Question about dosing (sliding scale?)

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kds0200

kds0200

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Hello again all! Bailey and I have been chugging right along, testing and shooting and making some good diet changes. I don't know if it's because he's settling into the new diet or because I keep changing doses but...because of his vastly different pre shot numbers, I keep changing doses. You'll see what I mean on the SS. I feel like yesterday morning I made the right call to scale down since his number started low (even if it was rising), and even though his PMPS last night was high, I scaled down from the previous night to make sure I didn't get an "unshootable" AMPS (which didn't turn out to be a problem). Tonight he had lower but rising numbers again, and I decided to shoot really low. Overnight I tend to err on the side of caution because if he goes hypo I don't think I'd know about it until morning.

I've been scanning through the threads (and read all through Lisa's post about Bouncy Ben and his sliding scale), but I'm curious to get some specific feedback on Bailey's SS.

Thank you in advance, and Happy Mid-Week Hooray! :-)
 
Hi Kellie,

You've been getting some great preshots! Much nicer than the reds. :-D Since today is the first real day with no higher carb dry, I wouldn't make any big changes. Your .75 for tonight's preshot should give you some good info about that low of a dose.

Because his numbers are gradually lowering, I'd keep gathering data and make decisions after you see some clearer patterns.
 
I wish I could give you some good advice, but I'm pretty new to this whole thing. I have a bouncy cat too, and I was changing the dosage a lot, but I am now experimenting with a lower, consistent dosage and I finally got a pre-shot number under 300 tonight after 3 days at this dosage. I've been doing a lot of research on this website (looking at older posts, etc) and it sounds like some cats do well with a sliding scale and others do better with consistent dosages. One of those "every kitty is different" topics of discussion.

I would definitely keep a close eye on his numbers since changing his food might cause a drop in his insulin needs. Good luck from one bouncy cat owner to another!
 
I'm with Sue. With diet changes going on, I wouldn't recommend a specific dose. Once he's settled into the new diet, you'll be able to make decisions based on the numbers you get. The diet will be a factor in BG. You're doing a great job!
 
Thanks for the feedback and encouragement, Sue, Jenny, and Rachel! You are all awesomesauce.

Bailey's appetite has been fluctuating with this new diet so I'm keeping an eye on that as well. He used to be free fed all the time and now that I've got the YAZC down 24 hours for him to munch on, he's not eating much of it but it does seem to be enough to keep him from being ravenous at our wet food meal times (7am/pm). I'm thinking that's a good thing since sometimes he eats so fast that it makes him sick. I suppose I should mention again too that the vet who prescribed the Prozinc said he should be on 3 units BID (though I've never given him more than 2.5 units).

I'm home all day grading freshman composition essays (I'm tired just thinking about it, lol) so I'll be taking breaks to test Bailey and see where he's at throughout the day. We have a vet appointment on Saturday but I think I'm going to cancel it. It's with the diagnosing vet who refused to prescribe anything other than insulin N and insisted I keep him on the diabetic Royal Canin dry. I'm just not really wanting to have the conversation about how I changed his diet and went to a new vet for the Prozinc. I respect the work the DXing vet does and she's a nice person but it just wasn't the right fit for Bailey. Breaking up is hard ;-)
 
I don't think a vet visit will do much for you. Now that you are testing at home, you have better information than you could get at the vet. What you might do, after he is well regulated or OTJ (anti jinx) go back and visit the first vet. It's possible she might be interested in the diet you used and hometesting and might be willing to change her approach?

It looks like the .75 might have been a little too low for last night's number. Just data. :mrgreen: Next time you get a preshot that low, maybe try a little more? What was really nice was a beautiful lower pmps! No red!
 
kds0200 said:
I've been scanning through the threads (and read all through Lisa's post about Bouncy Ben and his sliding scale)
Click to expand...

Hi from Lisa and Bouncy Ben. :lol: I love that! You have a similar feeding and dosing schedule to mine. FF before shots ant YAZC for free feeding. I'm wondering if you pick up the dry 2 hours before AMPS and PMPS testing? The reason I'm asking is that when I got up early this morning for a trip to the bathroom, I noticed Ben was snacking on some YAZC. It was about 3 hours before his AMPS test which was 597. So I'm thinking that some of my high morning numbers might not be bounce but are food spikes. I'm going to trying putting the food away about 3 hours early and see what happens. Which will mean getting up a 3AM then again at 6AM :o

Just curious what your experience has been.
 
