Scout's AMPS 124, skipping dose!

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Lori&Scout

Lori&Scout

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Hello PZI crew!

I'm very new to this so I wanted to get some opinions. Scout is doing well on 2U bid of PZI (5 days at that dose now) but her nadir numbers are still pretty high. I'd like to gently increase her dose to see if I can get her numbers down a bit, but I'm also in the process of further reducing her carb intake.

Before 1/17 she was eating Science Diet dry food (very high in carbs).
As of 1/17 I switched her to Purina DM dry (13% carb) and a combination of lower carb wet food.
I'm now in the process of weaning her off the dry food and onto a combination of Purina DM wet food (7%) and Evo/Blue ultra low carb food (not sure of exact percentage, if anyone knows the stats for various flavors please let me know - the kinds I'm trying aren't on the food list.) So her carb % should further reduce some. I will still leave some dry food out when I am at work all day for now, until I see how she handles no dry food out overnight for a few nights.

As you can see from her spreadsheet, the insulin has a pretty predictable effect, even if you factor in the variation in diet and the fact that I've not been shooting exactly 12 hours apart (usually it's like 13 hours - I'm shooting 8 hours later in the day than I was last Monday!) She's never tested below 160.

Do you think it is safe to increase her dose a little now or should I wait until the weekend or even longer?

Also does it make sense to do a curve before changing the dose or wait until the day or day after I change it? I could do a curve Saturday or Sunday but it's hard during the week.

Thanks in advance for any advice :)

Lori
 
Re: Scout dose increase?

Hi Lisa,
At first glance, a dose increase seems logical. The only thing that stops me from saying "yes" is that although you have a few mid-cycle numbers, you don't have a good picture of when the nadir is, or how low it might be. You've got what looks like a nadir on the 20th, but that was only the 2nd dose at 2.0u. The one that makes me hesitate is the daytime cycle on the 23rd. He may have gone "green" by +6 after that good drop to +3.

a curve on 2.0 would be a good idea, but then you have to hold it until the weekend, right? I would for sure hold the 2.0 for tonight, because I'm thinking the cycle today, where it looks like "no drop" is a fluke, and you might get a good drop overnight.

I would hold the dose until the weekend unless you can get nadir readings over the next 3 or 4 cycles, just to be sure....
When you increase, I'd recommend .25u max at a time.
Carl
 
Re: Scout dose increase?

Hey Carl,

Thanks for the advice. I will try to get nadir readings but one of them involves dragging us both out of bed at an ungodly hour and the other involves leaving work in the middle of the day. I'll try to get a couple before the weekend though then do a curve at the weekend and decide what to do then.

Any advice on leaving wet food out all day? I just put a huge bowl of Evo Cow flavor out thinking it would last Scout all night and the little bugger sat down and ate it all in one sitting. :roll: Anyway, I want to make sure she has plenty to get her through the day without encouraging her to overeat and without leaving dry food out. Maybe one of those automatic feeder things with different compartments?

Cheers,
Lori
 
Re: Scout dose increase?

Hi Lisa,

I agree that you should hold the dose and get a curve done this weekend to get a better picture of how it is working for her. Also because you are transitioning her off of dry and high carb food, her insulin needs will probably drop when she is eating only low carb wet food.

A timed feeder will help in making sure she has food available mid day, you could also freeze food portions to leave out for her to eat when they thaw.

Your numbers don't look all that bad right now.

Robin
 
Re: Scout dose increase?

Good afternoon Lori and Scout !

welcome to pzi from callie and me ;-) I agree I would hold and wait until this weekend when you can watch and test ! I have to tell you that my callie likes her tuna fish to cat_pet_icon she get a tiny nibble before and after her shot :-D you are doing great ! cat_pet_icon :YMHUG: dancing_cat
 
Re: Scout dose increase?

Well I managed to get her to stop eating even the low carb dry food by putting it out of her reach (not hard to do, in retrospect... her gimpy legs can barely jump anymore) and tonight I'm getting much better numbers!! Fingers crossed she doesn't go too low but she's at 123 +2 and she just ate a little more. From what I can tell so far her nadir seems to be around +4 so I'll watch her until then to make sure the numbers look good.

Thanks all and I'll keep you posted!

Lori
 
Re: Scout dose increase?

Oooh 84 at +3... my first green number!!! She just ate a bunch of wet food (much more than she had with her PM shot) so hopefully that will keep her number up. I plan to test again at +4 and give her high carb stuff if its below 55.

Lori
 
Re: Scout dose increase?

Hi Lori and welcome!
Taking away dry food can cause a huge drop in numbers for some kitties
as you can see....
so very glad you tested and will continue, if she just ate that will bring her numbers
up but a quick test at +4 would be great
Let us know how Scout is doing, but you are doing great!
 
Re: Scout dose increase?

Thank you all!!! Scout's numbers came back up nicely and this morning her AMPS was 292 which is pretty standard for her. I shot her as normal and will check at +4.

So after not even 3 hours sleep my alarm was going off and I kept hitting snooze without really waking up. Apparently Scout was having none of that as she came over and nuzzled me and headbutted me until I woke up properly. So thanks to Scout I got to work on time!!! Fortunately I've got someone to cover for me this afternoon so I can get a little sleep.

I'm so happy to see green numbers with no hypo, I hope it continues. I will reduce her dose if she goes any lower in the next few cycles though, I need my sleep! :)

Lori
 
Re: Scout 93 at +11 Whoa!!!

If someone with more experience doesn't mind having a look at my spreadsheet... I had one weird (low) cycle and now we're back to normal. This was 24 hours after cutting off her supply of dry food. She did eat quite a bit of wet food (Evo and Blue) so it wasn't a hunger strike.

Do you think her pancreas sputtered to life for a moment? Or did she have a bounce? Apart from that one low cycle (which had a low PMPS) she numbers are pretty regular, not high/low/high/high like I'd expect with a bounce.

Update: I just did a +11 to see if I could shoot her early and go to work, and I got 93!!! 93 at +11!!! Who knew when I had a 270 on empty stomach at +2? And she ate through the night and 2 hours ago this is not empty stomach. Maybe the pancreas is alive! Any other explanation?

Lori
 
Re: Scout dose increase?

Unless scout has figured out how to self administer a shot, or went pretty low late, I think it has to be some pancreas help.
So, stall and check in30, or skip?
carl
 
I guess I'm skipping the dose. It's been 12.5 hrs since her last shot now and I have to go to work.

WTG Scout's pancreas!!!

Lori (with a huge smile on my face today)
 
Huge smiles are always a good thing!
Have a fantastic Friday,
carl
 
If Scout's P is going to join the party you should think about lowering the dose.

It could also be the low carb food has lowered her bg's, a lower dose would be called for then too.

You guys are doing great.
 
Hmmm good call, Rob. I think 1U is probably enough to keep her out of the reds until we figure out what's going on. I'll check her again a couple hours before her normal PM shot time, but my plan is to not shoot below 225, 1U above that. Based on previous curves that should be safe either way.

Lor
 
Just a hunch, but I'd guess the huge smiles are still happening? Is you face getting sore from all that smiling yet? :-D

Great news, Lori!

Carl
 
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