Need dosing help. +11 PMPS and 409, no bounce?

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Catannc

Catannc

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Thanks again to those who were up with me last night! Now comes the "what to do now", heading out to buy some U-100's so I thought I'd test and post before I go.

One more thing, would she likely have gone as low if I had given her entire meal at shot instead of the half at shot half at +2? Can I get some opinions on not only the dose but feeding?

Cathy
 
Re: +11 PMPS and 409, no bounce?

Hi Cathy,

I'm not familiar with the details of what happened last night or your sugarbaby at all, so I cannot comment on your questions.

Hope you have a better day with no hypos today. Always remember, they will be sensitive to insulin after a hypo so you will certainly want to underdose. I'm sure others that helped you last night will be on shortly to assist.
 
NO HYPO, thank god. Just a 2+ of 144 and 3+of 86, need to bring her insulin down a bit. She was PMPS 339 and this happened on .5 units. Only thing different I did was the feeding.

Cathy
 
Oh...wow!! That is amazing on only a diet change? When I get home today, I'll catch up and get familiar with your situation. Very interesting!
 
There really is no way to know if the feeding would have made a difference, but I am going to say, "No" the BG would not have dropped as fast and hard if you had fed the entire meal with the insulin. "Normally" with Prozinc you do not see a significant drop in the BG until +1.5 or +2. (And, there is no such thing as "normal" with FD!) With Prozinc, you would like to see a 60 to 65 percent drop at nadir. The goal is to find a dose that will leave you with preshots, that will allow your dose to give you that type of drop at nadir. The nadir "normally" occurs between +4 and +8, once again--"normally!" There is truth that feeding during the drop will make it slower and softer. My suggestion would be-- maybe divide the food into 2 meals--giving 2/3 with the insulin and then 1/3 at +1. The feeding is just like the insulin dose-- it is all about trials and data collection. Your data from last night suggests that you get a Big Steep drop if you cut the food back into 1/2 at feeding and 1/2 at +2-- on .5 units.

I am not sure I answered your question....but, the simple answer is ...the insulin works with the amount of food fed. So, it is fair to assume, that the big steep drop last night was influenced by the reduction in your "normal" feeding.

Just continue to experiment with the food. Maybe get a +1 test in to see what is happening. If you had tested last night at +1, you might could have caught the drop earlier-- thus feeding earlier and slowing the drop.

The insulin and the food work together-- you just need to find out what works best for you--ECID!

Good Luck!
 
So go with Carl's recommendation to drop insulin to 1/3 or .2 or keep at .5? I WILL NOT be home from +2 to+6.
 
And yes Lisa, she was on 1 unit am and .5 in pm seeing 500's regularly and no real pattern to her curves. Changed from hill w/d dry to semi-raw diet, I got lucky and already had a meat grinder, and BAM!
 
Good morning, Cathy.

Since you are still figuring out best to manage the food/insulin, I would be cautious today and go with the .2. Especially since you won't be around. It may not be quite enough, but better safe than sorry. Remember that it is all data gathering. :-D

I like Kim's ideas on the food. I think I might also leave out something at that +6 mark?
 
I will get an auto feeder and try, but I don't have one right now so will go with the 2/3 at shot and 1/3 at +1. Gonna get the conversion chart, but how many teeny lines is .2 on U100?
 
I agree with Sue...reduce the dose today. If it isn't enough, no problem-- you can adjust. Trial and Data!
 
Oh yay, work decided they didn't need me today so I get to stay home and see what this does!
 
Fantastic! That will give you some opportunity to experiement with the food and see what happens.

She seems very food sensitive. You stopped that drop last night real fast. That is great info to have and use.
 
That is one reason I wasn't too worried, I had fed at 100 before and a half hour later got the same test (and only fed 1/2 tbsp of her normal low carb), so food will almost immediately hold her BG and then it will come back up with a small amount. I was just concerned because that was the earliest we had ever seen the low 100's and never seen a green value. She is evidently super sensitive to everything, low carb or high carb and insulin!
 
