Low AMPS, but skyhigh PMPS - What dose?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Hercule's mum, Aug 4, 2020.

  1. Hercule's mum

    Hercule's mum Member

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    Hercules is giving me quite low AMPS, below the cut off for giving him a shot. I tried to stall his food, but he is ready to pin me dow and chew my ears....:D Also, my thinking is that with hif BG at 76 I ought to be giving him food?

    The problem is that if I skip the dose, or reduce it, he goes into really high numbers by his PMPS.... Any suggestions of what to do?:arghh:
     
  2. Hercule's mum

    Hercule's mum Member

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    He eats a lot during the day, and there is no food available at night.

    He and his buddy are binge eaters....
     
  3. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Have you thought of an auto feeder during the night? It is important to try and feed the same amount of food during all the cycles....not all during the day and none at night.
    I see you have given 1 unit at +2. That will mean you will need to give the next dose 1 3/4 hours later.
    I would also try and get at least one test in during the pm cycles. They are just as important as the am cycles.
     
  4. Hercule's mum

    Hercule's mum Member

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    Hi Bron,

    Thanks for your message.

    Yes I have been thinking about an autofeeder. But I also don't know how much food he can actually have. He has lost weight before his diagnosis but I think he is recovering well. He always acts like he is starviiiiing... How do I come up with an ideal weight and amount of food?

    So do you think the food distribution is the issue here?

    Would it be wrong to give a lower dose at night? Prozinc user.
     
  5. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    I am not a Prozinc user so you would need to ask @Deb & Wink that question.

    If you feed about the same amount of food each cycle you are giving your kitty the same amount of food to work with the insulin each time. If you give most of the food during the day and not much at night you will get a big variation in the BGs.

    A lot of cats lose weight when they are first diagnosed. That is because they can’t utilise the nutrients in the food. Once they are getting insulin and the BGs come down they will start to put in weight.
    To work out how much food he needs you can use:
    20 calories /lb healthy body weight/day OR
    Calories per day = 13.6 x optimal lean body weight In lbs +70.
     
  6. Hercule's mum

    Hercule's mum Member

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    I think it would be quite hard to spread food equally throughout the day. I have been lucky that the diagnosis happened while I was working from home, but it (hopefully) won't stay like this forever....

    If I could schedule 4 equivalent feeds a day (adding one at night by an autofeeder) would that work?

    Also, since there is another cat in the house, how to make sure the right cat cats the evening feed? Anyone with multiple cat household could advise?
     
  7. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    You don’t have to spread the food over the whole day. It is usually better to feed most of the food in the first half of the cycles when the insulin is working the most.
    I understand how hard it is in a multi cat household. Are you awake for the first 5 or 6 hours of both cycles?
     
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  8. Hercule's mum

    Hercule's mum Member

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    I'm afraid not :oops:... I am a 9 hours sleep girl..... I have been planning a PJ party, but I keep getting worried I'll make a horrible mistake because I am not thinking clearly....I could possibly do 4 hour after PM shot evry now and then :oops: Am I a bad mother?
     
  9. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    You are not a bad momcat! You just have a confusing situation going on.
     
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  10. Hercule's mum

    Hercule's mum Member

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    Aghhh.... He just sits by me crying for food the whole day long.... :banghead: I am weak! Is a good thing that I a was usually not home, otherwise he would have gotten enourmous! :woot:
     
  11. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Hercules is not regulated yet. Once he is his appetite should diminish. I would feed him more snacks. There should be more solutions so hang on for more replies.
    A timed feeder may be in your future. No doubt Herc. loves his foods. There is a balance and a tricky one at that.
     
  12. Hercule's mum

    Hercule's mum Member

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    Help, someone!

    I just for a walk for a couple of hours and came back to a meassurement of 3.2 :woot:
    Gave him food and meassured again (5 minutes later, just to confirm the reading) and it gave me 3.5
    Is this a hypo, do I go ahead and give him sugar. He seems ok, behaviour wise and ate all his food and is happy to eat more...
     
