Kitty 4/19 amps

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kse

kse

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Kitty's amps this morning was 322. I shot 3 units.

I like the low pinks to shoot on. But, I want someone to explain to me how something concerning dosing works.

When I have had mid 400 preshots numbers and shot 3 units-- I have had 300 point drops. How is it that I can shoot that same 3 units into low 300s or high 200s and not get the same drop? This has been the hardest thing for me to grasp about dosing. I think this is why it is hard for me to shoot a consistent dose into lower numbers. Does my question make sense? Thanks for the feedback.

I will set the fluids up this afternoon!
 
Kim,
You are only a month from a serious DKA ..... the #'s leading up to and for awhile after, are all messed up. Then the external factors need to be put in the equation .... any other health issues? how is she doing every time she is tested, is she testing positive for ketones ..... the list is endless. Maybe in time she will settle down and always be the same on a precise dose, some do/some don't. Is she playing, eating, happy? then you should not worry so much, you are doing everything you need to, I have found the SQ fluids help a lot! I was ready to throw a party because I had a day of yellows! ...... then next day, everything the same, all magentas! So now I'm looking more for happy, playing and eating ......
Nancy and Payne (who is ...... )
 
I don't know how or why it works. It is another one of those "every cat is different" things. Some cats respond with a relatively equal drop, and some don't.... most don't actually.

Did you ever get those follow up thyroid tests back?
 
Yes--negative for Hyper T. I don't have the reports, but the vet assured me the "free" test was negative.

I am glad the preshot numbers are coming down--- and I know there is movement from spot checks. I just get anxious about shooting the 3 units into lower numbers---but, so far so good!
 
Don't think so much as you are shooting the lower numbers, as you are shooting to maintain the lower numbers ..... it seems years ago that I started and had a million questions ohmygod_smile and someone once said to one of my endless questions, you are not shooting this #, you are shooting the # that's coming. Not sure if that makes sense half the time but this is an imprecise science, and we are dealing with cats but don't tell Payne I said that :) we have gotten so close through all of this, I admire greatly how hard she fights!
Nancy and Payne .....
 
Payne is GREAT--- a true survivor!!! I admire her will and determination also!
 
One way to think of it is in percentages. You aren't looking at absolute #s between PS and nadir, you are looking at the % change. You want something in the 65% range, give or take maybe 5%, and from what I have seen that seems to work well with PZI. Steeper is usually too steep, shallower usually doesn't get them in good enough #s, with some exceptions of kitties who are very well regulated and don't zoom much.

Another way to think of it, following on what Nancy said, is that their #s often zoom once the PZI poops out. If you look at data at +1 and +2 that can give you a sense of their zoom rate, and that is what you are shooting into so to speak. So if you have for instance:

AMPS 350 3u
+1 400
+2 450 --> shot starts kicking in here
+6 150
etc

vs:

AMPS 200 3u
+1 300
+2 450 --> shot starts kicking in
+6 150

you can kind of see how it might work. The shallow curve in the second example is an illusion really b/c of the zoom. Of course it isn't that straightforward, and zoom rates can be variable and hard to predict, and the zoom can be happening at the same time the shot is kicking in so you may never actually see it in the #s, but hopefully that gives you some idea.

I have always thought of it as sort of a pressure variance, like a cork bobbing on the water. It takes a certain amount of pressure to keep the cork just under the water surface - if it is completely on top of the surface vs. just barely above it, the amount of distance it will travel is a lot different, but with the same cork & water it will take the same amount of pressure to keep it where you want it. That's probably bad science :) and a bad explanation :) but that's the image that helped me. Blue PSs have more upward pressure and the insulin is counteracting that rather than literally moving the #s down all that much. Of course that is ECID and depends on zoom rates & such whether or not that is true for a given cat.

The biggest thing I think to keep in mind is that if you are not seeing green nadirs or low blue ones, there isn't a compelling reason to lower your dose on PSs above your no-shoot. If you hit a nadir of 50 then yeah, lower that dose if the PS is a lot lower than you are used to, and collect data before testing higher doses. But if your nadir was only 250, you have so much room to go before you are in risky #s that IMO there's no need to lower the dose if the PS is above the no-shoot. (Barring cats where there is reason to believe the higher nadir is due to a dose too high.)
 
Looking at her SS, do you think you will be able to get in a nadir spot test anytime soon? I'm worried about her sitting in higher #s.
 
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