two and see if that helps even things out a bit.
 
Yes, we can be home today. The difference right now between Sat pm and today is that she was clearly going up when we shot the .75. Today, not so much though am about to grad another test in just a couple of minutes . . . If she's on the upswing, we'll try 1u.
 
She was not on the upswing. *sigh* 109 so fed and shot 0.75, which is half her usual dose.

I'm going to check her at +2 to see how breakfast is affecting her BGs (+1 or +2 may also be the end of the "overlap," which is still my theory for what's going on with her) and set today's strategy from there.

This is exactly how we wanted to spend Labor Day! :rolleyes: Still, very glad it's a day off.
 
That's the thing that's so tricky: you're shooting for the number where she'll be two hours from now, not the number she is right now. And it can be hard to predict where she'll be when the insulin wears off. She's still early enough in her diagnosis (less than three months), that it's okay to do a BCS once in awhile and collect data. Then you'll know for next time if she needed more or if the reduction was needed.
 
Big Chicken Shot :D. It's what we call a shot that's a big reduction from normal, and not required by the data we've collected so far. Usually around 50-75% of normal, and usually done because of a gut instinct, needing to the leave the house, or just facing a PS number we've never seen before and just not sure what to do. So you do a BCS, collect data, and use it to guide you the next time.
 
Big Chicken Shot! I *love* that! :D

For the record, I was *intending* to be brave ;) but she just wasn't coming up at all, and I'm not fully on board with this whole overlap concept yet. I *should* be -- back in mid-July, she had several of these long cycles (yellow AMPS to blue PMPS) on 1.5 units, too -- but that seems so long ago, and who knows if maybe it's her little pancreas trying it's best or maybe her little body learning that low'ish numbers aren't cause for a Big Bounce or maybe this or maybe that . . .
 
+3.5 = 199. So it looks like we could have gone with the 1u unit after all. *sigh*

On the plus side, her poor little ear gets a break. She only tolerates right-ear-sticks, and it looks like someone's been chewing on it just about now!
 
@Jenna Josie Argh.... these kitties!! They're both giving us fits today. I popped on to reference stalls (I haven't had to do them much) and saw your string. I got a pmps of 97 tonight, stalled -- 107 -- stalled -- 87. And I'm big chickening a NS... if he'd gone up from 107 even a smidge I would've done a reduced dose (I think :rolleyes:). He runs lower at night, and I'm a heavy sleeper so I don't trust I'd wake up to check him. Musing to the world (and our fellow diabetic kitty moms) will there come a time when we should/will get comfortable shooting on an 87? :eek:

I know I'm going to regret the NS... but better high for a day... (but I sure do hate those days).

(Oh, and Romeo only has one good ear too -- his other had a hematoma years ago and is basically worthless for poking. I feel terrible on these high stick days/weeks!)
 
HuskerGyrl said:
Musing to the world (and our fellow diabetic kitty moms) will there come a time when we should/will get comfortable shooting on an 87? :eek:
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Like pretty much everything around here: it depends. A couple of nights ago I gave a full dose on an 80. I'll be honest that it made me nervous, but it turned out just fine. However, there are several factors that made that okay. It would definitely not be okay for most cats. 1. Sam is a long term diabetic on his second diagnosis. 2. He's also one of the kitties that has pretty textbook responses to Prozinc. And 3: I know how to monitor him and I am comfortable steering if he started to go low.

For a cat that is newly diagnosed (less than six months), I wouldn't recommend shooting a full dose on a green. I'd say to stall, then if that didn't work, feed and retest and shoot late, or give a reduced dose. If there is a lot of data from previous experiments you could possibly do it eventually, but there is definitely a risk and it should never be done if you can't monitor carefully.

At this point Romeo is still new enough that either skipping or reducing was the right decision. And I always hope that kitties will just go into remission before they cross into "long term" land :bighug:
 
It’s so hard to know what to do! We’ve had to stall 3 times with low PS numbers just this week — Friday am, Saturday pm, Monday am — and I think I got it wrong every time! OTOH, I got it wrong in the same way (shooting lower reduction), so that should tell me something! And OTOH yet again, went with a higher reduction on a similar stall on 8/23 and had to steer her half the night ...

So yeah, @HuskerGyrl , I’m right there with you!
 
Djamila said:
Like pretty much everything around here: it depends. A couple of nights ago I gave a full dose on an 80. I'll be honest that it made me nervous, but it turned out just fine. However, there are several factors that made that okay. It would definitely not be okay for most cats. 1. Sam is a long term diabetic on his second diagnosis. 2. He's also one of the kitties that has pretty textbook responses to Prozinc. And 3: I know how to monitor him and I am comfortable steering if he started to go low.

For a cat that is newly diagnosed (less than six months), I wouldn't recommend shooting a full dose on a green. I'd say to stall, then if that didn't work, feed and retest and shoot late, or give a reduced dose. If there is a lot of data from previous experiments you could possibly do it eventually, but there is definitely a risk and it should never be done if you can't monitor carefully.

At this point Romeo is still new enough that either skipping or reducing was the right decision. And I always hope that kitties will just go into remission before they cross into "long term" land :bighug:
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Such good perspective @Djamila , thank you! In the event of an unsuccessful stall, would you shoot based on a post-food # or wait until the food wears off-- +2'ish? And then is your 12/12 schedule just el-screwed-o until you can ease them back? I realize these are hypotheticals, so if there are too many 'it depends', I'd understand, lol.
 