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  13. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Give some high carb food and retest in 30 mins. As long as he isnt showing symptoms. If he gets lethargic then give honey or Karo tagging some folks to be sure.
    @JanetNJ
    @Nan & Amber (GA)
     
  14. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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  15. Hercule's mum

    Hercule's mum Member

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    Thanks for answering me, JT. :bighug:

    Just retested him and was 5.2. I did panick and gave him a lick of honey....
    I am just getting really confused about what to do going forward....
     
  16. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    I would test again in another 30 mins. Just to make sure its not just the honey. ;)
     
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  17. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    @Deb & Wink Hi Deb do you think you can take a look at Hercule's SS and dose

    Thanks so much :bighug::cat:
     
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  18. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    lol Diane I can never remember who knows what insulin...I think I'm hopeless. :p
     
  19. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    No you're not, I went to the Prozinc forum and looked to see who gave advice lol
     
  20. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    AND I USUALLY do the same. Brain not functioning lately due to heat? Thats my excuse and I'm sticking to it.:p
     
  21. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Time for the next re-test?
     
  22. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Also, even without a Prozinc user here, pretty sure Herc has answered the dose question-- he wants less insulin :D.

    It looks like you shot 2hrs late this morning? I think you have an hour or so of wiggle room with Prozinc, but even so you will be shooting an hour later than your usual time tonight (that's assuming he comes up enough, that is).
     
  23. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    With the heat we are getting I believe it :joyful:
     
  24. Hercule's mum

    Hercule's mum Member

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    sorry feeding kids dinner. Just measured him again, sharp up...
     
  25. Hercule's mum

    Hercule's mum Member

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    Hi Nan, It looks he will come up enough for his Pm shot, but how much to give him? If he has 4.2 12 hours after his night shot (as he did this morning), how low is he going in the middle of the night? Yet he still rebounds quite high at the end of the day.... I'm tempted to give him only 1U this evening, what do you think?
     
  26. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    He has at least earned the 0.25U down to 1.0U. That's probably his new dose going forward, unless a Prozinc person comes on to suggest something different (he went this low on the reduced dose of 1.0U this morning, not sure if that makes a difference for this insulin-- I'm a lantus/levemir user).

    The rebounds you are seeing are perfectly normal-- he's just not used to these low numbers yet. His bounces are relatively short, at least!

    Yes, he may be going lower at night. If you can possibly get some nighttime tests in, that would be the best, but if not that's another reason to reduce for a while. Better to run a bit high than go too low when you can't monitor! Although again, I suspect the "highs" in Hercules' case are reactions to low numbers.
     
  27. Hercule's mum

    Hercule's mum Member

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    Thanks Nan, I really appreciate the reassurance!
     
  28. Critter Mom

    Critter Mom Well-Known Member

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    It might throw some small bit of light on night time cycles to grab a 'before bed' test each night. It's also a very wise safety precaution.


    Mogs
    .
     
  29. Hercule's mum

    Hercule's mum Member

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    Will do, Mogs. I'll need to move his shots a bit earlier slowly, but I'll do it soon!
     
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  30. Critter Mom

    Critter Mom Well-Known Member

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    Even if there are only a few hours between the PMPS and the 'before bed' test (e.g. +3 hrs) it can often give an early warning on where BG might be heading later in the cycle. And all data are good data. :)


    Mogs
    .
     
  31. Hercule's mum

    Hercule's mum Member

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    And here it is the really high PMPS: 26.5!
     
  32. Critter Mom

    Critter Mom Well-Known Member

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  33. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    We sooooo need some kind of pogo stick or trampoline emoji on this site!!!!!

    [edit: and Mogs comes through!!!]
     
  34. Critter Mom

    Critter Mom Well-Known Member

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  35. Hercule's mum

    Hercule's mum Member

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    LOL! :)

    So should I expect this bounces all the time? I tought it was a rare thing, or should I expect this to happen every night and not put too much weight on these high numbers? They scare me....
     
  36. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Well, hopefully not all the time as in forever, but yes, it's pretty common in early days of FD when the cat has gotten used to high numbers before diagnosis. Eventually his body will figure things out and settle down... eventually. Nothing to do until then except wait out the bounces!
     
