Nolan's Spread sheet.. numbers all over the place

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Last night, I think he bounced as he had a blue late in the cycle. Sometimes bounces happen the next test; sometimes the next cycle.

I think I'd be tempted to lower the dose a little on a preshot that is below 250 -260 (say 1.5?) for a few cycles and see if he settles in, without so much bouncing. And stick with the 2 units for 260+ You can try it for a while and see if he flattens out and is lower overall. If you do reduce, be sure to get ketone tests daily.

He isn't bad. Yellow preshots are always okay, certainly better than pink. But yes, it would be nice if he would drop a little overall. He is on a all wet low carb diet, right? No other medications or food?
 
Is nolan eating the same amount and same type of food everyday?
You said in your SS that "free feeds between shots during the day and at night". Is the amount eaten the same? If not then BGs will fluctuate.
 
Thanks, yes he is only eating wet food. I read that the Friskies Mariners Catch is one of the lower carb choices. That is all he eats and he has no other medication. Nolan is a big cat, hes not fat but just large. I give him a 5oz. can of food before each shot and he usually eats about 3/4 of that, and then snacks on the rest a bit later. I leave out a little extra wet food for him during the day to pick at, and I follow the same routine for the evening. I tested his keytones last week and he was negative, but I will test him again ASAP. I'm not really sure what the keytones indicate though....Generally his numbers are okay but I do want them to be better, especially at night, I can't understand why they tend to be higher. Also I guess I'm not really sure what numbers I'm shooting for overall. Is blue throughout the day healthy? I get nervous in the middle of the day when his numbers go lower, I know they are not in a dangerous range but I'm afraid they could just drop. Nolan has a vet appt. tomorrow but honestly I don't know what the vet will possibly do, she usually just checks his BG but I've been doing that now myself. Should I have her run any tests or anything, I mean is there anything else I should be looking out for? Usually she just tests his BG and tells me to higher or lower his dose, she never even did a curve when she told me what to dose him... I'll try the adjusted doses, and see if I can make a plan for a regular feeding schedule, its just very hard since I have two other cats in the house and I don't want to leave Nolan without food during the day in case he need it.....
 
You test for ketones so if he developed DKA, you could catch it early. (http://en.wikivet.net/Diabetic_Ketoacidosis) Usually it results from too little insulin, in appetite and an infection. It is unlikely Nolan would have it, but if you'd reduce the insulin a smidge, it would just be wise to get the tests.

If it were me, I think I'd take the spreadsheet to the vet and ask her how she thinks he is doing. A blood glucose test at her office will not give you much information as he is likely to be stressed and that will likely heighten his numbers. As long as he is eating and seems to be feeling okay, I don't know what other tests I'd want done.

Just for reference; we generally think a cat is regulated if they are in the mid 200s at preshot and then drop at nadir to double digits, but not below 40 which is approaching hypo territory. He is usually in that range at preshot (maybe a little high) and in blues at nadir, so he could drop a little midcycle. So the first goal is regulation. Then, if you want to push toward remission, you start tweaking the dose to try to get him in lower yellows at preshot and safe greens at nadir. Some people don't want to push toward remission early on or can't, because of their schedules. One of the other measures is the renal threshold. The thought is if the cat stays below the 250-280 range, his pancreas can heal.

You might look for a few other flavors of low carb he will eat. The fish flavors are usually the lowest, but most people limit them to a couple times a week. Not only is there the issue of mercury (just as with humans) but sometimes they get hooked on fish and won't eat other proteins. If your feeding shedule works best for you, I'd stick with it. Remember, this is not an exact science. So many things affect the numbers - from an upset tummy to seeing a squirrel outside to a satisfying poo. :-D Your job is to go with the flow and try to adapt to his patterns, when you can discern one. :mrgreen: Often cats are higher at night; they usually eat less and have less activity - both of which might change the numbers.

I think you both are doing fine. See what the vet says and maybe make some tweaks, if you are comfortable with them.
 
Thanks Sue, that really helped clear a few things up for me. I am pretty happy with his numbers some days, but then it seems like evenings he runs high, and this morning he had a preshot of 318! Yesterday mornings preshot was was about 100 points lower. Sometimes it feels like we are taking steps backward.
 
He was still heading down last night at +7 so he might have had a lower number later in the cycle and then a bounce this am. The late nadir (possibly last night and definitely the night before) are indicators that the dose is a smidge too high and causing the cycle to run long, thus causing the bounce the next am.
 
Well I just test Nolan for his PM shot and he was at 106! I'm waiting a little while and then going to test him again to see about giving him his dose. What should I lower it to? Today I went to the vet at 2:00 and he was at 149, that is around his Nadir. I showed the vet his SS and she said she though I should up his dose a little because his numbers seem high. She also said that at preshot time as long as he is at 100 I should go ahead and give him his regular dose! After this appointment I have decided that it is time for Nolan to get a new vet because that definitely doesn't sound right! I also asked about Zobaline for his neuropathy but she said she didn't know anything about it. Anyway I'm going to keep testing and working on getting Nolan regulated, so I need to figure out what to dose his at to get this all leveled out. I'm so thankful that I found this sight, I can't imagine what might have happened to Nolan if I had just been blindly following the vets advice! I'm going to go test Nolan again and see if his BG has gone up enough to feed him and give him his shot, if it has/when it does how much of a reduction should I be making?
 
What a nice surprise! I don't agree with your vet. Some ProZinc users shoot as low as 150-180, but only after they have lots of data that will help them predict what might happen. And even then, a tiny dose.

I wouldn't shoot until he is over 180 and definitely rising. And then maybe a token dose (one unit?) if you can monitor.

It definitely looks like he needs a dose reduction and that is great news!
 
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