Seeking opinions and input on timing of dose increase, please

@MrWorfMen's Mom

Linda, how are you doing today?

I'm not usually up this early. These test times are irregular because the first was a before bed test and the second was one I did when I woke up for a bathroom visit. The third one is because Clarence popped into my room to wake me up.

+3.5 225
+7.8 151
+9.6 125 (this puzzled me so after waking up a bit more, I decided to retest in case this one was bad for some reason)
+9.8 152

I know you have said there is a second dip with Vetsulin, is that what I'm seeing with the 125? He went up a lot in just a few minutes, which is also something that puzzles me, but it might have been because he was wanting me to feed him and I was trying to get him to go outside until his regular morning test & feeding time.
 
Given the small difference (roughly 20%) between the 151/125/152, I would think that the lower reading is indeed at least in part the 2nd little dip from the Vetsulin possibly along with some meter variance. That was a nice surf Clarence got and late in the cycle compared to many using Vetsulin. A kitty getting anxious about getting their own way/hungry can experience an elevation in BG fairly quickly so your refusal to feed him and trying to put him out could have played into that last reading.
 
Definitely a better start to the day but whether he will honour you with blues and/or green numbers today remains to be seen. These guys have a habit of not always doing what we expect them to do and I'm not a gambler and don't want to jinx you! :p
 
MrWorfMen's Mom said:
Definitely a better start to the day but whether he will honour you with blues and/or green numbers today remains to be seen. These guys have a habit of not always doing what we expect them to do and I'm not a gambler and don't want to jinx you! :p
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Right? He has for sure proven over and over that he can and will do the unexpected. Rebel Cats! Gotta love 'em.
I was hoping he would give me a chance to run down to town and see if the pet store has those treats Candy mentioned, I know they carry that brand - I got a dog food sample there and my dogs loved it.
 
Linda, I hope this doesn't cause a bounce... here is an update of Clarence's BG today during his low period. He did go down into the dark green and seemed a bit uncomfortable. He got very small amounts of his usual food in hopes that he would be able to maintain some low numbers without dropping too low. I tested him more than I have been just so I could monitor him in this range and trying to ward of a bounce later on.

+5 115
+5.7 90
+6 93
+6.3 88
+7 105
 
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Sorry just seeing this now. I would have said yes to testing in an hour. +5 is later in the cycle and Clarence hadn't dropped a lot early from AMPS suggesting the drop was not likely to suddenly drop swiftly at this point in time. I see he made it to green. YEAH! :D
Now I would test him 30 minutes from last test just to make sure he's not continuing to drop too much.
 
MrWorfMen's Mom said:
Sorry just seeing this now. I would have said yes to testing in an hour. +5 is later in the cycle and Clarence hadn't dropped a lot early from AMPS suggesting the drop was not likely to suddenly drop swiftly at this point in time. I see he made it to green. YEAH! :D
Now I would test him 30 minutes from last test just to make sure he's not continuing to drop too much.
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Linda, I updated my original post with his numbers. I left one off and got to get it on the ss: +3.4 175
 
MrWorfMen's Mom said:
Clarence is having a BEAUTIFUL cycle today. Nice smooth slide down and now hopefully a gentle rise. :joyful:
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I'm hoping and praying! I got him some freeze-dried treats at the pet store, but they didn't have the brand Candy was suggesting (they just had that brand of dog food, no treats). I picked up some PureBites beef liver, some Vital Essentials minnows (already gave him a couple of these), Chicken Hearts, and a small sample packet of Vital Essentials Rabbit Mini Nibs. I hope he likes these treats and I hope they are no carb, they are for sure low-carb. If Clarence doesn't like them, I know the dogs will!
 
@MrWorfMen's Mom

Good evening Linda, Clarence's PMPS is 238, I'm thinking of stalling a bit, thoughts?

Update: I stalled for 15 and tested again: 280
Question: think I should maybe reduce for the night to .75 or go ahead and give 1 and monitor him a little more than I have been at night? I would appreciate your input...
 
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Sorry Dee Dee. Wasn't online as late last night. Looks like Clarence bounced last night from those beautiful numbers yesterday. He doesn't usually hold bounces long so hopefully there will be more blues and greens today or tomorrow. I think the 1u was the right decision last night and at least he didn't keep you up all night with low numbers.
 