  37. Critter Mom

    Critter Mom Well-Known Member

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    BG-wise, there's only one thing worse than the way your heart sinks at seeing a really high reading, and that's the way it jumps up into your throat at the sight of a really low one. :nailbiting:

    Bouncing's not uncommon. Some cats don't bounce much at all, some bounce a bit, and then there are those who could win successive Olympic golds in trampolining. :rolleyes:


    Mogs
    .
     
    Last edited: Aug 4, 2020
  38. Hercule's mum

    Hercule's mum Member

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    It looks like Hercules will be a contender for the next olympics!

    Thanks all for helping me through a really stressful day!
     
  39. Deb & Wink

    Deb & Wink Well-Known Member

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    Any time your newly diagnosed cat drops into those neon green colors on the SS, it's time for a dose reduction of 0.25U. Doesn't matter which insulin you are using. This rule holds true for all the insulins.

    The only exceptions are cats that have been diabetic more than 1 year. Or cats that have higher ketones present.

    Some cats don't hold on to the good BG numbers with a dose reduction. But FIRST, you have to let the bounce clear. That can take 3 to 6 cycles (12 hours in each cycle). So be patient before deciding to increase the dose.

    Prozinc likes some consistency in the dose also, so no to the question about giving a different amount of insulin at night. You want to find a dose you can give every 12 hours.

    Don't concentrate too much, or worry too much over the high BG pre-shots. They should come down. We look at the mid-cycle nadirs to tell us if a dose adjustment is needed.

    You just did a food change too, to lower carb food. So you are likely to see some more low numbers, once the bouncing clears. Lower carb food can make a BIG difference in how well a feline diabetic does.

    Oyumpics contender in the high jump! Hercules!!!!! Go give yourselves gold medals, for doing such a good job managing this stressful situation.
     
  40. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    @Deb & Wink , is the reduced dose going forward 1.0U or (because only 1.0U was shot this morning) 0.75U? On Lantus, it'd be 1.0U (on the assumption that most of the action today was due to the 1.25U depot from previous shots), but I was wondering if the logic would be different with the in-and-out insulins like ProZinc?
     
  41. Deb & Wink

    Deb & Wink Well-Known Member

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    Good question Nan.

    The reduced dose going forward should be 0.75U. No depot with the in-and-out insulins like Prozinc.

    The reduction is taken because of the 3.2 mmol/L (58 mg/dL) at +8 from today's AM cycle 8/4/20. (or 4/8/20 in European format).
    Dose reduction is done with Prozinc, based on the most recent dose, which was the 1U. So 1U - the automatic 0.25U dose reduction would bring the dose down to 0.75U.

    p.s. I would not stall for more than 1 hour with Prozinc. If the BG level is not high enough after your 1 hour stall, than I would recommend either skipping the shot or doing a token dose. Token dose with Prozinc is usually somewhere in the 10% to 25% range of the regular dose.
     
  42. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Thanks Deb! I had an inkling that might be the case, but wasn't sure. That does make sense. Luckily, Hercules is bouncing pretty determinedly tonight, so the 1.0U on the spreadsheet for the PM shot should be fine for this cycle, going to 0.75U in the morning.
     
  43. Hercule's mum

    Hercule's mum Member

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    Thanks Deb and Nan. I woke up early today to do an "evening read", and went back to sleep, so only saw this now.... so I did gave him 1U this morning. His BG was much higher in the AMPS so hopefully will be OK. I'll stay home the whole day and stick with it if no bright greens to give his body a chance to regulate. I do understand what you say though, that it should be 0.75 and if I see a bright green I'll go down. I'll also try to get more readings this evening.

    Thank you so much for this discussion, super helpful! I learned a lot!
     
  44. Critter Mom

    Critter Mom Well-Known Member

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    I've not come across this distinction before, Deb (I'm always learning from you! :) ). Could you explain why this particular exception, please?


    Mogs
    .
     
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  45. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Yes, I think he'll be fine, but glad you'll be home to monitor anyway. I'm not worried in this case, but next time I will wait for a prozinc person if I'm at all unsure about which dose :confused: :confused: :confused:!