Alright, +1 is 471, not what I think we were hoping for. I'm gonna hold back her food until +2 at least and see if she starts coming down, sound good? It is nice to know what insulin dose keeps her from tanking though. At any point might I want to consider shooting another small dose, say another .1 or .2 or do we just want to let this cycle run and see what happens? Would it make sense if she's still high at +2 to give her the rest of the food and shoot .2 u again? It'd still be .1 u less than yesterday, and 2 separate doses should have different nadir points and keep her onset slower and possible let her surf longer?
 
That is more of the "usual" response with FD kitties. Many get a food rise in the first hour or two.

Regardless of what you get today, it will be information you can use to help in the next cycle.
 
okay sue, thanks. Just don't like seeing those numbers up toward the 500s. Will let her just run with it today.
 
NO, do not shoot again. You do not want to shoot Prozinc but once in your cycle. Regardless if you have a furshot or shoot a dose too low, you should not shoot additional insulin. Remember, Prozinc has a duration in the cat-- whether that duration is 9 hours or 12 hours in your cat. If you start shooting midcylce, you will be shooting into insulin that is already in the cats body and will create overlap-- you could overdose. That is VERY dangerous!

Just ride out this cycle and collect your data. It takes time to find the "Right" combination of food and insulin.

Don't worry about the high numbers for now, it is early in the dance for you. Go look at Kitty's spreadsheet in my signature...not the tid one, the other one. You will notice how many high numbers she had before we found what worked for Kitty. While we don't like high numbers......we can adjust to them. Kitty has been on Prozinc for a year now. She is 16.5 years old and doing great. It took time and many trials to find a regiment that worked for her---BUT, finally after 5 months of frustration--- I found what worked for her. And, we will find what works for Kitten too!
 
It is up to you....I normally feed with the shot and do NOT feed any 2 hours before or after each shot. I go back to "normally!" But, it normally takes about 2 hours for Prozinc to have an onset-- so the first two hours after shooting the insulin is not doing much. It is very common to see a food spike at +2. Then the duration starts wearing off pretty heavily at +10. So, I try not to feed in that window, because I know there is not much insulin to combat the carbs. If I feed midcycle, I try to do at Kitty's nadir-- when she is lowest and the insulin is most active. The only reason, I suggested feeding at +1 today, was because of the steep drop you saw last night. But, since you reduced the insulin-- it appears it was not necessary to feed early in the cycle to slow the drop.

Am I making any sense?!
 
Yep, perfect. So basically we're having a more normal response to insulin today, a good thing, keep checking her and feed somewhere between +4 and +6 depending on what she feels like doing with that small dose today. I figured no rush to feed since her values didn't crash, guess she was on just a tad too much insulin.
 
Whatever you think - it's just another piece of data. :-D

It could be a flat cycle because the dose is a little low ( we wanted to be safe) or it could be a bounce after her green last night. I am leaning toward the bounce, but you have a lot of time left in the cycle. We'll see. Check out some of the other spreadsheets. Kitties tend to bounce if they get a low number that they haven't seen before. It's very common and just part of the dance.
 
And once again she surprises me, HELLO 221 +3! Assuming food time as we just dropped 50%ish in an hour?
 
Yes, that looks more normal for the Prozinc curve-- the onset of the insulin has taken place. The insulin is strong at this point in the cycle. I would expect her to drop a little more in the next hour-- "probably" not drastically, and then by +4 or +5--level out. A "normal" Prozinc curve, would stay in the same range of numbers for about +4 to +7 and then slowly start back climbing up. Then at your next preshot, you should be back to a higher level--meaning you need to shoot again. The goal is to find a dose that will drop her into "good" numbers-- greens or low blues-- with a dose that drops her preshot readings about 65 percent.

Yes, I would feed her now if she is hungry!
 
well, she ate about a half a tablespoon. Not that interested in the food at all, which is a first.
 
No, have not yet and was actually just reading about it. So you really have to sneak up on the cat while it's urinating, this should be fun.
 
Well, sneaking up on them is the easiest way! I would suggest everyone check for Ketones, but especially Kitties that are on low doses of insulin and are early in the dance. One of the main culprits in the development of ketones is insufficient insulin, and when kitties are first dx- obviously they have spent some time with little or no insulin, before insulin therapy was started. So, you already have a kitty whose pancreas was not producing enough insulin-- thus diabetic, and now you are on a low dose. So, it is very crucial to test for ketones while you are trying to find the "right" dose.

