Pam & Alley

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Vicky & Gandalf (GA) & Murrlin

Vicky & Gandalf (GA) & Murrlin

Member Since 2009
Hi Pam, I'm starting a new thread here for you because I don't want this to get buried.

I see why he went low yesterday (explanation below) - according to spreadsheet your AM dose yesterday was .25U "or below" and the one the night before was .15 "or below." I assume the "or below" means you're simply not sure what you're shooting. My recommendation is to find a method by which you determine "this is how I do .15U." Whether you go by sight or the drop method is up to you. Have you seen the pictures here: http://www.steverapaport.com/jock/Syrin ... radations/ click on the pictures to the left to enlarge.
The webpage which includes that link is here: http://petdiabetes.wikia.com/wiki/Fine_dose

I think getting a method down is very important because as you discovered, even .1U difference has a different result. And I see why you went back to .25U as that AM number was a little yucky. The thing is, he dropped in to the 30s probably because he experienced a bit of overlap from that .15U the night before, so you should lower the dose to that or even below .15U to achieve shootable numbers at preshot times, both AM and PM. You can see what happens when he doesn't get a shot, so that means he still needs insulin, but a teeny, tiny bit.

It defies logic doesn't it?! Such a small amount wouldn't seem like it should do anything, but this Gentle Giant hormone knows your boy wants OTJ. And I bet he was playing in those 40s! Non-diabetics test in the 40s and 50s. He feels normal again! You're still doing really really well and the results must be encouraging!
 
Thanks for the link on the syringes, also Sheila helped with the microdoses. My husband is practicing right now and he is pumped, this cat is his baby. A little better so far than yesterday, but we are seeing the slight curve at +8 & sometimes +9, so we will see.
Thanks again to all,
Pam
 
OMG! I think he may have gotten into a little gravy tonite. Not sure, walked away from the kitchen for a few minutes after dinner and when I came back he was on the floor washing his face and paws and purring like crazy, yup, that had to be it! So taking this 393 PMPS as a food spike, not a rebound by any means, shot usual 3 drops.
His breathe smells like pork chops!
We are in the middle of a huge blizzard right now!
Pam
 
Oh, dear... well, cats will be cats. I would suggest watching his numbers to see that he can come back to his "normal" numbers in a cycle or two. When Beau got into dinner rolls after he was off insulin a few months, at first he could bring himself down (from 300s), but then he just couldn't and needed an assist for a few days - again his microdose of .05u.

You may be ok, so just monitor things and if you do decide to raise the dose, make it no more that one extra drop and only for one cycle - and get spot checks.

We're going to get that snow tomorrow as rain turning to freezing rain, then sleet and then snow. Fun times!
 
I think you are doing a great job, Pam! Keep up the good work! :thumbup

We are scheduled to get your all's storm starting late tonight w/rain, then sleet and by tomorrow a full on "blizzard"....

Going in for some last miute backhoe work today, then covering the job site for the "big storm"!
 
Pam & Alley said:
OMG! I think he may have gotten into a little gravy tonite. Not sure, walked away from the kitchen for a few minutes after dinner and when I came back he was on the floor washing his face and paws and purring like crazy, yup, that had to be it! So taking this 393 PMPS as a food spike, not a rebound by any means, shot usual 3 drops.
His breathe smells like pork chops!
We are in the middle of a huge blizzard right now!
Pam
Click to expand...

Pam, you might want to note that in your SS that he got into the gravy. I bet he enjoyed that little treat!

Also, on 12/9 that he ate after the +10 123. Good info to know.

Freezing rain turning to snow here right now too.
 