    Mogs, I think what Deb is referring to is the "three drops" standard for reductions for long-term diabetics. The rationale: some long-term diabetics don't seem to hold reductions well if you reduce every time they dip into the 40's. So, to keep from constantly yoyo-ing up and down, there's an alternate standard for reductions that caregivers with cats like this can use: take the 0.25U reduction only after you see three drops into the 40's on separate cycles, or a single drop below 40. I was just looking through the stickies on that board and I can't seem to locate a reference (other than the rule that any drop below 40 demands a reduction, no exceptions), but it's definitely in wide use over there. Not universally-- ECID and some long term diabetics hold reductions just fine-- but as a commonly-used option.
     
  46. Critter Mom

    Critter Mom Well-Known Member

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  47. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    No problem Mogs, anytime!

    That said, that explanation was for common practice on the Lantus board. I just checked the Prozinc stickies, and they have a more detailed and nuanced procedure [Edit: this is for the "Modified Prozinc Method"; the SLGS reduction point is unchanged at 90 as far as I can tell]:

    • If your cat is between six months to a year of diagnosis, look at the overall picture of your data to determine if a 0.25u reduction is warranted on a single number below 50.
      • Prozinc can be a little volatile at times, and there will be the occasional random drop. If you have a consistent body of mid-cycle tests that indicate the low number is unusual, you may consider holding the dose and continuing to monitor or you may choose to just shave a little off the dose.
      • If the low number appears to indicate a general downward trend of numbers, then it may indicate that you should indeed lower the dose.
      • If your cat is more than a year since diagnosis, a single number between 40-50 should not mean a full 0.25u reduction. You may shave a little off the next dose, or just hold the dose and continue to monitor.
      • Additional numbers between 40-50 in the days following would indicate the dose should be reduced.
      • Any cat, regardless of time since diagnosis should receive a reduction if there is a number below 40.

    Have to say, reading this, I kind of like this approach better. It doesn't have the simplicity, but it's a lot more geared to the individual cat.
     
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  48. Critter Mom

    Critter Mom Well-Known Member

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    @Nan & Amber (GA) - I agree.

    Thanks for rooting out the additional info, Nan. :)


    Mogs
    .
     
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  49. Hercule's mum

    Hercule's mum Member

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    Aghhh! 3.2! again! Wish I have seen Nan and Deb's comment earlier!
     
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  50. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Did you give him high-carb gravy or honey? Please re-test 30mins after the 3.2-- let's get him back up!
     
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  51. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    And on the bright side-- now we know that he doesn't bounce for very long even if he reaches great heights on his trampoline!
     
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  52. Hercule's mum

    Hercule's mum Member

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    mischief managed.... 5.3 30 minutes later.

    But I'm guessing we are not quite at the nadir from this morning dose, so I'll test him again soon. Fun afternoon!
     
  53. Hercule's mum

    Hercule's mum Member

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    I am lucky that he always will have more food....

    It is weird though that he went from 13 to 3 in 2 hours, no?
     
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  54. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    That is a very fast drop, yes. Definitely keep testing to see what other tricks he has in his bag for the day!
     
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  55. Critter Mom

    Critter Mom Well-Known Member

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    Eek! At least you're on the case and keeping Hercules safe. :)

    Ah, a wizardy kitty momma walks amongst us! :cool:


    Mogs
    .
     
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  56. Hercule's mum

    Hercule's mum Member

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    mogs - ;) Now if I could just magic away his diabetes... I could save a lot of time and money....
     
  57. Hercule's mum

    Hercule's mum Member

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    By the way, I just cliqued on saoirse's spreadsheet... impressive and neat! Well done you for getting her in remission. I like the format of your spreadsheet better, especially with the clear labels for different numbers; but I gues we moved on from this for some good reason?
     