Good Morning, Linda. Yes, he apparently did bounce from all the good numbers yesterday. Of note, though, he didn't bounce super high (yet anyway). I didn't recognize what was going on until after a couple more tests. And, he apparently bounced and maybe recovered from the bounce all in the same cycle because the few more tests I did showed he was basically flat. If that is the case, I'm hoping that means that he might be getting more used to the lower numbers. I could tell yesterday that he was uncomfortable in those dark green numbers.
His AMPS was 344. I should go for the 1u again, don't you think?
 
YEs I'd stick to 1u for now.

Don't be alarmed about Clarence not seeming to feel as well in the greens. They get so used to being in higher numbers that when they go down to normal range they have to adjust. My girl was always very comfortable in the yellows and high blues for the longest time but when she hit greens, she'd seem quiet and less active. Took awhile before I saw her "appreciating" the good numbers.
 
Thanks, Linda. And it is good to know that it isn't just Clarence -- I do get concerned when he is uncomfortable and it feels like I'm hurting him somehow. I know that isn't the case. He likes the yellows and the higher blues, too. I suspect his BG was elevated for quite some time and he spent a long time in those numbers, without me ever knowing something was wrong with him until he went up even higher and started showing symptoms. He used to be active and alert, now he just sleeps ALOT. When he gets uncomfortable in lower numbers, he wants to go hide somewhere and just sleep.
 
Clarence is doing very well for 2 months into this journey. Those observations are as important as the BG readings. Not only can they alert you to falling/rising numbers but they give you an overall perspective of how Clarence is doing. Sometimes with Vetsulin it's the broad swings of BG experienced each cycle that causes them to feel off. Clarence is actually having relatively smooth cycles which is great but are still going to take some adjustment as his BG regulate better.
 
MrWorfMen's Mom said:
Clarence is doing very well for 2 months into this journey. Those observations are as important as the BG readings. Not only can they alert you to falling/rising numbers but they give you an overall perspective of how Clarence is doing. Sometimes with Vetsulin it's the broad swings of BG experienced each cycle that causes them to feel off. Clarence is actually having relatively smooth cycles which is great but are still going to take some adjustment as his BG regulate better.
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Thank you, that gives me so much hope and it means so much to me to have HOPE right now. Hope is everything!
 
Linda, I hope your day is going well.

I don't know if you are checking in today or not, but I sort of think Clarence may be staying relatively flat today (Last test was at +5 and he was 195). When that happens, isn't it usually signaling the end of a bounce? Right now he is alert and not too uncomfortable, which usually indicates he is in the 200s or high 100s. I might test him one more time before his PMPS, but because of his behavior, I feel better just leaving him be. If you could weigh-in on whether I should continue to give him the 1 unit as long as his PMPS is high enough, I would appreciate it. And maybe what would be my options if his PMPS is lower than 200 or slightly above.
 
I don't think I'd call today a flat cycle with that initial drop of 80+ points and then 50+ more however it is not a bad cycle at all given the lows of yesterday. Slight bounce but short lived. Looks to me like last night was even flatter and was perhaps predicting the bounce starting to clear today. If you can monitor then I would stick with 1u if BG is 200 or above. If PMPS is just under (190s), then you could try a small reduction to 0.75u. If he is below 180, I don't know if I'd chance giving insulin. Let's see what he does at PMPS.
 
288

Thank, Linda. I think he had a fairly decent day. He was alert most of the day, it was good to see him like that.
 
MrWorfMen's Mom said:
I don't think I'd call today a flat cycle with that initial drop of 80+ points and then 50+ more however it is not a bad cycle at all given the lows of yesterday. Slight bounce but short lived. Looks to me like last night was even flatter and was perhaps predicting the bounce starting to clear today.
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Yes, you are correct, of course. It wasn't flat after all. Thank you for checking in. I know he felt pretty good today. With his PMPS being at 288, I will have to set some alarms to check on him.

My son and I will be dog-sitting beginning tonight for a week. A young dog. Clarence knows her (we fostered her and dog-sit her occasionally), so I won't be too surprised if I see some increase in his numbers for a couple days while she is here. I hope not, tho.
 
