Klinger was 70 this morning

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Marcy & Klinger (GA)

Marcy & Klinger (GA)

Member Since 2010
Hi all,
Klinger was 70 at his normal AMPS time. I fed him and waited and at 4:30 he was 102. I shot 1 u. Of course his PMPS was 373 (back in the pink :roll: ) and we reduced him back to 2.50u. Not sure if this is the right thing to do either. He had a great surf yesterday in the 100s, but he seems to go a little lower over night. My vet suggested reducing his PM dose - 2.75 in the am and 2.25 in the pm. I don't think this will work with Lev because of the shed...right?
We didn't have great results trying to shoot in between the 2.75 and 2.5 because of variation with the shooter. Any suggestion?
 
Marcy fwiw I had another very experienced lev user tell me i may end up shooting tom different doses am and pm.
I think (this is just me) the term 'shed' might be a little misleading. it's not like a dose of insulin is in there waiting to be used, it's more like this insulin has 24 hours staying power...less as you hit the 12 hour point but it's still in the body. shooting less or more at any given dose will impact that 12 hours.
am i making sense for you?
this is my understanding.
 
IMO, lev really doesn't work on non-consistent doses. The Lev (and lantus) "shed" is circulated insulin molecules bound to other molecules in the blood (in the case of Lev to albumin), but they bind and unbind repeatedly. They can only be used in the unbound state. Building the shed is a process of reaching a saturation point where that individual cat's metabolism is using/needing insulin at a consistent rate that equals the unbound insulin. For every cat this will be different. If you shoot too little insulin, even a little bit, that saturation decreases and BG goes up. If the next shot is a bit higher the shed is refilling, BG still goes up. But if that shoot is too much it catches up and probably gives you a late nadir. Then you shoot less and the shed is depleted and the BG goes up again. So you just ride the teeter totter up and down. Ideally, you find the midpoint and shoot that consistently and the numbers even out.

There are reasons to shoot different doses because the shot schedule is not 12/12, but you would have to spend time gathering data to see what will work for your cat. Lori, I think this is what you have to deal with, right? And it would probably mean that the cat is not regulated as well as it could be on a consistent 12/12 schedule. You do what you have to, though, to go to work, etc. Vicky works with having to move shot times every week for her work schedule. Always remember when you do this that shooting early = a dose increase and shooting late = a dose decrease.

Marcy, I think you will find that the 1u dose this morning is going to mess things up for a few cycles. The 373 tonight was probably due to too little insulin more than the 70 - but there could be a bit of a bounce in there too. Trying 2.5u again seems like a good plan, but now you will have to let his shed reset and the dose settle.

Klinger may be +11 or +12 nadirer. Melissa's PK is a late nadir kitty. The 90 or the 70 is a great nadir. If he climbs from there, then you know it is safe to give the full dose. But until you have more data a bit of decrease is good - but not 64%. Next time try a decrease of .25u or no more than .5u. Those would be the standard decrease for a nadir below 40, so should be fine for a 70 or 90.
 
mars72 said:
Hi all,
Klinger was 70 at his normal AMPS time. I fed him and waited and at 4:30 he was 102. I shot 1 u. Of course his PMPS was 373 (back in the pink :roll: ) and we reduced him back to 2.50u. Not sure if this is the right thing to do either. He had a great surf yesterday in the 100s, but he seems to go a little lower over night. My vet suggested reducing his PM dose - 2.75 in the am and 2.25 in the pm. I don't think this will work with Lev because of the shed...right?
We didn't have great results trying to shoot in between the 2.75 and 2.5 because of variation with the shooter. Any suggestion?
Click to expand...

I don't blame you for reducing the dose today. I have done it myself when I knew I wasn't going to be around. Usually it is a mistake but we do what we are comfortable with doing.

I think you were finally getting a breakthrough of sorts when you shot the 120 yesterday morning after he did go down nicely to the 90's at +11. You shot low to stay low, as the saying goes, and it worked. :)

I was wondering though, did he eat the same amounts during the day this past weekend? I was going to ask in your other thread if you could list the type of food you feed in your SS. I know you change it from Fancy Feast Classic to raw so was wondering if you could just list that in your spreadsheet, which ones you feed on any given day?

As far as dose, I would like to see you stick with the 2.75 a little longer if you were going to be home, but you can't be.

You said that half way between 2.75 and 2.50 was difficult because of variation of the shooter. I can understand that completely because my hubby and I have the same problem with those in-between doses.

So I would probably just stick with the 2.50 dose since you can't be there during the day. I don't know what else to tell you because that doesn't seem like enough. Maybe answer some of the food questions and we can figure it out from that angle. I would definitely not go with a different dose morning and night though. I just can't see that working well with this insulin, especially at this stage of the game with Klinger.
 
In order to shoot between the 2.5 and 2.75, you could get a sliver of paper the width of the length between the two amounts. Wedge the top pf the sliver of paper against the bottom of the lip of the syringe at the top (just above the .0u line) so it is snug against it and pull the dose to the bottom edge of the sliver of paper.