Ketone strips are cheap and are a tool you need in your chest! My Kitty went DKA-- and let me assure you, Ketones are BAD!

Get some strips and start checking her!
 
Arrrr, off to wallyworld again. Took me an hour this morning to find the stupid syringes as I didn't realize the only pharmacy open before 9 is the walgreens in the opposite direction that I went out in. Three pharmacies in and I'm outside muttering "You gotta be freaking kidding me, right?" I'll go after her next test in a few minutes. Would be good to know because she had a "small bladder" at the vet and they couldn't get a sample.
 
Sometimes at my Walmart, the ketostix are not out on the shelves for some reason. I have to ask the pharmacist for them-- they keep them behind the counter!
 
Got them, now if I can just catch her. Might have to entice my big boy to use her box, she HATES that and has to go immediately after him. Doing good, +5 is 148!

*i think this might be looking better than yesterday even, guess we'll see at the next test
 
Catannc said:
Thanks again to those who were up with me last night! Now comes the "what to do now", heading out to buy some U-100's so I thought I'd test and post before I go.

One more thing, would she likely have gone as low if I had given her entire meal at shot instead of the half at shot half at +2? Can I get some opinions on not only the dose but feeding?

Cathy
Click to expand...

Hi Cathy,
When it comes to food and how it interacts with YOUR cat and the insulin, it's trial and error. Think up some variations for feeding, times and amounts. Divide up her daily food intake into portions maybe 1tbsp size. You can give 2tbsp with shot, then 1tbsp every hour for 4hrs, then more tbsp at +6, +8, and +10, then see where the BG is at ps.
Then another day you can try other patterns of feeding.... think in spoon sizes .... 1 with ps shot, then 2tbsp at +2, +4, +6, +8 and +10.

If you look back at the numbers, maybe you can see the reaction of hourly feedings as opposed to feeding every 2 hours.
You can mix up the quantities at each feeding too, but just stay clear from just a couple meals a day and making them big meals. By spacing them out, you get more level numbers.
 
+6 169, so nadir was somewhere around +5 and she dropped about 67% from AMPS. Hoping she can hold a blue or low yellow for another hour.
 
You are getting great data! Hopefully, she will surf these numbers for a couple of hours before going up.

Looking Good! The curve so far looks like a typical Prozinc curve-- that is a good starting point, to have the curve appear.
 
Catannc said:
Got them, now if I can just catch her. Might have to entice my big boy to use her box, she HATES that and has to go immediately after him.
Click to expand...

If she's like mine, all it takes is scooping the box. Nothing more enticing than a clean box to go in!

I may have told you, I've got his box on a little table, so as soon as he goes in, I grab the ketostix and am right there with it. Not bending or crawling around on the floor to see which direction he's peeing in!

Just picked up a new bottle of ketostix - at the THIRD pharmacy I went to. I could've gone to Walmart and waited in line faster! They did offer to order them for me at both that didn't have them... but I finished his bottle this morning - didn't want to risk it while we're still keeping eyes on his ketones!
 
kse said:
Well, sneaking up on them is the easiest way! I would suggest everyone check for Ketones, but especially Kitties that are on low doses of insulin and are early in the dance. One of the main culprits in the development of ketones is insufficient insulin, and when kitties are first dx- obviously they have spent some time with little or no insulin, before insulin therapy was started. So, you already have a kitty whose pancreas was not producing enough insulin-- thus diabetic, and now you are on a low dose. So, it is very crucial to test for ketones while you are trying to find the "right" dose.

Ketone strips are cheap and are a tool you need in your chest! My Kitty went DKA-- and let me assure you, Ketones are BAD!

Get some strips and start checking her!
Click to expand...

Would you believe the little brat knew I was watching her and held her bladder from 2 pm yesterday until 7 am this morning, when I was in the bathroom, to pee her heart out into the one corner of the box the saran wrap didn't cover! :roll:
 
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