AMPS was 274
Rather hectic morning...
Clarence's night-time readings last night were higher than I was expecting early on. He was at 215 on his +3.9 (almost +4) and was hungry, so I went ahead and fed him. At +5 he was 212 but up to 239 at +6 (maybe food and/or excitement influenced?) and I didn't test him after that. I checked in on him once and he was doing alright, so I didn't test him. Not sure if he dropped lower than the 212 at any point, but he may have.

In any case, his AMPS was 274 this morning, so gave 1 unit. BUT he pulled away at the time of injecting and so it was a partial fur shot. We'll have to see what his readings are today.
 
MrWorfMen's Mom said:
If they play together, the exercice will do him good. Nice start to the night.
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Clarence will sometimes play with my terrier who is just a little bigger than him, but in general his attitude towards most dogs is one of: I'm the boss, see, and if you mess with me when I don't want you to, I will smack you! He was very interested in the visiting dog, but she is a large breed and more energetic than Clarence preferred last night, so he antagonized her a bit and then hissed and smacked her. She has cats at home, but I guess they steer clear of her while Clarence will not be intimidated by any dog. Anyway, I do think her presence will be good for him and keep him somewhat entertained and on his toes. :)
 
@MrWorfMen's Mom

Linda, I've been mostly testing Clarence in the early part of his cycle to try to catch any fast dropping early. I have only gotten a few tests later in the day. I know that today might be different because of a partial (and I have no idea how much) fur-shot. It looked like it was on the rise early today, but I did a test at 9.6 and it was basically the same as his +6. I just was hoping you might have some insight as to why. Anyway, I'm hoping it will come up more by his PMPS and pretty sure it will.
 
He's looking pretty flat the last cycle or 2 which can be indicative of an upcoming active cycle. Let's see what he does tonight.
 
So his AMPS was 367. He had been testing lower in the mornings the past couple of cycles. Do you think that is a small bounce? Also, what about increasing to 1.25 units? If it is a bounce, that might not be the best choice right now. I'm just not sure what to do. I've read that absorption of insulin is different depending on injecting site. I move it around -- that is what the vet tech told me to do--and lately I've been injecting around the 'scruff', could it make that much of a difference? I thought I'd ask because I don't know and I'm hoping that you (or someone that might be reading this) will know.
 
@MrWorfMen's Mom

@CandyH and Catcat

I'm thinking I need to increase to 1.25 units and wondering: wouldn't it be better to do so on a morning rather than night dose? I am thinking of doing it tomorrow morning, since his numbers have mostly been in the yellow range for a few days now.

Thank you for your consideration.

DeeDee
 
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couple of questions -- have you been using the same food for the past three days? is there anything going on at your place which could be stressing Clarence?

I'm not the expert that Linda is, but it looks like he's "clearing the bounce" -- so I would leave him at this dosage one more day (today and tonight) then re-evaluate, if his system is like Catcat's he *may* be working towards a lower level

if you do an increase, time it so you can be testing at or near his usual nadir, two things often happen
1) we call it NDW -- new dose wonkiness -- he will suddenly test HIGHER than he has been, for a day or two
or 2) he will suddenly drop more than you expected, then bounce

those high AMPS values are sooo typical of Vetsulin, my experience, cats often go lower at night as you've seen, then in the morning there's a bounce plus the insulin action has worn off ...

tagging Linda again -- I know she's been busy and there are several others needing her expertise as well -- I missed the tag, she might not have gotten it either

@MrWorfMen's Mom
 
Sorry but as Candy said, I didn't get the tag yesterday.

I like Candy's suggestion. My rule was always to do increases on a day cycle but then I had the luxury of being available to test during the day. I think your timing has to depend on your ability to monitor that first couple of cycles with the new dose. He does looks to be getting a bit stuck but as Candy mentioned, those flattish yellow cycles sometimes mean an active cycle in on the horizon. If he's still up today and you can monitor I'd increase to 1.25u.
Come on Clarence. We know you can do better! :)
 
CandyH and Catcat said:
couple of questions -- have you been using the same food for the past three days? is there anything going on at your place which could be stressing Clarence?