Jenna Josie said:
It’s so hard to know what to do! We’ve had to stall 3 times with low PS numbers just this week — Friday am, Saturday pm, Monday am — and I think I got it wrong every time! OTOH, I got it wrong in the same way (shooting lower reduction), so that should tell me something! And OTOH yet again, went with a higher reduction on a similar stall on 8/23 and had to steer her half the night ...

So yeah, @HuskerGyrl , I’m right there with you!
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Sooooooo hard!! Wrong/Shrong... any day that I don't kill my cat is a good day, lol... and I'm trying to remember that we are doing absolutely everything we can to help these babies and that's really all we can do. For many kitties (and their humans) diabetes is a death sentence... which I sometimes remind him of, as he's purring and headbunting after testing with some crazy number. He knew what he was doing when he picked me, that's for sure!

On the upside, I get to start his schedule fresh this morning at MY desired time... and let's be honest, my needs don't seem to factor into his little body's cooperation in the slightest these days so there's that! :D
 
HuskerGyrl said:
Such good perspective @Djamila , thank you! In the event of an unsuccessful stall, would you shoot based on a post-food # or wait until the food wears off-- +2'ish? And then is your 12/12 schedule just el-screwed-o until you can ease them back? I realize these are hypotheticals, so if there are too many 'it depends', I'd understand, lol.
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Of course it depends. ;) If the stall doesn't work and you feed, then retest after the food has increased the number, then the hope is that you can give the typical dose based on the data from previous cycles. Does that make sense? I feel like I'm not explaining it very well.

Basically prozinc wears off after 14 hours, but you don't want your schedule to be that far off, so you give the food to speed it up a little.

A couple of things in using this strategy: First of all, dosing consistently in the cycles leading up to it is important. Inconsistent dosing leads to inconsistent numbers and responses. So if the dose has moved around a lot, it's harder/impossible to predict what will happen. Second, if the kitty is frequently getting long cycles so the PS is too low to shoot, then the regular dose needs to be decreased to balance out the cycles again.

Hope that makes at least a little sense. Please ask for clarification if my rambling is too hard to make sense of :confused: It's been a long day :coffee:
 
Stalling without feeding is the better way to do it.

If you feed first, you're essentially creating "fake" data. You're shooting on a pre-shot that you caused, not the pre-shot that the insulin actually created. So you have to consider that and figure out if the regular dose needs to be adjusted. You also have to remember that you created that PS and use the "real" data for that cycle when you're looking for patterns. So you can do it once in awhile when you have to, but it can skew your perspective on how your kitty is doing.

It's a technique that Kris used fairly often when Teasel was on Prozinc because his numbers were all over the place and it was the only way she could keep him steady. But for most cats, and as a regular practice, it's not the way you want to go. Once in awhile though, it works.
 
Got it! That sounds ... complicated. ;) I’m going to pretend I never knew this was an option. Got my hands/head full with variables as it is! :D
 
I'm sure Kris can explain it better than I can! It's really not that complicated -- I think I'm just struggling to put thoughts together today.
 
An early night and lots of :coffee::coffee: tomorrow morning? That’s my own plan. :) (Wrong thread, but Josie just tested 204 at +3, which hopefully means a nice surf in the blues and is good enough for me after today’s midday surprise mini-drama!)
 
Jenna Josie said:
I’m going to pretend I never knew this was an option. Got my hands/head full with variables as it is! :D
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Literally, made me LOL!

@Djamila I get the concept I think, but yeah -- don't love that you're still shooting fairly blind (excepting precedent), but if I can be around/up to watch/check him -- definitely worth doing vs a NS (she says bravely in theory) ... it's the bloody overnights that trip me up.
 
I know the way Kris did it was to feed, wait 45 minutes, then shoot a reduced dose. That way, you have food on board, you can get an idea of what that food spike is going to bring the cat up to, and then shoot a dose based on that because you know about how far they have to drop from that number. Kris can tell me if I'm wrong (and I may be) but I think the theory is while on a normal day you are kind of going off what you know about the cat's normal patterns (the cat is at a good number and the food spike will bump him further so the shot shouldn't cause the cat to go too low) on a stall with food and then shoot day, you know the cat is too low to shoot, so you can know FOR SURE what the food spike is and how low the cat has to go with a shot on board. Therefore, you shoot a reduced dose knowing that the cat is lower than normal, but you have a better idea of what will happen since you know EXACTLY where the food spike is bringing them.

That may be wrong (it's kind of what I inferred) but that's how I always saw it. :) Again, that's sort of an advanced technique to use and one that does require some monitoring and time that you just may not have. You never have to use it...it's just another option for your toolbox.
 
Yes, I did this with Teasel when he was on ProZinc because he had crazy cycles a lot of the time. Rather than skip on a low PS or get caught up in a lengthy stall I'd feed him, wait about 45 minutes (in case he was hell bent on dropping further - never did though), retest him to see where he was and often give a very slightly reduced dose because the full dose had left him too low at PS. It's not something you want to do often but it can be helpful if your time is tight or you don't want to skip a dose.

I had to break the rules often because Teasel is very unpredictable. He's on Lantus now and I still break rules! ;)
 
Seems like a good reason to get more +1 and +2 tests, which I don’t have many of. Having them would provide data for % BG increase the food spike creates.
 
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