That way you could measure it pretty consistently and stop trying ot follow syringe marks tha may be .1 or.2u off from syringe to syringe....

Just an idea.

It's my opinion that the high following the 90 was sokme bounce from going lower than Klinger is used to, not that there was not enough insulin.

It is my understanding that the effects of shot A won't be seen in shot B, but rather in shot C or D....one or two cycles after it is shot.

You'll probably see some wonky numbers for the next few cycles from the dose changes, but I think it will even back out soon...be patient.

I also would think that this insulin is not a good candidate for changing doses between AM and PM unless you are really close to OTJ and shooting teensy micro doses on pretty low BG's...then you are pretty much at the whim and mercy of the insulin gods, but right now where you are, I think Klinger would benefit from consistent dosing...
 
Thanks for that explanation Sheila...I understand it better now. Tom has been on a consistant 12/12 for going on day 6 now. It took a while to find the hours that work best.
Someone (using lev for a few years now) did tell me that if Tom was always higher in the am it would be a possibility to shoot higher in the pm. I get your explanation tho' and appreciate the logic.
I have'nt ventured into doing anything like that yet,,,and now doubt that I will.
 
Thank you everyone for the great explanations and feedback. You ladies are AWESOME!
I won't be shooting a reduced dose at night.

pamela and tigger said:
I was wondering though, did he eat the same amounts during the day this past weekend? I was going to ask in your other thread if you could list the type of food you feed in your SS. I know you change it from Fancy Feast Classic to raw so was wondering if you could just list that in your spreadsheet, which ones you feed on any given day?
Click to expand...
He actually ate more over the weekend. He finished his 1st meal within the hour. Usually he leaves over 1/2 of it and grazes throughout the day. I need to update his profile...he stopped eating the raw food a few weeks ago. Sorry about that. He gets a can of beef for his 1st meal and then I leave another can of chicken out for him when I leave for work and the same food at PM feedings.


Technically, I'm working from home because we've had another snow storm. So, I better get back to work! :roll: Hmmm I just tested him and he's 79 at +7, so is this wonky numbers from the dose change???
Again, many, many thanks!
 
Gosh that curve was beautiful on the 6th! Whew doggies!

Um, today?...I wouldn't even hazard a guess after the dose changes and whatnot...watch he doesn't go too low- maybe soften the low with a LC snack-age, but otherwise, give it a few days IMO for the 2.5u to settle out and see what it will do.

do you feed Fancy Feast? Just curious when you mentioned beef then chicken...you mean cat food beef and chicken or just a can of beef and a can of chicken? ( have to ask for clarity...I assume it is cat food ;-) )

Was wondering if the raw just didn't work out, didn't like it or expense...? I made my own for awhile....60 pounds at a time! LOL!

But some of the cats that loved it, thre w it up in half an hour, other waitied 4 hours...eventually some didn't want to eat it, others did, but it was too much trouble for my batch of critters...I prefer they all eat the same thing and have it donw with.

now the dogs are enjoying the last of the raw in frozen "burger" patties form time to time...they LOVE it, they never throuw it up and they never refuse it and they always ask for more! Even my picky one! (cats get LC friskies canned, now)
 
do you feed Fancy Feast? Just curious when you mentioned beef then chicken...you mean cat food beef and chicken or just a can of beef and a can of chicken? ( have to ask for clarity...I assume it is cat food )

Was wondering if the raw just didn't work out, didn't like it or expense...? I made my own for awhile....60 pounds at a time! LOL!
:shock: 60 pounds! :shock: That's a lota meat!

Thanks, Melissa, yes, I was referring to him eating Fancy Feast. One can FF beef, one can FF chicken. Oddly he didn't like the combined FF beef and chicken.
He was really liking the raw rabbit and then one day he just stopped eating it. I tried a few more times - to get him interested in it again and he would just walk away. So, back to the Fancy Feast. I still have some partial bags in my freezer. The cost actually worked out to be about the same give or take a dollar.

Anyone have any insight on today's numbers?
AMPS 206, 2.5u
+3 200
+5 145
+7 79
+8 90
+9 100
+10 114
Click to expand...
Click to expand...
 
60 pounds! That's a lota meat!
Click to expand...

LOL! yeah- but there's alota cats here! 10 3/4, or is it 11 3/4? ...no, 10 3/4 cats here...and 2, 60# droolers. If I recall correctly, they ate 3 pounds and some change a day...or was it $3.18 a day to feed them? Anywoo...yup...thats alota meat!

Anyone have any insight on today's numbers?
Click to expand...

Um- they are GREAT! Wow!

I see you shot the 2.5 on 181 PS, right? If it were me, I think I'd get a +2 or +3ish to make sure he goes up. If he is going down, you better stay up! LOL! But I doubt he will.

If the numbers are not quite high enough for comfort before bed, I think I would set my alarm for +4 or +5ish as it looks like nadir was +7ish today, right?

Make sure you leave a snack out for overnight, too...(I think you said you do, anyway)
 
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