I'm not the expert that Linda is, but it looks like he's "clearing the bounce" -- so I would leave him at this dosage one more day (today and tonight) then re-evaluate, if his system is like Catcat's he *may* be working towards a lower level

if you do an increase, time it so you can be testing at or near his usual nadir, two things often happen
1) we call it NDW -- new dose wonkiness -- he will suddenly test HIGHER than he has been, for a day or two
or 2) he will suddenly drop more than you expected, then bounce

those high AMPS values are sooo typical of Vetsulin, my experience, cats often go lower at night as you've seen, then in the morning there's a bounce plus the insulin action has worn off ...

tagging Linda again -- I know she's been busy and there are several others needing her expertise as well -- I missed the tag, she might not have gotten it either

@MrWorfMen's Mom
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Thanks, Candy. He actually has been more active the last few days in the yellow zone, instead of sleeping all day and looking so miserable it would make me cry. I have been feeding the same food. There is a bit of stress with the young dog me and my son are pet-sitting, she is just such a rambunctious girl!
I didn't get his numbers from last night into the spreadsheet, but he was really flat, with no real decrease in numbers at the times I tested. I'll get the ss updated.
Anyway, because he was sooooo flat last night, and because I really want to get him back into some blues at least, I went ahead with the increase. I am able to monitor him today and can also monitor tonight as long as I can get a nap in at some point this afternoon! I can always back him off tonight if need be, right?

Thanks for tagging Linda. Maybe I'm not doing the tags correctly?
 
MrWorfMen's Mom said:
Sorry but as Candy said, I didn't get the tag yesterday.

I like Candy's suggestion. My rule was always to do increases on a day cycle but then I had the luxury of being available to test during the day. I think your timing has to depend on your ability to monitor that first couple of cycles with the new dose. He does looks to be getting a bit stuck but as Candy mentioned, those flattish yellow cycles sometimes mean an active cycle in on the horizon. If he's still up today and you can monitor I'd increase to 1.25u.
Come on Clarence. We know you can do better! :)
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Thanks, Linda. I went ahead with the increase and will monitor him. Maybe I'm jumping the gun a bit, but he really needs to start getting 'happy' at some lower numbers. And last night's numbers were high compared to what he has been. If necessary, I will reduce back to 1 tonight, but I'm gonna see how he does on the 1.25. If he would just listen to the encouraging words of me and you all... :)
 
not sure about the timing, but I suspect Linda was off line when you tagged, and this is a busy weekend for her -- not sure why I missed the tag from you, but yesterday was a mess for me -- unexpected afternoon nap made me miss the food bank distribution, by time I got there they were all packed up, got only a couple of canned goods and several bags of potato chips -- they DID save me a can of cat food though, and it's nice to get the smaller can of Friskies -- I think one of the local stores donates the unsold cat food that's past pull date
 
CandyH and Catcat said:
not sure about the timing, but I suspect Linda was off line when you tagged, and this is a busy weekend for her -- not sure why I missed the tag from you, but yesterday was a mess for me -- unexpected afternoon nap made me miss the food bank distribution, by time I got there they were all packed up, got only a couple of canned goods and several bags of potato chips -- they DID save me a can of cat food though, and it's nice to get the smaller can of Friskies -- I think one of the local stores donates the unsold cat food that's past pull date
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It is unfortunate that you missed the food bank distribution, but I guess the universe felt you needed some sleep!

It was late when I edited my post and put the tags in, so not surprised. I'm still trying to learn how to use this forum -- I'm very computer literate, but have very little experience with social media (and that is deliberate!). Yummm...potato chips!
 
For some reason, tags don't always work. I know putting them in a line one beside the other sometimes is a problem but you stacked them which I thought worked OK. Apparently not! Being signed on or not doesn't matter. They should show up when you sign on. There's been others having some issues to so not sure what is happening. :(
 
MrWorfMen's Mom said:
For some reason, tags don't always work. I know putting them in a line one beside the other sometimes is a problem but you stacked them which I thought worked OK. Apparently not! Being signed on or not doesn't matter. They should show up when you sign on. There's been others having some issues to so not sure what is happening. :(
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No matter, It wasn't especially urgent, I appreciate both you and Candy weighing in on it.

FYI, I will probably begin a NEW post with how Clarence is doing at the 1.25

Thanks and Happy Sunday to both you and Candy. Have a blessed day!
 
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