Kitty 8/4---shoot or wait?

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kse

kse

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8/3
pmps (+12.5) 347 shot f3.7---they fed her at the vet and did not have her food---have no idea what she ate!
+2 382
+4 286
+5 259
+7.5 233

8/4
amps (+12) 356 shot f3.7
+3 283
+5 259
+8 316

mdms 316 shot f3.7
+3 290
+8 268

pmps 268 shot s3.7
+1 287
+3.5 223



Good Morning!

I have no idea what we are doing right now! I shot a 12 hour cycle last night. The curve looked like a typical Prozic curve, not dramatic, but a late nadir at +8. So, out of respect to overlap and the 91 preshot the day before, I did not shoot into that +8 reading.

They fed her yesterday afternoon at her pmps at the vet--I did not take food, so I do not know what she ate. She is very carb sensitive, so any increase in carbs "normally" has a dramatic increase on her readings.

We are just testing and trying to figure out where we are--hopefully as we collect data, the direction we need to take will become clearer.

I am prepared to continue tid or bid--- whatever is necessary to keep her in the best numbers.

Have a Great Day!
 
Re: Kitty 8/4

Paws crossed this is the start of something good. My head spins sometimes when I try to follow all that you do. Such dedication.
 
Re: Kitty 8/4

Wendy--what you are saying makes sense, because it appears (for now anyway) that she is getting more duration. So, if I shoot tid-- I think I would want to cut the dose back. I am on my way into my office, but I am going to come home and check her at +8 and see if I want to shoot then or wait until +10 or +12.

With my work schedule, bid would be a tremendous help---but, I am not interested in the reds and blacks if we can avoid them. Something seems to have changed--and I do think the additional insulin every 8 hours is relevant to the change. She seems to feel good today!

I want to capitalize on the "change" if possible---I have no idea if she will be 400 at +8 or 200!!!

At least, I have hope after the two lower cycles that maybe she can get in better numbers.

Thanks for the help!
 
Re: Kitty 8/4

My educated guess (not being a vet, mind you) is that the overlap you get with TID really helps some cats whose bodies process insulin faster than others. As the pancreas heals due to getting insulin more often and not having those wild swings, you end up needing less. But that doesn't fix the fact that they still process insulin faster, so if you drop back to BID dosing you lose the benefit of overlap and keeping blood sugar more consistent. Eventually pancreases may heal enough that you can go back to BID dosing, as some have apparently done, but for others, TID I think may be necessary long term, especially if a chronic inflammatory condition is present, such as pancreatitis.

Don't know if that makes sense scientifically or not, but it seems like a reasonable guess to me. All those digestive enzymes rolling around in the bodies of pancreatitis cats play havoc on so many of their systems, so it makes sense to me that their bodies would not be able to process insulin the same as cats without that challenge. If the inflammation goes down or goes away, then they may not need the extra support that the TID dosing supplies. I do think that better control of blood glucose is key for pancreatitis cats who are also diabetic as it helps the pancreas work a little less hard. This is one reason why I think TID works so well for some, or a switch to one of the L's for others when cats have inflammatory processes going on.
 
Re: Kitty 8/4

Tested at +8 and she was 316--so I shot the 3.7. I will test her tonight and see what happens. She might could have lasted the 12 hours, BUT--why chance it?
 
Re: Kitty 8/4

Trying to keep up with it makes my head spin too!

:dizcat :dizcat :dizcat
 
+8 from midcycle test---268---would you shoot or wait?

Keep the pressure on? Am I being too aggressive?
 
Me too!!!

:dizcat :dizcat

I'm sure you will get it figured out!!!!! You might play around with shooting at something like +10s if you can manage the schedule, and see how she does. I don't know if that's the best route or not, just something I would consider if it were me.
 
Done deal---shot S3.7-----I hope I made the right decision. Truly, I gave fluids and I think she would have surfed until +12.

I will keep her tested. I haven't slept all week---why start tonight?!
 
Ok, you shot on a 261, she bounced for 2 cycles and then gave you the 91, shot up to a great big black bg bounce and then surfed the blues for what almost 12 hours?, and now has bounced for 2 more cycles.

It's your call, if you shoot can you test? Or you could reduce the dose to minimize the drop and maybe the bounce. Try to make the transition a little smoother for both of you.
 
There's no evidence of bounce after the 261 though, right? Maybe I'm missing it, I don't see any steep drops or low numbers, or even anything to cause liver training. The black number looks like liver training to me, and since that was a later shot, seems like that would be expected anyhow, given Kitty's "tendencies" :lol:

I'd consider reviewing the dose though on this: You shot on a black PS at +13 (?) and got a drop to a really nice blue nadir. So drop of about 75% (a little high, but not scary high). When you went back to TID after that, the numbers are actually worse, which makes me wonder if the dose is now a little too high for TID.