  58. Critter Mom

    Critter Mom Well-Known Member

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    If only! :smuggrin:

    Saoirse's spreadsheet is a custom jobbie that I developed over time for a few reasons:
    • I have PTSD and I can't hold information in my short term working memory or plan things any more and my brain gets completely overwhelmed and shuts down if I try to process stuff in real time so I gradually tweaked the spreadsheet to do all the heavy lifting for me to monitor her trends, etc. (The 7-day averages are particularly helpful.)

    • Again due to the anxiety disorder, the colour coding in the FDMB standard issue spreadsheet freaks out my nervous system (bizarre, but unfortunately true) so I had to change that.

    • I had to manage Saoirse's diabetes alongside chronic pancreatitis and later stage II CKD so it was necessary to keep track of clinical signs, food and water consumption, plus umpteen meds and supplements. The custom spreadsheet helped me to spot patterns of what did or did not agree with her - and also to backtrack to what had worked better in the past.

    • I used an Alphatrak 2 glucometer plus I'm in the UK (using SI units) and I couldn't get my head round the ranges in the FDMB standard spreadsheet. I found it easier to set up the BG ranges to suit my own needs. Also, despite being a cognitive disaster zone these days I am still a dyed-in-the-wool control freak (background in engineering and project management). I desired a more nuanced view of Saoirse's BG status, hence the additional ranges at the top of the sheet.
    The FDMB sheet is great for most people's needs, and anyone can use it without any prior experience of using a spreadsheet. For my situation, the over-engineering was driven by necessity - I'd never have been able to care for Saoirse properly without it - but the design of Saoirse's sheet does require a certain familiarity with spreadsheet functionality in order to maintain it. Horses for courses.

    Saoirse was wonderful when she went into remission. Sadly it didn't hold for long. I wanted to keep her on a single droplet of Lantus once a day (AM cycle) because it was just enough to support her little pancreas and calm the inflammation. Our own vet had agreed in principle to this approach, given that I am at home all the time to monitor her (housebound) and by that stage he had complete confidence in my ability to keep her safe (he regularly reviewed the 'brief' spreadsheet). Regrettably Saoirse was then referred to an internal medicine specialist and she hadn't a clue about using Lantus or tightly regulating feline diabetics. Legally in the UK she had higher authority than my own vet about what treatments Saoirse was allowed. She decided that Saoirse could not go back on insulin until her BG levels exceeded 11.1mmol/L (over the frelling renal threshold!!!) because, according to her, it is not safe to give insulin to a feline diabetic with a BG lower than this. My own vet's hands were completely tied. He wasn't exactly happy about the situation. I can still see the regret in his eyes as he apologised to me...

    That woman was provided with ALL of Saoirse's BG data, clinical signs, etc., but arrogance trumped evidence and within 6-8 weeks Saoirse's pancreatitis started to worsen again, her clinical signs disimproved and her BG levels started creeping up. I had to wait until her blood sugar was so high it was spilling into her bladder before my vet could legally prescribe insulin for her again. It took months. Saoirse paid a very high price for that woman's intransigence... :( :mad:


    Mogs
    .
     
    Last edited: Aug 5, 2020
  59. Hercule's mum

    Hercule's mum Member

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    Oh, How horrible Mogs! That seems so insane! poor Saoirse!

    It is quite difficult to get a constant vet, left alone a good one. I am also in the uk, and live in a small city, but all the vets are big companies now with dozens of vets. Thankfully, we saw one hat has agreed to keep email contact and she is trusting me so far.

    I 100% agree with the colours in the chart, they make me anxious too! If it ever up to vote, I'll vote for your! But no, I am very grateful I found the forum and all the help. It has made a huge difference. Hercule's bounce big time again, but I am getting used to it and not freaking out....:)
     
  60. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Well, he definitely made his point about wanting to go down to 0.75U, that's for sure!
     
  61. Critter Mom

    Critter Mom Well-Known Member

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    B****y capitalism. :rolleyes:

    You never said truer.

    I've had dealings with dreadful, bad, average, wonderful and astoundingly good vets down the years. Realistically, as in any walk of life, some are better in their field than others. The trouble with medical specialists - human or veterinary - is the cost when they don't get it right.

