Nighttime is always the Worst

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Bruce Wayne, Apr 1, 2021.

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  1. Bruce Wayne

    Bruce Wayne Member

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    Feb 10, 2021
    So here are the facts:
    • ProZinc is used 2x a day every 12 hours
    • Meal times are ever 6 hours (0630 3oz /1200 2oz/ 1830 3oz/ 2400 2oz)
    • About two tbsp of water added to the wet food
    • Exercise is similar throughout the day
    That is pretty consistent. I used to do my 2nd shot at 10.5 hours instead of 12 based on what my vet said. I was thinking maybe that was making the PM worse for Bruce..like maybe there is too much overlap with the first and second cycle.

    Now that we are running a tight ship, I can't understand why he always seems to drop low just at night. I have never observed or tested hypos during the day. Is it me? Am I just hyper aware at night? Is there a chance the insulin is overlapping? in which case... I am not even sure how an every 14 hour cycle would look.. it would be different every day.

    I have been advised by my vet to consider lowering just the PM dose, but advised against that here. I am kind of out of ideas. It is so strange though.

    Any thoughts / tips / experience with this?
     
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  2. Oscar and Carrie

    Oscar and Carrie Member

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    Feb 20, 2021
    Hey Lauren,

    I am still fairly new to this, so I'll tag @Deb & Wink as well for more advice.

    I would definitely reduce your next dose to 2.25u, especially as that low 68 was on an Alphatrak.

    The lack of consistency in the recent numbers suggests to me that he is bouncing, which may be caused by him dropping too low during his cycles, and then the body responding by releasing sugars, leading to increased readings. Bounces normally take about 3-5 days to clear, so I would keep him at the lower dosage for at least that amount of time, unless at any point you get another reading of less than 90, then you would immediately decrease the next dosage by 0.25 and then carry on the process again at the new lower dose.

    If you can, try to get some additional readings at between +4 and +7 during the AM cycle so have a better idea of how low he is going.
     
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  3. SashaV

    SashaV Well-Known Member

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    Apr 25, 2020
    Carrie is right, Bruce earned a reduction.

    And the PJ parties is unfortunately a part of this journey. Keep your 12 hour schedule, with time you'll learn to manipulate the cycle with food. But the PJ parties may never stop. It's annoying I know, Mauer did the exact same thing on me :banghead:
     
  4. Dyana

    Dyana Well-Known Member

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    Dec 28, 2009
    I wonder if moving his mid-cycle snack up an hour or so, would help to boost his numbers, create a flatter cycle, and cause less bouncing.
     
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  5. Bruce Wayne

    Bruce Wayne Member

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    Feb 10, 2021
    @Oscar and Carrie - thanks for the reply. I bumped down to 2.25. Really hoping to stay here for a few cycles to level him out. I had to leave my house today so I missed my +7 but got the +8. He’s pretty high but he moved when he got his shot this morning so maybe he didn’t get some of it.

    do you know why it’s not recommended to do different AM and PM doses ?

    @SashaV - pj parties it is. I guess I will learn to sleep during the day lol :confused:

    @Dyana - I did introduce a lunch and a mid cycle snack at night. 2oz of wet food at 12a and 12a. Are you recommending another one ?
     
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  6. SashaV

    SashaV Well-Known Member

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    Apr 25, 2020
    I will most likely join you tonight o_O:confused:
     
  7. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Could you put those tines in the + hour format we use here? Since we all live in different time zones, and people give their cats insulin at different times of the day, we need context for the 12 am and 12 pm.

    So, if those meals and snack are at 4 hours after the insulin shot, that would be +4. 6 hours after, would be +6, etc. Could you make those notes on the SS please, in the Remarks column?

    Right now, it certainly looks like Bruce is bouncing. Those black and red BG numbers, after a drop like Bruce took last night to the neon green BG levels, indicates a bounce.

    He definitely earned that dose reduction down to 2.25U. Don't try to give him a skinny or fat dose at this point. Right now you want to be more consistent with the dose. You should also try to be consistent on the times of the dose. I notice you have started to put a time in for when you gave the dose. Some of those times are an hour to an hour and a half different.
     
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  8. Dyana

    Dyana Well-Known Member

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    Dec 28, 2009
    What I meant was, it looks like on your spreadsheet for the 31st and 1st, that you fed a lunch at +5, and I thought maybe you could try to experiment feeding him an hour or so earlier, like at +3.5 or at +4 instead. It might help to bring up his BGs just a little bit before nadir and flatten the cycle.
    Are you also giving him a midnight snack in the night time?
     
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  9. majandra

    majandra Well-Known Member

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    Oct 11, 2018
    One thing that helped Rhubarb get her morning PS lower was giving a snack 3 hrs before shot. I have a rotating dish that I had set to rotate to empty 2hrs before shot. It seemed to help.
     
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  10. Bruce Wayne

    Bruce Wayne Member

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    Feb 10, 2021

    Sorry I didn’t see this sooner. He gets his snacks about +5hrs morning and night. I could adjust when that is. I bought a timed feeder recommended to me on another thread. Before I saw this I moved him back to 2.5 (after three cycles of 400s and high 300s). He went back to 80 for the first time after a PMPS of almost 500. I think it’s bc he played pretty hard earlier tonight. But I’m going to keep a close eye on him tonight.
     
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  11. Oscar and Carrie

    Oscar and Carrie Member

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    Feb 20, 2021
    Since you've just had another reading at less than 90, you should go back down to the 2.25 dosage. Looking at his numbers I definitely don't think you should be increasing right now.

    Remember, the dosage is based on nadir, not the pre-shot. I don't think you're getting enough information about what is happening to Bruce mid-cycle right now to figure out how low he is going. If you're able to get some tests in during the day between +4 and +6 that would help to fill the gaps in the data.
     
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  12. SashaV

    SashaV Well-Known Member

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    Apr 25, 2020
    Why are you still not testing before shots?
    When you're doing the SLGS you're reducing at 90, so Carrie is right 2.25U is your new dose.

    And I totally agree Carrie, you need more testing during the cycle.
    You're not doing AMPS but you have high PMPS, to me that says he has been lower. You just didn't catch it.
     
  13. Bruce Wayne

    Bruce Wayne Member

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    Feb 10, 2021
    Okay. I reduced today. And I will try to see if I can stay home to get his +4 and +6 since I am not used to seeing an AMPS of 200s. Since I am back in the office I have to get my mid cycle information in PM and weekends. But I am a little worried today so I might call in to my office.
     
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  14. SashaV

    SashaV Well-Known Member

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    Apr 25, 2020
    And that's exactly why we test. If you went to work, shooting blind you might not have a cat to come home to. So important! I'm so glad you got one today! :bighug::bighug:
     
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  15. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    So if Bruce had been at 86 or 90 at pre-shot, but you did not test first, and gave him the full dose, then he could have dropped very low during the cycle. Low as in hypoglycemic, possibly symptomatic hypoglycemia.

    It's why we so strongly encourage you to always get that pre-shot test, so you know your cat's BG levels are high enough to give the insulin in the first place.

    p.s. I know you just reduced Bruce, but those low greens in the 80's and 90's indicate he did well on the dose reduction. He may need another dose reduction very soon
     
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