Will post those note, good suggestion, thanks. BUT he did not get into anything tonite and his PMPS was 410. SPOILER ALERT!!! FEELING SORRY FOR MYSELF!!! Maybe it is the lack of sleep, watching him during the night, but right now I feel defeated. Can his body already be used to this insulin? To make matters worse, my vet called to see how he was doing on the Levemir, and when I read her the numbers, she suggested changing him to another insulin already. That I will not do yet. No way. He did respond very well to Lev, now it seems it is not lasting long enough, with his amps and pmps still way too high. Higher dose will send him sinking slowing in between. I am just ranting here, and I apologize, feel better already, after all, Thursday was good. Ok, now if I can just figure out how to give myself a swift kick I'll be just dandy. UGH!
Pam
 
You might be OK with 4 drops. Not sure how that compares to the .25 or less, but he had his best numbers on that. Did you notice his nadirs were also later then, whereas now they are a couple hours earlier at least? Makes me think the 3 drops aren't quite enough.

If I suggest 3 1/2 drops will that make you crazy? :lol:

I'm actually serious. At these tiny doses, even 1 drop more would be a 33% increase in dose. That's a lot. Below 1U I like to think in terms of percentage change rather than partial units.
 
Pam, is the 3 drops more or less than the ".25u or less" dose? Even by eyeballing it, can you make a guess there?

I truly do not think he could be resistant to lev yet. He had some sort of amazingly potent response to it at first, and now he either needs more insulin - or he needs less. There just isn't enough data to tell yet which it is. I think he was rebounding on the N. He was dropping over 300 points in 1-2 hrs on a .5u dose. My gut (and my "rebound-colored glasses) tells me he is still rebounding on the lev and that going to 2 drops might show better numbers.

Rebound on the longer acting insulins looks like high flat numbers, punctuated (sometimes) by very low numbers. It looks like one dose is too much (the lows), but that the next lower dose is not enough (the high flat numbers), when in fact, both doses are too high. This is what happened with Beau. On .5u he hit the 30s, on .4u he was high and flat, but he was still in rebound. If you take a look at Beau's SS at his first week on lev you will see some familiar numbers. You will notice that I immediate dropped the dose - and then started raising it again. Then I went up and down and got no where except just as frustrated and disappointed as you are now. When I started reducing - and kept reducing - then the numbers got better.

I agree with you that changing inulins now is not the answer. This is a problem with the dose that needs figuring out. The same problem will exist on a new insulin, IMO.
 
awwww, Pam, DON'T give up! You are just getting started and you have the getting started blues- that's all.

Sleep deprivation does that to us, so does constant monitoring without the results you want. You have to take care of yourself first or those loved ones around you will suffer- including Alley.

It's a hard concept to abide by, especially when you are exhausting yourself just so your loved one is better, but you know it doesn't work like that. That's why they tell the adults on the airplane to put their own oxygen mask on FIRST, before their childs...if you are sucking for air and can't get any, who is there to help your child? ...Pam- you gotta get your air mask on!

If it were me, I'd step back a bit and breath. I also wonder if you need to take the 3 drops and stick with it for like 12 cycles or so? My PK has about a 6 day settle times ( historically) even on the microdosing. maybe all the changes in drop amounts have his body wondering WTH?!

ETA- I wanted to mention, for Paul-Kyle, shot placement made alot of difference! I was shooting scruff, then sides and after much work and many months I realized PK got the biggest bang out of the smallest dose by shooting his right side- behind the end of his rib cage in the soft fleshy part above his back hip- what would be our side at belly button level about.

If I alter shot area, I change shot effectiveness (more/less punch). So, I have shot the same general area, within the diameter of a quarter, for many, many months. It works for us.

Also, I find it helpful to define the goal I am after.

Are you wanting to get Alley in constant green 24/7? Are you okay if he stays above renal if that means he is a happier kitty? Do you just want him under 400 and nothing more? Do you want him OTJ and there is no gray area? ...you know what I am saying?

Without clear goals, no matter what result you get you won't have any satisfaction or sense of accomplishment, you know?

Maybe whatever goal you have now needs to be changed to more realistic expectations? You can always redefine the goal later, when results of your first goal are met.