    I live in a rural town so we still have more 'traditional' practices here (and long may that continue). Our main vet is an absolute topper: really collaborative, progressive in attitude to treatment, highly approachable and open to discussion on treatment choices, very kind and caring - and he had a sugar cat himself until recently! Overall, the vets at the practice are happy to work in partnership with clients, not like some holier-than-thou types.

    I'm very glad to hear you've found a vet who's collaborative. Makes a huge difference, especially as diabetics can be frequent flyers! ;)

    In case no-one's yet mentioned it to you, should you so desire you can share Hercules' spreadsheet with your vet. Provided the permissions are set up OK in the spreadsheet you can just email them the link and they can view it (no need for them to have a Google account). Both my vet and myself found it really helpful to do so.

    I, too, am beyond grateful for this place. The members here are wonderful, and helped to save Saoirse's life on more than one occasion (and what's left of my sanity). I will be eternally grateful to the members here, and I will never be able to repay or pay forward all that they have given to me and to my beloved girl...

    I'm glad you found FDMB. :)

    It's one thing to read about diabetes in a book or on a website but it bears little relation to the lived experience of managing the disease day to day. It is both a reassurance and a great comfort to know there are people here who are that little bit further along the path and who are ready and waiting to hold your hand and show you the way any time you need it.


    Mogs
    .
     
  62. Hercule's mum

    Hercule's mum Member

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    Loud and clear!! :blackeye:

    But do you have any idea why is his BG so all over the place, sharp drops, sharp peaks.... would a lower dose lead to a more "rolling hills" kind of situation because it reduces bounces?
     
  63. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    It might help. A lower dose that doesn't bring him as far down may help tamp down the bounces a little, but it probably won't eliminate them.It's not just "too low" as in lime green, it's "too low" as in what Hercule is used to.

    Just takes time for him to get used to lower and lower numbers. At least the bounces seem short!
     
  64. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    He's a cat! ;)

    Being serious now, your instincts here are good. This can be the case with some cats, though not all (I'm lookin' at you, trampoline junkies). For example, sometimes you can get a situation where for one of the day's cycles the cat is high enough at preshot to dose safely but is too low at preshot to dose on the other cycle. Tweaking the dose to lower it slightly can in some cases lead to the cat having high enough preshot BGs on both cycles to enable safe dosing. Granted the nadir might not be as low as with the higher dose but ijt's better for the cat to run slightly higher than to skip doses altogether.

    While there are typical patterns of response to particular insulins, only time and testing will reveal how a given insulin will affect a particular cat. There are two really key things that make tracking spreadsheets so valuable. First, they help us keep our kitties safe. Second, they help us mere humans to 'learn' our cats. :)


    Mogs
    .
     
  65. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Nothing much to add to the information that @Nan & Amber (GA) already provided on the Prozinc dosing protocols. The Prozinc dosing protocols were expanded and rewritten in February 2020. Lots of good detail there now.
    Nothing much to add to the information that @Critter Mom provided.

    You 2 have it covered, and covered well.

    The reduction to the 0.75U dose was because your cat had dropped into those neon green BG numbers, which told us the dose was a bit too high. That lower 0.75U dose should be held for a bit. Not increased back to 1U unless the bounces don't clear and the BG levels get too high and don't come back down at mid-cycle.

    If you see another neon green number, (like you did today 8/5/20 on the 1U dose) that is another automatic 0.25U dose reduction. Please, please take those dose reductions when the BG levels are telling you the dose is too high. Let's keep Hercules safe from a hypo. Yes, he is bouncing sky high. But you recently changed the food fed too, to a lower carb option. Since you did not see the recommendation to lower the dose from 1U to 0.75U and gave the 1U dose this morning 8/5/20, that would not be another automatic dose reduction. Let's see what Hercules looks like in the morning at AMPS or at PMPS tomorrow, 8/6/20.

    See the Prozinc ISG group, the stickies at the top for more specific Prozinc information. Lots of good reading there. Don't expect to take it all in at once.

    p.s. New thread please? This one is getting long and the message board works better if the threads are shorter. Link this older thread in at the top of the new thread. Thanks.
     

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