Hey Sue, that's good advice! And to me all data is good data at this point (or maybe "useful" data would be better). I've noticed sometimes that makes my notes on Bailey's SS go a little long but I'm sure eventually I'll relax and quit being so hyper-vigilant. Live and learn and keep on living!

Lisa and Bouncy Ben! Bouncy Bailey says, "Meow!" to his bouncing friend. Might be something about the B's ;-) That's good advice about taking up the food before the pre shot tests too. Bailey's appetite has been a little off last night and today (not eating very much at all but the fire alarm went off at 4am - low battery - and now I'm thinking about it that might've been a little disruptive to him - all these little things can have such an effect). But I'll keep an eye out and once he's eating more regularly again try picking up the food a couple of hours before the tests. I'll be curious to see what Ben is like with this too.
 
I put up the food at 1 AM this morning. And Ben's AMPS was 443 so I'm not sure that made a big difference. But I'm gonna try it for a few more cycles and see what happens. Just want to let you know what my findings were so far.
 
Hi Kellie and Bailey. When I can, I jump on now and then to read as much as I can. It is such a learning curve in trying to find out how your kittie reacts to different changes whether it is the diet, doses, environment, etc. and I like learning from others as well as sharing too. Anyway, looks like you have been doing a great job in testing and collecting the data.

I go back and forth between sliding scales and consistent doses with Merlin. When Merlin bounced a lot, especially at first, I found that consistency worked better and then once the bounces were somewhat under control, I would move to a sliding scale. When I first created my sliding scale, I made notes in my comment section of what dose worked (i.e. goal to get closer to lower blue and green numbers for nadir) with corresponding pre-shot number and then would update my sliding scale after once it has worked two times. Actually I continue to do that today. So another words, when I try a different dose for the first time, I "pend" the change on my comment section to remind me to use that dose the next time for that number (or near that number). Once it has worked twice, then I update the scale. I am continuing to update my sliding scale today.
 
kds0200 said:
But I'll keep an eye out and once he's eating more regularly again try picking up the food a couple of hours before the tests. I'll be curious to see what Ben is like with this too.
Click to expand...

Have put up food 3-4 hours before AMPS and PMPS and also gave him nothing but wet without access to dry at all and still had high AMPS numbers. So I'm not sure that is Ben's problem.

Good luck with Bouncy Bailey.
 
Lisa - well, it was worth a try for Ben! I see the SS says you're trying a steady 1 unit dose for a few days so I'm curious to see how that part of it goes. I've actually decided to do sort of the same thing for Bailey, but we're going to hold steady at 1.5 (unless he just has super low pre shot numbers again). I never did try taking up his food since he's been eating so sparingly anyway -- but he did hack up a big hairball this morning and that seemed to make him feel better. I've also branched out to a few different flavors on the FF canned food and that seems to make him more interested in food again (can't say I blame him, I'd get tired of chicken pate all the time too! lol). With free feeding the YAZC, I noticed he'd been eating some overnight but couldn't tell how much, so last night I measured out 1/2 cup and this morning poured what was leftover back in and he'd eaten about 1/6 cup in that 12 hour period, which seemed about right considering what I've read about YAZC. Bailey was free fed all his life until he was first diagnosed, so I think he's glad to get back to that :-)

I'm going to do a mini curve today (test every three hours instead of every two) and see how that turns up. His nadir wasn't very low yesterday but he got a bit more insulin this morning so I want to see how that dose does (especially since I would like to hold steady with it for a while). It's encouraging though to see his pre shot numbers in the 300s instead of the 400/500s!

Cindi (and Merlin!), thanks for sharing your experience! That sounds like a good strategy for updating the sliding scale. With so many variables to consider, having those notes to look back on is so helpful.

Well, the weekend is here - I hope everyone has a great one, filled with purrs and snuggles and fun! :-D

x KS
 
I noticed that Ben eats only a mouthful of dry food once in a while too. So I don't think it has a significant impact on this sugars. So far the steady dose has caused no huge drops just more a gradually surf. But I'll take that for now over a drop to the yellow followed by a surge to the blacks. I work for the next 4 nights so I think it is a good time to hold steady and surf. I'll be keeping an eye on your SS to see how Bailey is doing.

Bouncy cats unite!
 