Hang in there, cyber friend! (((((HUGS)))))

YOU CAN DO THIS!!!! :RAHCAT
 
Vicki, Sheila, Melissa,
Thanks so much for the encouragement!
A new day, and 4 drops. Hoping for a longer stretch of better numbers, we'll see.
For the answers asked, we believe that the .25 we were giving him was higher than the 3 drops. Evaluating the syringe markings, definetly less on the 3 drops.
Interesting that lower numbers helped you, Sheila, and I believe it may help here.
Makes no sense the numbers we are getting at preshot levels.
I like the idea of free feeding all day long, another great suggestion, sometimes he appears finicky if he is not hungry at dinner/shot time. Alley's pal, Gidget, eats right along side him and she would really welcome the extra snacks. Poor thing is so used to getting his low carb diet she has lost a little weight! But she is super healthy!
We are hoping the 4 drops will work better, will try this for a few cycle days unless his numbers dictate differently. Onward and upward!

BTW, snow stopped this morning, total about 18 inches.

Pam
 
You're welcome!

No advice at this point. We'll see what 4 drops does. Interesting you think the 3 drops was less than .25U. As you say, onward.

We didn't get much snow here, just a skiff, but it's 14° here now and supposed to drop another 10° by the AM. The wind is ferocious though. I cancelled my shopping plans as I can't see myself running from store to store in this wind. I work in our mall so going there is OUT! LOL

You might notice, we don't mind chit chat on Lev ;-) We are geographically diverse even though 3 of us live in IL, we can have 20° differences in temps. I think Pamela got quite a bit of snow where she is in Northern IL. They have blizzard warnings for counties north of me.
 
Don't know how long ago his +7 of 52 was, but I will be interested in how the rest of the cycle goes - and what his PS tonight and tomorrow morning is. I believe that if he drops lower this afternoon and/or after tonight's shot OR if his PS's are really high still, that he has been rebounding and needs less insulin (than 3 drops).

Man, 18" of snow! Are you in the mountains? That is a LOT of snow. We are having high winds, dropping temps and blowing snow. I think the snow total is supposed to be 3-6", but the winds are gusting to 55 mph and the temps are dropping toward zero tonight. That makes the windchill well below zero - and there are people gathering for an outdoor football game right now! (Bears and Patriots at Soldiers Field). No thank you! I am staying inside today and the next two days if I can. Temps will be in the single digits or low teens through Tues. Brrrr.....!
 
His +8 (3:30 mountain time) was 59, so on the way up. Also curious about tonite's number and to shoot or not to shoot. Spent last 2 nights up every couple of hours checking on him.
Will be nice when (and if) he settles in. I agree with you about rebound and maybe needing less insulin, may try that for sure tonite.
Turned on the Bears game, WOW..what a mess. News said the Metrodome in MN caved in due to the weight of the snow. We are in the mountains, 8800 feet. But the snow out here is light and fluffy, not wet like back home. Lived in Indiana (Michigan City area) all our lives, just moved out here in August. Love the snow!
Thanks for your help, it is invaluable.
Pam
 
Pam & Alley said:
I like the idea of free feeding all day long, another great suggestion, sometimes he appears finicky if he is not hungry at dinner/shot time.
Click to expand...

One thing about the Levemir ISG is that we can agree to disagree and everyone is fine with that. :-D

So I will just say that I don't believe it is prudent to feed after +10 because you could be artificially inflating the preshot number. If you shoot on that number and the food spike wears off soon after, and then the insulin kicks in, you have just shot on a number that was lower than what you thought.

Anyway, things are looking good today. I will be anxious too to see what his preshot number will be. Try to get in a +11 (or +10 if it is not too late by now) test and then you will be able to see if he is on the rise when you test him at +12. It might make the decision of what to shoot then a lot easier.

Just saw your post above - posting at the same time it seems. The 59 at +8 is basically the same as the previous 52 so you can't assume he is on the way up yet.

I saw the snow caving in the Metrodome on TV. They caught it on a webcam in the stadium. It was really something!
 
Test at 6:30 was 137, he is not hungry and did not eat but a teaspoon after the test. This is usually his dinnertime. Now I can compare his before food (he did graze most of the day) to his after food PS and decide. I think keeping a small amount of food out almost all day helped keep his numbers in check. At 4 drops, it could have gone downhill fast.
But this is a very happy day compared to yesterday.
 
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