I'm not really sure and am not a TID expert at all, and given that my kitty had fairly long duration, maybe the same rules don't apply, and maybe Kitty's longer duration cycles are just wonky ones and not a sign of anything more. With Bix though I know when I got a breakthrough, I had to literally reduce the dose the next cycle, the breakthrough dose was too much for a maintenance dose, and we stairstepped down in 0.1 and 0.2 increments almost every cycle or two for several days as he stayed in good numbers and his liver settled down. Now that's not going on with Kitty consistently enough to expect that level of change, but just kind of musing & brainstorming.

Definitely don't want you to lose progress, I don't know what the answer is. It does make me a little nervous though if she got a 75% drop on a +13 shot, and +8 is like a dose increase, so the math makes me nailbite_smile . Even on 200 PS of course technically she could tolerate that level of drop and still have a safe nadir, so maybe I should just chill out. :mrgreen:

Another thing I would consider if you get blues again is trying As Needed dosing - shoot as soon as she is over 200 and see if you can keep her in better numbers longer. She may not be consistent enough to do that, but if you can, it can be magic.
 
Ohmygod--- I know you really love your kitty, but how do you keep all this straight in your head and still get to have a life? Thank god for this web site and its devoted members. Don't you wonder how people manage this alone?
 
Didn't see Yin's or Yang's comments and shot the 3.7 into the 268. I did consider cutting the tid dose back-- the dose was skinnier than the others--but, in the same range. I honestly think she would have surfed pretty good until +12--what was scariest to me, was the 268 was the lowest test I had on the cycle. It appears since the green +8 and blue surf, her nadir has shifted a couple of hours later-- which means it appears her duration is getting better.

I am flying by the seat of my pants, and truly have no idea what I should be doing at the present time! I don't want to lose any positive results.....even if we just settle back into bid without zooming, I will feel the tid has been worth it.

I will test tonight--but, I am a little nervous!
 
Yeah, it's tough. TID is out of my comfort zone, so hopefully some of the TIDers will chime in. I might pay more attention to rising numbers with what you are seeing lately. Can you just take a week off work and deal with it all LOL? I don't know how anyone manages this stuff while holding down a job too!
 
My feeling is that if you are going to shoot TID, you need to reduce the dose given what has been happening with the longer duration. If you don't want to reduce it, then you need to do what Joanna suggested and go to "as needed" which makes the schedule unknown. What I've found though is that there is a big difference between 8 hours and 12 hours, and those last four can get really, really long when you are seeing them zoom. Maybe Kitty can work her way back to BID but I'd be nervous continuing to give the same dose you've been on a TID schedule given what has been happening.
 
kse said:
Didn't see Yin's or Yang's comments and shot the 3.7 into the 268. I did consider cutting the tid dose back-- the dose was skinnier than the others--but, in the same range. I honestly think she would have surfed pretty good until +12--what was scariest to me, was the 268 was the lowest test I had on the cycle. It appears since the green +8 and blue surf, her nadir has shifted a couple of hours later-- which means it appears her duration is getting better.

I am flying by the seat of my pants, and truly have no idea what I should be doing at the present time! I don't want to lose any positive results.....even if we just settle back into bid without zooming, I will feel the tid has been worth it.

I will test tonight--but, I am a little nervous!
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Kim, I've told you before that I won't shoot unless I'm sure she's rising. Given the numbers you posted it looks to me like she wasn't. If I get a number lower than the prior tests, I always do a rising number test before I will shoot again. Today, for example, after Shaikha's fever broke, she ended up surfing blues at +8. So, I waited since she'd dropped from +6 to +8. She started rising not long after that, but I ended up shooting at +9 once I was sure she was continuing that trend. In the past, shooting on a falling number has really compounded things in a way I wasn't comfortable with (like a steep drop). The one rule I try to follow always is making sure she's going up before she gets more on this schedule.

Like I said, you either cut back the dose (which likely will cut duration some) or you go to a longer dosing interval, but I don't think you can continue to shoot the same dose given what has been happening.
 
Well, good thing I just bought a new bottle of test strip--- I have the HC FF and Karo out.......you guys are really making me nervous.
 
+1 287 I did feed her at shot time.....but, at least she isn't dropping...
 
I don't know why you are nervous, maybe you should cut your dose but your #'s have backed up what you've done. We shoot all the time when we don't know if the number is rising. When we shoot in the AM, is it a rising #? Do we always do a test a few hours before a shot? If you use the 20% variance in meter readings, all the numbers can line up.

What we don't understand is why she threw a 91?? I think the t.i.d. is helping but you have only been doing it 3 weeks, I think it looks good ..... except it happened when you were gone.
 
You know how to handle this Kim. I don't mean to discount what the others say, I think the advice is sound, but there is a certain amount of flying by the seat of your pants no matter what, and you could hardly be more dedicated and responsible in taking care of her. So relax and know you will do fine.
 
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