Yeah, I'm with you on that, Lisa. Bailey only has a bit of the dry and very rarely. I know everyone says to cut out the dry completely but I just can't seem to do it. We have completely switched proportions though, eating 95% wet and the little dry left over, so that's great compared to what I had been feeding him before all this education ;-)

Bailey has had some weird numbers the last couple of days, including a little hiccup last night between the +9 and PMPS. That drop down to 79 at +6 today really surprised me so I'm curious to see how his PMPS is. Keeping an eye on you and Ben too. And whatever your work is, I hope your nights are going easy!
 
Well, judging from the PMPS (432) he hit the bottom of that drop pretty hard and bounced just as high as he could! Still holding the dose steady at 1.5, mostly because I don't know what else to do but also because I want to see how he does on a steady dose for at least a few more days. I noticed he'd eaten about 1/4 cup YAZC, mostly in the afternoon (after the +6 test). But I didn't think a zero carb food, even dry, could be responsible for that much of a bounce (??).

Anyway, I'm still all about gathering data! For an English major I've sure turned into quite a little scientific nerd over this whole thing (haha). Honestly though, I sort of look forward to our testing times. When I sit down with the tester Bailey comes up purring (because he knows he'll get a treat and some extra lovin' when it's all done), and I like just laying him back on my lap to get at his paw for the blood drop and having him be so relaxed. He's never been a very cuddly cat and I've been his human for seven years but it's weird lately, it's almost like he trusts me more, or at least in a different way than he did before.

Sorry if I'm waxing poetic or whatever. I keep looking for the bright sides in this ordeal since that seems to be a good way to get through it ;-)
 
Yes, that looks like a bounce, Kellie. Any time he drops 80%, he is likely to bounce! Is feeding him early in the cyle working at all? If he doesn't seem interested in food then, you could feed less for the meal after the preshot, keep him a little hungry so he would be interested in food around +3?

I know bouncing is frustrating. Maybe it will help to know that eventually they DO stop. And if he stays below that renal threshold for the majority of the cycle, he can be healing his pancreas. I like your plan to stay with 1.5 for awhile and see if he settles down.

Lots of members note the closeness that develops between a diabetic kitty and their bean. Yes, part of it is the treats, but my theory is that they are feeling better and they realize you are helping them.
 
I was expecting the number to be higher to be honest. I just didn't want to jinx by saying anything! I agree with all Sue says about it being a bounce and keeping it steady for a bit. That'll give you more info about what he does on a steady dose.

I hear you about being a scientific nerd!!! I was an English major myself, never into science, but I became a giant nerd myself when my girl was diagnosed! I loved testing time because it told me more about how Gypsy was doing. I got good information from those times. And like you say, it was some great snuggling time! Gypsy loved to snuggle with me....she came running at test time because she knew what would follow!!!
 
Hey Sue, I like that suggestion. I'm going to be gone most of today but I have a friend who can feed him at +4 and +8 so that's the plan. I'm not too worried about keeping him hungry because the last couple of days it seems like he's always ready to eat (basically getting back to his old self, lol). I'd also still like to put a little more weight back on him so feeding a little more often will be good.

Rachel, I've found that I generally try to expect higher numbers too, if only to be pleasantly surprised when they end up being less than I'd imagined ;-) But his pre shot numbers had been in the 300s for a couple of days so getting up above 400 again was a surprise even to me.

Lately though Bailey seems to have more energy, be purring more, and almost always comes running when I walk through the front door (unless he's been napping, then it takes him a couple of minutes to stretch on his way to greet me, haha). I keep noticing those things so that I won't slip into thinking that this is all just about numbers on a page. It's just a day at a time still, just like it has been, and I'm glad I've got such good family and friends (both here and IRL) to help us through this! :-D
 
So, we've been holding steady with our 1.5 units of ProZinc for several days now. The last two days he seemed to be leveling out just a little (nadirs not so low, PMPS not too high - at least out of the 400s). I'm generally wondering now what my next step should be - if we should stay steady with the dose or start making small changes up or down.

Today's tests have been terrible though and I think there must be something wrong with the meter. My first sign was when his +6 was in the 200s and it hasn't been that high in a while, then the two +9 tests had almost 100 points difference and I know that can't be right. I'm off to buy new batteries and test strips before the PMPS and hoping that's really all it is (and not actually a problem with Bailey, who is acting just fine, active and lovey and eating/grazing as usual).

I guess really I should make sure it's a problem with the meter and not Bailey before I start making dosing adjustments. So now I'm just thinking out loud! Still, curious to hear what others think, about any or all of this.


EDIT: +11 & PMPS - Replaced battery and used new test strips. Getting numbers like what we're used to seeing now! Seems that much at least was an easy fix... ;-)
 
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